Form of Subscription Agreement




 Exhibit 4.1 
 APPENDIX B 

 

 

 SUBSCRIPTION AGREEMENT 
  

													
	 1
	  	YOUR INITIAL INVESTMENT
		
		  	Make all checks* payable to: “STRATEGIC STORAGE TRUST, INC.”
		
		  	*Cash, cashier’s checks/official bank checks under $10,000, foreign checks, money orders, third party checks, or traveler’s checks are not accepted.
		
		  	 The minimum initial investment is $1,000**. All additional investments must be at least $100.
  
 Investment Amount: $
                    
  
 ** The minimum purchase for Minnesota, New Jersey, New York and North Carolina residents is 250 shares ($2,500), except for IRAs which must purchase a minimum of 100
shares ($1,000).

	 	  	  
  ̈  By Mail – Attach a check
made payable to Strategic Storage Trust, Inc.
  ̈  By Wire – UMB Bank, N.A., 1010 Grand, 4th Floor, Kansas City, MO 64106, ABA# 101000695 Strategic Storage
        Trust, Inc. Account # 9871879437. When sending a wire, please request that the wire references the
        subscriber’s name in order to assure the wire is credited to the proper account.
  ̈  Asset Transfer – Attach a copy of the asset transfer form. Original to be sent to the transferring institution.
  

		  	 ̈ Waiver of
Commission – Please check this box if you are eligible for a waiver of commission. Waivers of commissions are available for purchases through an affiliated investment advisor, participating Broker-Dealer or its retirement plan, or for a
representative of a participating Broker-Dealer or his or her retirement plan or family member(s).
	 2
	  	FORM OF OWNERSHIP
		  	(Select only one)
		  	Non-Custodial Ownership	 		 	Custodial Ownership
		  	  ̈  Individual Ownership
  ̈  Transfer on Death – Fill out
Transfer on Death Form
        to effect designation (available through your financial
        advisor).
  ̈  Joint Tenants with Rights of Survivorship – All
        parties must sign.
  ̈  Community Property – All parties must sign.
  ̈  Tenant In Common – All parties must sign.
  ̈  Corporate Ownership – Authorized signature
        required.
    Include copy of corporate resolution.
  ̈  Partnership Ownership – Authorized signature
        required.
	 		 	  ̈
  Traditional / Simple IRA – Custodian signature
        required in Section 7.
  ̈  Roth IRA – Custodian signature required in Section
        7.
  ̈  KEOGH Plan – Custodian signature
required in
        Section 7.
  ̈  Simplified Employee Pension / Trust (SEP)
  ̈  Pension / Profit-Sharing Plan / 401k – Custodian
        signature required in Section 7.
  ̈  Uniform Gift to Minors Act / Uniform Transfers
        to Minors Act – Custodian signature required in
        Section 7.

	  	 		 	State of 	 	 	  	Custodian for 	 	 
		  	    Include copy of partnership agreement
	 		 	Required for custodial ownership accounts
		  	  ̈
  Estate – Authorized representative(s) signature
        required.
	 		 	Name of Custodian, Trustee, or Other Administrator
		  	 		 	 
		  	Name of Authorized Representative(s)	 		 	Mailing Address
		  	 	 		 	 
		  	 	 		 	City, State & Zip Code
		  	 	 		 	 
		  	Include a copy of the court appointment dated within 90 days.	 		 	  
 Custodian Information – To be completed by Custodian
listed above.

		  	  ̈  Trust – Include a copy of the first and last page of the
	 		 	Custodian Tax ID#
		  	       trust.	 		 	 
		  	  ̈
  Pension Plan and Profit Sharing Plan (Non-
        Custodian)
  ̈  Other
	 		 	Custodian Account #
		  	 		 	 

  

													
		  	Name of Trustee(s)	 		 	Custodian Telephone #
		  	 	 		 	 
		  	 	 		 	Special Instructions
		  	Include a copy of the first and last page of the plan, as well as Trustee information.	 		 	 
		  		 		 	 
		  		 		 	 
		  		 		 	 

 Regular Mail: Strategic Storage Trust, Inc. c/o DST Systems, Inc., PO Box 219406, Kansas City, MO 64121-9406 
 Overnight Mail: Strategic Storage Trust, Inc. c/o DST Systems, Inc., 430 W. 7th Street, Kansas City, MO 64105 
 Wire Information: UMB Bank, N.A., 1010 Grand, 4th Floor, Kansas City, MO 64106 ABA# 101000695 Account # 9871879437 
 Investor Services Toll Free Phone Line: 866-418-5144 
  

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	 3
	 	ADDRESS INFORMATION	  	
		 	Subscriber Information (All fields must be completed)	  	
		 	 Investor
  
	  	 Co-Investor

 


  

							
		 	 Home Telephone
  
	 	 Business Telephone
  
	  	 Email
Address
  


  

