Exhibit 1.1
Bream Ventures, Inc.
SUBSCRIPTION AGREEMENT
Gentlemen:
The Investor named below, by payment of the purchase price for such Common
Shares, by the delivery of a check payable to Bream Ventures, Inc., hereby
subscribes for the purchase of the number of Common Shares indicated below
(minimum of twenty five thousand shares) of Bream Ventures, Inc. at a purchase
of $0.05 per Share as set forth in the Prospectus.
By such payment, the named Investor further acknowledges receipt of the
Prospectus and the Subscription Agreement, the terms of which govern the
investment in the Common Shares being subscribed for hereby.
A. INVESTMENT: (1) Number of Shares ----------
(2) Total Contribution ($0.05/Share) $---------
Date of Investor's check -----------
B. REGISTRATION:
(3) Registered owner:
-----------------------------
Co-Owner:
-----------------------------
(4) Mailing address:
-----------------------------
City, State & zip:
-----------------------------
(5) Residence Address (if different from above):
--------------------------------------------
(6) Birth Date: _____/______/______
(7) Employee or Affiliate: Yes ______ No ______
(8) Social Security: #: ______/______/______
U.S. Citizen [ ] Other [ ]
Co-Owner Social Security:
#: ______/______/______
U.S. Citizen [ ] Other [ ]
Corporate or Custodial:
Taxpayer ID #: ______/______/______
U.S. Citizen [ ] Other [ ]
(9) Telephone (H) ( ) -------------------
C. OWNERSHIP [ ] Individual Ownership [ ] XXX or Xxxxx
[ ] Joint Tenants with Rights of Survivorship
[ ] Trust/Date Trust Established --------------------
[ ] Pension/Trust (S.E.P.)
[ ] Tenants in Common [ ] Tenants by the Entirety
[ ] Corporate Ownership [ ] Partnership
[ ] Other ------------------------
D. SIGNATURES: By signing below, I/we represent that I/we have read the
Prospectus.
Registered Owner: -----------------------------
Co-Owner: -----------------------------
Print Name of Custodian or Trustee: ----------------------------
Authorized Signature: ------------------------------
Date: ------------------------
Signature: -----------------------------
MAIL TO:
Bream Ventures, Inc.
0000 Xxxxxx Xxxxx
Xxxx Xxxxxxxxx, X.X.
X0X 0X0
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FOR OFFICE USE ONLY:
Date Received: ------------------------------------------------
Date Accepted/Rejected -----------------------------------------
Subscriber's Check Amount: ----------------------------
Check No. -------------------- Date Check -------------------
Deposited ----------------------------------
MR #--------------------------
