Number of Shares Subscribed for. Amount of Subscription: $__________________ ___________________________________________ ___________________________________________ Name of Individual Social Security No. ___________________________________________ ___________________________________________ Street Address Date of Birth ___________________________________________ __________________ _______________________ City State Zip Code Home Phone Business Phone Manner in which Shares are to be held (check one): / / Individual Ownership / / Community Property / / Tenants-in-Common / / Separate Property / / Joint Tenant with Right of Survivorship / / Other (please specify) ________________________________ Signature Accepted this ___ day of __________, 200_. ISECURETRAC CORP. By: ____________________________ THE ENTITY SIGNATURE PAGE FOR ISECURETRAC CORP. SUBSCRIPTION AGREEMENT Date:_________________, 200_____________
Number of Shares Subscribed for. Amount of Subscription: $___________________ __________________________________________ ____________________________________________ Name of Corporation or Entity Federal Tax Identification No. __________________________________________ ____________________________________________ Address State of Incorporation or Formation __________________________________________ ___________________ _______________________ City State Zip Code Phone Fax Manner in which Shares are to be held (check one): / / Partnership / / Limited Liability Company / / Corporation / / Limited Liability Partnership / / Trust / / Other (please specify)_____________ _________________________________ Signature _________________________________ Title Accepted this ___ day of __________, 200_. ISECURETRAC CORP. By: ____________________________
Number of Shares Subscribed for. A number equal to (A) the product of (i) 120% and (ii) the sum of Investor ARYA Shares and the Top Up Shares (as defined below), plus (B) the difference of Sponsor Promote Allocation Shares (as defined below) minus Investor ARYA Shares. The “Top Up Shares” shall mean a number of Shares equal to (A) the product of (i) the Investor ARYA Shares and (ii) the quotient of the redemption value per Investor ARYA Share on the Closing Date divided by $10.00, minus (B) the Investor AXXX Xxxxxx.
Examples of Number of Shares Subscribed for in a sentence
Each Seller hereby appoints Xxxxx Xxxxxx as the agent, proxy and attorney-in-fact for such Seller for all purposes under this Agreement (including full power and authority to act on such Seller’s behalf).
RECORD DATE POSITIONS Number of Shares Number of Shares Subscribed for Number of Shares Subscribed for Pursuant to Beneficially Owned Number of Rights Pursuant to Rights Over-Subscription Privilege 1.
Number of Shares Subscribed for NAME OF PURCHASER at $0.12 per share.
NYISO publishes hourly load- weighted average LMPs for both real-time and day-ahead markets.
In the Web document, selecting a caT link fires the associated transition.
More Definitions of Number of Shares Subscribed for
Number of Shares Subscribed for. Total Purchase Price: $___________________ A check in the full amount of the purchase price, payable to "Molecular Diagnostics and Therapeutics, Inc. Escrow Account" accompanies this executed Subscription Agreement. Form of Ownership: __Individual __Partnership __Joint Tenants With Rights of __Trust survivorship (both sign) __Limited Liability Company, LLC __Tenants in Common (all sign) __Corporation INDIVIDUALS _________________________ _____________________________ ___________ Signature of Subscriber Print Name Date ______________________________________________________________________________ Mailing Address _________________________________ _______________________________________ Telephone Number Social Security Number _________________________ _____________________________ ___________ Signature of Subscriber Print Name Date ______________________________________________________________________________ Mailing Address _________________________________ _______________________________________ Telephone Number Social Security Number CORPORATIONS, TRUSTS, PARTNERSHIP, LLCs ______________________________________________________________________________ Name of Corporation, Trust, Partnership or LLC By: ________________________________________ _____________________________ Signature of Authorized Representative Print Name ________________________________________ _____________________________ Capacity of Authorized Representative Date ______________________________________________________________________________ Mailing Address ********************** Accepted as to Shares on . ------------ ------------------------ Molecular Diagnostics and Therapeutics, Inc. By:_________________________________________ Its:__________________________________ Please make your check payable to: Molecular Diagnostics and Therapeutics, Inc. Escrow Account.
Number of Shares Subscribed for. Total Payment enclosed: $___________ USD (Please make check payable to PortalToChina.com, Inc.)
