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.) ☐ sign, and include a copy of the Corporation’s Articles and certified Corporate Resolution authorizing the signature) ☐ show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) Please execute this Subscription Agreement by completing the appropriate section below. 1. If the subscriber is an INDIVIDUAL, complete the following: Signature of Subscriber Name (please type or print) Signature of Spouse or Co-Owner if funds are to be invested as joint tenants by the entirety or community property. Name (please type or print) 2. If the subscriber is a CORPORATION, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the corporation listed below (“Corporation”) to acquire the Units and, further, that the Corporation has all requisite authority to acquire such Units. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Corporation and that he has authority under the articles of incorporation, bylaws, and resolutions of the board of directors of such Corporation to execute this Subscription Agreement. Such officer encloses a true copy of the articles of incorporation, the bylaws and, as necessary, the resolutions of the board of directors authorizing a purchase of the investment herein, in each case as amended to date. Name of Corporation (please type or print) Name: Title: 3. If the subscriber is a PARTNERSHIP, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned is a general partner of the partnership named below (“Partnership”), and has been duly authorized by the Partnership to acquire the Units and that he has all requisite authority to acquire such Units for the Partnership. The undersigned represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Partnership and he is authorized by such Partnership to execute this Subscription Agreement. Such partner encloses a true copy of the partnership agreement of said Partnership, as amended to date, together with a current and complete list of all partners thereof. Name of Partnership (please type or print) Name: Title: 4. If the subscriber is a TRUST, complete the following: The undersigned hereby represents, warrants and covenants that he is duly authorized by the terms of the trust instrument (“Trust Instrument”) for the (“Trust”) set forth below to acquire the Units and the undersigned, as trustee, has all requisite authority to acquire such Units for the Trust. The undersigned, as trustee, executing this Subscription Agreement on behalf of the Trust, represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Trust and he is authorized by such Trust to execute this Subscription Agreement. Such trustee encloses a true copy of the Trust Instrument of said Trust as amended to date. Name of Trust (Please type or print) By: Name: Title: 5. If the subscriber is a LIMITED LIABILITY COMPANY, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the Limited Liability Company listed below (“Company”) to acquire the Units and, further, that the Company has all requisite authority to acquire such Units. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Company and that he has authority under the articles of organization, company agreement, and resolutions of the managers and/or members, as applicable, of such Company to execute this Subscription Agreement. Such officer encloses a true copy of the articles of organization, the operating agreement and, as necessary, the resolutions of the managers and/or members authorizing a purchase of the investment herein, in each case as amended to date. Name of Trust (Please type or print) By: Name: Title: ACCEPTED BY THE COMPANY this the _____ day of _________, 2020. By: Name: Title: GOLDEN MATRIX GROUP, INC. (THE “COMPANY”) ALL INFORMATION CONTAINED IN THIS APPLICATION WILL BE TREATED CONFIDENTIALLY. The undersigned understands, however, that the Company may present this application to such parties as the Company, in its discretion, deems appropriate when called upon to establish that the proposed offer and sale of the Securities are exempt from registration of the Securities Act of 1933, as amended, or meet the requirements of applicable securities and blue sky laws. PART I - INDIVIDUALS (OTHERS COMPLETE PART II) 1. Name: ______________________________________________________________ 2. Residence Address: ____________________________________________________ 3. Social Security Number:_________________________________________________ 4. Present Employer: 5. I prefer to have communications sent to:
Appears in 1 contract
Amount of Subscription. The undersigned hereby subscribes to _____________ purchase an aggregate of 7,333,529 Units for an aggregate amount 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: _______________ Units. $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________ 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 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 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 CONSTI-TUTES 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 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.) ☐ __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 execute this Subscription Agreement by completing the appropriate section below.
