EXECUTION BY SUBSCRIBER WHICH IS AN ENTITY Sample Clauses

EXECUTION BY SUBSCRIBER WHICH IS AN ENTITY. (Corporation, Partnership, Trust, Etc.) _______________________________________________________________________________ Name of Entity (Please Print) Date of Incorporation or Organization: State of Principal Office: Federal Taxpayer Identification Number: _________________________________________________ ______________________ Office Address ______________________ City, State and Zip Code ______________________ Telephone Number ______________________ Fax Number (if available) ______________________ E-Mail (if available) By: ______________________________ Name: Attest: ___________________________ Title: (If Entity is a Corporation) The undersigned FINRA member firm acknowledges receipt of the notice required by Rule 3050 of the FINRA Conduct Rules _________________________________ ACCEPTED this ______day of _______ 2008, on behalf of IX Energy Holdings, Inc. Name of FINRA Firm By: ______________________________ By: ______________________________ Name: Title: Name: Title:

EXECUTION BY SUBSCRIBER WHICH IS AN ENTITY. (Corporation, Partnership, Trust, Etc.) Name of Entity (Please Print) Date of Incorporation or Organization: _________________ State of Principal Office:____________________________ Federal Taxpayer Identification Number:________________ Office Address City, State and Zip Code Telephone Number Fax Number (if available) E-Mail (if available) [seal] By: Attest: Name: (If Entity is a Corporation) Title: The undersigned FINRA member firm acknowledges receipt of the notice required by Rule 3050 of the FINRA Conduct Rules Name of FINRA Firm (if applicable) By: By: Name: Name: Title: Title: ¨ You are (i) a bank, as defined in Section 3(a)(2) of the Securities Act of 1933, as amended (the “Securities Act”), (ii) a savings and loan association or other institution, as defined in Section 3(a)(5)(A) of the Securities Act, whether acting in an individual or fiduciary capacity, (iii) a broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), (iv) an insurance company as defined in Section 2(13) of the Securities Act, (v) an investment company registered under the Investment Company Act of 1940, as amended (the “Investment Company Act”), (vi) a business development company as defined in Section 2(a)(48) of the Investment Company Act, (vii) a Small Business Investment Company licensed by the U.S. Small Business Administration under Section 301 (c) or (d) of the Small Business Investment Act of 1958, as amended, (viii) a plan established and maintained by a state, its political subdivisions, or an agency or instrumentality of a state or its political subdivisions, for the benefit of its employees and you have total assets in excess of $5,000,000, or (ix) an employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”) and (1) the decision that you shall subscribe for and purchase Interests (the “Interests”) of Mission First Capital LLC is made by a plan fiduciary, as defined in Section 3(21) of ERISA, which is either a bank, savings and loan association, insurance company, or registered investment adviser, (2) you have total assets in excess of $5,000,000 and the decision that you shall subscribe for and purchase the Interests is made solely by persons or entities that are accredited investors, as defined in Rule 501 of Regulation D promulgated under the Securities Act (“Regulation D”) or (3) you are a self-directed plan and the decision that you shal...

EXECUTION BY SUBSCRIBER WHICH IS AN ENTITY. (Corporation, Partnership, LLC, Trust, Etc.) x $0.50 Per Unit Units subscribed for Purchase Price Aggregate Purchase Price Name of Entity (Please Print) (If Entity is a Corporation)