ACKNOWLEDGEMENT FORM
EXHIBIT 6.7
ACKNOWLEDGEMENT FORM
The undersigned is a party to a subscription agreement for shares of common stock (the “Common
Stock”) of Cereplast, Inc. (the “Company”) offered by the Company in a private placement, dated May
1, 2007, for a purchase price of $0.38 per share (the “Offering”). The undersigned hereby
acknowledges and consents to the increase in the maximum gross proceeds of the offering from US
$10,000,000 to US $15,000,000:
Signature | Signature | ||||||||
Print Name | Print Name | ||||||||
Date:
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Date: | ||||||||
Telephone No.:
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Telephone No.: | ||||||||
Email Address:
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Email Address: | ||||||||
THIS FORM SHOULD BE RETURNED TO:
CEREPLAST, INC. 0000-0000 Xx Xxxxxxx Xxxxxxxxx Xxxxxxxxx, Xxxxxxxxxx 00000 |
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Attention:
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Xxxxxxx Garden, Senior Vice-President Email: xxxxxxx@xxxxxxxxx.xxx |