1. If the subscriber is an INDIVIDUAL, complete the following: _____________________________________________ Signature of Subscriber _____________________________________________ Name (please type or print) _____________________________________________ Signature of Spouse or Co-Owner if funds are to be invested as joint tenants by the entirety or community property. _____________________________________________ Name (please type or print)) Subscription Agreement
2. If the subscriber is a CORPORATION, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the corporation listed below (“Corporation”) to acquire the Units and, further, that the Corporation has all requisite authority to acquire such Units. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Corporation and that he has authority under the articles of incorporation, bylaws, and resolutions of the board of directors of such Corporation to execute this Subscription Agreement. Such officer encloses a true copy of the articles of incorporation, the bylaws and, as necessary, the resolutions of the board of directors authorizing a purchase of the investment herein, in each case as amended to date. Name of Corporation (please type or print) By: __/s/ Xxxx Xxxxxxx, Jr.___ By: __/s/ Xxxxxxx Higgins___ Name: Xxxx Xxxxxxx, Jr. Name: Xxxxxxx Xxxxxxx Title:: Co-Chief Executive Officer Title: Co-Chief Executive Officer
3. If the subscriber is a PARTNERSHIP, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned is a general partner of the partnership named below (“Partnership”), and has been duly authorized by the Partnership to acquire the Units and that he has all requisite authority to acquire such Units for the Partnership. The undersigned represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Partnership and he is authorized by such Partnership to execute this Subscription Agreement. Such partner encloses a true copy of the partnership agreement of said Partnership, as amended to date, together with a current and complete list of all partners thereof. _____________________________________________ Name of Partnership (please type or print) By: __________________________________________ Name: ___________________________________________ Title:: _____________________________________________ Subscription Agreement
4. If the subscriber is a TRUST, complete the following: The undersigned hereby represents, warrants and covenants that he is duly authorized by the terms of the trust instrument (“Trust Instrument”) for the (“Trust”) set forth below to acquire the Units and the undersigned, as trustee, has all requisite authority to acquire such Units for the Trust. The undersigned, as trustee, executing this Subscription Agreement on behalf of the Trust, represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Trust and he is authorized by such Trust to execute this Subscription Agreement. Such trustee encloses a true copy of the Trust Instrument of said Trust as amended to date. Name of Trust (Please type or print) By: Name: Title:
5. If the subscriber is a LIMITED LIABILITY COMPANY, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the Limited Liability Company listed below (“Company”) to acquire the Units and, further, that the Company has all requisite authority to acquire such Units. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Company and that he has authority under the articles of organization, company agreement, and resolutions of the managers and/or members, as applicable, of such Company to execute this Subscription Agreement. Such officer encloses a true copy of the articles of organization, the operating agreement and, as necessary, the resolutions of the managers and/or members authorizing a purchase of the investment herein, in each case as amended to date. Name of Trust (Please type or print) By: Name: Title: ACCEPTED BY THE COMPANY this the _____ day of _________, 2020. By: ________________________ Name: Title: GOLDEN MATRIX GROUP________________________________ ACCEPTED BY THE COMPANY this the 24th day of April, INC2014. By: /s/ Xxx Xxxx Xxx Xxxx, President Subscription Agreement JAMMIN JAVA CORP. (THE “COMPANY”) ALL INFORMATION CONTAINED IN THIS APPLICATION WILL BE TREATED CONFIDENTIALLY. The undersigned understands, however, that the Company may present this application to such parties as the Company, in its discretion, deems appropriate when called upon to establish that the proposed offer and sale of the Securities are exempt from registration of the Securities Act of 1933, as amended, or meet the requirements of applicable securities and blue sky laws.
. PART I - INDIVIDUALS (OTHERS COMPLETE PART II)
1. Name: ______________________________________________________________
2. Residence Address: ____________________________________________________:
3. Social Security Number:_________________________________________________
4. Present Employer:
5. I prefer to have communications sent to:
Appears in 1 contract
Amount of Subscription. The undersigned hereby subscribes to _____________ Units Shares for an aggregate amount of $___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ UnitsShares. 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 Shares should be registered in:_________________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of Securitiesshares:___________________________________________________ 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 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.
