For Individual Investors. A government issued form of picture identification (e.g., passport or drivers license). ____ Proof of the individual’s current address (e.g., current utility bxxx), if not included in the form of picture identification. ____ One or more of the above documentations has previously provided to Placement Agent.
For Individual Investors. For Investors other than Individuals: Signature (Please Print or Type Name of Investor) By: (Please Print or Type Name) Signature (1) Signature (Please Print or Type Name of Signatory) Title (1): (Please Print or Type Name) By: Signature (2) (Please Print or Type Name of Signatory) Title (2): ACKNOWLEDGMENT State of ) County of ) ss.: ) On this day of , before me personally appeared , who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to or who executed the foregoing instrument in his/her personal or authorized capacity, and who duly acknowledged to me that execution of the same is his/her own free act and deed and made with appropriate authority. My Commission Expires: Notary Public [Seal] Notary: Please complete state, county, date and names of all persons signing and affix notarial seal. Pursuant to the Operating Agreement, the subscription is hereby accepted in the amount set forth in Exhibit 1 below and the investor is hereby admitted as a Member as of____________, 2000. Bessemer Trust Company, N.A., as Manager of Meadowbrook Equity Fund III, LLC By:________________________________ Name: _____________________________ Title:_______________________________ EXHIBIT 1 TO SUBSCRIPTION AGREEMENT SUBSCRIPTION ASSETS The Subscription Assets consist of the following4, subject to change as provided below:
For Individual Investors. 1. ☐ The Subscriber is a natural person whose net worth, taken together with the net worth of such person’s spouse or spousal equivalent, exceeds $1,000,000;
For Individual Investors. ¨ A government issued form of picture identification (e.g., passport or drivers license). ¨ Proof of the individual’s current address (e.g., current utility xxxx), if not included in the form of picture identification. For Funds of Funds or Entities that Invest on Behalf of Third Parties: ¨ A certificate of due formation and organization and continued authorization to conduct business in the jurisdiction of its organization (e.g., certificate of good standing). ¨ An “incumbency certificate” attesting to the title of the individual executing these subscription materials on behalf of the prospective investor. ¨ A completed copy of a certification that the entity has adequate anti-money laundering policies and procedures (“AML Policies and Procedures”) in place that are consistent with the USA PATRIOT Act, OFAC and other relevant federal, state or non-U.S. anti-money laundering laws and regulations (with a copy of the entity’s current AML Policies and Procedures to which such certification relates). ¨ A letter of reference any entity not located in the U.S. or other FATF country, from the entity’s local office of a reputable bank or brokerage firm that is incorporated, or has its principal place of business located, in the U.S. or other FATF Country certifying that the prospective investor maintains an account at such bank/brokerage firm for a length of time and containing a statement affirming the prospective investor’s integrity.
For Individual Investors. ____________ 1. Subscriber represents that he or she has an individual net worth, or together with his or her spouse a combined net worth, in excess of $1,000,000. For purposes of this representation, “net worth” means the excess of total assets (exclusive of primary residence but inclusive of the excess indebtedness on such residence over its fair market value) at fair market value over total liabilities.
For Individual Investors. A government issued form of picture identification (e.g., passport or drivers license). ____ Proof of the individual’s current address (e.g., current utility bxxx), if not included in the form of picture identification. ____ One or more of the above documentations has previously provided to Placement Agent. For Funds of Funds or Entities that Invest on Behalf of Third Parties: _____ A certificate of due formation and organization and continued authorization to conduct business in the jurisdiction of its organization (e.g., certificate of good standing). _____ An “incumbency certificate” attesting to the title of the individual executing these subscription materials on behalf of the prospective investor. _____ A completed copy of a certification that the entity has adequate anti-money laundering policies and procedures (“AML Policies and Procedures”) in place that are consistent with the USA PATRIOT Act, OFAC and other relevant federal, state or non-U.S. anti-money laundering laws and regulations (with a copy of the entity’s current AML Policies and Procedures to which such certification relates). _____ A letter of reference for any entity not located in the U.S. or other FATF country, from the entity’s local office of a reputable bank or brokerage firm that is incorporated, or has its principal place of business located, in the U.S. or other FATF Country certifying that the prospective investor maintains an account at such bank/brokerage firm for a length of time and containing a statement affirming the prospective investor’s integrity. ____ One or more of the above documentations has previously provided to Placement Agent. * As of the date hereof, countries that are members of the Financial Action Task Force on Money Laundering (“FATF Country”) are: Argentina, Australia, Austria, Belgium, Brazil, Canada, Denmark, Finland, France, Germany, Greece, Hong Kong, Iceland, Ireland, Italy, Japan, Luxembourg, Mexico, Kingdom of the Netherlands, New Zealand, Norway, Portugal, Russian Federation, Singapore, South Africa, S pain, Sweden, Switzerland, Turkey, United Kingdom and the United States of America.
