GALT PETROLEUM, INC. SUBSCRIPTION AGREEMENT
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EX-10.1 5 galt_ex101.htm FORM OF SUBSCRIPTION AGREEMENT galt_ex101.htm
The foregoing Subscription is hereby accepted in full on behalf of Galt Petroleum, Inc.
EXHIBIT 10.1
GALT PETROLEUM, INC.
SUBSCRIPTION AGREEMENT
Galt Petroleum, Inc.
175 South Main Street
15th Floor
Salt Lake City, Utah 84111
RE: Galt Petroleum, Inc. Common Stock
Ladies and Gentlemen:
The undersigned investor in this Subscription Agreement hereby acknowledges receipt of the Prospectus, dated __________________, 2012, of Galt Petroleum, Inc., a Nevada corporation (the “Company”), and subscribes for the following number of shares upon the terms and conditions set forth in the Prospectus.
The Investor agrees that this Subscription Agreement is subject to availability and acceptance by the Company.
The Investor hereby subscribes for ____________ shares of the Company’s common stock (“Common Stock”) at $1.00 per share, for an aggregate purchase price of $____________.
Payment of $____________ as payment in full of the purchase price is being made via check directly to the Company.
If this subscription is rejected by the Company, in whole or in part, for any reason, all funds will be returned within three business days of the Company’s receipt of such funds, without interest or deduction of any kind.
Purchaser Information:
| Printed Name: | |
| Signature: | |
| Date: | |
| Address: |
The foregoing Subscription is hereby accepted in full on behalf of Galt Petroleum, Inc.
Date ___________________.
| GALT PETROLEUM, INC. | ||
| By: | ||
| Cary Valerio | ||
| President and Principal Executive Officer | ||
