Form of Subscription Agreement
EXHIBIT 10.1
SUBSCRIPTION AGREEMENT
Goldenwell Biotech, Inc.
The undersigned (the “Subscriber”) hereby irrevocably subscribes for that number of shares of common stock (the “Shares”) of Goldenwell Biotech, Inc., a Nevada corporation (the “Company”), set forth below, upon and subject to the terms and conditions set forth in the Company’s Prospectus dated _________, 2020, in the United States Securities and Exchange Commission Registration Statement on Form S-1, to which this Subscription Agreement is attached and which the Subscriber acknowledges as having received and read.
Total number of shares subscribed for at US $0.05 per share: ________________ shares.
Amount paid with this Subscription Agreement at a price of US $_____ per Share: US $________.
This Subscription Agreement constitutes the entire agreement among the parties hereto with respect to the subject matter hereof and may be amended only by a writing executed by all parties.
IN WITNESS WHEREOF,
The undersigned has executed this Subscription Agreement this ____ day of ______________, 2020.
Name of Entity (for purchasers which are entities only): _____________________
* Signature: _________________________________________
* Print Name: ________________________________________
Print Title (for purchasers which are entities only): _________________________
* Address: ____________________________________________
____________________________________________
Subscriber’s US Social Security Number or
* Identification number of home jurisdiction: ___________________________
Signature of Co-owners, if applicable: ___________________________________
* Name as it should appear on the Certificate: _______________________________
If Joint Ownership, check one (all parties must sign above):
[ ] Joint Tenants with Right of Survivorship
[ ] Tenants in Common
[ ] Community Property
If Fiduciary or Business Entity check one:
[ ] Trust Authorized Person _________________________ Capacity_____________________
[ ] Estate Authorized Person _________________________ Capacity_____________________
[ ] Corporation Authorized Person _________________________ Capacity_____________________
[ ] Limited Liability Company
Authorized Person _________________________ Capacity_____________________
[ ] Partnership Authorized Person _________________________ Capacity_____________________
[ ] Other ____________________ (Describe)
Authorized Person _________________________ Capacity_____________________
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ACCEPTANCE OF SUBSCRIPTION
The foregoing Subscription is hereby accepted for and on behalf of Goldenwell Biotech, Inc. this _____ day of _____________, 2020.
GOLDENWELL BIOTECH, INC.
By: ______________________________
Name: _______________________
Title: _______________________
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