NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 8 contracts
Samples: Subscription Agreement (Hana Biosciences Inc), Subscription Agreement (Manhattan Pharmaceuticals Inc), Subscription Agreement (Ziopharm Oncology Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 6 contracts
Samples: Subscription Agreement (Healthcare Providers Direct Inc.), Subscription Agreement (BioSolar Inc), Subscription Agreement (Platinum Studios, Inc.)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 3 contracts
Samples: Subscription Agreement (Ziopharm Oncology Inc), Subscription Agreement (TheRetirementSolution.com, Inc.), Subscription Agreement (TheRetirementSolution.com, Inc.)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) Rule 3050 of the Rules of Fair PracticeNASD Conduct Rules. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 3 contracts
Samples: Subscription Agreement (GoFish Corp.), Subscription Agreement (Red Carpet Entertainment Inc), Subscription Agreement (China Broadband Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ --------------------------------- Name of NASD Member Firm By: ______________________________ ------------------------------ Authorized Officer Date: ____________________________----------------------------
Appears in 2 contracts
Samples: Subscription Agreement (Aronex Pharmaceuticals Inc), Subscription Agreement (National Investment Managers Inc.)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ --------------------------------------------------------- --------------------------------------------------------- --------------------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. __________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 2 contracts
Samples: Subscription Agreement (Sparta Commercial Services, Inc.), Subscription Agreement (Epixtar Corp)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes __Yes_______ No ___No_______ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: _____________________________ Authorized Officer
Appears in 2 contracts
Samples: Note and Warrant Purchase Agreement (Innovive Pharmaceuticals, Inc.), Note and Warrant Purchase Agreement (Innovive Pharmaceuticals, Inc.)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ o No o If Yes, please describe: __________ If Yes, please describe: ____________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 2 contracts
Samples: Subscription Agreement (Originoil Inc), Subscription Agreement (Diet Coffee Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes )? YES _____________ No NO _______________ If Yes, please describe: :** ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ **If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: - Signature _________________________________ Authorized Officer - Printed Name Date: _____________________, 2002
Appears in 1 contract
Samples: Subscription Agreement (Inkine Pharmaceutical Co Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ ------------------------------------ ------------------------------------ ------------------------------------ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ --------------------------------- Name of NASD Member Firm By: ______________________________ ------------------------------ Authorized Officer Date: ____________________________----------------------------
Appears in 1 contract
Samples: Subscription Agreement (Conversion Technologies International Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ --------------------------------------------------------- --------------------------------------------------------- --------------------------------------------------------- *If Subscriber Holder is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ --------------------------------- Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
Samples: Exchange Agreement and Letter of Transmittal (Hybridon Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): )? Yes _________ No __________ If Yes, please describe: :** ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ **If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. ________________________________________________________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
Samples: Subscription Agreement (Discovery Laboratories Inc /De/)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ )? YES NO --------- ---------- If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ :** -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- **If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ --------------------------------------------- Name of NASD Member Firm By: ______________________________ ------------------------------------------ Authorized Officer - Signature -------------------------------------------- Authorized Officer - Printed Name Date: ____________________________, 2000 -----------------------------
Appears in 1 contract
Samples: Subscription Agreement (Inkine Pharmaceutical Co Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes ____YES _____ No _____NO _____ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ ----------------------------------------------------------------------- ----------------------------------------------------------------------- ----------------------------------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ ------------------------------------ Name of NASD Member Firm By: ______________________________ --------------------------------- Authorized Officer Date: ____________________________--------------------------------
Appears in 1 contract
Samples: Subscription Agreement (Innovative Drug Delivery Systems Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ |_| No |_| If Yes, please describe: __________ If Yes, please describe: _______________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. __________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
Samples: Subscription Agreement (National Investment Managers Inc.)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm firm? (please check one): Yes _________ No __________ --- -- If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ ------------------------------- Name of NASD Member Firm By: ______________________________ By:---------------------------- Authorized Officer Date: ____________________________Date:--------------------------
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *-------------------------------------------------------------------------------- If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ ---------------------------------- Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
Samples: Subscription Agreement (National Scientific Corp/Az)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes )? YES _________ No NO __________ If Yes, please describe: :** _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ **If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _____________________________________ Name of NASD Member Firm By: _________________________________ Authorized Officer - Signature _________________________________ Authorized Officer - Printed Name Date: _____________________________ , 2000
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes )? YES _________ No NO __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ :** ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ** If Subscriber Purchaser is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ ---------------------------------- Name of NASD Member Firm By: ______________________________ ---------------------------------- Authorized Officer - Signature ---------------------------------- Authorized Officer - Printed Name Date: _____________________________ , 2004
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *-------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- * If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ --------------------------------- Name of NASD Member Firm By: ______________________________ ------------------------------ Authorized Officer Date: ____________________________----------------------------
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No If Yes, please describe: __________ If Yes, please describe: ________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. __________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
Samples: Subscription Agreement (American Technologies Group Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No If Yes, please describe: __________ If Yes, please describe: _______________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ** If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________:
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ YES NO ----- ----- If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ ---------------------------------------------- ---------------------------------------------- ---------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ --------------------------------- Name of NASD Member Firm By: ______________________________ ------------------------------ Authorized Officer Date: ____________________________----------------------------
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *------------------------------------------------------------------------------ ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ * If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) Rule 3050 of the Rules of Fair PracticeNASD Conduct Rules. __________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber Investor is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. ___________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
Samples: Securities Purchase Agreement (Nanopierce Technologies Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ YES NO ----------- ----------- If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber the Purchaser is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
Samples: Unit Purchase Agreement (Zim Corp)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes YES _____ü____ No _NO _________ If Yes, please describe: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ *If Subscriber subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair PracticeNASD Conduct Rules. ______________________________________________________________________ Name of NASD Member Firm By: :____________________________________________________________________ _______________________________________________________________________ Authorized Officer Date: :___________________________________________________________________
Appears in 1 contract
Samples: Subscription Agreement (Cardima Inc)
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ *If Subscriber Purchaser is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. __________________________________ Name of NASD Member Firm By: ______________________________ Authorized Officer Date: ____________________________
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes ____________ No ____________ If Yes, please describe: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ *If Subscriber Purchaser is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ ---------------------------------------- Name of NASD Member Firm By: ______________________________ ------------------------------------ Authorized Officer Date: ____________________________----------------------------------
Appears in 1 contract
NASD AFFILIATION. Are you affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned NASD member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of Fair Practice. _________________________________ ---------------------------------- Name of NASD Member Firm By: ______________________________ ------------------------------ Authorized Officer Date: ____________________________Date:-----------------------------
Appears in 1 contract
Samples: Subscription Agreement (National Investment Managers Inc.)
NASD AFFILIATION. Are you Is the Subscriber affiliated or associated with an NASD member firm (please check one): Yes _________ No __________ YES |_| NO |_| If Yes, please describe: _________________________________________________________ _________________________________________________________ _________________________________________________________ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- *If Subscriber is a Registered Representative with an NASD member firm, have the following acknowledgment signed by the appropriate party: The undersigned Subscriber NASD member firm acknowledges receipt of the notice required by Article 3, Sections Articles 28(a) and (b) of the Rules of Fair Practice. _________________________________ ----------------------------------- Name of NASD Member Firm By: ______________________________ -------------------------------- Authorized Officer Date: ____________________________------------------------------
Appears in 1 contract
Samples: Subscription Agreement (Nephros Inc)