Common use of Amount of Subscription Clause in Contracts

Amount of Subscription. The undersigned hereby subscribes to _____________ Shares for an aggregate amount of $___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ Shares. 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 Shares should be registered in:_________________________________________________ If different than subscriber name please advise of the reason for such difference: __________________________________________________________________ Address for registration of shares:___________________________________________________ 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 CONSTITUTES 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) ___ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ___ TENANTS IN COMMON (both or all parties must sign) ___ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ___ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER authorized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ___ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) ___ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation’s Articles and certified Corporate Resolution authorizing the signature) ___ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 16, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 2 contracts

Samples: Common Stock Subscription Agreement, Common Stock Subscription Agreement (Panther Biotechnology, Inc.)

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Amount of Subscription. The undersigned hereby subscribes to _____________ Shares Units for an aggregate amount of $___________. Subscription Agreement Golden Matrix Group, Inc. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ SharesUnits. 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 Shares Units should be registered in:_________________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of sharesSecurities:___________________________________________________ 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 CONSTITUTES 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. Subscription Agreement Golden Matrix Group, Inc. 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) ___ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ___ TENANTS IN COMMON (both or all parties must sign) ___ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ___ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER authorized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ___ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) ___ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation’s Articles and certified Corporate Resolution authorizing the signature) ___ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 1617 THROUGH 19, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 20 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. Subscription Agreement Golden Matrix Group, Inc. EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Subscription Agreement (Golden Matrix Group, Inc.)

Amount of Subscription. The undersigned hereby subscribes to _____________ Shares for purchase an aggregate amount of 7,333,529 Units for a total of $___________2,500,000. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ 2,500,000.00 Subscribed forFor: _______________ Shares. $2,500,000 in Units Social Security or Taxpayer I.D. Number [required if applicable]: _________:___________________ Business Address (including zip code): ____________________Attention: Xxx Prychitka, CFO & VP Shared Services________ 0000 Xxxxxxxxx Xxxx, Mississauga, ON L4Y 1S4 Business Phone: ( ) ____________________________ 000 000 0000 Residence Address (including zip code) Residence Phone: (____________________________ Residence Phone: ( ) ____________________________ All communications to be sent to: x Business or Residence Address Name Shares should be registered in:_________________________________________________ If different than subscriber name please advise of the reason for such difference: __________________________________________________________________ Address for registration of shares:___________________________________________________ Email Address:__________________________________________________________________ Please indicate on the following pages page 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 CONSTITUTES CONSTI­TUTES 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 's domicile and his or her particular personal circumstances. Subscription Agreement Jammin Java Corp. 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) ________ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ________ TENANTS IN COMMON (both or all parties must sign) ________ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ________ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER authorized autho­rized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ________ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) __X_____ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation’s 's Articles and certified Corporate Resolution authorizing the signature) ________ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 16, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Subscription Agreement (Jammin Java Corp.)

Amount of Subscription. The undersigned hereby subscribes to _____________ Shares for an aggregate amount of $___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ Shares. 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 Shares should be registered in:___________________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of shares:_____________________________________________________ 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 CONSTITUTES 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) ___ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ___ TENANTS IN COMMON (both or all parties must sign) ___ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ___ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER authorized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ___ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) ___ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation’s Articles and certified Corporate Resolution authorizing the signature) ___ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 16, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Common Stock Subscription Agreement (Panther Biotechnology, Inc.)

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Amount of Subscription. The undersigned hereby subscribes to _____________ Shares Units for an aggregate amount of $___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ SharesUnits. Social Security or Taxpayer I.D. Number [required if applicable]: ____________________________ Business Address (including zip code): ____________________________ 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 Shares Units should be registered in:_________________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of sharesSecurities:___________________________________________________ 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 CONSTITUTES 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. Subscription Agreement Golden Matrix Group, Inc. 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) ___ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ___ TENANTS IN COMMON (both or all parties must sign) ___ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ___ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER authorized autho-rized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ___ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) ___ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation’s Articles and certified Corporate Resolution authorizing the signature) ___ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 1617 THROUGH 19, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 20 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.Golden Matrix Group, Inc.

Appears in 1 contract

Samples: Subscription Agreement (Golden Matrix Group, Inc.)

Amount of Subscription. The undersigned hereby subscribes to _____________ Shares for an aggregate amount of $___________. Preferred Stock Subscription Agreement Petrolia Energy Corporation “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ Shares. 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 Shares should be registered in:___________________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of shares:_____________________________________________________ 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 CONSTITUTES 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) ___ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ___ TENANTS IN COMMON (both or all parties must sign) ___ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ___ Preferred Stock Subscription Agreement Petrolia Energy Corporation LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER authorized autho-rized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ___ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) ___ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation’s Articles and certified Corporate Resolution authorizing the signature) ___ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 16, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. Preferred Stock Subscription Agreement Petrolia Energy Corporation EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Preferred Stock Subscription Agreement (Petrolia Energy Corp)

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