					
		 	 Investor Social Security Number / Tax ID
Number
  
	  	 Birth Date / Articles
of Incorporation (MM/DD/YY)
  


  

					
		 	 Co-Investor Social Security Number / Tax
ID Number
  
	  	 Co-Investor Birth Date
(MM/DD/YY)
  


  

							
	  Please indicate Citizenship Status    	 	U.S. Citizen    Resident Alien – Country of Origin
                                         
                                         
                 
		 		 	Non-resident Alien – Country of Origin
                                         
                                         
                                   

  

			
	  Residence Address (No P.O. Box allowed)

  

									
		 	 Street Address
  
	 	 City
  
	 	 State
  
	 	 Zip Code
  


  

			
	  Mailing Address* (if different from above – P.O. Box allowed)

  


									
		 	 Street Address
  
	 	 City
  
	 	 State
  
	 	 Zip Code
  


  

	*	If the co-investor resides at another address, please attach that address to the subscription agreement. 

  

			
	 4
	 	DISTRIBUTIONS
		
		 	Complete this section to enroll in the Distribution Reinvestment Plan or to elect to receive distributions by check mailed to you, by check mailed to a third-party or alternate address, or
by direct deposit.

 IRA accounts may not direct distributions without the custodian’s approval. 
  

			
		 	I hereby subscribe for shares of Strategic Storage Trust, Inc. and elect the distribution option indicated below: (Select only one)

 1.  ̈ Participate in the Distribution Reinvestment Plan (see Prospectus for details) 
 2.  ̈ Check mailed to the residence address set forth in Section 3 above 
 3.  ̈ Check mailed to the mailing address set forth in Section 3 above 
 4.  ̈ Check Mailed to Third-Party / Alternate Address 
          To direct distributions to a party other than the registered owner, please provide
applicable information 
          below. 
  

							
		 	 Name /Entity Name / Financial Institution

  
	 	 Account No.
  
	 	 Mailing
Address
  


  

							
		 	 City
  
	 	 State
  
	 	 Zip Code
  


 5.  ̈ Direct Deposit Please attach a pre-printed voided check or a deposit slip. (Non-Custodian Investors Only) 
  

			
		 	I authorize Strategic Storage Trust, Inc., or its agent, to deposit my distribution to my checking or savings account. This authority will remain in force until I notify Strategic Storage
Trust, Inc., or its agent, in writing to cancel it. In the event that Strategic Storage Trust, Inc., or its agent, deposits funds erroneously into my account, they are authorized to debit my account for an amount not to exceed the amount of the
erroneous deposit.

 
  

					
		 	 Please Attach a Pre-printed Voided Check or Deposit Slip Here
 (The above services cannot be established without a pre-printed voided check or deposit slip.)

		 	  

 



	  	For Electronic Funds Transfers, signatures of bank account owners are required exactly as they
appear on bank records. If the registration at the bank differs from that on this Subscription Agreement, all parties must sign below.
		 	  	Signature
		 	  	 
		 	  	 
		 	  	Signature
		 	  	 


							
		 	Your Bank’s ABA Routing Number	  	Your Bank Account Number	  	 ̈  Checking Account       ̈  Savings Account
		 	 	  	 	  

 Regular Mail: Strategic
Storage Trust, Inc. c/o DST Systems, Inc., Po Box 219406, Kansas City, MO 64121-9406 
 Overnight Mail: Strategic Storage
Trust, Inc. c/o DST Systems, Inc., 430 W. 7th Street, Kansas City, MO 64105 
 Wire Information: UMB Bank, N.A., 1010 Grand,
4th Floor, Kansas City, MO 64106 ABA# 101000695 Account # 9871879437 
 Investor Services Toll Free Phone Line: 866-418-5144

  

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		 	ACCOUNT OPTIONS (You may select more than one option)
		 	 A.  ̈ Automatic Investment Plan. Electronic Funds Transfer from your bank account directly to your Strategic Storage Trust, Inc. investment account ($100 Minimum). I authorize Strategic Storage Trust,
Inc., or its agent, to draft from my checking or savings account. This authority will remain in force until I notify Strategic Storage Trust, Inc., or its agent, in writing to cancel it. In the event that Strategic Storage Trust, Inc., or its agent,
drafts funds erroneously from my account, they are authorized to credit my account for an amount not to exceed the amount of the erroneous draft.
 (Automatic Investment Plan is not available to residents of Alabama or Ohio.)

		 	Name of Financial Institution	 	Mailing Address
		 	 	 	 
		 	 	 	 

  

							
		 	City	  	State	  	Zip Code
		 		  		  	 
		 	 	  	 	  	 

  

					
		 	 Please Attach a Pre-printed Voided Check or Deposit Slip Here
 (The above services cannot be established without a pre-printed voided check or deposit slip.)

