PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. TO: Wolverine Resources Corp. (the "Issuer"), of #00 00000 Xxxxxxxx Xxxx, Richmond, BC V7A 1X8. Subject and pursuant to the terms set out in the Terms on pages 3 to 4 of this Subscription Agreement, the General Provisions on pages 7 to 12 of this Subscription Agreement and the other schedules and appendices attached which are hereby incorporated by reference, the Purchaser hereby irrevocably subscribes for, and on Closing will purchase from the Issuer, the following securities at the following price: _____________________Shares US$0.02 per Share for a total purchase price of US$___________________ The Purchaser owns, directly or indirectly, the following securities of the Issuer: [Check if applicable] The Purchaser is ☐ an affiliate of the Issuer or ☐ a member of the professional group The Purchaser directs the Issuer to issue, register and deliver the certificates representing the Shares as follows: Name to appear on certificate Name and account reference, if applicable Account reference if applicable Contact name Address Address Telephone Number EXECUTED by the Purchaser this _____ day of ____________________, 2023. By executing this Subscription Agreement, the Purchaser certifies that the Purchaser and any beneficial purchaser for whom the Purchaser is acting is resident in the jurisdiction shown as the "Address of Purchaser".
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. The undersigned (the “Subscriber”) hereby irrevocably subscribes for and agrees to purchase from Sustinere Holdings, Inc. (the “Issuer”) that number of common shares of the Issuer (each, a “Share”) as is set out below at a price of USD $____ per Share. The Subscriber agrees to be bound by the terms and conditions set forth in the attached “Terms and Conditions of Subscription for Shares”. ____________ Shares of the Issuer US$_____ per Share for a total purchase price of U.S.$ The Subscriber or the Beneficial Purchaser owns, directly or indirectly, the following securities of the Issuer: _____________ Shares ____________________ Warrants [Check if applicable] The Subscriber or the Beneficial Purchaser is [ ] an insider of the Issuer. The Subscriber directs the Issuer to issue, register and deliver the certificates representing the Shares as follows: Name to appear on certificate Name and account reference, if applicable Account reference if applicable Contact name Address Address Telephone Number EXECUTED by the Subscriber this ____ day of ___________, 2018. By executing this Subscription Agreement, the Subscriber certifies that the Subscriber and any beneficial purchaser for whom the Subscriber is acting are resident in the jurisdiction shown as the “Address of Subscriber” or “Address of Beneficial Purchaser”, respectively. EXECUTION BY SUBSCRIBER: DETAILS OF BENEFICIAL PURCHASER X (IF NOT THE SAME AS SUBSCRIBER) Signature of individual (if Subscriber is an individual) X Authorized signatory (if Subscriber is not an individual) Name of Beneficial Purchaser (please print) Name of Subscriber (please print) Address of Beneficial Purchaser (residence) Name of authorized signatory (please print) Telephone Number of Beneficial Purchaser Address of Subscriber E-mail address of Beneficial Purchaser Telephone Number of Subscriber Accepted this ___ day of ____________, 2018 SUSTINERE HOLDINGS, INC. E-mail address of Subscriber Per: Social Security/Tax I.D. No. of Subscriber Authorized Signatory By signing this acceptance, the Issuer agrees to be bound by the Terms on pages 3 to 4, the General Provisions on pages 6 to 13, and the other schedules and appendices incorporated by reference.
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. The undersigned (the “Subscriber”) hereby irrevocably subscribes for and agrees to purchase from Epic Stores Corp. (the “Issuer”) that number of shares of common stock of the Issuer (each, a “Share”) set out below at a price of US$0.30 per Share. The Subscriber agrees to be bound by the terms and conditions set forth in the attached “Terms and Conditions of Subscription for Share”. Subscriber Information Xxxxxx Xxxx Shares to be Purchased 500,000 (Name of Subscriber) (Number of Shares) __________________________ Account Reference (if applicable): X”Xxxxxx Xxxx” (Signature of Subscriber – if the Subscriber is an Individual) Total Subscription Price: $150,000 (the “Subscription Amount”, plus wire fees if applicable) X __________________________ (Signature of Authorized Signatory – if the Subscriber is not an Individual) __________________________ (Name and Title of Authorized Signatory – if the Subscriber is not an Individual) __________________________ (SIN, SSN, or other Tax Identification Number of the Subscriber) __________________________ (Subscriber’s Address, including postal or zip code) __________________________ (Telephone Number) (Email Address) Register the Shares as set forth below: __________________________ (Name to Appear on Certificates Representing Shares) __________________________ (Account Reference, if applicable) __________________________ (Address, including postal or zip code) Deliver the Shares as set forth below: __________________________ (Attention - Name) __________________________ (Account Reference, if applicable) __________________________ (Street Address, including postal or zip code – no PO Boxes permitted) __________________________ (Telephone Number)
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. TO: Mantra Venture Group Ltd. (the “Company”) #560 – 800 00000 00xx Xxxxxx, Xxxxxx, Xxxxxxx Xxxxxxxx, Xxxxxx X0X 0X0 Subject and pursuant to the attached “Terms and Conditions” of this Subscription Agreement, including all schedules and appendices attached hereto, the Subscriber hereby irrevocably subscribes for, and on the Closing Date, will purchase from the Company, the following securities at the following price: __________________Units US$0.17 per Unit for a total purchase price of ________________________________ The Subscriber owns, directly or indirectly, the following securities of the Company: ________________________________________________________________________________ [Check if applicable] The Subscriber is an [ ] affiliate of the Company The Subscriber directs the Company to issue, register and deliver the certificates representing the Shares and Warrants as follows: Name to appear on certificate Name and account reference, if applicable Account reference if applicable Contact name Address Address Telephone Number EXECUTED by the Subscriber this ______day of _________, 201__.
