Name of Purchaser. SIGNATURE OF AUTHORIZED SIGNATORY OF PURCHASER: ________________________________ Name of Authorized Signatory: __________________________________________________ Title of Authorized Signatory: _________________________________________________ Email Address of Purchaser:_____________________________________________________ Address for Notice of Purchaser: Address for Delivery of Securities for Purchaser (if not same as above):
Name of Purchaser. Cranshire Capital Master Fund, Ltd. ___ _____
Name of Purchaser. Sabby Healthcare Master Fund, Ltd.
Examples of Name of Purchaser in a sentence
Print Name of Purchaser By: Signature of Authorized Signatory Name of Authorized Signatory (if an entity) Title of Authorized Signatory (if an entity) The signatory hereto is an “accredited investor”, as that term is defined in Regulation D under the Securities Act of 1933, as amended (the “Act”).
Print Name of Purchaser By: Signature of Authorized Signatory Name of Authorized Signatory (if an entity) Title of Authorized Signatory (if an entity) The signatory hereto is an “accredited investor,” as that term is defined in Regulation D under the Securities Act of 1933, as amended (the “Act”).
Sr. No.Drug codeDrug nameSpecifications IP/BP/USPDate of endorsement obtained from State DrugsCommissionerWhether Endorsement is in Generic or brandname Add As Many Rows You Want To Add (Additional column should be inserted asking date of permission from CDSCO,in case of all newly introduced drugs and Fixed dose combinations)ANNEXURE -7SECURITY DEPOSIT FORM To: (Name of Purchaser) WHEREAS (Name of Supplier)Hereinafter called "the Supplier" has undertaken, in pursuance of Contract No. dated,200....
Purchases of Advertising in a Program Book or on a Sign Name of Purchaser Purchase Made By:Business Entity Other Individual/Sole ProprietorshipStreet Address City State Zip Code Date Received Event # Aggregate Purchases for All Events Amount of Program Ad Purchase Amount of Sign PurchaseTotal of Section L3 II.
Name of Purchaser, Project/Job location and some other relevant information are as per Bid document/Annexure.
More Definitions of Name of Purchaser
Name of Purchaser. Xxxxxx Xxxxx Name of Purchaser: XWRT2 LP Name of Purchaser: SBMT2 LP Name of Purchaser: Godfrey2468 LP Name of Purchaser: LeeMadison9189 LP Name of Purchaser: RossPlan LP
Name of Purchaser. Dated: By: Name: Title: Outstanding principal amount of [Class [A] [B] [C] [D] [E]] [[Senior][Junior] Subordinated] Notes: $__________
Name of Purchaser. Dated: -------------------------- -------------------------- By: ------------------------------ Name: Title: Aggregate principal amount of: Series [ ] Notes: $ -------------- Taxpayer identification number: ---------------- Address for notices: Wire transfer information for payments: Bank: -------------------------------- Address: Bank ABA#: -------------------------------- Account #: -------------------------------- Telephone: -------------------------------- Facsimile: -------------------------------- Attention: -------------------------------- Registered name: -------------------------- EXHIBIT A-3 TO ARG II BASE INDENTURE FORM OF TRANSFER CERTIFICATE FOR TEMPORARY GLOBAL NOTE OR PERMANENT GLOBAL NOTE TO RESTRICTED GLOBAL NOTE (TRANSFEROR) [Letterhead of Transferor] Reference is hereby made to the Amended and Restated Base Indenture, dated as of [ ], 2002 (the "BASE INDENTURE"), and the Series [ ] Supplement thereto, dated as of [ ] (the "SERIES [ ] SUPPLEMENT" and together with the Base Indenture, the "INDENTURE"), each between ARG II and The Bank of New York, as trustee. Capitalized terms used but not defined herein shall have the meanings assigned to them in the Indenture. Other terms shall have the meanings assigned to them in Rule 144A under the United States Securities Act of 1933, as amended (the "SECURITIES ACT"). This letter relates to U.S. $_________ principal amount of Series [ ] Notes (the "NOTES") of ARG II which are held in the registered name of [insert name of transferor] (the "TRANSFEROR"). The Transferor has requested a transfer of such Notes to [insert name of transferee]. In connection with such request, and in respect of such Notes, the Transferor does hereby certify that such Notes are being transferred in accordance with Rule 144A under the Securities Act to a transferee that the Transferor reasonably believes is purchasing the Notes for its own account or an account with respect to which the transferee exercises sole investment discretion and the transferee and any such account is a "qualified institutional buyer" within the meaning of Rule 144A, and such transferee is aware that the sale to it is being made in reliance upon Rule 144A, and any applicable securities laws of any state of the United States or any other jurisdiction. This letter and the statements contained herein are made for the benefit of ARG II and the Trustee. [TRANSFEROR] By: ----------------------------- Name: Title: Dated: ______________, _____ EXHIBIT A-4 TO...
