Initial Stock Purchase Information

Name: ___________________________________ ACT: ________

Company #1

1. Name of Company: ________________________________

2. Symbol: _____________

3. Price per share: _______________ Date: _______________

4. Number of shares: _______________

5. Total cost for shares (Price per share x Number of shares): _______________

6. Broker Fees (2% of total cost of shares): _______________

7. Total Cost (Total cost of shares + Broker Fees): _______________

Company #2

1. Name of Company: ________________________________

2. Symbol: _____________

3. Price per share: _______________ Date: _______________

4. Number of shares: _______________

5. Total cost for shares (Price per share x Number of shares): _______________

6. Broker Fees (2% of total cost of shares): _______________

7. Total Cost (Total cost of shares + Broker Fees): _______________

Company #3

1. Name of Company: ________________________________

2. Symbol: _____________

3. Price per share: _______________ Date: _______________

4. Number of shares: _______________

5. Total cost for shares (Price per share x Number of shares): _______________

6. Broker Fees (2% of total cost of shares): _______________

7. Total Cost (Total cost of shares + Broker Fees): _______________

Company #4

1. Name of Company: ________________________________

2. Symbol: _____________

3. Price per share: _______________ Date: _______________

4. Number of shares: _______________

5. Total cost for shares (Price per share x Number of shares): _______________

6. Broker Fees (2% of total cost of shares): _______________

7. Total Cost (Total cost of shares + Broker Fees): _______________