Investor Subscription Agreement
Georgia International Mining Corporation
Persons interested in purchasing shares of the Common Stock of Georgia
International Mining Corporation (the "Shares") must complete and
return this Subscription Agreement along with their check or money
order to:
Georgia International Mining Corporation, 299 1917 Xxxx 0xx Xxxxxx
Xxxxxxxxx, XX. X0X-0X0
When accepted by Georgia International Mining Corporation, a Nevada
Corporation (the "Company"), this Subscription Agreement shall
constitute an irrevocable subscription for shares of Common Stock, of
the Company. The minimum investment is $200 (200,000 shares). A copy of
the accepted Agreement will be returned as a receipt and a stock
certificate will be issued shortly thereafter.
The undersigned (referred to herein as the "Subscriber") desires to
become a SHAREHOLDER and hereby irrevocably (after 72 hours) tenders
this subscription agreement and subscribes for that number of shares
(the "Shares") of the Company's common stock as stated below, at the
price of $0.001 per share, upon the terms, conditions and
representations set forth herein.
1. The Subscriber acknowledges and represents as follows:
(a) That the Subscriber does not rely upon the verbal
representation made by any officer, employee or agent of the
Company. Notwithstanding the availability of other relevant
information on the Internet or elsewhere, Subscriber represents
that this subscription is based upon their knowledge of the
company and agree on its plans to purchase mining rights.
(b) That the Subscriber has the net worth and/or income to be
able to bear the economic risk of an investment in the Shares
and
(c) That the Subscriber has such knowledge and experience in
financial and business matters so as to be capable of evaluating
the merits and risks of an investment in the Shares; and
(d) That the Subscriber has determined that the Shares are a
suitable investment for him, her or it and meets his, her or its
investment objectives and financial needs, and that the
Subscriber has adequate means for providing for current financial
needs and personal contingencies and has no need for liquidity if
a market for the Shares does not develop; and
(e) That the Subscriber recognizes that an investment in the
Shares is highly speculative and involves a high degree of risk
and
(f) That the Subscriber is purchasing the shares herein for
investment purposes only.
2. The Subscriber represents and warrants that he, she or it is a bona
fide resident of, and is domiciled in the State, or jurisdiction
stated below and that the Shares are being purchased solely for the
beneficial interest of the Subscriber.
3. The Subscriber understands that the Company will escrow the proceeds
from the shares sold and that stock certificates will be issued only
after the Company is successfully listed on the 'Over The Counter
Bulletin Board' (OTCBB), at which time the Company will transfer the
funds to its regular account. The Subscriber understands that the
Company will also use and rely upon all of the representations,
warrants, registration and subscriber information provided herein.
4. REGISTRATION INFORMATION: (Please print)
Name of
Subscriber
Street \ Address
City
Province \ State
Postal \
Zip
Social Sec.
Number
Business Number
Shares Purchased
Amount Enclosed
$
Register Shares
As*
*(If different from the above "Name
of Subscriber", Register Shares as shown here.)
5. THE SUBSCRIBER(s) IS (are): (check one)
( ) Corporation
( ) Trust:
( ) A single person
Trustees(s)________________________
( ) Husband and wife, community
property
Trust Date ________________________
( ) Joint Tenants
Name of Trust _____________________
( ) A married (man) (woman) as
(his) (her) separate property
For the Benefit
of___________________
( ) Tenants in Common
( ) Custodian for__________________
under the Uniform Gift to Minors
Act of
the State of :
( )
Other____________________________
My Check Is Enclosed. Money order or Certified Check
or Bank Draft Is Enclosed.
Signature(s): __________________________________
Signature of Subscriber(s)
Date: _______________
Signature of Subscriber(s)
Print Name(s)
______________________
Print Name(s)
_____________________
Acceptance by Company:
Subscription accepted this _______ day of _________________, _______,
by :
Georgia International Mining Corporation
__________________________________________
Xxxx Xxxxx, Director