1. If the subscriber is an INDIVIDUAL, complete the following: _____________________________________________ Signature of Subscriber _____________________________________________ Name (please type or print) _____________________________________________ Signature of Spouse or Co-Owner if funds are to be invested as joint tenants by the entirety or community property. _____________________________________________ Name (please type or print)
2. If the subscriber is a CORPORATION, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the corporation listed below (“Corporation”) to acquire the Units Shares and, further, that the Corporation has all requisite authority to acquire such UnitsShares. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Corporation and that he has authority under the articles of incorporation, bylaws, and resolutions of the board of directors of such Corporation to execute this Subscription Agreement. Such officer encloses a true copy of the articles of incorporation, the bylaws and, as necessary, the resolutions of the board of directors authorizing a purchase of the investment herein, in each case as amended to date. ___________________________________________ Name of Corporation (please type or print) By: ________________________________________ Name: ______________________________________ Title:: _______________________________________
3. If the subscriber is a PARTNERSHIP, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned is a general partner of the partnership named below (“Partnership”), and has been duly authorized by the Partnership to acquire the Units Shares and that he has all requisite authority to acquire such Units Shares for the Partnership. The undersigned represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Partnership and he is authorized by such Partnership to execute this Subscription Agreement. Such partner encloses a true copy of the partnership agreement of said Partnership, as amended to date, together with a current and complete list of all partners thereof. _____________________________________________ Name of Partnership (please type or print) By: __________________________________________ Name: ________________________________________ Title:: _________________________________________
4. If the subscriber is a TRUST, complete the following: The undersigned hereby represents, warrants and covenants that he is duly authorized by the terms of the trust instrument (“Trust Instrument”) for the (“Trust”) set forth below to acquire the Units Shares and the undersigned, as trustee, has all requisite authority to acquire such Units Shares for the Trust. The undersigned, as trustee, executing this Subscription Agreement on behalf of the Trust, represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Trust and he is authorized by such Trust to execute this Subscription Agreement. Such trustee encloses a true copy of the Trust Instrument of said Trust as amended to date. __________________________________ Name of Trust (Please type or print) By: _______________________________ Name: _____________________________ Title:: ______________________________
5. If the subscriber is a LIMITED LIABILITY COMPANY, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the Limited Liability Company listed below (“Company”) to acquire the Units Shares and, further, that the Company has all requisite authority to acquire such UnitsShares. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Company and that he has authority under the articles of organization, company agreement, and resolutions of the managers and/or members, as applicable, of such Company to execute this Subscription Agreement. Such officer encloses a true copy of the articles of organization, the operating agreement and, as necessary, the resolutions of the managers and/or members authorizing a purchase of the investment herein, in each case as amended to date. ___________________________________________ Name of Trust Company (Please please type or print) By: ________________________________________ Name: ______________________________________ Title: _______________________________________ ACCEPTED BY THE COMPANY this the _____ day of _________, 20202016. PANTHER BIOTECHNOLOGY, INC. By: :______________________________ Name: :____________________________ Title: GOLDEN MATRIX GROUP:_____________________________ PLEASE ALSO COMPLETE THE QUESTIONNAIRE BEGINNING ON PAGE 18 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. Subscription Documents - Continued PANTHER BIOTECHNOLOGY, INC. (THE “COMPANY”) INVESTOR APPLICATION (QUALIFICATION QUESTIONNAIRE) (CONFIDENTIAL) ALL INFORMATION CONTAINED IN THIS APPLICATION WILL BE TREATED CONFIDENTIALLY. The undersigned understands, however, that the Company may present this application to such parties as the Company, in its discretion, deems appropriate when called upon to establish that the proposed offer and sale of the Securities are exempt from registration of the Securities Act of 1933, as amended, or meet the requirements of applicable securities and blue sky laws.
PART I - INDIVIDUALS (OTHERS COMPLETE PART II)
1. Name: ______________________________________________________________
2. Residence Address: __________________________________ Residence Telephone: _____________________________
3. Social Security Number:: ______________________________ Date of Birth: __________________________________ Citizenship: __________________________________
4. Present Employer:: __________________________________ Business Address: __________________________________ Business Telephone: __________________________________ Title/Position: __________________________________ Length of Time: __________________________________
5. I prefer to have communications sent to:: Home Address or _________Business Address
Appears in 1 contract
Samples: Common Stock Subscription Agreement
Amount of Subscription. The undersigned hereby subscribes to _____________ Units Shares for an aggregate amount of $___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ UnitsShares. 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:_______________________ 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 Securitiesshares:_____________________________________________________ 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) ☐ 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 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 execute this Subscription Agreement by completing the appropriate section below.
