NEOSURG TECHNOLOGIES, INC.
STOCK ORDER FORM
GUIDE AND INSTRUCTIONS
STOCK OWNERSHIP GUIDE
INDIVIDUAL
The stock is to be registered in an individual's name only. You may not list
beneficiaries for this ownership.
JOINT TENANTS
Joint Tenancy with Right of Survivorship identifies two or more persons as
owners of the stock. Upon the death of one of the owners, ownership
automatically passes to the surviving tenant(s). You may not list beneficiaries
for this ownership.
TENANTS IN COMMON
Tenants in Common identifies two or more persons as owners of the stock. When
stock is held by tenants in common, upon the death of one co-tenant, ownership
of the stock will be held by the surviving co-tenant(s) and by the heirs of the
deceased co-tenant. All parties must agree to the transfer or sale of shares
held by tenants in common. You may not list beneficiaries for this ownership.
INDIVIDUAL RETIREMENT ACCOUNT
Individual Retirement Account ("IRA") holders may make stock purchases from
their IRA through a pre-arranged "trustee-to-trustee" transfer. Stock may only
be held in a self-directed IRA. Please contact the Stock Sales Center if you
have any questions about your IRA account or to obtain a list of local brokers
who will open a self-directed IRA, or check with your broker.
UNIFORM GIFT TO MINORS/UNIFORM TRANSFERS TO MINORS
For Texas residents and residents of many states, stock may be held in the name
of a custodian for the benefit of a minor under the Uniform Transfers to Minors
Act. For residents of most other states, stock may be held in a similar type of
ownership under the Uniform Gift to Minors Act of the individual states. For
either ownership, the minor is the actual owner of the stock with the adult
custodian being responsible for the investment until the minor reaches legal
age.
Instructions: If you are a Texas resident and wish to register stock in this
------------
ownership, check "Uniform Transfers to Minors." For other states, see your
legal advisor if you are unsure about the correct registration of your stock.
On the first "NAME" line, print the first name, middle initial and last name of
the custodian, with the abbreviation "CUST" after the name. Print the first
name, middle initial and last name of the minor on the second "NAME line. Only
one custodian and one minor may be designated.
CORPORATION/PARTNERSHIPS
Corporations/Partnerships may purchase stock. Please provide the
Corporation/Partnership's legal name and Tax I.D. number.
FIDUCIARIES:
Generally, fiduciary relation-ships (such as Conservatorship, Legal Trust,
Guardianship, etc.) are established under a form of a trust agreement or are
pursuant to a court order. Without a legal document establishing a fiduciary
relationship, your stock may not be registered in a fiduciary capacity.
Instructions: On the first "NAME" line, print the first name, middle initial
------------
and last name of the fiduciary if the fiduciary is an individual. If the
fiduciary is a corporation, list the corporate title on the first "NAME" line.
Following the name, print the fiduciary "title" such as trustee, executor,
personal representative, etc.
<PAGE>
On the second "NAME" line, print either the name of the maker, donor or testator
OR the name of the beneficiary. Following the name, indicate the type of legal
document establishing the fiduciary relationship (agreement, court order, etc.).
In the blank after "Under Agreement Dated," fill in the date of the document
governing the relationship. The date of the document need not be provided for a
trust created by a will.
An example of fiduciary ownership of stock in the case of a trust is: John D.
Smith, Trustee for Thomas A. Smith Under Agreement Dated 06/09/87.
ITEM INSTRUCTION
ITEMS 1 AND 2
Fill in the number of shares that you wish to purchase and the total payment
due. The amount due is determined by multiplying the number of shares by the
subscription price of $6.75 per share. The minimum purchase is 200 shares. The
maximum purchase amount in the Offering by any person is $____ of the common
stock in the Offering.
ITEM 3
Payment for shares may be made in cash (only if delivered by you in person) or
by check, bank draft or money order made payable to Oxford Financial Group. DO
NOT MAIL CASH. If you choose to make a cash payment, take your Stock Order Form
and payment in person to the Stock Sales Office listed at the bottom of the
Stock Order Form. Your funds will earn interest as provided in the Prospectus.
ITEM 6
The stock transfer industry has developed a uniform system of shareholder
registrations that we will use in the issuance of NeoSurg Technologies, Inc.
common stock. Print the name(s) in which you want the stock registered and the
mailing address of the registration. Include the first name, middle initial and
last name of the shareholder. Avoid the use of two initial. Please omit words
that do not affect ownership rights, such as "Mrs.," "Mr.," "Dr.," "special
account," etc.
Enter the Social Security or Tax I.D. number of one registered owner. This
registered owner must be listed on the first "NAME" line. Be sure to include
your telephone number because we will need to contact you if we cannot execute
your order as given. Review the Stock Ownership Guide on this page and refer to
the instructions for Uniform Gift to Minors/Uniform Transfer to Minors and
Fiduciaries.
<PAGE>
