CINJET, INC. - COMMON STOCK SUBSCRIPTION AGREEMENT
CINJET,
INC. - COMMON STOCK
Investment
I
desire
to purchase shares of Cinjet, Inc. at $0.25 per share for a total of
$
Make
Checks Payable to: Escrow
Specialists, Cinjet, Inc. Escrow Account
Subscriber
Information: Please clearly print name(s) in which Shares are to be acquired.
All correspondence will go to the Investor Residence Address
Investor
1 (First, Middle I., Last):
Investor
2 (First, Middle I. Last):
Registration
for the Investment (how the investment should be titled):
Investor
Residence Address 1: Check
one
of the following:
U.S.
Citizen
Investor
Residence Address 2:
Resident
Alien
City,
State
ZIP
Code Foreign
Resident; Country ________
U.S. Citizen residing outside the U.S.
Enter
the
taxpayer identification number. For most individual taxpayers, it is their
Social Security Number. Note:
If the
purchase is in more than one name, the number should be that of the first person
listed. For IRAs, Keoghs, and qualified plans, enter both the Social Security
Number and the Taxpayer Identification Number for the plan.
Social
Security Number Taxpayer
Identification Number (if applicable)
Form
of
Ownership (Individual, XXX, Trust, UGMA, Pension Plan, etc.)
Subscriber
Signature: The undersigned has the authority to enter into this subscription
agreement on behalf of the person(s) or entity registered above.
Authorized
Signature of Investor 1 ________________________________________ Date:_____________________________________
Authorized
Signature of Investor 2 ________________________________________ Date:_____________________________________
Company’s
Acceptance (To be completed only by an authorized representative of the
Company.)
The
foregoing subscription is accepted this ____________ day of ________________,
_____
___________________________________
Authorized
Representative of the Company