1. If the subscriber is an INDIVIDUAL, complete the following: _____________________________________________ Signature of Subscriber _____________________________________________ Name (please type or print) _____________________________________________ Signature of Spouse or Co-Owner if funds are to be invested as joint tenants by the entirety or community property. _____________________________________________ Name (please type or print)
2. If the subscriber is a CORPORATION, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the corporation listed below (“Corporation”) to acquire the Units Shares and, further, that the Corporation has all requisite authority to acquire such UnitsShares. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Corporation and that he has authority under the articles of incorporation, bylaws, and resolutions of the board of directors of such Corporation to execute this Subscription Agreement. Such officer encloses a true copy of the articles of incorporation, the bylaws and, as necessary, the resolutions of the board of directors authorizing a purchase of the investment herein, in each case as amended to date. _____________________________________________ Name of Corporation (please type or print) By: __________________________________________ Name: ______________________________________ Title:: ____________________________________
3. If the subscriber is a PARTNERSHIP, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned is a general partner of the partnership named below (“Partnership”), and has been duly authorized by the Partnership to acquire the Units Shares and that he has all requisite authority to acquire such Units Shares for the Partnership. The undersigned represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Partnership and he is authorized by such Partnership to execute this Subscription Agreement. Such partner encloses a true copy of the partnership agreement of said Partnership, as amended to date, together with a current and complete list of all partners thereof. _____________________________________________ Name of Partnership (please type or print) By: ________________________________________________ Name: ______________________________________________ Title:: _______________________________________________
4. If the subscriber is a TRUST, complete the following: The undersigned hereby represents, warrants and covenants that he is duly authorized by the terms of the trust instrument (“Trust Instrument”) for the (“Trust”) set forth below to acquire the Units Shares and the undersigned, as trustee, has all requisite authority to acquire such Units Shares for the Trust. The undersigned, as trustee, executing this Subscription Agreement on behalf of the Trust, represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Trust and he is authorized by such Trust to execute this Subscription Agreement. Such trustee encloses a true copy of the Trust Instrument of said Trust as amended to date. ____________________________________________ Name of Trust (Please type or print) By: Name: Title:
5. If the subscriber is a LIMITED LIABILITY COMPANY, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the Limited Liability Company listed below (“Company”) to acquire the Units Shares and, further, that the Company has all requisite authority to acquire such UnitsShares. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Company and that he has authority under the articles of organization, company agreement, and resolutions of the managers and/or members, as applicable, of such Company to execute this Subscription Agreement. Such officer encloses a true copy of the articles of organization, the operating agreement and, as necessary, the resolutions of the managers and/or members authorizing a purchase of the investment herein, in each case as amended to date. _____________________________________________ Name of Trust Company (Please please type or print) By: __________________________________________ Name: ______________________________________ Title: ____________________________________ ACCEPTED BY THE COMPANY this the _____ day of _________, 20202017. By: :____________________________ Name: :____________________________ Title: GOLDEN MATRIX GROUP, INC. :____________________________ PETROLIA ENERGY CORPORATION (THE “COMPANY”) ALL INFORMATION CONTAINED IN THIS APPLICATION WILL BE TREATED CONFIDENTIALLY. The undersigned understands, however, that the Company may present this application to such parties as the Company, in its discretion, deems appropriate when called upon to establish that the proposed offer and sale of the Securities are exempt from registration of the Securities Act of 1933, as amended, or meet the requirements of applicable securities and blue sky laws.