		 	  

 



	  	For Electronic Funds Transfers, signatures of bank account owners are required exactly as they
appear on bank records. If the registration at the bank differs from that on this Subscription Agreement, all parties must sign below.
		 	  	Signature
		 	  	 
		 	  	 
		 	  	Signature
		 	  	 


							
		 	Your Bank’s ABA Routing Number	  	Your Bank Account Number	  	 ̈  Checking Account       ̈  Savings Account
		 	 	  	 	  

  

			
		 	I Authorize Strategic Storage Trust, Inc. or its agent to draft from
my checking or savings account $                     ($100 Minimum) each month on the 1st of the month, beginning the first month after my initial investment.
		 	B.  ̈ Electronic Delivery of
Reports and Updates. I authorize Strategic Storage Trust, Inc. to make available on its website at www.strategicstoragetrust.com and through a CD with links to a website its quarterly reports, annual reports, proxy statements, prospectus
supplements or other reports required to be delivered to me, as well as any property or marketing updates, and to notify me via e-mail when such reports or updates are available in lieu of receiving paper documents. (You must provide an e-mail
address if you choose this option.)

  

					
		 	        E-mail address:	 	 

  

					
	6	 	BROKER-DEALER/FINANCIAL ADVISOR INFORMATION (All fields must be completed)
		 	 The Financial Advisor must sign below to complete order. The Financial Advisor hereby warrants that he/she is duly licensed and may
lawfully sell shares in the state designated as the investor’s legal residence.
  

		 	Broker-Dealer Name	 	Broker-Dealer Mailing Address
		 	 	 	 

  

							
		 	City	  	State	  	Zip Code
		 	 	  	 	  	 

  

											
		 	Broker-Dealer CRD Number	 		  	Telephone Number	 		  	Fax Number
		 	 	 		  	 	 		  	 

  

					
		 	Financial Advisor Firm Name & Branch Number	 	Financial Advisor Name
		 	 	 	 

  

					
		 	Advisor Mailing Address	 	 
		 	 	 	 

  

							
		 	City	  	State	  	Zip Code
		 	 	  	 	  	 

  

											
		 	Advisor CRD Number	 		  	Branch Number	 		  	Telephone Number
		 	 	 		  	 	 		  	 

  

							
		 	E-mail Address	 	 	 	Fax Number
		 	 	 	 	 	 

  

	 ̈	Registered Investment Advisor (RIA): If this box is checked, commission will be waived. All sales of securities must be made through a Broker-Dealer. If an
RIA has introduced a sale, the sale must be conducted through (1) the RIA in his or her capacity as a Registered Representative of a Broker-Dealer, if applicable; (2) a Registered Representative of a Broker-Dealer which is affiliated with the RIA,
if applicable; or (3) if neither (1) nor (2) is applicable, an unaffiliated Broker-Dealer. (Section 6 must be filled in.) 

 Regular Mail: Strategic Storage Trust, Inc. c/o DST Systems, Inc., Po Box 219406, Kansas City, MO 64121-9406 
 Overnight Mail: Strategic Storage Trust, Inc. c/o DST Systems, Inc., 430 W. 7th Street, Kansas City, MO 64105 
 Wire Information: UMB Bank, N.A., 1010 Grand, 4th Floor, Kansas City, MO 64106 ABA# 101000695 Account # 9871879437 
 Investor Services Toll Free Phone Line: 866-418-5144 
  

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 The undersigned confirm on behalf of the Broker-Dealer that they (1) have reasonable grounds to
believe that the information and representations concerning the investor identified herein are true, correct and complete in all respects; (2) have discussed such investor’s prospective purchase of shares with such investor; (3) have
advised such investor of all pertinent facts with regard to the lack of liquidity and marketability of the shares; (4) have delivered a current Prospectus and related supplements, if any, to such investor; (5) have reasonable grounds to
believe that the investor is purchasing these shares for his or her own account; and (6) have reasonable grounds to believe that the purchase of shares is a suitable investment for such investor, that such investor meets the suitability
standards applicable to such investor set forth in the Prospectus and related supplements, if any, and that such investor is in a financial position to enable such investor to realize the benefits of such an investment and to suffer any loss that
may occur with respect thereto. 

