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Notice To Buy Shares For Investment
To The Board of Directors
In order to induce you to sell shares of the common stock of [Corpoartion], ("the Corporation") I herewith make the following representations:
(a) that I am purchasing the shares for my own account, for investment, and not for distribution or resale.
(b) that I not will not resell or otherwise dispose or encumber the shares until and unless that changed circumstances or contingencies, none of which I am aware of at this time that I would need to dispose of the shares.
(c) That I am a bona fide and legal resident of the state of [State]. I if determine at some later time to sell or otherwise dispose of the shares that I will only sell or otherwise transfer the shares to another resident of the state of [State], or any other state approved by the corporation.
(d) That prior to any sale, transfer or other disposition I will deliver a written opinion of legal counsel that either:
(i) there is an exisiting exemption from registration under any applicable state or federal laws;
(ii) registration requirements necessary for such a proposed transfer have been met fully, and that the sale may proceed under the securities laws.
Such opinion shall be reasonably acceptable to the corporation.
The corporation may include stock transfer restrictions on the shares.
IT IS A VIOLATION OF FEDERAL AND STATE LAW TO MAKE FALSE REPRESENTATIONS IN ORDER TO INDUCE THE SALE OF SECURITIES.
*** If Required By State Law ***
This Section for Notary:
STATE OF -------)
) ss: [date]
COUNTY OF ------)
On [Date] before me, [Name of Notary], notary, personally appeared [Name of Person(s) Involved], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
[Name of Notary Public]
My commission expires: [date]