70
Exhibit 99.1
SUBSCRIPTION AGREEMENT
Xxxxxx Mines Limited
1160 - 0000 Xxxx Xxxxxxx Xxxxxx
Xxxxxxxxx, Xxxxxxx Xxxxxxxx
Xxxxxx X0X 0X0
Dear Sirs:
Concurrent with execution of this Agreement, the undersigned (the
"Purchaser") is purchasing ________________ shares of Common Stock of
Xxxxxx 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: XXXXXX 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 ________________, _______.
XXXXXX MINES LIMITED
BY: __________________________________
Title: ___________________________
