MOUNTAIN STATES CAPITAL INC
SB-2/A, EX-10.3, 2000-09-25
SHORT-TERM BUSINESS CREDIT INSTITUTIONS
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                                   (MSC Logo)



$_________

                  1407 East Thomas Road Phoenix, Arizona 85014

                    18% 12 MONTH PROMISSORY NOTE, SERIES DP-_______

       STATED MATURITY DATE:________________

Mountain States Capital,  Inc., a corporation  duly organized and existing under
the laws of the State of Arizona (herein referred to as the "Issuer"), for value
received,  hereby  promises  to  ___________  or  registered  assigns,  upon due
presentment  of this Note for payment,  the  principal  sum of  $_______________
Dollars on or prior to the date set forth above (the "Stated  Maturity")  and to
pay interest on the unpaid portion of said principal sum on the Stated  Maturity
from the date hereof  through the day  immediately  preceding  the date on which
such principal sum becomes due and payable,  compounded on the first day of each
month beginning on the date set forth above.  Because of this  compounding,  the
annual  yield will be 19.56%.  The Issuer shall also pay interest on any overdue
principal and on overdue interest,  at the rate per annum specified in the title
of this note.

The principal and interest so payable on the Maturity  Date,  and any redemption
of Notes that may be made on any  Redemption  Date,  will,  as  provided  in the
Indenture referred to on the reverse hereof, be paid to the Person in whose name
this Note (or one or more Predecessor Notes) is registered on the Regular Record
Date for the date on which interest or principal is payable (a "Payment  Date"),
which shall be the close of business on the 20th day of the month preceding that
in which such Payment Date or Redemption  Date occurs (whether or not a Business
Day).  Any  redemption  not  made  on the  Redemption  Date or  interest  not so
punctually  paid or duly provided for shall forthwith cease to be payable to the
registered  Holder on the Regular  Record Date, and may be paid to the Person in
whose  name this Note (or one or more  Predecessor  Notes)  is  registered  on a
Special  Record Date for the payment of such defaulted  redemption  proceeds and
interest  to be  fixed  by  the  Trustee,  notice  whereof  shall  be  given  to
Noteholders  not less than 10 days prior to such Special  Record Date, or may be
paid,  at any  time  in any  other  lawful  manner  not  inconsistent  with  the
requirements  of any securities  exchange on which the Notes may be listed,  and
upon such notice as may be required by such exchange, all as more fully provided
in said Indenture.

The  principal of and interest on this Note are payable in such coin or currency
of the United  States of  America as at the time of payment is legal  tender for
payment  of public  and  private  debts,  at the  office or agency of the Issuer
designated  for such  purpose in the United  States of  America;  provided  that
interest may be paid, at the option of the Issuer, by check mailed to the Person
entitled thereto at his address as it appears on the Note Register.

Reference  is made to the  further  provisions  of this  Note  set  forth on the
reverse  hereof,  which shall have the same effect as though  fully set forth at
this place.

Unless the certificate of authentication hereon has been executed by the Trustee
by manual  signature,  this Note shall not be entitled to any benefit  under the
Indenture, or be valid or obligatory for any purpose.

In Witness Whereof, Mountain States Capital, Inc., has caused this instrument to
be signed, manually or in facsimile,  by its Chief Executive Officer,  President
or a Vice  President  and by  its  Secretary  or an  Assistant  Secretary  and a
facsimile of its corporate seal to be imprinted hereon.

Dated: __________________                          MOUNTAIN STATES CAPITAL, INC.