Number of Shares Subscribed for. Total Payment enclosed: $___________ USD (PLEASE MAKE CHECK PAYABLE TO AMP PRODUCTIONS, LTD.)
Number of Shares Subscribed for. Total Amount of Subscription: x $0.01 ______________ per Share $_______________ _________________________________________ ____________________________________________ Print Full Legal Name of Subscriber Print Full Legal Name of Co-Subscriber (if applicable) _________________________________________ ____________________________________________ Signature of (or on behalf of) Subscriber Signature of (or on behalf of) Co-Subscriber (if applicable) Name: Title: Address of Subscriber: Address of Co-Subscriber (if applicable): _________________________________________ ____________________________________________ _________________________________________ ____________________________________________ _________________________________________ ____________________________________________ Social Security or Taxpayer Identification Social Security or Taxpayer Identification Number of Subscriber Number of Co-Subscriber (if applicable) TYPE OF OWNERSHIP: [ ] Individual [ ] Joint Tenants [ ] Partnership with Rights of Survivorship [ ] Corporation [ ] LLC [ ] Trust [ ] Other: Date of Trust: ____________________________________________ Name of Trustee: _________________________________________ ____________________________________________ Mail to: Carol McMahan Synergy Law Group, LLC 730 West Randolph Street Suite 000 Xxxxxxx, IL 60661 Subscription Agreed to and Accepted: KOPR RESOURCES CORP. By: ________________________________ Andrea Schlectman President and Chief Executive Officer
Number of Shares Subscribed for. Shares INDIVIDUAL SUBSCRIBER: ENTITY SUBSCRIBER: ------------------------------------ ------------------------------------ (Signature of Subscriber) (Print Name of Subscriber) By: ------------------------------------ -------------------------------- (Typed or Printed Name) Name: ------------------------------ Title: ----------------------------- ------------------------------------ ------------------------------------ (Residence Address) (Address) ------------------------------------ ------------------------------------ (City, State and Zip Code) (City, State and Zip Code) ------------------------------------ ------------------------------------ (Telephone Number) (Telephone Number) ------------------------------------ ------------------------------------ (Telecopier Number) (Telecopier Number) ------------------------------------ ------------------------------------ (Tax I.D. or Social Security Number) (Tax I.D. or Social Security Number) ACCEPTED: NEUROBIOLOGICAL TECHNOLOGIES, INC. By: ________________________________________ Name: Xxxx X. Xxxxxxx Title: President and Chief Executive Officer Date: _________, 2000 SCHEDULE A NTI Shares Reserved as of March 16, 2000 25,000,000 Authorized (13,846,881) Common stock issues (1,900,771) Options issued (91,108) Reserved for options (65,266) Reserved for ESPP (4,777,676) Warrants issued (2,332,000) Preferred ----------- 1,986,298 Remaining
Number of Shares Subscribed for. Total Purchase Price: $_________________________ A check in the full amount of the purchase price, payable to "Power Save International, Inc. Escrow Account" accompanies this executed Subscription Agreement. Form of Ownership: __ Individual __ Partnership __ Joint Tenants With Rights of __ Trust survivorship (both sign) __ Limited Liability Company, LLC __Tenants in Common (all sign) __ Corporation INDIVIDUALS ----------------------------- ------------------------------ ---------- Signature of Subscriber Print Name Date Mailing Address ----------------------------- ------------------------------ Telephone Number Social Security Number ----------------------------- ------------------------------ ----------- Signature of Subscriber Print Name Date Mailing Address ----------------------------- ------------------------------ Telephone Number Social Security Number CORPORATIONS, TRUSTS, PARTNERSHIPS, LLCs Name of Corporation, Trust, Partnership or LLC By: _________________________________ __________________________________ Signature of Authorized Representative Print Name --------------------------------- ---------------------------------- Capacity of Authorized Representative Date Mailing Address ************************* Accepted as to ______________ Shares on ________________ , 199 _. Power Save International, Inc. By: _________________________________ Its: ______________________________ Please make your check payable to: Power Save International, Inc. Escrow Account.
Number of Shares Subscribed for. Shares against payment in cash in the amount of $____________, representing $1.00 per Share.