EXHIBIT 10.9 Form of Subscription Agreement
APPLICATION FOR SUBSCRIPTION FOR COMMON STOCK
ORIGINAL ISSUE: Up to 5,000,000 shares of Common Stock, $.001 par value
("Common Stock").
ISSUE PRICE: $1.00 per share
The undersigned, having received and read the Prospectus, dated ______________,
does hereby offer to purchase up to _________ shares of Common Stock of Humitech
International Group, Inc. ("Humitech") at a subscription price of $1.00 per
share. (For more information about the Common Stock, please refer to the
Prospectus.)
APPLICATIONS FOR SUBSCRIPTION MUST BE RECEIVED BY HUMITECH NO LATER THAN FIVE
O'CLOCK (5:00) P.M., CENTRAL TIME ON __________, 2003, THE EXPIRATION DATE OF
THE OFFERING (SUBJECT TO EXTENSION BY HUMITECH WITHOUT NOTICE TO SUBSCRIBERS).
THIS SUBSCRIPTION MAY NOT BE REVOKED AFTER IT HAS BEEN RECEIVED BY HUMITECH.
Humitech can accept this Offer for all or any portion of the shares subscribed
for, or it can reject this Application. For more information concerning the
application and acceptance process, please refer to the Prospectus. If Humitech
does not accept, in whole or in part, any subscription for shares, Humitech will
mail a refund to the subscriber in an amount equal to the subscription price for
the shares as to which such subscription is not accepted.
Enclosed with the Subscription Application is A CHECK PAYABLE TO HUMITECH
INTERNATIONAL GROUP, INC. for the full amount of this subscription, for a total
of $___________, which amount when received by Humitech shall become immediately
available to Humitech, subject to the following instructions:
1. The full subscription price for shares must be included with
the Application. THE SUBSCRIPTION PRICE MUST BE PAID IN UNITED
STATES CURRENCY BY CHECK, BANK DRAFT OR MONEY ORDER PAYABLE TO
HUMITECH INTERNATIONAL GROUP, INC. Failure to include the full
subscription price with the Application shall give Humitech
the right to disregard the Application.
2. Certificates representing shares of stock duly subscribed and
paid for will be issued by Humitech as soon as practicable
following receipt of good funds.
3. The funds received by Humitech from the undersigned will
become immediately available to Humitech.
4. If this subscription offer, or any part thereof, is
subsequently rejected by Humitech, Humitech will return to the
undersigned as much of this payment as exceeds the amount
required for the shares allotted to the undersigned.
Shares purchased by the undersigned shall be registered as listed below. (If
certificates for shares are to be issued in more than one name, please specify
whether ownership is to be as tenants in common, joint tenants, etc. If
certificates for shares are to be issued in the name of one person for the
benefit of another, please indicate whether registration should be as trustee or
custodian for such other person, and specify the exact name and date of the
trust and/or other pertinent information concerning the trust or custodial
arrangement.)
HOW SHARE ARE TO BE REGISTERED NUMBER OF SHARES
(PLEASE PRINT OR TYPE) (AT $1.00 PER SHARE)
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It is agreed that by executing this Subscription Agreement, the undersigned
acknowledges and agrees to all of the terms and conditions of the Offering as
contained in the Prospectus. The undersigned acknowledges that Humitech reserves
the right to accept or reject this subscription, in whole or in part, and to
reduce the number of shares subscribed for hereunder.
IN WITNESS WHEREOF, I (we) have executed this Application in triplicate, and
returned the top two (2) copies thereof to: Humitech International Group, Inc.,
00000 Xxxxxx Xxxxxxx, Xxxxx 000, Xxxxxxx, XX 00000, together with our check in
the sum of $_____________.
We understand that all information submitted on this Application will be
maintained in confidence by Humitech.
DATED:___________________________
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Signature Date
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Name (Please print or type)
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Mailing Address
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City and State Zip Code
Mail to: __ Business __ Residence
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Signature Date
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Name (Please print or type)
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Mailing Address
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City and State Zip Code