Attest: __________________                         By:__________________________
---------------------------
                (FORM OF TRUSTEE'S CERTIFICATE OF AUTHENTICATION)
               This is one of the Series of Notes referred to in
                        the within-mentioned Indenture.
                                           U.S. BANK TRUST NATIONAL ASSOCIATION,
                                           Trustee
                                           By:__________________________________
                                                      Authorized Officer
<PAGE>
This Note is one of a duly authorized  issue of Notes of the Issuer,  designated
as its 18% 12 Month Promissory Notes (herein called the "Notes"),  issued and to
be issued in one or more Series,  and is part of the series of Notes  designated
on the face hereof (herein called the "Notes of this Series"), all issued and to
be issued  under an  Indenture  dated as of June 8, 2000,  (as  amended,  herein
called the  "Indenture"),  between  the  Issuer  and U. S. Bank  Trust  National
Association (the "Trustee"), which term includes any successor Trustee under the
Indenture, to which Indenture and all indentures supplemental thereto (including
the  indenture  supplemental  thereto that  authorized  the Note of this Series)
reference is hereby made for a statement of the respective  rights thereunder of
the Issuer,  the Trustee and the Holders of the Notes,  and the terms upon which
the Notes are, and are to be,  authenticated  and  delivered.  All terms used in
this Note that are defined in the Indenture shall have the meanings  assigned to
them in the Indenture.

As provided in the Indenture,  the Notes are issuable in Series that may vary as
provided or permitted in the Indenture. All Notes of each Series are equally and
ratably secured to the extent provided by the supplemental indenture authorizing
such  Series.   This  Note  is  one  of  the  Series  specified  in  its  title.
Notwithstanding  anything to the contrary in this Note, no recourse on this Note
or under  the  Indenture  shall be taken  against  any  property  of the  Issuer
included  in the  Trust  Estate  (if any) for other  series  of notes  under the
Indenture  securing  the  Notes,  it being  understood  that  this  Note and the
Issuer's  duties under the  Indenture are  obligations  that are to be satisfied
solely from the Trust Estate (if any) for the series DP-_________ Notes and from
other assets of the Issuer that are not pledged to secure other series of notes.

The Notes are subject to mandatory redemption under the circumstances  described
in the following paragraphs 1 and 2.

1. So long as no Event of  Default  has  occurred  and is  continuing  under the
Indenture,  the Issuer will redeem Notes of this Series presented for redemption
at a  redemption  price  equal to 100% of the unpaid  principal  amount  thereof
(hereinafter  referred  to as the  "Redemption  Price")  plus  interest  accrued
thereon and unpaid,  if any, to but not including the date fixed for  redemption
(the  "Redemption  Date").  Such redemption will be made on dates  determined as
follows: On each Payment Date commencing ___________, Notes shall be redeemed in
Whole Note (i.e.  $1,000,  plus interest that has been deferred and  compounded)
increments upon ninety (90) days advance written request of the holder thereof.

Notes sought to be redeemed pursuant to the preceding paragraph may be presented
for redemption by delivery to the Trustee of: (a) the Notes to be redeemed,  and
(b) a written  request for  redemption in form  satisfactory  to the Trustee and
signed  by the  Holder  or  duly  authorized  representative  (with  appropriate
evidence of authority). Only Notes presented for redemption at least ninety (90)
days  prior to the  Redemption  Date will be  eligible  for  redemption  on that
Redemption  Date. All such Notes  presented for  redemption  will be held by the
Trustee  until the Issuer is able to redeem  them,  unless  withdrawn by written
request actually  received by the Trustee by the last day of the month preceding
that in which they would  otherwise have been redeemed.  Notes shall be redeemed
in the  order  of  receipt  by the  Trustee.  The  Trustee  may  establish  such
procedures  as it may deem fair and equitable in order to determine the order of
receipt of such Notes.

2. So long as no Event of  Default  has  occurred  and is  continuing  under the
Indenture,  the Issuer, at its option,  may redeem any or all of the Outstanding
Notes of this  Series  on any  Redemption  Date at the  Redemption  Price of the
principal  amount thereof (plus interest accrued and unpaid on such Notes to but
not including the Redemption Date).

If an  Event  of  Default  as  defined  in  the  Indenture  shall  occur  and be
continuing,  the principal of all the Notes,  or of all the Notes of any Series,
may  become or be  declared  due and  payable  in the manner and with the effect
provided in the Indenture.

