SUBSCRIPTION AGREEMENT
Exhibit 99.1
000 Xxxxxxxx Xxx.
Xxxxxxxx Xxx Xxxx 00000
Gentlemen:
The undersigned has read and understands the matters set forth in your prospectus dated September 23, 2010. The undersigned represents as set forth below and subscribes to purchase ____________________Shares at $0.25 per Share, for $_______________, provided that you accept this subscription. There is no minimum amount of shares that must be sold and proceeds may be utilized at the issuer's discretion. If any checks are delivered to any NASD member, the member must promptly, by noon of the next business day, transmit all checks received to the issuer or any person entitled thereto. The undersigned, if an individual, is a resident of, or, if a corporation, partnership or trust, has as its principal place of business:
The State of New York_____
The State of Florida_____
The District of Columbia____ Other State _____________
A State foreign to U.S.A._____
Dated:______________
Signature:__________________________________________
If not an individual:
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___________________________________
Name of Corporation, Trust, or Partnership
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___________________________
Print or type name of Signer
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________________________
State where incorporated,
organized, or domiciled
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___________________________
P.O. Box or Street Address
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| ________________________
Print Signer's Capacity
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___________________________
City, State and Zip Code
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________________________
Tax ID
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___________________________
Social Security Number
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________________________
Fax and Phone Numbers
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