PART I - INDIVIDUALS (OTHERS COMPLETE PART II)
1. Name: ______________________________________________________________:
2. Residence Address: ____________________________________________________Residence Telephone:
3. Social Security Number:_________________________________________________
4. Present Employer:
5. I prefer to have communications sent to:
Appears in 1 contract
Samples: Preferred Stock Subscription Agreement (Petrolia Energy Corp)
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 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 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 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 execute this Subscription Agreement by completing the appropriate section below.
1. If the subscriber is an INDIVIDUAL, complete the following: Signature of Subscriber Name (please type or print) Signature of Spouse or Co-Owner if funds are to be invested as joint tenants by the entirety or community property. Name (please type or print)
2. If the subscriber is a CORPORATION, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the corporation listed below (“Corporation”) to acquire the Units and, further, that the Corporation has all requisite authority to acquire such Units. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Corporation and that he has authority under the articles of incorporation, bylaws, and resolutions of the board of directors of such Corporation to execute this Subscription Agreement. Such officer encloses a true copy of the articles of incorporation, the bylaws and, as necessary, the resolutions of the board of directors authorizing a purchase of the investment herein, in each case as amended to date. Name of Corporation (please type or print) Name: Title:
3. If the subscriber is a PARTNERSHIP, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned is a general partner of the partnership named below (“Partnership”), and has been duly authorized by the Partnership to acquire the Units and that he has all requisite authority to acquire such Units for the Partnership. The undersigned represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Partnership and he is authorized by such Partnership to execute this Subscription Agreement. Such partner encloses a true copy of the partnership agreement of said Partnership, as amended to date, together with a current and complete list of all partners thereof. Name of Partnership (please type or print) Name: Title:
4. If the subscriber is a TRUST, complete the following: The undersigned hereby represents, warrants and covenants that he is duly authorized by the terms of the trust instrument (“Trust Instrument”) for the (“Trust”) set forth below to acquire the Units and the undersigned, as trustee, has all requisite authority to acquire such Units for the Trust. The undersigned, as trustee, executing this Subscription Agreement on behalf of the Trust, represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Trust and he is authorized by such Trust to execute this Subscription Agreement. Such trustee encloses a true copy of the Trust Instrument of said Trust as amended to date. Name of Trust (Please type or print) By: Name: Title:
5. If the subscriber is a LIMITED LIABILITY COMPANY, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the Limited Liability Company listed below (“Company”) to acquire the Units and, further, that the Company has all requisite authority to acquire such Units. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Company and that he has authority under the articles of organization, company agreement, and resolutions of the managers and/or members, as applicable, of such Company to execute this Subscription Agreement. Such officer encloses a true copy of the articles of organization, the operating agreement and, as necessary, the resolutions of the managers and/or members authorizing a purchase of the investment herein, in each case as amended to date. Name of Trust (Please type or print) By: Name: Title: ACCEPTED BY THE COMPANY this the _____ day of _________, 2020. By: Name: Title: GOLDEN MATRIX GROUP, INC. (THE “COMPANY”) ALL INFORMATION CONTAINED IN THIS APPLICATION WILL BE TREATED CONFIDENTIALLY. The undersigned understands, however, that the Company may present this application to such parties as the Company, in its discretion, deems appropriate when called upon to establish that the proposed offer and sale of the Securities are exempt from registration of the Securities Act of 1933, as amended, or meet the requirements of applicable securities and blue sky laws.
PART I - INDIVIDUALS (OTHERS COMPLETE PART II)
1. Name: ______________________________________________________________
2. Residence Address: ____________________________________________________
3. Social Security Number:_________________________________________________
4. Present Employer:
5. I prefer to have communications sent to:
Appears in 1 contract
Amount of Subscription. The undersigned hereby subscribes to _____________ Units Shares for an aggregate amount of $___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ UnitsShares. 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 Shares should be registered in:___________________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of Securitiesshares:_____________________________________________________ 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 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 execute this Subscription Agreement by completing the appropriate section below.
