SUBSCRIPTION AGREEMENT
0000 Xxxxxxxx Xxx
Xxxxxxxxx, XX 00000
Dear Sirs:
Concurrent with execution of this Agreement, the undersigned (the “Purchaser”) is purchasing __________________________________________________ (__________) shares of Common Stock of Clear System Recycling, Inc. (the “Company”) at a price of $0.05 per share (the “Subscription Price”).
Purchaser hereby confirms receipt of the Prospectus dated ____________________, and that Purchaser has had an opportunity to review. Purchaser agrees not to rely on any written or verbal statements or representations except for those contained the Prospectus.
Purchaser hereby confirms the subscription for and purchase of said number of shares and hereby agrees to pay herewith the Subscription Price for such Shares.
MAKE CHECK PAYABLE TO: CLEAR SYSTEM RECYCLING, INC.
Executed this _____ day of ___________________, 2011.
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| Signature of Purchaser |
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Address of Purchaser |
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Printed Name of Purchaser ____________________________________ Tax ID Number of Purchaser |
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PLEASE ENSURE FUNDS ARE IN US DOLLARS
____________________________ | X $0.05 | = | US$_______________________ | ||||
Number of Shares Purchased |
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| Total Subscription Price | |||
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Form of Payment: | Cash:___________ | Check #: _____________ | Other: _________________ | ||||
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