Common use of Number of Shares Subscribed For Clause in Contracts

Number of Shares Subscribed For. Signature of Subscriber: ----------------------------------- Name of Subscriber: ----------------------------------- Address of Subscriber: ----------------------------------- Subscribers Social Security No. ----------------------------------- ACCEPTED BY: CONCRETE CASTING INCORPORATED Signature of Authorized Signatory: ------------------------------------ Name of Authorized Signatory: ------------------------------------- Position of Authorized Signatory: -------------------------------------

Number of Shares Subscribed For. Signature of Subscriber: ----------------------------------- ---------------------------------- Name of Subscriber: ----------------------------------- ------------------------------ Address of Subscriber: ----------------------------------- Subscribers ---------------------------------- Subscriber's Social Security No. ----------------------------------- -------------------------------- ACCEPTED BY: CONCRETE CASTING INCORPORATED RESOLUTION ASSISTANCE CORPORATION Signature of Authorized Signatory: ------------------------------------ --------------------------------- Name of Authorized Signatory: ------------------------------------- --------------------------------- Position of Authorized Signatory: --------------------------------------------------------------------- Date of Acceptance: ------------------------------------