For Individual Investors. Name: Telephone: 0; Home Address: &# 160; _______________________________________________________________________________________________________ Date of Birth: _______________________ U. S. Citizen Yes ______ No ______ Social Security Number:_________________________________________________________________________________ Occupation or Profession:_______________________________________________________________________________ Nature of Business:_____________________________________________________________________________________ Name and Address of Employer:__________________________________________________________________________ Business Telephone:____________________________________________________________________________________ Current Position or Title: Period Employed: Nature of Duties:  60; Prior Employment (if current employment is less than five years): Name of Prior Employer: Period Employed: Communications should be sent to (check one): ______ Residence ____ Business
For Individual Investors. ____________ 1. Subscriber represents that he or she has an individual net worth, or together with his or her spouse a combined net worth, in excess of $1,000,000. For purposes of this representation, “net worth” means the excess of total assets at fair market value, including, home, home furnishings and automobiles, over total liabilities. ____________ 2. Subscriber represents that he or she had an individual income of more than $200,000 in each of the last two calendar years or joint income with his or her spouse in excess of $300,000 in each of those years and reasonably expects to reach the same income level in the current calendar year.
For Individual Investors or Other Entity Investors: ____________________________ _________________________________ (Print Name of entity) (Signature) By:_________________________ Print Name:_______________________ (Signature) Print Name:__________________ __________________________________ Title:________________________ (Signature of Joint Tenant, Joint Investor, or Tenant in Common, if any) Agreement of Custodian of Individual Retirement Account (To be completed if investment is through an IXX) The undersigned, being the custodian of the below named individual retirement account, hereby accepts and agrees to this subscription. By:____________________________ ________________________________ Signature of Authorized Signatory Print Name of Custodian ______________________________ Print Name of Authorized Signatory The Subscriber requests that the Offered Shares be issued in the following name and delivered to the following address: Name: ____________________________________________ Address: ____________________________________________ Accepted: SITESTAR CORPORATION By: _____________________________ Name: Sxxxxx X. Xxxx Title: Chief Executive Officer, Chief Financial Officer, and Director Date of Acceptance:__________ , 20__ Exhibit A NUMBER OF OFFERED SHARES AND SUBSCRIPTION PRICE Name of Subscriber Number of Offered Shares Subscribed for by Subscriber Price per Offered Share Total Subscription Price $0.001 par value $ Initials of the Subscriber: _____ A Subscriber wishing to subscribe for Offered Shares may do so by taking the following steps:
For Individual Investors. I certify that I am a natural person whose individual net worth, or joint net worth with the person’s spouse, excluding the value of any principal residence, at the time of his purchase exceeds $1,000,000. I certify that I am an accredited investor because I had individual income in excess of $200,000 in each of the two most recent years or joint income with that person’s spouse in excess of $300,000 in each of those years and has a reasonable expectation of reaching the same income level in the current year. FOR TRUSTS The Subscriber hereby certifies that it is an accredited investor because it is a trust with total assets in excess of $5,000,000, was not formed for the specific purpose of acquiring the Units offered and its purchase is directed by a sophisticated person. As used in the foregoing sentence, a “sophisticated person” is one who has such knowledge and experience in financial and business matters that he or it is capable of evaluating the merits and risks of the prospective investment. The Subscriber hereby certifies that it is a bank as defined in Section 3(a)(2) of the Securities Act, a savings and loan association or another institution as defined in Section 3(a)(5)(A) of the Securities Act, acting in a fiduciary capacity, and subscribing for the purchase of the Units being offering on behalf of a trust account or accounts. The Subscriber hereby certifies that it is a revocable trust which may be amended or revoked at any time by the grantors thereof and all of the grantors are accredited investors. The Manager, in its sole discretion, may request information regarding the basis on which such entity owners are accredited.
