QUARTA-RAD, INC. Subscription Agreement
Exhibit 99.1
Subscription Agreement
1. Investment:
The undersigned (“Buyer”) subscribes for ____________ Shares of Common Stock of QUARTA-RAD, INC. at $0.20 per share.
Total subscription price ( $0.20 times number of Shares): = $_____________________.
PLEASE MAKE CHECKS PAYABLE TO: QUARTA-RAD, INC.
2. Investor information:
Name (type or print) | SSN/EIN/Taxpayer I.D. | ||
E-Mail address: | |||
Address |
Joint Name (type or print) | SSN/EIN/Taxpayer I.D | ||||
E-Mail address: | |||||
Address (If different from above) | |||||
Mailing Address (if different from above): | |||||
Street | City/State | Zip | |||
Business Phone: ( ) | Home Phone: ( ) | ||||
3. Type of ownership: (You must check one box)
Individual | Custodian for | |||
Tenants in Common | Uniform Gifts to Minors Act of the State of: | |||
|
Joint Tenants with rights of Survivorship | Corporation (Inc., LLC, LP) – Please List all officers, directors, partners, managers, etc.: | ||
Trust | ||||
Community Property | Other (please explain) |
4. Further Representations, Warrants and Covenants. Buyer hereby represents warrants, covenants and agrees as follows:
(a) | Buyer is at least eighteen (18) years of age with an address as set forth in this Subscription Agreement. |
5. Acceptance of Subscription.
(a) | It is understood that this subscription is not binding upon the Company until accepted by the Company, and that the Company has the right to accept or reject this subscription, in whole or in part, in its sole and complete discretion. If this subscription is rejected in whole, the Company shall return to Buyer, without interest, the Payment tendered by Buyer, in which case the Company and Buyer shall have no further obligation to each other hereunder. In the event of a partial rejection of this subscription, Buyer’s Payment will be returned to Buyer, without interest, whereupon Buyer agrees to deliver a new payment in the amount of the purchase price for the number of Shares to be purchased hereunder following a partial rejection of this subscription. |
6. Governing Law.
(a) | This Subscription Agreement shall be governed and construed in all respects in accordance with the laws of the State of Delaware without giving effect to any conflict of laws or choice of law rules. |
IN WITNESS WHEREOF, this Subscription Agreement has been executed and delivered by the Buyer and by the Company on the respective dates set forth below.
INVESTOR SUBSCRIPTION ACCEPTED AS OF | ||||||
day of | , | |||||
Signature of Buyer | ||||||
QUARTA-RAD, INC. | ||||||
Printed Name | 0000 X. Xxxxxx Xx, Xxxxx 000 | |||||
Xxxxxxxxxx, XX 00000 | ||||||
Date | By: | |||||
Xxxxxx Xxxxxxxx, Chief Executive Officer |
Deliver completed subscription agreements and checks to:
0000 X. Xxxxxx Xx., Xxxxx 000
Xxxxxxxxxx, XX 00000