Common use of Amount of Subscription Clause in Contracts

Amount of Subscription. The undersigned hereby subscribes to purchase an aggregate of 7,333,529 Units for a total of $2,500,000. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $2,500,000.00 Subscribed For: $2,500,000 in Units Social Security or Taxpayer I.D. Number [required if applicable]:___________________ Business Address (including zip code): Attention: Xxx Prychitka, CFO & VP Shared Services________ 0000 Xxxxxxxxx Xxxx, Mississauga, ON L4Y 1S4 Business Phone: 000 000 0000 Residence Address (including zip code) Residence Phone: (____) All communications to be sent to: x Business or Residence Address Please indicate on the following page the form in which you will hold title to your interest in the securities. PLEASE CONSIDER CAREFULLY. ONCE YOUR SUBSCRIPTION IS ACCEPTED, A CHANGE IN THE FORM OF TITLE CONSTI­TUTES A TRANSFER OF THE INTEREST IN THE SECURITIES AND MAY THEREFORE BE RESTRICTED BY THE TERMS OF THIS SUBSCRIPTION, THE SECURITIES AND MAY RESULT IN ADDITIONAL COSTS TO YOU. Subscribers should seek the advice of their attorneys in deciding in which of the forms they should take ownership of the interest in the securities, because different forms of ownership can have varying gift tax, estate tax, income tax, and other consequences, depending on the state of the investor's domicile and his or her particular personal circumstances. Subscription Agreement Jammin Java Corp. Please select one of the following forms of ownership: ________ INDIVIDUAL OWNERSHIP (one signature required) ________ JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON (both or all parties must sign) ________ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ________ TENANTS IN COMMON (both or all parties must sign) ________ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ________ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER autho­rized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ________ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) __X_____ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation's Articles and certified Corporate Resolution authorizing the signature) ________ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Subscription Agreement (Jammin Java Corp.)

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Amount of Subscription. The undersigned hereby subscribes to purchase _____________ Units for an aggregate of 7,333,529 Units for a total amount of $2,500,000___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $2,500,000.00 __________ Subscribed Forfor: $2,500,000 in Units _______________ Units. Social Security or Taxpayer I.D. Number [required if applicable]:: __________________________________________ Business Address (including zip code): Attention: Xxx Prychitka, CFO & VP Shared Services________ 0000 Xxxxxxxxx Xxxx, Mississauga, ON L4Y 1S4 Business Phone: 000 000 0000 ( ) Residence Address (including zip code) Residence Phone: (____( ) All communications to be sent to: x Business or Residence Address Name Units should be registered in:__________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of Securities:__________________________________________ Email Address:__________________________________________ Please indicate on the following page pages the form in which you will hold title to your interest in the securities. PLEASE CONSIDER CAREFULLY. ONCE YOUR SUBSCRIPTION IS ACCEPTED, A CHANGE IN THE FORM OF TITLE CONSTI­TUTES CONSTITUTES A TRANSFER OF THE INTEREST IN THE SECURITIES AND MAY THEREFORE BE RESTRICTED BY THE TERMS OF THIS SUBSCRIPTION, THE SECURITIES AND MAY RESULT IN ADDITIONAL COSTS TO YOU. Subscribers should seek the advice of their attorneys in deciding in which of the forms they should take ownership of the interest in the securities, because different forms of ownership can have varying gift tax, estate tax, income tax, and other consequences, depending on the state of the investor's ’s domicile and his or her particular personal circumstances. Subscription Agreement Jammin Java Corp. Golden Matrix Group, Inc. Please select one of the following forms of ownership: ________ INDIVIDUAL OWNERSHIP (one signature required) ________ JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON (both or all parties must sign) ________ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ________ TENANTS IN COMMON (both or all parties must sign) ________ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ________ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER autho­rized autho-rized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ________ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) __X_____ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation's ’s Articles and certified Corporate Resolution authorizing the signature) ________ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) EXECUTION Please execute this PLEASE ALSO COMPLETE PAGES 17 THROUGH 19, AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 20 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. Subscription Agreement by completing the appropriate section below.Golden Matrix Group, Inc.

Appears in 1 contract

Samples: Subscription Agreement (Golden Matrix Group, Inc.)

