FOR TRUSTS. Initial a. The undersigned financial institution certifies that it is (i) a bank, savings and loan association, or other regulated financial institution; (ii) acting in its fiduciary capacity as trustee; and (iii) subscribing for the purchase of the Note on behalf of the subscribing trust. and/or Initial b. The undersigned certifies that the subscribing trust has total assets in excess of $5,000,000, and that the person making the investment decision on behalf of the trust has such knowledge and experience in financial and business matters that he is capable of evaluating the merits and risks of an investment in the Note. and/or Initial c. The undersigned certifies that it is a revocable trust that may be amended or revoked at any time by the grantors thereof, and all of the grantors are accredited investors under either 1(a) above, 1(b) above (i.e., $1,000,000 net worth), or l(c) or l(d) above (i.e., $200,000 individual or $300,000 joint income). Please list below the names of all grantors. ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( )
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Samples: Convertible Promissory Note Subscription Agreement (Wilson Brothers Usa Inc), Promissory Note Subscription Agreement (Wilson Brothers Usa Inc)
FOR TRUSTS. Initial a. ____
(a) The undersigned financial institution certifies that it is (i) a bankbank as defined in Section 3(a)(2) of the Act, or any savings and loan association, or other regulated financial institutioninstitution as defined in Section 3(a)(5) of the Act; (ii) acting in its fiduciary capacity as trustee; and (iii) subscribing for the purchase of the Note Preferred Shares on behalf of the subscribing trust. and/or
or Initial b. ____ (b) The undersigned certifies that the subscribing trust has total assets in excess of $5,000,000, and that the person making the investment decision on behalf of the trust has such knowledge and experience in financial and business matters that he or she is capable of evaluating the merits and risks of an investment in the NoteSecurities. and/or or Initial c. ____ (c) The undersigned certifies that it is a revocable trust that may be amended or revoked at any time by the grantors thereof, and all of the grantors are accredited investors under either 1(aas described in 2(b) above, 1(b) above (i.e., $1,000,000 net worth), or l(c) or l(d) above (i.e., $200,000 individual or $300,000 joint income). Please list below the names of all grantors. ____________________ ________ ( grantors and the manner in which they qualify (check the applicable category below): $200,000 (individual) ( $1,000,000 or $300,000 (joint) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( )Names of All Grantors Net Worth Minimum Income --------------------- --------- --------------
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Samples: Securities Purchase Agreement (Genzyme Transgenics Corp)
FOR TRUSTS. Initial a. The undersigned financial institution certifies that it is (i) a bank, savings and loan association, or other regulated financial institution; (ii) acting in its fiduciary capacity as trustee; and (iii) subscribing for the purchase of the Note on behalf of the subscribing trust. and/or
Initial b. The undersigned certifies that the subscribing trust has total assets in excess of $5,000,000, and that the person making the investment decision on behalf of the trust has such knowledge and experience in financial and business matters that he is capable of evaluating the merits and risks of an investment in the Note. and/or Initial c. The undersigned certifies that it is a revocable trust that may be amended or revoked at any time by the grantors thereof, and all of the grantors are accredited investors under either 1(a) above, 1(b) above (i.e., $1,000,000 net worth), or l(c) or l(d) above (i.e., $200,000 individual or $300,000 joint income). Please list below the names of all grantors. Director, Executive Officer Check the Applicable Column Names of All Equity Owners $1,000,000 Net Worth $200,000 (individual) or $300,000 (joint) Minimum Income ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( ) ____________________ ________ ( ) ( )
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