1. If the subscriber is an INDIVIDUAL, complete the following: _____________________________________________ Signature of Subscriber _____________________________________________ Name (please type or print) _____________________________________________ Signature of Spouse or Co-Owner if funds are to be invested as joint tenants by the entirety or community property. _____________________________________________ Name (please type or print)
2. If the subscriber is a CORPORATION, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the corporation listed below (“Corporation”) to acquire the Units Shares and, further, that the Corporation has all requisite authority to acquire such UnitsShares. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Corporation and that he has authority under the articles of incorporation, bylaws, and resolutions of the board of directors of such Corporation to execute this Subscription Agreement. Such officer encloses a true copy of the articles of incorporation, the bylaws and, as necessary, the resolutions of the board of directors authorizing a purchase of the investment herein, in each case as amended to date. _____________________________________________ Name of Corporation (please type or print) By: __________________________________________ Name: ______________________________________ Title:: ____________________________________
3. If the subscriber is a PARTNERSHIP, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned is a general partner of the partnership named below (“Partnership”), and has been duly authorized by the Partnership to acquire the Units Shares and that he has all requisite authority to acquire such Units Shares for the Partnership. The undersigned represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Partnership and he is authorized by such Partnership to execute this Subscription Agreement. Such partner encloses a true copy of the partnership agreement of said Partnership, as amended to date, together with a current and complete list of all partners thereof. _____________________________________________ Name of Partnership (please type or print) By: ________________________________________________ Name: ______________________________________________ Title:: _______________________________________________
4. If the subscriber is a TRUST, complete the following: The undersigned hereby represents, warrants and covenants that he is duly authorized by the terms of the trust instrument (“Trust Instrument”) for the (“Trust”) set forth below to acquire the Units Shares and the undersigned, as trustee, has all requisite authority to acquire such Units Shares for the Trust. The undersigned, as trustee, executing this Subscription Agreement on behalf of the Trust, represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Trust and he is authorized by such Trust to execute this Subscription Agreement. Such trustee encloses a true copy of the Trust Instrument of said Trust as amended to date. ____________________________________________ Name of Trust (Please type or print) By: ________________________________________ Name: ______________________________________ Title:: _______________________________________
5. If the subscriber is a LIMITED LIABILITY COMPANY, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the Limited Liability Company listed below (“Company”) to acquire the Units Shares and, further, that the Company has all requisite authority to acquire such UnitsShares. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Company and that he has authority under the articles of organization, company agreement, and resolutions of the managers and/or members, as applicable, of such Company to execute this Subscription Agreement. Such officer encloses a true copy of the articles of organization, the operating agreement and, as necessary, the resolutions of the managers and/or members authorizing a purchase of the investment herein, in each case as amended to date. _____________________________________________ Name of Trust Company (Please please type or print) By: __________________________________________ Name: ______________________________________ Title: ______________________________________ ACCEPTED BY THE COMPANY this the _____ day of _________, 20202016. By: :____________________________ Name: :____________________________ Title: GOLDEN MATRIX GROUP:____________________________ PANTHER BIOTECHNOLOGY, INC. (THE “COMPANY”) ALL INFORMATION CONTAINED IN THIS APPLICATION WILL BE TREATED CONFIDENTIALLY. The undersigned understands, however, that the Company may present this application to such parties as the Company, in its discretion, deems appropriate when called upon to establish that the proposed offer and sale of the Securities are exempt from registration of the Securities Act of 1933, as amended, or meet the requirements of applicable securities and blue sky laws.
PART I - INDIVIDUALS (OTHERS COMPLETE PART II)
1. Name: ______________________________________________________________
2. Residence Address: ____________________________________________________
3. Social Security Number:_____________________
4. Present Employer: ________________________________________
4. Present Employer:
5. I prefer to have communications sent to:
Appears in 1 contract
Samples: Common Stock Subscription Agreement (Panther Biotechnology, Inc.)
Amount of Subscription. The undersigned hereby subscribes to _____________ Units Shares for an aggregate amount of $___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $__________ Subscribed for: _______________ UnitsShares. 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 Shares should be registered in:_________________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of Securitiesshares:___________________________________________________ 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 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 execute this Subscription Agreement by completing the appropriate section below.
