EXHIBIT 10.3
PLEASE READ CAREFULLY BEFORE SIGNING
THIS SUBSCRIPTION AGREEMENT CALLS FOR SIGNIFICANT
REPRESENTATIONS FROM YOU
SUBSCRIPTION AGREEMENT
The undersigned hereby subscribes for and agrees to purchase the number of
shares of common stock of Western Feed Xxxxx, Inc., a Kansas corporation
("WFM") indicated below, at a price of Forty Cents ($.40) per share. By
executing this Subscription Agreement, the undersigned acknowledges that WFM
is relying on the accuracy and completeness of the representations contained
in this Subscription Agreement in complying with its obligations under
applicable securities laws and that the undersigned could be found liable to
WFM for damages caused by any misrepresentations in this Subscription
Agreement.
The undersigned represents to WFM that:
1. The undersigned has received WFM's prospectus, dated ________________,
2003.
2. The undersigned is an individual who is a bona fide resident of, and
is domiciled in, or a legal entity located in the following state:
check one _____ Kansas
_____ ________________
Common Shares
- Minimum of 125,000 shares
- ________ common shares @ $.40/share $___________
Payment
_______ number of shares
x $.40
___________ Total Purchase Price
ONCE YOU SIGN THIS SUBSCRIPTION AGREEMENT AND SEND IT TO US WITH YOUR CHECK,
YOUR SUBSCRIPTION IS IRREVOCABLE AND WILL ONLY BE RETURNED TO YOU IF YOUR
SUBSCRIPTION IS NOT ACCEPTED OR IF WE DO NOT FULFILL ALL CONDITIONS TO BREAK
ESCROW AND COMPLETE THE SALE OF COMMON STOCK.
Please mail or deliver the following to WFM at the appropriate address below:
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- Your check for the total purchase price (payable to "Western Feed
Xxxxx, Inc. Escrow Account")
- This Subscription Agreement
Please mail or deliver the following to WFM at the appropriate address below:
- Your check for the total purchase price (payable to "Western Feed
Xxxxx, Inc. Escrow Account")
- This Subscription Agreement
BY MAIL: BY HAND DELIVERY:
Western Feed Xxxxx, Inc. Western Feed Xxxxx, Inc.
Xxxxx 0, Xxxx Xxxx Xxxx Xxxxx 0, Xxxx Xxxx Xxxx
XX Xxx 000 Xxxxx Xxxx, Xxxxxx 00000
Xxxxx Xxxx, Xxxxxx 00000
Your initial payment will be deposited at the U.S. Bank, National
Association, Omaha, Nebraska and held in escrow.
We will not break escrow and complete the sale of common stock until WFM
receives and accepts subscription for at least the minimum offering amount
until WFM has a binding commitment from a lender to obtain debt financing to
fund the balance of the project cost beyond the amount of equity raised and
until the Kansas Securities Commissioner provides a written consent to
release of funds from escrow.
This subscription is made pursuant to, and is subject to, the terms and
conditions of the registration approved by the Office of the Securities
Commissioner of the State of Kansas for Western Feed Xxxxx, Inc.
dated _________________________, 2003, and such other states in which
the undersigned is domiciled or located, if applicable.
By executing this Subscription Agreement, the undersigned is not waiving
any rights under the securities laws, including the Securities Act of 1933
and the Securities Exchange Act of 1934.
This Subscription Agreement has been signed by the undersigned
on _____________________, 2003.
__________________________________________
Print or Type Name of Subscriber
__________________________________________
Signature
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__________________________________________
Officer Title if Subscriber if Entity
__________________________________________
__________________________________________
__________________________________________
Address of Subscriber
__________________________________________
Social Security Number of Federal Employer
Identification Number
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