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 $0.01): _______________ (the “Aggregate Purchase Price”).
Number of Units subscribed for. Purchase Price Per Unit (each Unit consists of 82,866 shares of Common Stock of Lightwave Logic, Inc. and a Warrant to purchase 82,866 shares of Common Stock at $0.80 per share): $50,000 (Minimum purchase is for one (1) Unit unless waived by the Company) Aggregate Purchase Price: $__________________________________________ SUBSCRIPTION PROCEDURES Complete and sign the enclosed Subscription Documents in accordance with the instructions below and return them to: Lightwave Logic, Inc., 0000 Xxxxxxxx Xxxxxx, Xxxxx X, Xxxxxxxx, Xxxxxxxx, XXX, with your payment by either (a) a check or money order payable in United States currency to: “Lightwave Logic, Inc.” in the applicable subscription amount or (b) a wire transfer of immediately available funds to the bank account specified and in accordance with the domestic wire instructions set forth below: Bank Name: Xxxxx Fargo Bank Location: 0000 Xxxxxxx Xxxx Xxxxxxxxxx, Xxxxxxxx, 00000 XXX Phone: 000-000-0000 Fax: 000-000-0000 Routing Number: 000000000 Account Number: 2000012127160 Name on Account: Lightwave Logic, Inc. * The Company reserves the right to increase the amount of the Offering up to $5,000,000 in Units at its sole discretion. IF YOU WISH TO SUBSCRIBE, PLEASE CAREFULLY FOLLOW THE INSTRUCTIONS BELOW. SUBSCRIPTION DOCUMENTS THAT ARE MISSING REQUESTED INFORMATION OR SIGNATURES CANNOT BE CONSIDERED UNTIL SUCH INFORMATION AND SIGNATURES ARE PROVIDED. ALL SUCH INFORMATION WILL BE TREATED CONFIDENTIALLY. SUBSCRIPTION DOCUMENTS One purpose of the Subscription Documents is to provide the Company with sufficient information in connection with its intended reliance upon certain exemptions from the registration and qualification requirements of federal and state securities laws and to determine whether you meet the minimum legal requirements under such laws to purchase securities in this offering. The Company will be relying on the representations and warranties made in the Subscription Documents and on the information supplied.
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. $ __________________________(at $1.20 per Unit)
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. Total Purchase Price for Units: ---------------------
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. Purchase Price per Unit: $50,000 (Minimum purchase is one Unit unless waived by the Company) Aggregate Purchase Price: $ Taxpayer I.D. Number Signature of Subscriber As (check one) Individual _____Tenants in Common____ Capacity in which signed: Existing Partnership ____Joint Tenants _____ Corporation ____Trust ____ Subscriber’s mailing address Minor with Adult Custodian under UGMA _____ (if different than business address) Subscriber’s name and business address (please type or print) Taxpayer I.D. Number of Co-Subscriber Signature of Co-Subscriber Co-Subscriber’s name and business Co-Subscriber’s mailing address address (please type or print) (if different than business address)
Number of Units subscribed for. Units BOX B:
