ONLINE HOLDINGS, INC. - common stock Subscription Agreement Investment
Exhibit 99.1
ONLINE HOLDINGS, INC. - common stock
Investment
I desire to purchase _____________ shares of Online Holdings, Inc at $0.125 per share for a total of $ _____________
Make Checks Payable to: Brighton Bank Online Holdings, Inc., Escrow Account
Subscriber Information: Please clearly print name(s) in which Shares are to be acquired. All correspondence will go to the Investor Residence Address
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Investor 1 (First, Middle I., Last):
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Investor 2 (First, Middle I. Last):
__________________________________________________________________________________________________
Registration for the Investment (how the investment should be titled):
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Investor Residence Address 1: ______________________________________________ Check one of the following:
_______________________________________________________________________ U.S. Citizen
Investor Residence Address 2: ______________________________________________ Resident Alien
_______________________________________________________________________ Foreign Resident; Country
City, State ZIP Code U.S. Citizen residing outside the U.S.
Enter the taxpayer identification number. For most individual taxpayers, it is their Social Security Number. Note: If the purchase is in more than one name, the number should be that of the first person listed. For IRAs, Keoghs, and qualified plans, enter both the Social Security Number and the Taxpayer Identification Number for the plan.
__________________________ _______________________________
Social Security Number Taxpayer Identification Number (if applicable)
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Form of Ownership (Individual, XXX, Trust, UGMA, Pension Plan, etc.)
Subscriber Signature: The undersigned has the authority to enter into this subscription agreement on behalf of the person(s) or entity registered above.
Authorized Signature of Investor 1 ________________________________________ Date:__________________
Authorized Signature of Investor 2 ________________________________________ Date:_________________
Company's Acceptance (To be completed only by an authorized representative of the Company.)
The foregoing subscription is accepted this ____________ day of ________________, _____
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Authorized Representative of the Company