70
Exhibit 99.1
SUBSCRIPTION AGREEMENT
▇▇▇▇▇▇ Mines Limited
1160 - ▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇
▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇
▇▇▇▇▇▇ ▇▇▇ ▇▇▇
Dear Sirs:
Concurrent with execution of this Agreement, the undersigned (the
"Purchaser") is purchasing ________________ shares of Common Stock of
▇▇▇▇▇▇ Mines Limited (the "Company") at a price of $0.10 per Share (the
"Subscription Price")
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: ▇▇▇▇▇▇ MINES LIMITED
Executed this _____ day of ________________, _______, at
_____________________ (Street Address), ___________________ (City),
_________________ (State) ________ (Zip Code).
___________________________________
Signature of Purchaser
___________________________________
Printed Name of Purchaser
___________________________________
Social Security Number/
Tax I.D.
Number of Shares Purchased Total Subscription Price
__________________________ ________________________
Form of Payment: Cash _________________
Check# _________________
Other _________________
ACCEPTED THIS _____ DAY OF ________________, _______.
▇▇▇▇▇▇ MINES LIMITED
BY: __________________________________
Title: ___________________________
