INVESTOR SUBSCRIPTION AGREEMENT FOR GOLDEN WEST BREWING COMPANY, INC.
INVESTOR SUBSCRIPTION AGREEMENT
FOR
GOLDEN WEST BREWING COMPANY, INC.
Persons interested in purchasing shares ("Shares") of Common Stock of Golden West Brewing Company, Inc.(the "Company") must complete, execute, and deliver this Subscription Agreement (the "Agreement") along with their check made payable to "Golden West Brewing Company, Inc. Escrow Account, Corporate Stock Transfer, Inc., Escrow Agent" to:
Golden West Brewing Company,, Inc.
000 Xxxx 0xx Xxxxxx
Xxxxx, Xxxxxxxxxx 00000
If and when accepted by the Company, this Agreement shall constitute a subscription for shares of Common Stock, $.0001 par value per share of the Company.
The Company reserves the right to reject in its entirety any subscription which is tendered or to allocate to any prospective purchaser a smaller number of shares than the prospective purchaser has subscribed to purchase. In such event, the Company will return to you at the address set forth in this Agreement your payment (or a pro rata portion of your payment, if such subscription is rejected only in part), without interest or deduction.
An accepted copy of this Agreement will be returned to you as your receipt, and a stock certificate will be issued to you shortly thereafter.
I/we hereby tender this Agreement for the purchase of ________ shares, at a price of $0.50 per share. With this Agreement, I/we tender payment in the amount of $________ ($0.50 per share) for the shares subscribed.
In connection with this investment in the Company, I/we represent and warrant as follows:
a. Prior to tendering payment for the shares, I/we received and reviewed the Company's prospectus dated ___________ 2005, and have relied on no other information or materials in reaching my/our investment decision.
b. I/we represent and warrant that no broker-dealer or member of the National Association of Securities Dealers, Inc. has participated or been involved in any manner whatsoever in my investment decision.
c. I am/we are bona fide resident(s) of
______________________________
(State)
______________________________
(Country)
d. I/we understand and agree that this subscription agreement is subject to the terms and conditions of the Fund Escrow Agreement more fully described in the Company's prospectus
Please register the shares which I am/we are purchasing as follows:
Name: _______________________________________________
As (check one):
|
___ |
Individual |
___ |
Tenants-in-Common |
|
|
___ |
Partnership |
___ |
Joint Tenants |
|
|
___ |
Corporation |
___ |
Trust |
|
|
___ |
Minor with adult custodian Under the Uniform Gift to Minors Act |
For the person(s) who will be registered shareholder(s):
Name: _____________________________ Telephone: ____________________________
Social Security or Taxpayer ID number: ___________________________________________
Street Address: _____________________________________________
__________________________________________________________
City State Zip
Date of Birth: _____________________________
_______________________________________ ______________________
Signature Date
ACCEPTED BY: GOLDEN WEST BREWING COMPANY, INC.
By:____________________________________________ _______________________
Date
Its: ____________________________________________
