SUBSCRIPTION AGREEMENT
Exhibit
4.1
0000 Xxxx
Xxxxxx, #X
Xxxxxxx
Xxxxx, XX 00000
The
undersigned has received the prospectus dated __________, 2010 (“Prospectus”),
and hereby subscribes for _____________ shares of $.001 par value common stock
of On Time Filings, Inc., a Nevada corporation (“Company”), for a subscription
price of $0.10 per share (“Offered Shares”). The undersigned hereby
agrees that this subscription shall be irrevocable and shall survive the death
or disability of the undersigned. Payment of the purchase price for
the Offered Shares is due upon subscription.
The
undersigned acknowledges that (i) the Company has the right to accept or reject
this subscription in whole or in part, (ii) this subscription shall be deemed to
be accepted by the Company only when the Company signs this Subscription
Agreement; and (iii) the undersigned has relied only on that information
specified in the Prospectus.
Number of
Offered Shares: _________________. Subscription Amount: ___________
(number of Offered Shares multiplied by $0.10)
Make
check payable
to: “On Time Filings,
Inc.”
Please
print name(s) or title, residence address, and SSN or Tax ID for which the
Offered Shares are to be registered. Please notify the Company in
writing if your address changes before you either receive your shares or are
notified that your subscription has not been accepted.
| Name | ||
| Street | ||
| City | State | Zip Code |
| SSN or Tax ID No. (For joint ownership, both parties must provide a Social Security Number or similar tax identification) | ||
Indicate
type of ownership:
o Partnership
Ownership
o
Custodian for a Minor
Date
Trust
Established: ____________________________________________________________________________________________
Name of
Trustee or other Administrator
________________________________________________________________________________
Each
subscriber represents that:
|
(a)
|
The
information contained herein is complete and accurate and may be relied
upon, and
|
|
(b)
|
The
undersigned will notify the Company immediately of any material change in
any such information occurring prior to the acceptance of the
undersigned’s subscription, including any changes in address or other
contact information.
|
1
IN
WITNESS WHEREOF, the undersigned has executed this Subscription Agreement as of
this ______ day of ____________ 2010.
FOR
INDIVIDUALS:
______________________________________________________________________________________________________________________________________________________________________________
Print
Name
______________________________________________________________________________________________________________________________________________________________________________
Signature
NAME
AND SIGNATURE OF JOINT TENANT OR TENANT IN COMMON
______________________________________________________________________________________________________________________________________________________________________________
Print
Name
______________________________________________________________________________________________________________________________________________________________________________
Signature
FOR
TRUSTS, CORPORATIONS, PARTNERSHIPS
______________________________________________________________________________________________________________________________________________________________________________
Print
Name of Entity
By:___________________________________________________________________________________________________________________________________________________________________________
Print name and capacity (Trustee,
President or General Partner) of person making investment decision
______________________________________________________________________________________________________________________________________________________________________________
Signature
Signature
Agreed to
and accepted:
a Nevada corporation
By:
_______________________________________
Xxxxxxx
Xxxxxxx
Its: President
2
