IMMECOR SHARE PURCHASE AGREEMENT
California Residents: If your purchase is for more than $2,500
you will need to sign the representation at the bottom of this
Share Purchase Agreement!
o: Immecor Corporation
100~000 Xxxxxxxxxxxx Xxxxxx Xxxxx
Xxxxxxx Xxxx, XX 00000
(000) 000-0000
I have received and had an opportunity to read the Prospectus by which
the shares are offered. I represent that I am purchasing for investment.
Signature: ___________________________________________________________
Date: _____________
Enclosed is payment for ____________ shares (minimum 100) at $5.25 per
share, totaling $ _____________
Register the shares in the following name(s) and amount(s):
Name(s): ____________________________________________
Number of shares: ________________
As (check one): / / Individual / / Joint Tenants / / Trust
/ / Tenants in Common / / Corporation
/ / Other ___________________
For the person(s) who will be registered shareowner(s):
Mailing Address: _____________________________________________________________
City, State & Zip Code: ________________________________________________________
Telephone Numbers: Business: ( )____________________
Home: ( )______________________
Social Security or Taxpayer ID Number: _________________________________________
(Please attach any special mailing instructions
other than those shown above.)
No Share Purchase Agreement Is Effective
Until Acceptance (You will be mailed a signed and numbered
copy of this agreement to retain for your records.)
Share Purchase Agreement accepted by Immecor Corporation:
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Xxxxxx X. Xxxxxxxxxx, President & CEO Date
[If your purchase is for more than $2,500:] I (we) have at least the following
minimum income and net worth (You may include income and net worth for both
spouses. "Net worth" includes individual retirement plans and other assets,
valued at not more than fair market value, and excludes home, home furnishings
and automobiles): A minimum net worth of at least $75,000 and minimum gross
income of $50,000 during the current tax year; or, in the alternative, a minimum
net worth of $150,000. In either case, the amount of this investment does not
exceed 10 percent of my (our) net worth.
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Signature Date