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. TO: PARK PLACE ENERGY CORP. (the “Issuer”) Subject and pursuant to the Terms (as defined below), the General Provisions (as defined below) and the other attached schedules and appendices, all of which are hereby incorporated herein by reference, the Purchaser hereby irrevocably subscribes for, and on the Closing Date (as defined below) will purchase from the Issuer, the following securities at the following price: _____________________ Shares U.S.$0.25 per Share for a total purchase price of U.S.$ ________ The Purchaser owns, directly or indirectly, the following securities of the Issuer: [Check if applicable] The Purchaser is [ ] an affiliate of the Issuer or [ ] a professional advisor of the Issuer. The Purchaser directs the Issuer to issue, register and deliver the certificates representing the Shares as follows: Name to appear on certificate Name and account reference, if applicable Account reference if applicable Contact name Address Address Telephone Number EXECUTED by the Purchaser on this _______ day of _______________ , 2014. By executing this Subscription Agreement, the Purchaser certifies that the Purchaser is a resident in the jurisdiction shown as the “Address of Purchaser”.
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. TO: American Lithium Minerals, Inc. (the “Issuer” or the “Company”) Subject and pursuant to the terms set out in this Subscription Agreement and the other schedules and appendices attached which are hereby incorporated by reference, the Purchaser hereby irrevocably subscribes for, and on Closing will purchase from the Issuer, the following securities at the following price: Debenture in the principal amount of USD$500,000, for a total purchase price of USD$500,000. The Purchaser owns, directly or indirectly, the following securities of the Issuer: [Check if applicable] The Purchaser is an [ ] affiliate of the Issuer. The Purchaser directs the Issuer to issue, register and deliver the certificates representing the Purchased Securities as follows: REGISTRATION INSTRUCTIONS DELIVERY INSTRUCTIONS Look Back Investments, Inc. Name to appear on certificate Name and account reference, if applicable Calle Xxxxxxx X. Xxxxxxx, Suite 1-A, #5 Contact name El Cangrejo, Panama City, Panama Address Address Telephone Number EXECUTED by the Purchaser this _______ day of _____________, 2011. By executing this Subscription Agreement, the Purchaser certifies that the Purchaser and any beneficial purchaser for whom the Purchaser is acting is resident in the jurisdiction shown as the “Address of Purchaser”.
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. TO: Arkanova Energy Corporation (the “Issuer”), of 000 Xxxx Xxxxx Xxxx, Xxxxx 000, Xxxxxx, XX 00000. Subject and pursuant to the terms set out in the Terms on page 3, the General Provisions on pages 5 to 12, and the other schedules and appendices attached which are hereby incorporated by reference, the undersigned subscriber (“Subscriber”) hereby irrevocably subscribes for, and on Closing will purchase from the Issuer, the following securities at the following price: 1,000,000 Common Shares of the Issuer (each, a “Share”) US$0.10 per Share for a total purchase price of US$100,000 The Subscriber or the Beneficial Purchaser owns, directly or indirectly, the following securities of the Issuer: ______________________________________________________________________________________________ [Check if applicable] The Subscriber or the Beneficial Purchaser is [ ] an insider of the Issuer. The Subscriber directs the Issuer to issue, register and deliver the certificates representing the Shares as follows: Xxxxxx Xxxxxxx Name to appear on certificate Name and account reference, if applicable Account reference if applicable Contact name Address Address
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. TO: Cheetah Oil & Gas Ltd. Box 172 Station A, Nanaimo, British Columbia, V9R 5K9 Subject and pursuant to the attached “Terms and Conditions” of this Subscription Agreement, including all schedules and appendices attached hereto, the Subscriber hereby irrevocably subscribes for, and on the Closing Date, will purchase from the Company, the following securities at the following price: _____Units US$0.05 per Unit for a total purchase price of _____________________________ The Subscriber owns, directly or indirectly, the following securities of the Company: [Check if applicable] The Subscriber is [ ] an affiliate of the Company The Subscriber directs the Company to issue, register and deliver the certificates representing the Shares as follows: Name to appear on certificate Name and account reference, if applicable Account reference if applicable Contact name Address Address Telephone Number EXECUTED by the Subscriber this ______ day of ________, 2009.
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. TO: SOMBRIO CAPITAL CORP. (the “Issuer”), 300 Xxxxx Xxxx, Xxxxxx, Xxxxxxx X0X 0X0 Subject and pursuant to the terms set out in the Terms on pages 9 to 10, the General Provisions on pages 11 to 18 and the other appendices, acknowledgements, provisions and forms attached which are hereby incorporated by reference, the undersigned purchaser (the “Subscriber”) hereby irrevocably subscribes for, and on Closing will purchase from the Issuer, the following securities at the following price: USD $0.001 per share for a total purchase price of USD $5,000 The Subscriber owns, directly or indirectly, the following securities of the Issuer: Nil [Check if applicable] The Subscriber is [ X ] an insider of the Issuer or [ ] a member of the professional group The Subscriber directs the Issuer to issue, register and deliver the certificates representing the Purchased Securities as follows: REGISTRATION INSTRUCTIONS DELIVERY INSTRUCTIONS
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. The undersigned (the “Subscriber”) hereby irrevocably subscribes for and agrees to purchase from ArcPacific Resources Corp. (the “Issuer”) that number of units of the Issuer (each, a “Unit”) set out below at a price of $0.07