1. If the subscriber is an INDIVIDUAL, complete the following: _____________________________________________ Signature of Subscriber _____________________________________________ Name (please type or print) _____________________________________________ Signature of Spouse or Co-Owner if funds are to be invested as joint tenants by the entirety or community property. _____________________________________________ Name (please type or print)
2. If the subscriber is a CORPORATION, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the corporation listed below (“Corporation”) to acquire the Units Shares and, further, that the Corporation has all requisite authority to acquire such UnitsShares. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Corporation and that he has authority under the articles of incorporation, bylaws, and resolutions of the board of directors of such Corporation to execute this Subscription Agreement. Such officer encloses a true copy of the articles of incorporation, the bylaws and, as necessary, the resolutions of the board of directors authorizing a purchase of the investment herein, in each case as amended to date. ___________________________________________ Name of Corporation (please type or print) By: ________________________________________ Name: ______________________________________ Title:: _______________________________________
3. If the subscriber is a PARTNERSHIP, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned is a general partner of the partnership named below (“Partnership”), and has been duly authorized by the Partnership to acquire the Units Shares and that he has all requisite authority to acquire such Units Shares for the Partnership. The undersigned represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Partnership and he is authorized by such Partnership to execute this Subscription Agreement. Such partner encloses a true copy of the partnership agreement of said Partnership, as amended to date, together with a current and complete list of all partners thereof. _____________________________________________ Name of Partnership (please type or print) By: __________________________________________ Name: ________________________________________ Title:: _________________________________________
4. If the subscriber is a TRUST, complete the following: The undersigned hereby represents, warrants and covenants that he is duly authorized by the terms of the trust instrument (“Trust Instrument”) for the (“Trust”) set forth below to acquire the Units Shares and the undersigned, as trustee, has all requisite authority to acquire such Units Shares for the Trust. The undersigned, as trustee, executing this Subscription Agreement on behalf of the Trust, represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Trust and he is authorized by such Trust to execute this Subscription Agreement. Such trustee encloses a true copy of the Trust Instrument of said Trust as amended to date. __________________________________ Name of Trust (Please type or print) By: _______________________________ Name: _____________________________ Title:: ______________________________
5. If the subscriber is a LIMITED LIABILITY COMPANY, complete the following: The undersigned hereby represents, warrants and covenants that the undersigned has been duly authorized by all requisite action on the part of the Limited Liability Company listed below (“Company”) to acquire the Units Shares and, further, that the Company has all requisite authority to acquire such UnitsShares. The officer signing below represents and warrants that each of the above representations or agreements or understandings set forth herein applies to that Company and that he has authority under the articles of organization, company agreement, and resolutions of the managers and/or members, as applicable, of such Company to execute this Subscription Agreement. Such officer encloses a true copy of the articles of organization, the operating agreement and, as necessary, the resolutions of the managers and/or members authorizing a purchase of the investment herein, in each case as amended to date. ___________________________________________ Name of Trust Company (Please please type or print) By: ________________________________________ Name: ______________________________________ Title: _______________________________________ ACCEPTED BY THE COMPANY this the _____ day of _________, 20202016. By: :______________________________ Name: :____________________________ Title: GOLDEN MATRIX GROUP:_____________________________ PANTHER BIOTECHNOLOGY, INC. (THE “COMPANY”) ALL INFORMATION CONTAINED IN THIS APPLICATION WILL BE TREATED CONFIDENTIALLY. The undersigned understands, however, that the Company may present this application to such parties as the Company, in its discretion, deems appropriate when called upon to establish that the proposed offer and sale of the Securities are exempt from registration of the Securities Act of 1933, as amended, or meet the requirements of applicable securities and blue sky laws.
PART I - INDIVIDUALS (OTHERS COMPLETE PART II)
1. Name: ______________________________________________________________
2. Residence Address: __________________________________
3. Social Security Number: ______________________________
34. Social Security Number:_______________Present Employer: __________________________________
4. Present Employer:
5. I prefer to have communications sent to:
Appears in 1 contract
Samples: Common Stock Subscription Agreement (Panther Biotechnology, Inc.)