OBITX, INC. Subscription Agreement The undersigned subscriber (the “Subscriber”) acknowledges having had the opportunity to review the books and records of OBITX, Inc., (the “Company”) desires to subscribe for shares of common stock of the Company....
The undersigned subscriber (the “Subscriber”) acknowledges having had the opportunity to review the books and records of OBITX, Inc., (the “Company”) desires to subscribe for shares of common stock of the Company. The Subscriber hereby subscribes for that number of shares of common stock of the Company (“Shares”) and on the terms as indicated below and subject to the provisions of the Certificate of Incorporation and Bylaws of the Company.
Subscription Information
Name and Mailing Address of Subscriber:
Facsimile Number:
Name and Address for Share Registration (if different):
Amount of Subscription: # of Shares Total Price
Common Stock ($.0001 per share) $
Total Subscription Amount $
Name of Beneficial Owners represented by Subscriber (if Subscriber is acting in any sort of nominee or fiduciary capacity):
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Subscriber Representation
The Subscriber represents and warrants that:
2
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INDIVIDUAL SIGNATURE PAGE
Your signature on this Individual Signature Page evidences the agreement by you to be bound by the Subscription Agreement and Shareholders Agreement. 1. The undersigned hereby represents that (a) the information contained in this Subscription Agreement is complete and accurate and (b) the undersigned will notify Xxxx Xxxxxxxxx, Company Secretary (321.802.2474), immediately if any material change in any of this information occurs before the acceptance of the undersigned ‘s subscription and will promptly send the Company written confirmation of such change. 2. The undersigned hereby certifies that he or she has read and understands this Subscription Agreement and Shareholders Agreement. IN WITNESS WHEREOF, THE Subscriber has executed this Subscription Agreement this ___ day of __________ 2017. I. Number of Shares Aggregate Subscription Price: $ Business Name or Name of Individual: Address:
If individual, age: Telephone Number(s): Residence: Business: Federal Tax I.D. or Social Security Number:
(Signature)
(Printed or typed name and Title)
(Second signature-required if Shares held in more than one name)
Subscription for Shares is hereby accepted by the __________, 2017
By: 3
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