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I, _________(1)_________, do hereby subscribe to purchase __(2)__ shares of Stock of ___________(3)___________, a ___(4)___ corporation (the "Company"), Par Value of which is $___(5)___, and for which I agree to pay $___(6)___ per share, for a total purchase price of $___(7)____.

I agree that my failure to pay any installments as may be required in a promissory note accompanying this subscription agreement is a default of my obligation hereunder, and if those

installments are not timely paid, (i) the Company may immediately terminate this Agreement; (ii) my right, title and interest in all the stock purchased hereby shall be null and void; (iii) the Company may cancel all shares of stock then held by me; (iv) I shall forfeit any monies which have been paid to the Company hereunder; and (v) I shall be deemed to have waived any and all claims or cause(s) of action which I may have against the Company.

DATED: ________(8)___________

______________(9)______________

Sworn to and subscribed before me this _(10)_ day of________(11)_______, 19_(12)_.

(SEAL)

_____________(13)______________

Notary Public

My Commission Expires:

_________(14)____________

ACCEPTED by and for the Corporation:

_____________(15)______________

President

DATED: _________(16)___________

The information in this document is designed to provide an outline that you can follow when formulating business or personal plans. Due to the variances of many local, city, county and state laws, we recommend that you seek professional legal counseling before entering into any contract or agreement.