Amount of Subscription. The undersigned hereby subscribes to purchase _____________ Shares for an aggregate of 7,333,529 Units for a total amount of $2,500,000___________. Preferred Stock Subscription Agreement Petrolia Energy Corporation “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $2,500,000.00 __________ Subscribed Forfor: $2,500,000 in Units _______________ Shares. Social Security or Taxpayer I.D. Number [required if applicable]: Business Address (including zip code): Business Phone: ( ) Residence Address (including zip code) Residence Phone: ( ) All communications to be sent to: Business or Residence Address Name Shares should be registered in:___________________ Business Address (including zip code): Attention: Xxx Prychitka, CFO & VP Shared Services_________________________________ 0000 Xxxxxxxxx Xxxx, Mississauga, ON L4Y 1S4 Business PhoneIf different than subscriber name please advise of the reason for such difference: 000 000 0000 Residence Address (including zip code) Residence Phone: (____) All communications to be sent to: x Business or Residence _________________________________________________________________ Address for registration of shares:_____________________________________________________ Email Address:______________________________________________________________________ Please indicate on the following page pages the form in which you will hold title to your interest in the securities. PLEASE CONSIDER CAREFULLY. ONCE YOUR SUBSCRIPTION IS ACCEPTED, A CHANGE IN THE FORM OF TITLE CONSTI­TUTES CONSTI-TUTES A TRANSFER OF THE INTEREST IN THE SECURITIES AND MAY THEREFORE BE RESTRICTED BY THE TERMS OF THIS SUBSCRIPTION, THE SECURITIES AND MAY RESULT IN ADDITIONAL COSTS TO YOU. Subscribers should seek the advice of their attorneys in deciding in which of the forms they should take ownership of the interest in the securities, because different forms of ownership can have varying gift tax, estate tax, income tax, and other consequences, depending on the state of the investor's ’s domicile and his or her particular personal circumstances. Subscription Agreement Jammin Java Corp. Please select one of the following forms of ownership: ________ INDIVIDUAL OWNERSHIP (one signature required) ________ JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON (both or all parties must sign) ________ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ________ TENANTS IN COMMON (both or all parties must sign) ________ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ________ Preferred Stock Subscription Agreement Petrolia Energy Corporation LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER autho­rized autho-rized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ________ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) __X_____ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation's ’s Articles and certified Corporate Resolution authorizing the signature) ________ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 16, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. Preferred Stock Subscription Agreement Petrolia Energy Corporation EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Preferred Stock Subscription Agreement (Petrolia Energy Corp)

Amount of Subscription. The undersigned hereby subscribes to purchase _____________ Shares for an aggregate of 7,333,529 Units for a total amount of $2,500,000___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $2,500,000.00 __________ Subscribed Forfor: $2,500,000 in Units _______________ Shares. Social Security or Taxpayer I.D. Number [required if applicable]:: ____________________________ Business Address (including zip code): Attention: Xxx Prychitka, CFO & VP Shared Services____________________________ 0000 Xxxxxxxxx Xxxx, Mississauga, ON L4Y 1S4 Business Phone: 000 000 0000 ( ) ____________________________ Residence Address (including zip code) Residence Phone: (____________________________ Residence Phone: ( ) ____________________________ All communications to be sent to: x Business or Residence Address Name Shares should be registered in:_________________________________________________ If different than subscriber name please advise of the reason for such difference: __________________________________________________________________ Address for registration of shares:___________________________________________________ Email Address:__________________________________________________________________ Please indicate on the following page pages the form in which you will hold title to your interest in the securities. PLEASE CONSIDER CAREFULLY. ONCE YOUR SUBSCRIPTION IS ACCEPTED, A CHANGE IN THE FORM OF TITLE CONSTI­TUTES CONSTITUTES A TRANSFER OF THE INTEREST IN THE SECURITIES AND MAY THEREFORE BE RESTRICTED BY THE TERMS OF THIS SUBSCRIPTION, THE SECURITIES AND MAY RESULT IN ADDITIONAL COSTS TO YOU. Subscribers should seek the advice of their attorneys in deciding in which of the forms they should take ownership of the interest in the securities, because different forms of ownership can have varying gift tax, estate tax, income tax, and other consequences, depending on the state of the investor's ’s domicile and his or her particular personal circumstances. Subscription Agreement Jammin Java Corp. Please select one of the following forms of ownership: ________ INDIVIDUAL OWNERSHIP (one signature required) ________ JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON (both or all parties must sign) ________ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ________ TENANTS IN COMMON (both or all parties must sign) ________ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ________ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER autho­rized authorized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ________ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) __X_____ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation's ’s Articles and certified Corporate Resolution authorizing the signature) ________ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 16, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Common Stock Subscription Agreement (Panther Biotechnology, Inc.)

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Amount of Subscription. The undersigned hereby subscribes to purchase _____________ Units for an aggregate of 7,333,529 Units for a total amount of $2,500,000___________. Subscription Agreement Golden Matrix Group, Inc. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $2,500,000.00 __________ Subscribed Forfor: $2,500,000 in Units _______________ Units. Social Security or Taxpayer I.D. Number [required if applicable]:: _______________________ Business Address (including zip code): Attention: Xxx Prychitka, CFO & VP Shared Services_________________________________________ 0000 Xxxxxxxxx Xxxx, Mississauga, ON L4Y 1S4 Business Phone: 000 000 0000 ( ) ________________________________________________________ Residence Address (including zip code) Residence Phone: (_________________________________________ Residence Phone: ( ) ________________________________________________________ All communications to be sent to: x Business or Residence Address Name Units should be registered in:__________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of Securities:_________________________________________ Email Address:__________________________________________ Please indicate on the following page pages the form in which you will hold title to your interest in the securities. PLEASE CONSIDER CAREFULLY. ONCE YOUR SUBSCRIPTION IS ACCEPTED, A CHANGE IN THE FORM OF TITLE CONSTI­TUTES CONSTI-TUTES A TRANSFER OF THE INTEREST IN THE SECURITIES AND MAY THEREFORE BE RESTRICTED BY THE TERMS OF THIS SUBSCRIPTION, THE SECURITIES AND MAY RESULT IN ADDITIONAL COSTS TO YOU. Subscribers should seek the advice of their attorneys in deciding in which of the forms they should take ownership of the interest in the securities, because different forms of ownership can have varying gift tax, estate tax, income tax, and other consequences, depending on the state of the investor's ’s domicile and his or her particular personal circumstances. Subscription Agreement Jammin Java Corp. Golden Matrix Group, Inc. Please select one of the following forms of ownership: ________ INDIVIDUAL OWNERSHIP (one signature required) ________ JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON (both or all parties must sign) ________ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ________ TENANTS IN COMMON (both or all parties must sign) ________ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ________ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER autho­rized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ________ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) __X_____ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation's ’s Articles and certified Corporate Resolution authorizing the signature) ________ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 17 THROUGH 19, AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 20 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. Subscription Agreement Golden Matrix Group, Inc. EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Subscription Agreement (Golden Matrix Group, Inc.)

