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UNIVERSAL CAPITAL GROWTH FUND NEW ACCOUNT APPLICATION
ONE ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
▇▇▇-▇▇▇-▇▇▇▇
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INITIAL / / Establish the account specified below with the enclosed check for $________________________, payable to
INVESTMENT Universal Capital Growth Fund. Minimum initial investment (except for retirement plans) is $500, except
that an investor making an initial investment of $50 or more may take up to 12 months to reach that $500
minimum account size.
/ / Payment has been made by Fed. funds wire on___________, ___________________________________________________,
Date Name of Bank
$________________
Amount
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ACCOUNT 1. Individual_______________________________________________________ ____________________________ ____________
First Name Middle Initial Last Name Social Security Number Birth Date
2. Joint Tenant(s)__________________________________________________ ____________________________ ____________
First Name Middle Initial Last Name Social Security Number Birth Date
__________________________________________________ ____________________________ ____________
First Name Middle Initial Last Name Social Security Number Birth Date
(Joint tenancy with right of survivorship will be assumed unless otherwise stated)
3. Gift to Minor_______________________________________________________________________________ as custodian for
Name of Custodian (Only one person allowed by law)
______________________________under the______Transfer to Minor Act__________________________ ________________
Name of Minor State Minor's Soc. Sec. # Birth Date
4. Trust___________________________________________________________ ___________________________________________
Soc. Sec. # or Tax ID Number
Trustee(s)______________________________________________________ ___________________________________________
Note: Send a copy of the trust agreement with this Application. Date of Trust
5. Organization____________________________________________________ ___________________________________________
Tax Identification Number
Type: / / Corporation / / Partnership / / Other (please specify)____________________________________
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ADDRESS SHAREHOLDER TRUSTEE
__________________________________________________________ ____________________________________________________
Street Street
__________________________________________________________ ____________________________________________________
City State Zip Code City State Zip Code
Phone__________________________ _________________________ Phone_______________________________________________
Home Business
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CERTIFICATION I certify that I am of legal age and have received and read the Fund's current Prospectus. I release the Fund
AND SIGNATURE agents and representatives from all liability and agree to indemnify the same from any and all losses, damages
or costs for acting in good faith in accordance with the privileges selected.
Cross out (2) if Under penalties or perjury, I hereby certify (1) that the Social Security or Taxpayer I.D. Number above is
it is not correct correct and (2) that I am not subject to backup withholding because (a) I have not been notified by the IRS that
I am subject to backup withholding as result of a failure to report all interest or dividends, or (b) the IRS
has notified me that I am no longer subject to backup withholding. (You must cross out item (2) if it is not
correct.) I agree that the Fund and its transfer agent may redeem shares and retain the proceeds from any of my
account(s) with the Fund up to a total of (c) any IRS penalties attributable to my failure to provide either the
Fund or its transfer agent with correct and complete information requested by them and (b) any tax not withheld
from distributions to me which should have been withheld by them.
All Co-owners must ________________________________________________________________________ ______________________________________
sign if the Authorized Signature Title (if applicable)
account is held by
Co-owners ________________________________________________________________________ ______________________________________
Authorized Signature Title (if applicable)
________________________________________________________________________ ______________________________________
Authorized Signature Title (if applicable)
__________________________________
Date
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AUTOMATIC / / Check here to automatically withdraw a specific amount from your bank account each month to invest into
INVESTMENT PLAN Universal Capital Growth Fund. I authorize the Fund's agent to draw checks of initiate Automated Clearing
House ("ACH") debits against the bank account described on the attached voided check on the date and in the
amounts shown below. I understand that this authorization will remain effective until I notify the Fund in
writing of its termination and until the Fund and its Agent have a reasonable time to act on that
termination.
Amount of monthly investment:________________(MUST BE $50 OR MORE)
Date of each monthly investment:_______________(ANY DAY BETWEEN THE 1ST AND THE 28TH; PLEASE CHOOSE A DATE AT
LEAST TWO WEEKS AFTER YOUR ACCOUNT IS OPENED TO LEAVE TIME FOR BANK PROCESSING)
Write "void" across the face of a check from the bank account you wish to use and attach it to this application.
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SYSTEMATIC / / I wish to activate the systematic withdrawal plan. Payment frequency: / / monthly / / quarterly
WITHDRAWALS Amount of check (minimum $100) $___________________
A minimum initial I understand that by selecting this program all dividends and distributions credited to my account must be
investment of reinvested regardless of the distribution option previously selected. Payments will begin the month or quarter
$25,000 is following the date of purchase.
required to
initiate this
service
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DISTRIBUTION DIVIDENDS (AND CAPITAL GAINS, IF ANY) WILL BE REINVESTED IN ADDITIONAL SHARES OF THE FUND UNLESS YOU ELECT TO
INSTRUCTIONS TO RECEIVE CASH
/ / Check this box to receive dividends and capital gains in cash.
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LETTER OF / / LETTER OF INTENT
INTENT I agree to the provisions of the Letter of Intent set forth in the Appendix to the Prospectus. I intend to
Read the Prospectus invest at least the amount checked below over a 13 month period from the date of the purchase.
for further details
or call ▇▇▇-▇▇▇-▇▇▇▇. / / $100,000 / / $250,000
1.5 percent of the Other accounts in the Fund to be included in calculating the applicable sales commission:
dollar amount
indicated will be Shareholder Names Account No.
held in escrow ----------------- -----------
until the intended
purchase has been ___________________________________________________________________________ ___________________________________
completed.
___________________________________________________________________________ ___________________________________
___________________________________________________________________________ ___________________________________
___________________________________________________________________________ ___________________________________
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RIGHT OF / / I qualify for the cumulative quantity discount as outlined in the Prospectus. My other accounts in the Fund
ACCUMULATION are as follows:
Shareholder Names Account No.
----------------- -----------
___________________________________________________________________________ ___________________________________
___________________________________________________________________________ ___________________________________
___________________________________________________________________________ ___________________________________
___________________________________________________________________________ ___________________________________
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FOR DEALER ONLY The undersigned ("Dealer") agrees to all applicable provisions in this Application and the Selling Group
(Please Print) Agreement, guarantees the signature of and representations by the Shareholder, agrees to notify Universal
Capital Growth Fund of any purchases made under a Letter of Intent or rights of accumulation and represents that
this Application is properly executed by a signer authorized to guarantee signatures for the Dealer.
Dealer's Name___________________________________________________________________________________________________
Main Office Address_____________________________________________________________________________________________
Branch Street Address___________________________________________________________________________________________
Representative Name_________________________________________ Rep No.____________ Telephone No. _________________
Authorized Signature of Dealer__________________________________________________________________________________
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