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 $____ per Share. The Subscriber agrees to be bound by the terms and conditions set forth in the attached “Terms and Conditions of Subscription for Shares”. US$_____ 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. X (IF NOT THE SAME AS SUBSCRIBER) Signature of individual (if Subscriber is an individual) 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 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.
Appears in 2 contracts
Samples: Private Placement Subscription Agreement (Sustinere Holdings, Inc.), Private Placement Subscription Agreement (Sustinere Holdings, Inc.)
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. The undersigned 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 for, and agrees to on Closing will purchase from Sustinere Holdingsthe Issuer, Inc. (the “Issuer”) that number of common shares of following securities at the Issuer (each, a “Share”) as is set out below at a price of USD $____ per Share. The Subscriber agrees to be bound by the terms and conditions set forth in the attached “Terms and Conditions of Subscription for Shares”. following price: US$_____ 0.10 per Share for a total purchase price of U.S.$ US$200,000 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. X (IF NOT THE SAME AS SUBSCRIBER) Signature of individual (if Subscriber is an individual) 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 2012 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 5 to 1312, and the other schedules and appendices incorporated by reference. If funds are delivered to the Issuer’s lawyers, they are authorized to immediately release the funds to the Issuer.
Appears in 1 contract
Samples: Private Placement Subscription Agreement (Arkanova Energy Corp.)
PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT. The undersigned (the “Subscriber”) hereby irrevocably subscribes for and agrees to purchase from Sustinere Holdings, TO: WOLVERINE EXPLORATION Inc. (the “Issuer”) that number ), of common shares of 0000 Xxxxxxx Xxxx, Xxxxxxx, XX V2J 6V5. Subject and pursuant to the Issuer (each, a “Share”) as is terms set out below at a price of USD $____ per Share. The Subscriber agrees to be bound by the terms and conditions set forth in the Terms on pages 3 to 4 of this Subscription Agreement, the General Provisions on pages 7 to 12 of this Subscription Agreement and the other schedules and appendices attached “Terms which are hereby incorporated by reference, the Purchaser hereby irrevocably subscribes for, and Conditions of Subscription for Shares”. US$_____ per Share for a total on Closing will purchase price of U.S.$ from the Issuer, the following securities at the following price: 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 affiliate of the Issuer. Issuer or [ ] a member of the professional group The Subscriber 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 Subscriber this ____ day X Signature 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. X (IF NOT THE SAME AS SUBSCRIBER) Witness Signature of individual (if Subscriber Purchaser is an individual) X Name of Witness Authorized signatory (if Subscriber Purchaser is not an individual) Address of Witness 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 2010 Address of Purchaser (residence) Per: *Telephone Number Authorized Signatory *E-mail address of Subscriber Per: *Social Security/Tax I.D. Insurance No./Gov ID No. of Subscriber Authorized Signatory .: *Required from all Purchasers By signing this acceptance, the Issuer agrees to be bound by the Terms on pages 3 to 44 of this Subscription Agreement, the General Provisions on pages 6 to 13, 11 of this Subscription Agreement and the other schedules and appendices incorporated by reference. If funds are delivered to the Company’s lawyers, they are authorized to release the funds to the Issuer without further authorization from the Purchaser. Reference date of this Subscription Agreement ____________________, 2010 (the “Agreement Date”) The Issuer WOLVERINE EXPLORATION INC. (the “Company or Issuer”) Offering The offering consists of shares of common stock (“Shares”). Purchased Securities The “Securities or Purchased Securities” under this Subscription Agreement are the Shares. Total Amount This offering is not subject to any minimum or maximum offering.
Appears in 1 contract
Samples: Private Placement Subscription Agreement (Wolverine Exploration Inc.)