Common use of Address Information Clause in Contracts

Address Information. For individual subscribers this address should be the Subscriber’s primary legal residence. For entities other than individual subscribers, please provide address information for the entities primary place of business. Information regarding a joint subscriber should be included in the column at right. Legal Address Le▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇▇▇▇▇▇ City, State, and Zip Code City, State, and Zip Code AGREED AND SUBSCRIBED ACCEPTED This ___ day of _________, 2018 This ___ day of _______, 2018 By: By: Name: Ia▇ ▇▇▇▇▇▇▇▇ Name: Pa▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Title (if any): Title: Chief Executive Officer I, ___________________, am the ________________ of ____________________ (the “Entity”). I certify that I am empowered and duly authorized by the Entity to execute and carry out the terms of the Securities Purchase Agreement and to purchase and hold the Note and Warrants, and certify further that the Securities Purchase Agreement has been duly and validly executed on behalf of the Entity and constitutes a legal and binding obligation of the Entity.

Address Information. For individual subscribers this address should be the Subscriber’s primary legal residence. For entities other than individual subscribers, please provide address information for the entities primary place of business. Information regarding a joint subscriber should be included in the column at right. Legal Address Le▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇Legal Address Da▇▇▇▇, ▇▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇▇▇▇▇▇ City, State, and Zip Code City, State, and Zip Code AGREED AND SUBSCRIBED ACCEPTED This ___ day of _________, 2018 This ___ day of _______, 2018 By: By: Name: IaTi▇▇▇▇▇ ▇’▇▇▇▇▇▇▇▇ Name: Pa▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Title (if any): Managing Member Title: Chief Executive Officer I, ___________________Ti▇▇▇▇▇ ▇’▇▇▇▇▇▇▇▇, am the ________________ Managing Member of ____________________ IC, LLC (the “Entity”). I certify that I am empowered and duly authorized by the Entity to execute and carry out the terms of the Securities Purchase Agreement and to purchase and hold the Note and Warrants, and certify further that the Securities Purchase Agreement has been duly and validly executed on behalf of the Entity and constitutes a legal and binding obligation of the Entity.