SUBSCRIPTION AGREEMENT
EXHIBIT 99.1
XxxxxXxxxx.xxx
000 Xxxxx Xxxxxx
Xxxxxxx, Xxxxxxx
Xxxxxx X0X 0X0
Dear Sirs:
Concurrent with execution of this Agreement, the undersigned (the "Purchaser") is purchasing ________________ shares of Common Stock of XxxxxXxxxx.xxx (the "Company") at a price of $2.65 per Share (the "Subscription Price").
Purchaser hereby confirms the subscription for and purchase of said number of Shares and hereby agrees to pay herewith the Subscription Price for such Shares.
Purchaser further confirms that Xxxxxxx X. Xxxxxxx and/or Xxxxxx X. Xxxxxxxx solicited him/her/it to purchase the shares of Common Stock of the Company and no other person participated in such solicitation other than Xxxxxxx X. Xxxxxxx and/or Xxxxxx X. Xxxxxxxx.
MAKE CHECK PAYABLE TO: XxxxxXxxxx.xxx.
Executed this _____ day of ________________, _______, at _____________________ (Street Address), ___________________ (City), _________________ (State) ________ (Zip/Postal Code).
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Number of Shares Purchased |
Total Subscription Price |
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Form of Payment: |
Cash ____________ |
Check# ___________ |
Other ____________ |
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ACCEPTED THIS _____ DAY OF ________________, _______.
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XxxxxXxxxx.xxx |
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BY: |
____________________________________ |
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Title: _______________________________ |
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