EXHIBIT 99.1
SUBSCRIPTION AGREEMENT
for
IPORUSSIA, INC.
Common Stock
Securities Offered - The Company is offering 3,000,000 shares (par value
$.0001 per share) at $1.00 per share. Persons interested in purchasing common
stock of IPORUSSIA, INC. must complete and return this Subscription Agreement
along with their check or money order to:
[ESCROW AGENT NAME AND ADDRESS]
Subject only to acceptance by IPORUSSIA, INC. (the "Company"), in its
discretion, of this subscription, and acceptance by the Company of subscriptions
to purchase at least an aggregate of 500,000 shares of its Common Stock pursuant
to the Company's Prospectus dated __________, 2003 (the "Prospectus"), the
undersigned hereby subscribes to purchase the number of common shares of the
Company at the aggregate subscription price set forth below.
Subscription - The undersigned hereby subscribes to purchase the number of
shares of common stock of the Company shown in the following table at a purchase
price of $1.00 per share. The minimum subscription is 1,000 shares, and the
number of shares purchased must be in multiples of 100.
NUMBER OF COMMON SHARES =
---------------------------------
MULTIPLY BY PRICE OF SHARES x $1.00 per share
---------------------------------
AGGREGATE SUBSCRIPTION PRICE = $
--------------------------------
Check or money order shall be made payable to IPORUSSIA, INC. and sent to
_____________ for deposit in the escrow account established by the Company at
that bank if this subscription is accepted.
An accepted copy of this Agreement will be returned to the Subscriber
as a receipt, and physical stock certificates will be delivered to each Investor
within thirty (30) days after the later of the initial closing of the offering
being made pursuant to the Prospectus or the date of receipt of this
subscription.
Subscription Agreement Page 1 of 2
The undersigned represents and warrants as follows:
a) Prior to tendering payment for the shares, the undersigned has
received a copy of the Prospectus.
b) The undersigned is a bona fide resident of the state of
_________________.
Please register the shares which I am purchasing as follows (check one):
|_| Individual |_| Tenants in Common |_| Partnership
|_| Joint Tenants |_| Corporation |_| Trust
|_| Minor with adult custodian under the uniform Gift to Minors Act |_| XXX
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Name of Registered Owner (Please Print) Residence Address
------------------------------------- --------------------------------
Name of Co-Owner (Please Print) City or Town
------------------------------------- --------------------------------
Registered Owner Tax I.D. or State Zip Code
Social Security Number
--------------------------------
------------------------------------- Telephone
Co-Owner Tax I.D. or
Social Security Number --------------------------------
E-Mail Address (optional)
-------------------------------------
Signature of Subscriber
------------------------------------- Date:
Name of Subscriber (Printed) ---------------------------
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ACCEPTED BY IPORUSSIA, INC.
By: Date
-------------------------------- ---------------------------------
NOTE: IF SIGNING FOR A TRUST, PARTNERSHIP OR CORPORATION, PLEASE INDICATE THE
NAME OF SUCH ENTITY AND THE CAPACITY IN WHICH YOU ARE ACTING. IF EXECUTED BY A
TRUST, A MAJORITY OF THE TRUSTEES; IF EXECUTED BY A PARTNERSHIP, A GENERAL
PARTNER OR BY A CORPORATION, A DULY AUTHORIZED OFFICER SHOULD SIGN THIS
SUBSCRIPTION AGREEMENT.
Subscription Agreement Page 2 of 2
