Amount of Subscription. The undersigned hereby subscribes to _____________ Units for an aggregate amount of $___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ Units. Social Security or Taxpayer I.D. Number [required if applicable]: _______________________ Business Address (including zip code): _________________________________________ Business Phone: ( ) ________________________________________________________ Residence Address (including zip code) _________________________________________ Residence Phone: ( ) ________________________________________________________ All communications to be sent to: ☐ Business or ☐ Residence Address Name Units should be registered in:__________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of Securities:_________________________________________ Email Address:__________________________________________ Please indicate on the following pages the form in which you will hold title to your interest in the securities. PLEASE CONSIDER CAREFULLY. ONCE YOUR SUBSCRIPTION IS ACCEPTED, A CHANGE IN THE FORM OF TITLE CONSTI-TUTES A TRANSFER OF THE INTEREST IN THE SECURITIES AND MAY THEREFORE BE RESTRICTED BY THE TERMS OF THIS SUBSCRIPTION, THE SECURITIES AND MAY RESULT IN ADDITIONAL COSTS TO YOU. Subscribers should seek the advice of their attorneys in deciding in which of the forms they should take ownership of the interest in the securities, because different forms of ownership can have varying gift tax, estate tax, income tax, and other consequences, depending on the state of the investor’s domicile and his or her particular personal circumstances. Please select one of the following forms of ownership: ☐ INDIVIDUAL OWNERSHIP (one signature required) ☐ JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON (both or all parties must sign) ☐ signatures required if interest held in both names) ☐ TENANTS IN COMMON (both or all parties must sign) ☐ sign, and include a copy of the Partnership Agreement) ☐ sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ☐ sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) ☐ si...
Amount of Subscription. Number of Shares: ___________________
Amount of Subscription. The undersigned hereby subscribes to purchase an aggregate of ___________ Units for a total of $______________.
Amount of Subscription a. Shares of Stock (including fractions thereof) $0.50 minimum investment, 1 share.
b. Total Cash Contribution ($0.50 per share, Common Stock, par value, $.01; $0.50 per share).
Amount of Subscription. (a) Amount of Investment: _________________
(b) Total Shares Purchased: _________________ OHMC Subscriber’s Initials Initials
Amount of Subscription. $ ------------------------------ ------------------ Print Name Number of Units to be Purchased: , including ------------------------------ ------------------- $____________ principal amount of Purchased Debentures Signature of Investor and ________ Purchased Warrants ------------------------------ Social Security Number ------------------------------ Address and Fax Number ------------------------------ E-mail Address ACCEPTED AND AGREED: TEGAL CORPORATION By: --------------------------------- Dated: ------------------------------ SIGNATURE PAGE TO TEGAL CORPORATION SUBSCRIPTION AGREEMENT Dated _______, 2003 IF the INTERESTS will be held as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY, please complete the following:
Amount of Subscription. $ Print Name of Purchaser ------------------ Number of Units to be Purchased: ---------------------------------- , including Signature of a Purchaser $____________ principal amount of Purchased Debentures and ________ Purchased Warrants ----------------------------------- Social Security Number ----------------------------------- Print Name of Spouse or Other Purchaser ----------------------------------- Signature of Spouse or Other Purchaser ----------------------------------- Social Security Number ----------------------------------- Address ----------------------------------- Fax Number ------------------------------------ E-mail Address ACCEPTED AND AGREED: TEGAL CORPORATION By: -------------------------------------------------- Dated: -------------------------------------- SIGNATURE PAGE TO TEGAL CORPORATION SUBSCRIPTION AGREEMENT Dated ______, 2003 IF the PURCHASER is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY, TRUST or OTHER ENTITY, please complete the following: IN WITNESS WHEREOF, the undersigned has executed this Agreement this ____ day of ____, 2003. Number of Units to be Purchased: , including $____________ principal amount of Purchased Debentures and ________ Purchased Warrants ----------------------------------- Print Full Legal Name of Partnership, Company, Limited Liability Company, Trust or Other Entity By: ------------------------------- (Authorized Signatory) Name: ------------------------------ Title: ---------------------------- Address and Fax Number: ------------ ----------------------------------- Taxpayer Identification Number: -------------- Date and State of Incorporation or Organization: ------------------------------ Date on which Taxable Year Ends: ----------------------------------------------- E-mail Address: ------------------------------- ACCEPTED AND AGREED: TEGAL CORPORATION By: -------------------------------------------------- Name: ----------------------------------------------- Title: ----------------------------------------------- Dated: ---------------------------------------------- EXHIBITS AND SCHEDULES TO THE UNIT SUBSCRIPTION AGREEMENT Exhibit 1: Form of Debentures Exhibit 2: Form of Warrants Exhibit 3: Form of Registration Rights Agreement Exhibit 4: Form of Financial Advisory Agreement Exhibit 5: Form of Subsidiary Guaranty Exhibit 6: Form of Security Agreement Exhibit 7: Legal Opinion Exhibit 8: Risk Factors Exhibit 9: Company Disclosure Letter EXHIBIT 5 Form of SUBSIDIARY GUARANTY New York, New Y...