																	
	  
 X   

	  	 	 	 	  	 	  	 	 	  
 X  
	  	 	 	 	  	 
	 	  	Financial Advisor Signature	 	 	  	Date	  	 State
 of Sale
	 	 	  	 Branch Manager Signature
 (If required by Broker-Dealer)
	 	 	  	Date

  

					
		 	7   	  	SUBSCRIBER SIGNATURES

 Strategic Storage Trust, Inc. is
required by law to obtain, verify and record certain personal information from you or persons on your behalf in order to establish the account. Required information includes name, date of birth, permanent residential address and social
security/taxpayer identification number. We may also ask to see other identifying documents. If you do not provide the information, Strategic Storage Trust, Inc. may not be able to open your account. By signing the Subscription Agreement, you agree
to provide this information and confirm that this information is true and correct. If we are unable to verify your identity, or that of another person(s) authorized to act on your behalf, or if we believe we have identified potentially criminal
activity, we reserve the right to take action as we deem appropriate which may include closing your account. 
 Please separately initial
each of the representations below. Except in the case of fiduciary accounts, you may not grant any person a power of attorney to make such representations on your behalf. In order to induce Strategic Storage Trust, Inc. to accept this subscription,
I hereby represent and warrant to you as follows: 
  

															
	[ALL ITEMS MUST BE READ AND INITIALED.]	 		  	  Owner  	  	 	  	 	  	Joint
Owner	 	 
	 (1)    
	  	I have received the Prospectus of Strategic Storage Trust, Inc., and I fully understand that I am entitled to a refund of my subscription
amount upon written request to Strategic Storage Trust, Inc. if the request is received within five (5) business days of either (i) completion of the Subscription Agreement or (ii) my receipt of the Prospectus, whichever is earlier.	 		  	



	  		  		  	



	 	
	 	  	 		  	  		  	  	 
	 	  	 		  	  		  	  	 
	 (2)    
	  	I have (i) a net worth (exclusive of home, home furnishings and
automobiles) of $250,000 or more, or (ii) a net worth (as described above) of at least $70,000 and had during the last tax year or estimate that I will have during the current tax year a minimum of $70,000 gross annual income, or that I meet the
higher suitability requirements imposed by my state of primary residence as set forth in the Prospectus under “SUITABILITY STANDARDS.” I will not purchase additional shares unless I meet those suitability requirements at the time of
purchase.	 		  	



	  		  		  	



	 	
	  	 		  		  		  		  		 	
	 (3)    
	  	 I acknowledge that there is no public market for the shares and, thus, my
investment in shares is not liquid.
  
  
	 		  	



	  		  		  	



	 	
	 (4)    
	  	 I am purchasing the shares for my own account.
  
	 		  	



	  		  		  	



	 	

 If you participate in the Distribution Reinvestment Plan or make subsequent purchases of shares of Strategic
Storage Trust, Inc., including purchases made pursuant to our Automatic Investment Program, you agree that, if you fail to meet the suitability requirements for making an investment in shares or can no longer make the other representations or
warranties set forth in this Section 7, you are required to promptly notify Strategic Storage Trust, Inc. and your Broker-Dealer in writing. 
 TAXPAYER IDENTIFICATION NUMBER OR SOCIAL SECURITY NUMBER CERTIFICATION (required): The investor signing below, under penalties of perjury, certifies that (1) the number shown on this Subscription Agreement
is my correct taxpayer identification number (or I am waiting for a number to be issued to me), (2) I am not subject to backup withholding because I am exempt from backup withholding, I have not been notified by the Internal Revenue Service
(“IRS”) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the IRS has notified me that I am no longer subject to backup withholding, and (3) I am a U.S. person (including a U.S.
resident alien), unless I have otherwise indicated in Section 3 above. 
 Certification instructions. You must cross out item
2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. 
 I understand that I will not be admitted as a stockholder until my investment has been accepted. Depositing of my check alone does not constitute
acceptance. The acceptance process includes, but is not limited to, reviewing the Subscription Agreement for completeness and signatures, conducting an Anti-Money Laundering check as required by the USA PATRIOT Act and depositing funds.

 The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup
withholding. 
  

															
	  
 X   

	  	 	 	 	  	 	 	  
 X  
	  	 	 	 	  	 
	 	  	Signature of Owner or Custodian	 	 	  	Date	 	 	  	Signature of Joint Owner or Beneficial Owner (if applicable)	 	 	  	Date

 (MUST BE SIGNED BY CUSTODIAN OR TRUSTEE IF IRA OR QUALIFIED PLAN IS ADMINISTERED BY A THIRD PARTY) 
 All items on the Subscription Agreement must be completed in order for your subscription to be processed. Subscribers are encouraged to read the Prospectus in its entirety for a complete explanation of an investment in Strategic Storage
Trust, Inc. 
 Regular Mail: Strategic Storage Trust, Inc. c/o DST Systems, Inc., Po Box 219406, Kansas City, MO 64121-9406 

 Overnight Mail: Strategic Storage Trust, Inc. c/o DST Systems, Inc., 430 W. 7th Street, Kansas City, MO 64105 

Wire Information: UMB Bank, N.A., 1010 Grand, 4th Floor, Kansas City, MO 64106 ABA# 101000695 Account # 9871879437 
 Investor Services Toll Free Phone Line: 866-418-5144 
  

 B-4