FORM OF SUBSCRIPTION. (To be signed only upon exercise of Option) To COIL TUBING TECHNOLOGY, INC.: The undersigned, the holder of the enclosed Option, hereby irrevocably elects to exercise the purchase right represented by such Option for, and to purchase thereunder, * shares of Common Stock of COIL TUBING TECHNOLOGY, INC. and herewith makes payment of US $_______________(or elects to pay for the exercise in shares of common stock pursuant to Section 3(f)(ii) of the Stock Option Agreement as evidenced by the calculation below by checking this box o), and requests that the certificate or certificates for such shares be issued in the name of and delivered to the undersigned. Dated:______________ ____________________________________________ (Signature must conform in all respects to name of holder as specified on the face of the enclosed Option) ____________________________________________ (Printed Name) ____________________________________________ (Address) (*) Insert here the number of shares called for on the face of the Option or, in the case of a partial exercise, the portion thereof as to which the Option is being exercised, in either case without making any adjustment for additional Common Stock or any other stock or other securities or property which, pursuant to the adjustment provisions of the Option Agreement pursuant to which the Option was granted, may be delivered upon exercise. Calculation pursuant to Section 3(f)(ii) of the Stock Option Agreement ________________ = Total Shares Exercised ________________ = Purchase Price (as defined and adjusted in the Stock Option Agreement) ________________ = Fair Market Value - the average closing price of the Common Stock (if actual sales price information on any trading day is not available, the closing bid price shall be used) for the five trading days prior to the date of exercise of this Warrant (the “Average Closing Bid Price”), as reported by the National Association of Securities Dealers Automated Quotation System (“NASDAQ”), or if the Common Stock is not traded on NASDAQ, the Average Closing Bid Price on the over-the-counter market or pink sheets; provided, however, that if the Common Stock is listed on a stock exchange, the Fair Market Value shall be the Average Closing Bid Price on such exchange; and, provided further, that if the Common Stock is not quoted or listed by any organization, the fair value of the Common Stock, as determined by the Board of Directors of the Company, whose determination shall be conclusive,...
FORM OF SUBSCRIPTION. TO: Enterra Systems Inc. 00 - 0000 Xxxxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxx Xxxxxxxx Xxxxxx X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for___________ common shares (the “Shares”) of Enterra Systems Inc. (the “Company) pursuant to the within Warrants at US$1.15 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned Holder hereby certifies that the undersigned is not a U.S. person and is not subscribing for the Shares on Behalf of a U.S. person. The undersigned hereby directs that the Shares be registered as follows: NAME(S) IN FULL ADDRESS(ES) NUMBER OF SHARES C.M.M.G. Finance, Inc. 000-000 Xxxx Xxxxxxxx Xxxxxx Xxxxxxxxx XX TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this 29 day of November, 2005. In the presence of: C.M.M.G. Finance, Inc. Signature of Witness Authorized Signature Please print below your name and address in full. Name (Mr./Mrs./Miss) Xx. Xxxxxxxx Xxxxxx Address 000-000 Xxxx Xxxxxxxx Xxxxxx Xxxxxxxxx XX
FORM OF SUBSCRIPTION. TO: Global Innovative Systems, Inc. 1703, Top Glory Tower 000 Xxxxxxxxxx Xxxx Xxxxxxxx Xxx Xxxx Xxxx The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Global Innovative Systems, Inc. (the “Company) pursuant to the within Warrants at US$_______ per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned Holder hereby certifies that the undersigned is not a U.S. person and is not subscribing for the Shares on behalf of a U.S. person. The undersigned hereby directs that the Shares be registered as follows: NAME(S) IN FULL ADDRESS(ES) NUMBER OF SHARES TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of __________________, ______. In the presence of: Signature of Witness Signature of Warrant Holder Please print below your name and address in full. Name (Mr./Mrs./Miss) Address
FORM OF SUBSCRIPTION. (To be signed only upon exercise of Warrant) To: Aura Systems, Inc.
FORM OF SUBSCRIPTION. (To be signed only upon exercise of Warrant) To Xxxxxxx Chaus, Inc. The undersigned, the Holder of the within Warrant, hereby irrevocably elects to exercise the purchase right represented by such Warrant for, and to purchase thereunder, _____(1) shares of Common Stock of Xxxxxxx Chaus, Inc. and herewith makes payment of $_____ therefor, and requests that the certificate or certificates for such shares be issued in the name of and delivered to the undersigned. Dated -------------------------------------- (Signature must conform in all respects to name of Holder as specified on the face of the Warrants) -------------------------------------- (Address)
FORM OF SUBSCRIPTION. TO: Pan American Gold Corporation Suite 605 – 000 Xxxx Xxxxxx Vancouver, BC V6C 2B3 The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Pan American Gold Corporation (the “Company) pursuant to the within Warrants at CDN$0.83 per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned Holder hereby certifies that the undersigned is not a U.S. person and is not subscribing for the Shares on behalf of a U.S. person. The undersigned hereby directs that the Shares be registered as follows: NAME(S) IN FULL ADDRESS(ES) NUMBER OF SHARES
FORM OF SUBSCRIPTION. [To be executed only upon exercise of Warrant] To Simmxxx Xxxdings, Inc.: The undersigned registered holder of the within Warrant hereby irrevocably exercises such Warrant for, and purchases thereunder, _____________ (1) shares of the Common Stock and herewith makes payment of $_________________ therefor, and requests that the certificates for such shares be issued in the name of, and deliver to _________________, whose address is Dated: ----------------------------- (Signature must conform in all respects to name of holder as specified on the face of Warrant) ------------------------------------ (Street Address) ------------------------------------ (City) (State) (Zip Code)
FORM OF SUBSCRIPTION. TO: Intelimax Media Inc. 2320 - 000 Xxxx Xxxxxxxx, Xxxxxxxxx, Xxxxxxx Xxxxxxxx, X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Intelimax Media Inc. (the “Company) pursuant to the within Warrants at US$____ per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned hereby directs that the Shares be registered as follows: NAME(S) IN FULL ADDRESS(ES) NUMBER OF SHARES ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ TOTAL: ___________________________ (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of __________________ , ______. In the presence of: ___________________________ ___________________________ Signature of Witness Signature of Warrant Holder Please print below your name and address in full. Name (Mr./Mrs./Miss) ___________________________ Address ___________________________ ___________________________
FORM OF SUBSCRIPTION. TO: Eden Energy Corp. 1925 – 000 Xxxxxxx Xxxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned Holder of the within Warrants hereby subscribes for ____________ common shares (the “Shares”) of Eden Energy Corp. (the “Company) pursuant to the within Warrants at [US$3.25 or US$5.25] per Share on the terms specified in the said Warrants. This subscription is accompanied by a certified cheque or bank draft payable to or to the order of the Company for the whole amount of the purchase price of the Shares. The undersigned hereby directs that the Shares be registered as follows: NAME(S) IN FULL ADDRESS(ES) NUMBER OF SHARES TOTAL: (Please print full name in which share certificates are to be issued, stating whether Mr., Mrs. or Miss is applicable). DATED this ________ day of __________________, 2006. In the presence of: Signature of Witness Signature of Warrant Holder Please print below your name and address in full. Name (Mr./Mrs./Miss)
FORM OF SUBSCRIPTION. (To be signed only upon exercise of Warrant) To: THINKENGINE NETWORKS, INC. [The undersigned, the Holder of the within Warrant, hereby irrevocably elects to exercise the purchase right represented by such Warrant for, and to purchase thereunder, * shares of Common Stock of ThinkEngine Networks, Inc., and herewith makes payment of $__________ and requests that the certificates for such shares be issued in the name of, and delivered to, ___________________, whose address is _______________________.]
