FORM OF SUBSCRIPTION AGREEMENT
SUBSCRIPTION AGREEMENT
Gentlemen:
I/We hereby subscribe to ____________ shares of common stock, $0.001
par value per share, of xXxXxxxxxx.xxx, Inc., a Colorado corporation, at $.25
per share. Such shares are being issued pursuant to a registration of
xXxXxxxxxx.xxx, Inc. common stock in accordance with the terms of a prospectus
filed with the Securities and Exchange Commission which was declared effective
on the ___ day of ___________________, 2001. I/We hereby subscribe in the amount
of:
US$_________________ ($5,000 minimum)
Method of Payment
Please check one of the following:
[ ] I/We am/are tendering cash in United States dollars in the
above amount.
[ ] I/We am/are tendering a check, bank draft or postal express
money order payable in U.S. dollars to "xXxXxxxxxx.xxx, Inc." in
the above amount.
[ ] I/We confirm that I/we have instructed my/our bank to pay, by
wire transfer to "xXxXxxxxxx.xxx, Inc.", the above amount to:
Bank: Bank of New York
ABA No.: 000-000-000
For credit to: BNF Correspondent Corp.
Account No.: 89-001-869-6-8
For further credit to: xXxXxxxxxx.xxx, Inc.
Account No.: A9-13490-1-51
By execution and delivery of this Subscription Agreement, I/we hereby represent
and warrant as follows:
1. I/We have received a copy of the prospectus of xXxXxxxxxx.xxx, Inc. dated
___ day of ____________________, 2001
2. The shares are being acquired for investment purposes.
3. I/We acknowledge that payments with respect to subscriptions and
redemptions will be made in U.S. dollars and that adverse fluctuations in
exchange rates could reduce the return to me/us upon the redemption of
shares.
4. I/We acknowledge that the officers and directors of iGoHealthy have
reserved the right to reject this application, in whole or in part, and
need not give a reason for such rejection.
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I/We have executed this Subscription Agreement on the ____ day of
_________________, 2001, in ______________________________ (Please indicate
city, state and country).
Signature(s) of Applicant(s) Name (title, if necessary) and Address of
Applicant(s)
Notes:
(a) In the event of joint registration, all applicants must sign.
(b) In the event of registration of shares in the name of a trust,
partnership or corporation, please provide the full name of the entity
and the official title of the person executing this Agreement on behalf
of such trust, partnership or corporation.
SUSBSCRIBER'S AGENT
Name :
Address :