Amount of Subscription. The undersigned hereby subscribes to purchase _____________ Shares for an aggregate of 7,333,529 Units for a total amount of $2,500,000___________. “PURCHASER” Check enclosed in the amount of $____________ or Wire Transfer Sent in the Amount of $2,500,000.00 __________ Subscribed Forfor: $2,500,000 in Units _______________ Shares. Social Security or Taxpayer I.D. Number [required if applicable]:: ________________________ Business Address (including zip code): Attention: Xxx Prychitka, CFO & VP Shared Services_______________________________________ 0000 Xxxxxxxxx Xxxx, Mississauga, ON L4Y 1S4 Business Phone: 000 000 0000 ( ) ____________________________________________________ Residence Address (including zip code) Residence Phone: (____________________________________________ Residence Phone: ( __) _________________________________________________________ All communications to be sent to: x __ Business or __ Residence Address Name Shares should be registered in:___________________________________________________ If different than subscriber name please advise of the reason for such difference: _____________________________________________________________________ Address for registration of shares:_____________________________________________________ Email Address:______________________________________________________________________ Please indicate on the following page pages the form in which you will hold title to your interest in the securities. PLEASE CONSIDER CAREFULLY. ONCE YOUR SUBSCRIPTION IS ACCEPTED, A CHANGE IN THE FORM OF TITLE CONSTI­TUTES CONSTITUTES A TRANSFER OF THE INTEREST IN THE SECURITIES AND MAY THEREFORE BE RESTRICTED BY THE TERMS OF THIS SUBSCRIPTION, THE SECURITIES AND MAY RESULT IN ADDITIONAL COSTS TO YOU. Subscribers should seek the advice of their attorneys in deciding in which of the forms they should take ownership of the interest in the securities, because different forms of ownership can have varying gift tax, estate tax, income tax, and other consequences, depending on the state of the investor's ’s domicile and his or her particular personal circumstances. Subscription Agreement Jammin Java Corp. Please select one of the following forms of ownership: ________ INDIVIDUAL OWNERSHIP (one signature required) ________ JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND NOT AS TENANTS IN COMMON (both or all parties must sign) ________ COMMUNITY PROPERTY (one signature required if interest held in one name, i.e., managing spouse; two signatures required if interest held in both names) ________ TENANTS IN COMMON (both or all parties must sign) ________ GENERAL PARTNERSHIP (fill out all documents in the name of the PARTNERSHIP, by a PARTNER authorized to sign, and include a copy of the Partnership Agreement) ________ LIMITED PARTNERSHIP (fill out all documents in the name of the LIMITED PARTNERSHIP, by a GENERAL PARTNER autho­rized authorized to sign, and include a copy of the Limited Partnership Agreement and any other document showing that the investment is authorized) ________ LIMITED LIABILITY COMPANY (fill out all documents in the name of the LIMITED LIABILITY COMPANY, by a member authorized to sign, and include a copy of the LIMITED LIABILITY COMPANY’s Operating Agreement and any other documents necessary to show the investment is authorized.) __X_____ CORPORATION (fill out all documents in the name of the CORPORATION, by the President or other officer authorized to sign, and include a copy of the Corporation's ’s Articles and certified Corporate Resolution authorizing the signature) ________ TRUST (fill out all documents in the name of the TRUST, by the Trustee, and include a copy of the instrument creating the trust and any other documents necessary to show the investment by the Trustee is authorized. The date of the trust must appear on the Notarial where indicated.) PLEASE ALSO COMPLETE PAGES 16, 17 OR 18 AS APPLICABLE, BELOW, AND THE QUESTIONNAIRE BEGINNING ON PAGE 19 OF THIS SUBSCRIPTION AGREEMENT, WHICH IS A REQUIRED PART OF THIS AGREEMENT. EXECUTION Please execute this Subscription Agreement by completing the appropriate section below.

Appears in 1 contract

Samples: Common Stock Subscription Agreement (Panther Biotechnology, Inc.)

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