Number of Units subscribed for Sample Clauses

Number of Units subscribed for. One (1) Units against payment in cash in the amount of $ 25,000 , representing $25,000 per Unit, each representing 0.625% of Gross Margin. If the Units hereby subscribed for are to be owned by more than one person in any manner, the Purchaser understands and agrees that all of the co-owners of such Units must sign this Subscription Agreement.
Number of Units subscribed for. Payment tendered (number of units subscribed for multiplied by $.50): ______________
Number of Units subscribed for. Aggregate purchase price for number of Units subscribed for at $100,000 per Unit $ ------------------------ ------------------------------------- ------------------------------------- Signature of Subscriber Taxpayer Identification or Social (and title, if applicable) Security Number ------------------------------------- ------------------------------------- Signature of Joint Purchaser Taxpayer Identification or Social (if any) Security Number ------------------------------------- ------------------------------------- Name and Residence Address Mailing Address (Post Office Address Not Acceptable) (if different from Residence Address) ------------------------------------- ------------------------------------- Name (please print as name will appear Name (please print) on certificate) ------------------------------------- ------------------------------------- Number and Street Number and Street ------------------------------------- ------------------------------------- City State Zip Code City State Zip Code ACCEPTED BY: ENCHIRA BIOTECHNOLOGY CORPORATION Dated: By: --------------------------- -------------------------- President and CEO PURCHASER QUESTIONNAIRE Enchira Biotechnology Corporation 0000 Xxxxxxxx Xxxxxx Xxxxx Xxx Xxxxxxxxx, Xxxxx 00000 Attention: President Re: Purchase of Units Ladies & Gentlemen: The information contained herein is being furnished to Enchira Biotechnology Corporation, a Delaware corporation, (the "Company") in connection with the purchase of Units by the undersigned to assure the Company that the undersigned will meet the suitability standards for potential investors for purposes of federal and state securities laws, and to assure that the offer and sale of such securities by the Company may be made to the undersigned without registration under the Securities Act of 1933, as amended (the "Act"), and applicable state securities laws. The undersigned represents to the Company that (i) the information and representations contained herein are complete and accurate and may be relied upon by the Company and (ii) the undersigned will notify the Company immediately of any material change in any of such information occurring prior to the closing of the purchase of the Securities by the undersigned. All information furnished is for the sole use of the Company and their counsel and will be held in confidence, except that this Questionnaire may be furnished to such parties as is necessary to establish compliance with federal or state securit...
Number of Units subscribed for. $ __________________________ (at $1.20 per Unit)
Number of Units subscribed for. 2,000,000 ------------------------------------------------ Total Dollar Amount: $500,000 ------------------------------------------------ Signature of Subscriber: /s/ Andrew C. Burton ------------------------------------------------ Andrew C. Burton Managing Membxx Xxxx xx Xxxxcriber: Arclight Capital, LLC ------------------------------------------------ Address of Subscriber: 2062 Troon Dr., Henderson, NV 00000 ------------------------------------------------ Subscriber's SS# or Tax Identification #: ###-##-#### ---------------------------------------------- Email contact address: aburton@sfgnyc.com ---------------------------------------------- Primary Contact Number: (702) 372 - 3604 Fax Number: ( ) - --- --- ---- --- --- ----- ACCEPTED BY: IVANY MINING, INC. Signature xx Xxthorized Signatory: /s/ Derek Ivany ------------------------------------ Name of Authorized Signatory: Derek Ivany ------------------------------------ Position of Authorized Signatory: CEO ------------------------------------ Date of Acceptance: December 1, 2007 ------------------------------------ ACCREDITED INVESTOR DEFINITION The Subscriber will be an "Accredited Investor" as such term is defined in Rule 501 of Regulation D promulgated under the United States Securities Act of 1933, as amended (the "Act") if the Subscriber is any of the following:
Number of Units subscribed for units Purchase Price for Units ($1,000 per Unit (maximum 12,500 units)) US$ If the Subscriber is signing as agent for a disclosed principal (the “Disclosed Principal”), complete the following: INTERNATIONAL CUMO MINING CORPORATION
Number of Units subscribed for. (All Subscribers should please print information below exactly as they wish it to appear in the records of the Company.)
Number of Units subscribed for. Purchase Price: (at $______ per unit) Form of joint ownership of Units (if applicable): o JTTEN o JTWROS o JTTIC IN WITNESS WHEREOF, the undersigned has executed this Subscription Agreement on the date set forth below. By: Federal Tax ID Number Name: Title: State of Organization Address: Telephone: Fax: Email: Date: Number of Units Subscribed For: Purchase Price: (at $______ per unit) Exact Name in Which Securities are to be Registered:
Number of Units subscribed for. Number of Units Oversubscribed for: ___________________
Number of Units subscribed for. Purchase Price ($4.00 times the number of Units): $ Signature (Subscriber) Date Signature (Subscriber) Date Please print title or capacity Please print title or capacity (if other than as individual unitholder) (if other than as individual unitholder) Xxxxxx Xxxxxxx Xxxxxx Xxxxxxx Xxxx, Xxxxx, Zip Code City, State, Zip Code Telephone Telephone