Specimen Subscription Agreement
SUBSCRIPTION AGREEMENT
CORTEX SYSTEMS INC.
(A Nevada Corporation)
000 Xxxxx Xxx Xxxxx, Xxxxx 000
Xxxxxxxx, Xxxxxxx Xxxxxxxx
X0X 0X0 Xxxxxx
The prospective purchaser who is signing below hereby tenders
this Purchase Offer and applies for the purchase of the number of shares
of common stock, $.0001 par value, set forth below, in Cortex Systems
Inc., (hereafter "Corporation") at a price of $0.10 per share and encloses
a check, bank draft, or money order, payable to "Cortex Systems Inc." in
the amount set forth below for the stated number of shares. The
prospective purchaser understands that these funds will be
held by Cortex Systems Inc. for a period of up to 90 days
(or an additional 90 days if so extended by the Corporation,
for a total of 180 days), from the date of the Prospectus.
The prospective purchaser further understands that these funds may not be
returned to the prospective purchaser. The prospective purchaser hereby
acknowledges receipt of a copy of the Prospectus.
The prospective purchaser further hereby represents and warrants as follows:
1. The prospective purchaser, if a person, is at least 21 years of
age and, whether or not a person, has adequate means of providing for his
current needs and personal or other contingencies and has no need for liquidity
in his investments.
2. The prospective purchaser understands that this purchase offer does not
become a purchase agreement unless payment submitted with the purchase offer is
promptly paid by the bank upon which it is drawn and until the
offer is accepted by a duly authorized officer or agent of the Company.
The Company may accept or reject any or all of the offer.
3. The prospective purchaser hereby acknowledges and agrees that he/she is
not entitled to cancel, terminate or revoke this
purchase offer or any agreements of the prospective purchaser
hereunder and that the purchase agreements shall
survive death, disability or transfer of control of the prospective purchaser.
MAKE CHECK PAYABLE TO: CORTEX SYSTEMS INC.
Executed this day of , 200 at .
Dollar Amount of Purchase Offer: $
Number of Shares of Purchase Offer:
Address Signature of Purchaser
Address Printed SURNAME of Purchaser
City / State Printed FIRST name (and initials) of Purchaser
Country / Zip Code
Taxpayer Identification or
Social Security Number
Accepted By:
CORTEX SYSTEMS INC.
By:
Title:
Date:
