EXHIBIT 10.2
Form of Subscription Agreement
SUBSCRIPTION AGREEMENT
----------------------
Winmark, Inc.
000 X. 0xx Xxxxxx
Xxxxx 000
Xxxxxx, Xxxxx 00000
Attn: Xxxx Xxxxxxxx
1. APPLICATION. The undersigned ("Investor"), intending to be legally
bound, hereby subscribes for ______________ Shares of the $.001 par value Common
Stock ("Securities") of Winmark, Inc, a Nevada corporation (the "Company") at a
purchase price of ten cents($0.10) per Share, equaling a total price of
_______________________________ Dollars ($____________).
The undersigned understands that his/her Subscription to purchase
Securities may be accepted or rejected in whole or in part by the Company in its
sole discretion. Enclosed is the undersigned's check made payable to
Manufacturers and Traders Trust Company/Winmark Escrow Account" and has been
forwarded to the escrow account in the self-addressed stamped envelope that has
been provided for convenience. The Investor may also elect to submit his
subscription funds to the escrow account VIA wire transfer as provided in this
Agreement.
2. representations and warranties. The undersigned represents and warrants
as follows:
(a) The Securities are being purchased solely for the undersigned's account,
for investment purposes only and not with a view to the distribution of
said Securities and not with a view to assignment or resale thereof, and no
other person will have a direct or indirect beneficial interest in such
Securities.
(b) The undersigned, if a corporation, partnership, trust or other entity is
authorized and otherwise duly qualified to purchase and hold the Securities
and to enter into this Subscription Agreement.
3. MISCELLANEOUS.
(a) This Subscription Agreement shall survive the death or disability of the
undersigned and shall be binding upon the undersigned's heirs, executors,
administrators, successors and permitted assigns.
(b) This Subscription Agreement has been duly and validly authorized, executed
and delivered by the undersigned and constitutes the valid, binding and
enforceable agreement of the undersigned. If this Subscription Agreement is
being completed on behalf of a corporation, partnership, or trust, it has
been completed and executed by an authorized corporate officer, general
partner, or trustee.
(c) This Subscription Agreement referred to herein constitutes the entire
agreement between the parties hereto with respect to the subject matter
hereof and together supersede all prior discussions or agreements relating
to the purchase of these Securities.
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(d) Within five (5) days after receipt of a written request from the Company,
the undersigned agrees to provide such information, to execute and deliver
such documents and to take, or forbear from taking, such actions or provide
such further assurances as reasonably may be necessary to correct any
errors in documentation or to comply with any and all laws to which the
Company is subject.
(e) The Company shall be notified immediately of any change in any of the
information contained above occurring prior to the undersigned's purchase
of the Securities or at any time thereafter for so long as the undersigned
is a holder of the Securities.
4. REPRESENTATIONS. The undersigned hereby additionally represents and
warrants that:
(i) The undersigned is purchasing for his/her/its own account and not on
behalf of any other person.
(ii) The undersigned will not sell or assign the Securities except in
accordance with the provisions of the Securities Act of 1933, as amended,
or pursuant to the registration Requirements under the Act, or pursuant to
an available exemption under the Act such as Rule 144, which requires a
prior holding period of not less than one year from date of purchase.
(iii) Share certificates shall bear an appropriate restrictive legend that
restricts the further sale or assignment of the Securities except in
accordance with the foregoing provisions set forth above.
(iv) The undersigned is aware that there is no public market for the
Company's Securities that the transfer of Securities is subject to certain
restrictions according to law and that, as a consequence, it may not be
possible for the undersigned to liquidate the Securities, which may have to
be held indefinitely, which makes this offering an illiquid investment.
