Moggle, Inc.
Exhibit 1.2
000 Xxxxxxxxxxxx Xxxxxxxxx
Xxxxx 000
Xxxx Xxxxxx, XX 00000
(000) 000-0000
The undersigned (the “Subscriber”) hereby irrevocably subscribes for that number of Shares of Common Stock (“Shares”) of Moggle, Inc. (the “Company”) set forth below, upon and subject to the terms and conditions set forth in the Company’s Prospectus dated ,
200__to which this Subscription Agreement is attached.
Total Number of Shares subscribed for at $1.00 per Share: ________________shares.
Amount paid with this Subscription Agreement at a price of $1.00 per Share: US $ _________________________
IN WITNESS WHEREOF, the undersigned has executed this Subscription Agreement this ______ of _________, 200_.
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Signature |
Subscriber’s Social Security or Tax
Identification Number: | |
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Print Name: |
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Print Title: |
Signature of Co-owners if applicable: | |
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Address: |
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Number and Street |
Telephone Number: | |
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City, State, Zip |
Email Address: | |
Name as it should appear on the Certificate: ______________________________________________________
If Joint Ownership, check one (all parties must sign above):
[ ] Joint Tenants with Right of Survivorship
[ ] Tenants in Common
[ ] Community Property
If Fiduciary or Business Entity check one:
[ ] Trust Authorized Person _________________________ Capacity_____________________
[ ] Estate Authorized Person _________________________ Capacity_____________________
[ ] Corporation Authorized Person _________________________ Capacity_____________________
[ ] Limited Liability Company
Authorized Person _________________________ Capacity_____________________
[ ] Partnership Authorized Person _________________________ Capacity_____________________
[ ] Other ____________________ (Describe)
Authorized Person _________________________ Capacity_____________________
ACCEPTANCE OF SUBSCRIPTION
The foregoing Subscription is hereby accepted for and on behalf of Moggle, Inc. this _____day of __________, 200_.
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By |
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Xxxxxxx Xxxxx, President or | ||
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Xxxxxx Xxxxxxxxxx, Secretary | ||