As provided in the  Indenture  and  subject to certain  limitations  therein set
forth,  the transfer of this Note may be  registered on the Note Register of the
Issuer,  upon surrender of this Note for  registration of transfer at the office
or agency of the Issuer in the United  Stated of America,  duly  endorsed by, or
accompanied  by a written  instrument  of transfer in form  satisfactory  to the
Trustee duly executed by, the Holder  hereof or his attorney duly  authorized in
writing, and thereupon one or more new Notes of the same series and maturity, of
authorized  denominations and for the same aggregate  principal amount,  will be
issued to the designated transferee or transferees.

Prior to the due  presentment  for  registration  of transfer of this Note,  the
Issuer,  the  Trustee  and any agent of the Issuer or the  Trustee may treat the
Person in whose name this Note is registered as the owner hereof for the purpose
of receiving  payment as herein  provided and for all other purpose,  whether or
not this Note be overdue, and neither the Issuer, the Trustee nor any such agent
shall be affected by notice to the contrary.

The  Indenture  permits,  with  certain  exceptions  as  therein  provided,  the
amendment  thereof and the  modification  of the rights and  obligations  of the
Issuer and rights of the Holders of the Notes under the Indenture at any time by
the Issuer with the consent of the Holders of a majority in aggregate  principal
amount of Notes at the time  Outstanding (as defined in the Indenture),  in case
Outstanding  Notes of all Series are to be affected,  or with the consent of the
Holders of a majority  in  aggregate  principal  amount of the Notes at the time
Outstanding  of each Series to be affected,  in case one or more,  but less than
all, of the Series of Notes then  Outstanding are to be affected.  The Indenture
also contains  provisions  permitting  the Holders of specified  percentages  in
aggregate principal amount of the Notes at the time Outstanding, and of Notes at
the time Outstanding of each Series to be affected in case one or more, but less
than all,  such Series are to be  affected,  on behalf of the Holders of all the
Notes,  to  waive  compliance  by the  Issuer  with  certain  provisions  of the
Indenture and certain past defaults under the Indenture and their  consequences.
Any such  consent or waiver by the Holder of this Note shall be  conclusive  and
binding  upon such  Holder and upon all  future  Holders of this Note and of any
Notes issued upon the  registration of transfer hereof or in exchange herefor or
in lieu hereof  whether or not  notation of such  consent or waiver is made upon
this Note.

The  term  "Issuer"  as used in this  Note  includes  any  successor  under  the
Indenture.

The Notes are  issuable  only in  registered  form  without  coupons in original
denominations of $1,000 and any integral  multiple  thereof ("Whole Notes"),  as
provided in the Indenture and subject to certain  limitations therein set forth.
The Notes are exchangeable for a like aggregate principal amount of Notes of the
same series and maturity of a different authorized denomination, as requested by
the Holder surrendering same.

No  reference  herein to the  Indenture  and no provision of this Note or of the
Indenture shall alter or impair the obligation of the Issuer,  which is absolute
and  unconditional,  to pay the  principal  of and  interest on this Note at all
times, place and rate, and in the coin or currency, herein prescribed.

                             REQUEST FOR REDEMPTION

The undersigned Holder, or legal  representative of the Holder,  hereby presents
the within Note of Mountain  States  Capital,  Inc.,  for redemption on the next
Redemption  Date upon  which  such Note  would be  eligible  for  redemption  in
accordance with, and subject to, the terms and conditions of the within Note and
the Indenture.

Dated:________________             Signed:______________________________________
                          (Please sign exactly as your name appears on the Note)

                              (FORM OF ASSIGNMENT)

The undersigned  Holder, or legal  representative of the Holder,  hereby assigns
this note to:


--------------------------------------------------------------------------------

--------------------------------------------------------------------------------
(print or type name, address and zip code of assignee)

The assignee's  Social Security Number or other Taxpayer  Identification  Number
is: ______________________

I hereby appoint the Trustee as my agent,  with full power of  substitution,  to
transfer  my Note on the Note  Register  and the other  books and records of the
Issuer.

Dated:________________             Signed:______________________________________
                          (Please sign exactly as your name appears on the Note)


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