FORM OF SUBSCRIPTION (to be signed only on exercise of Warrant)
EX-10.10 4 ex1010.htm EXHIBIT 10.10 ex1010.htm
FORM OF SUBSCRIPTION
(to be signed only on exercise of Warrant)
TO: ACQUIRED SALES CORP.
The undersigned, pursuant to the provisions set forth in the attached Warrant (No.____), hereby irrevocably elects to purchase (check applicable box):
___ ________ shares of the Common Stock covered by such Warrant; or
___ the maximum number of shares of Common Stock covered by such Warrant pursuant to the cashless exercise procedure set forth in Section 2.
The undersigned herewith makes payment of the full purchase price for such shares at the price per share provided for in such Warrant, which is $___________. Such payment takes the form of (check applicable box or boxes):
___ $__________ in lawful money of the United States; and/or
___ the cancellation of such portion of the attached Warrant as is exercisable for a total of _______ shares of Common Stock (using a Fair Market Value of $_______ per share for purposes of this calculation); and/or
___ the cancellation of such number of shares of Common Stock as is necessary, in accordance with the formula set forth in Section 2, to exercise this Warrant with respect to the maximum number of shares of Common Stock purchasable pursuant to the cashless exercise procedure set forth in Section 2.
The undersigned requests that the certificates for such shares be issued in the name of, and
delivered to ________________________________________________________________________________________________________________________________
whose address is ____________________________________________________________________________________________________________________________
delivered to ________________________________________________________________________________________________________________________________
whose address is ____________________________________________________________________________________________________________________________
The undersigned represents and warrants that all offers and sales by the undersigned of the securities issuable upon exercise of the within Warrant shall be made pursuant to registration of the Common Stock under the Securities Act of 1933, as amended (the "Securities Act"), or pursuant to an exemption from registration under the Securities Act.
Dated:___________________ | _______________________________________________________________ (Signature must conform to name of holder as specified on the face of the Warrant) _______________________________________________________________ _______________________________________________________________ (Address) |