Amount of Subscription. The undersigned hereby subscribes (or subscribes for the Investor, as the case may be) for the total amount as set forth below: Total Amount of Subscription: $__________________ Make checks or wire transfers payable to: "BIOMUNE SYSTEMS, INC." THE UNDERSIGNED HEREBY CERTIFIES that the foregoing information is true, correct and accurate to the best of the undersigned's knowledge. DATED this _____ day of September, 1996. IF INDIVIDUAL(S): ________________________________ ________________________________ Name (Please Print) Signature ________________________________ ________________________________ Name (Please Print) Signature IF CORPORATION, PARTNERSHIP, LIMITED LIABILITY COMPANY OR TRUST (ATTACH RESOLUTION AUTHORIZING ACQUISITION OF SHARES, IF NECESSARY): ________________________________ ________________________________ Name (Please Print) Signature Title: _________________________ ________________________________ ________________________________ Name (Please Print) Signature Title: _________________________ CERTIFICATE OF ACCEPTANCE Subscription: Accepted: __________ Rejected __________ BIOMUNE SYSTEMS, INC., a Nevada corporation ________________________________ ____________________________, 1996 David G. Derrick Date Chief Executive Ofxxxxx APPENDIX "A"
Amount of Subscription. US$ • Registration of Shares. The Shares issued to Subscriber are to be registered in the Fund’s books in the name of (insert name and address): • Written Communications. All written communications from the Fund to Subscriber should be sent to Subscriber at the following address (insert address): • Telephone, Fax and Email Telephone: Fax: Email: • Domicile, Etc. Subscriber, if an individual, is a citizen of and has its principal place of business in . • Authorized Persons. The names of the persons authorized by Subscriber to give and receive instructions between the Fund and Subscriber, together with their signatures, are set forth below. Such persons are the only persons so authorized by Subscriber until further notice to the Fund by any one of such persons: Print Name Signature
Amount of Subscription. The Subscriber is an "investment company" within the meaning of the Investment Company Act or an entity that would be an "investment company" but for the exception provided for in Section 3(c)(1) or 3(c)(7) thereof. ¨ The Subscriber elects to opt out of participation in the 26North BDC, Inc.'s dividend reinvestment plan. ¨ Print or Type Name of Subscriber Signed by: (Title, if applicable) Typed or printed address of Subscriber (as described in Section 10(l)): Please list Type of Entity (e.g., individual, corporation, estate, trust, partnership, exempt organization, nominee, custodian) and check the applicable box(es) below, if any: __________________________________________________ If the Subscriber is a "FOIA Subscriber" as such term is defined in Section 10(q) of this Subscription Agreement: ¨ If the Subscriber is a "Benefit Plan Investor" for purposes of this Agreement: ¨ If the Subscriber is a "401(k)/IRA Investor" as such term is defined in Section 10(p) of this Agreement: ¨ If the Subscriber is an "Other Plan Investor" for purposes of this Agreement : ¨ Subscriber's Social Security or Federal Tax Identification No.: Is the party signing this document acting as a nominee or custodian for another person or entity? Yes ¨ No ¨ Country of residence for U.S. federal income tax purposes Consent to electronic delivery of Form 1099? Yes ¨ No ¨ * If yes, please read and sign Exhibit F. Check the following box if, to the knowledge of the Subscriber, the Subscriber is controlled by, controls or is under common control with any other shareholder of the Company. ¨ 26North BDC, Inc. Investor Signature Page The foregoing Subscription Agreement is hereby accepted by the undersigned as of the acceptance date listed below: Name: Title: A Duly Authorized Officer Date of Acceptance: _________________ Amount of Capital Commitment accepted by the Company (if less than the amount set forth on the Subscriber's signature page above as permitted by Section 1): $________________________ 26North BDC, Inc. Acceptance Form The Subscriber hereby represents and warrants, pursuant to Section 10(m) of the attached Agreement, that he, she or it is correctly and in all respects described by the category or categories set forth below directly next to which the Subscriber or its authorized representative has checked the corresponding category or categories. Capitalized terms not defined herein shall have the meanings assigned to them in the Subscription Agreement.