5. ACCREDITED INVESTOR CERTIFICATION. The undersigned further represents
and warrants as indicated below:
(Please xxxx one or more of the seven following statements)
[ ] 1. I am a natural person who had individual income of more than $200,000
in each of the most recent two years, or joint income with my spouse
in excess of $300,000 in each of the most recent two years, and
reasonably expect to reach that same income level for the current
year. The term "income", for purposes of this Subscription Agreement,
shall be computed as follows: individual adjusted gross income, as
reported (or to be reported) on a federal income tax return, increased
by (1) any deduction of long-term capital gains under Section 1202 of
the current Internal Revenue Code (the "Code"), (2) any deduction for
depletion under Section 611 of the Code, (3) any exclusion for
interest under Section 103 of the Codes and (4) any losses of a
partnership as reported on Schedule E of Form 1040);
[ ] 2. I am a natural person whose individual net worth (i.e., total assets
in excess of total liabilities), or joint net worth with my spouse,
will at the time of purchase of the Securities be in excess of
$1,000,000;
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[ ] 3. The Investor is a trust, which trust has total assets in excess of
$5,000,000, which is not formed for the specific purpose of acquiring
the Securities being offered and whose purchase is directed by a
sophisticated person as described in Rule 506(b)(ii) of Regulation D
and who has such knowledge and experience in financial and business
matters that he is capable of evaluating the risks and merits of an
investment in the Securities;
[ ] 4. The Investor is an employee benefit plan within the meaning of Title I
of the Employee Retirement Income Security Act of 1974, and either (a)
the investment decision will be made by a plan fiduciary, as defined
in Section 3 (21) of such Act, which is either a bank, insurance
company, or a registered investment adviser; or (b) the employee
benefit plan has total assets in excess of $5,000,000; or (c) the
employee benefit plan is a self-directed plan, within the meaning of
Title I of such act, and the person directing the purchase is an
Accredited Investor. *
[ ] 5. The Investor otherwise satisfies the requirements of Section
501(a)(1), or satisfying the requirements of Section 501(a)(2) or (3)
of Regulation D promulgated under the Act, which includes but is not
limited to, a self-directed employee benefit plan where investment
decisions are made solely by persons who are "Accredited Investors" as
otherwise defined in Regulation D;
[ ] 6. I am a Director or Executive Officer of the Company; or
[ ] 7. The Investor is an entity (other than a trust) in which all of the
equity owners meet the requirements of at least one of the above
subparagraphs.
The undersigned has executed this Subscription Agreement this _______ day
of___________________________, 2004.
_________________________ x $ per share = $_________________ USD
(Shares being purchased) ----------------------- (Subscription Price)
If the Investor is an individual, check whether purchased as [ ] JOINT TENANTS,
as [ ] TENANTS IN COMMON, as [ ] COMMUNITY PROPERTY, or as an [ ] Individual.
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Securities should be issued in the name(s) of:
_______________________________________ _______________________________________
(Print or Type Owner's Name) (Print or Type Owner's Name)
_______________________________________ _______________________________________
(Owner's Mailing Address) (Owner's Mailing Address)
_______________________________________ _______________________________________
(City) (State) (City) (State) (Zip)
_______________________________________ _______________________________________
(Telephone) (Telephone)
_______________________________________ _______________________________________
(Signature of Investor) (Signature of Investor)
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If the Investor is a [ ] PARTNERSHIP, [ ] CORPORATION, [ ] LIMITED LIABILITY
COMPANY, or [ ] TRUST (check applicable):
_______________________________________ _______________________________________
(Print Name of Entity as Owner) (Title)
_______________________________________ _______________________________________
(Owner Mailing Address) (Print Name of Authorized Officer)
_______________________________________ by:___________________________________
(City) (State) (Signature) (Zip)
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Subscription Accepted And Agreed To
This _________________ Day of _________________________ 0000
XXXXXXX, INC.
By:
-----------------------------------------------
Xxxx Xxxxxxxx, its President
WIRING INSTRUCTIONS:
ABA #000000000
M&T Bank Buffalo NY
A/C 6239397070
f/f/c Trust account # 0000000
Account Name: Winmark, Inc
Attn: Xxxx Xxxxxxx
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