Name of Purchaser in Annex A]
Name of Purchaser. Signature:____________________________________ By:_________________________________________ Subscription Price: $ 1.35 Title:________________________________________ Address: ____________________________________ Telephone: ___________________________________ Fax: _________________________________________ SS/Tax ID Number______________________________ For purposes of assuring Pimi Agro Cleantech, Inc. (the “Company”) that you qualify as an "accredited investor," as defined in Rule 501 of Regulation D under the Securities Act of 1933, as amended (the "Securities Act”), you represent and warrant that you are an "accredited investor" by virtue of your responses to the questions below. In order to certify that you are an accredited investor, respond affirmatively to at least one of the following questions (check "yes" below the appropriate items(s)):
Name of Purchaser. Signature of Authorized Signatory of Purchaser Name of Authorized Signatory: Title of Authorized Signatory: Email Address of Purchaser: Address for Notice of Purchaser: Address for Delivery of Securities for Purchaser (if not same as above): First Closing Subscription Amount: $177,500 First Closing Series A Warrant Shares: 355,000 First Closing Series B Warrant Shares: 355,000 First Closing Shares: 152,295 Second Closing Subscription Amount: $177,500 Second Closing Series A Warrant Shares: 355,000 Second Closing Series B Warrant Shares: 355,000 Second Closing Shares: 152,295 EIN Number: SIGNATURE PAGES CONTINUE 35 INVESTOR QUESTIONNAIRE CERTIFICATION PRIDE BUSINESS DEVELOPMENT HOLDINGS, INC.. INVESTOR QUESTIONNAIRE (ALL INFORMATION WILL BE TREATED CONFIDENTIALLY) To: Pride Business Development Holdings, Inc. This Investor Questionnaire ("Questionnaire") must be completed by each potential investor in connection with the offer and sale of the shares of restricted common stock and warrants of Pride Business Development Holdings, Inc. (the "Securities"). The Securities are being offered and sold by Pride Business Development Holdings, Inc. (the "Company") without registration under the Securities Act of 1933, as amended (the "Act"), and the securities laws of certain states, in reliance on the exemptions contained in Section 4(2) of the Act and on Regulation D promulgated thereunder and in reliance on similar exemptions under applicable state laws. The Company must determine that a potential investor meets certain suitability requirements before offering or selling Securities to such investor. The purpose of this Questionnaire is to assure the Company that each investor will meet the applicable suitability requirements. The information supplied by you will be used in determining whether you meet such criteria, and reliance upon the private offering exemptions from registration is based in part on the information herein supplied. This Questionnaire does not constitute an offer to sell or a solicitation of an offer to buy any security. Your answers will be kept strictly confidential. However, by signing this Questionnaire, you will be authorizing the Company to provide a completed copy of this Questionnaire to such parties as the Company deems appropriate in order to ensure that the offer and sale of the Securities will not result in a violation of the Act or the securities laws of any state and that you otherwise satisfy the suitability standards applicable to...
Name of Purchaser. Date: Signature: Telephone: Address: DOB: Hearing Aid Specialist: Xxxxx Xxxxx-Xxxxxxxx, H.A.S. ACA Signature: License Number: HA4026