Form D Filing. The Company hereby agrees that it shall file in a timely manner a Form D relating to the sale of the Shares under this Agreement, pursuant to Regulation D promulgated under the Securities Act. The parties hereto have executed this Agreement as of the date and year first above written. By: /s/ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ Chief Executive Officer The undersigned hereby executes and delivers to MedeFile International, Inc., the Securities Purchase Agreement (the “Agreement”) to which this signature page is attached, which Agreement and signature page, together with all counterparts of such Agreement and signature pages of the other Purchasers named in such Agreement, shall constitute one and the same document in accordance with the terms of such Agreement. Number of Shares: 400,000 Signature: A&O Family LLC By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ Title: Manager Address: Telephone: Fax: Tax ID Number: Please provide us with the following information: 1. The exact name that the Shares are to be registered in (this is the name that will appear on the stock certificate(s)). You may use a nominee name if appropriate: A&O Family LLC 2. The relationship between the Purchaser of the Shares and the Registered Holder listed in response to item 1 above: 3. The mailing address of the Registered Holder listed in response to item 1 above: 4. The Tax Identification Number of the Registered Holder listed in response to item 1 above:
Appears in 1 contract
Sources: Securities Purchase Agreement (Medefile International, Inc.)
Form D Filing. The Company hereby agrees that it shall file in a timely manner a Form D relating to the sale of the Shares under this Agreement, pursuant to Regulation D promulgated under the Securities Act. -- The parties hereto have executed this Agreement as of the date and year first above written. By: /s/ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ Chief Executive Officer The undersigned hereby executes and delivers to MedeFile International, Inc., the Securities Purchase Agreement (the “Agreement”) to which this signature page is attached, which Agreement and signature page, together with all counterparts of such Agreement and signature pages of the other Purchasers named in such Agreement, shall constitute one and the same document in accordance with the terms of such Agreement. Number of SharesFax: 400,000 Signature: A&O Family LLC By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ Title: Manager Address: Telephone: Fax: Tax ID Number: Please provide us with the following information:
1. The exact name that the Shares are to be registered in (this is the name that will appear on the stock certificate(s)). You may use a nominee name if appropriate: A&O Family LLC▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇
2. The relationship between the Purchaser of the Shares and the Registered Holder listed in response to item 1 above:
3. The mailing address of the Registered Holder listed in response to item 1 above:
4. The Tax Identification Number of the Registered Holder listed in response to item 1 above:
Appears in 1 contract
Sources: Securities Purchase Agreement (Medefile International, Inc.)
Form D Filing. The Company hereby agrees that it shall file in a timely manner a Form D relating to the sale of the Shares Securities under this Agreement, pursuant to Regulation D promulgated under the Securities Act. The parties hereto have executed this Agreement as of the date and year first above written. By: /s/ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ Chief Executive Officer The undersigned hereby executes and delivers to MedeFile InternationalCirque Energy, Inc., the Securities Purchase Agreement (the “Agreement”) to which this signature page is attached, which Agreement and signature page, together with all counterparts of such Agreement and signature pages of the other Purchasers named in such Agreement, shall constitute one and the same document in accordance with the terms of such Agreement. Number of Shares: 400,000 __________ Signature: A&O Family LLC By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ Title: Manager Address: Telephone: Fax: Tax ID Number: Please provide us with the following information:
1. The exact name that the Shares Securities are to be registered in (this is the name that will appear on the stock certificate(s)). You may use a nominee name if appropriate: A&O Family LLC:
2. The relationship between the Purchaser of the Shares Securities and the Registered Holder listed in response to item 1 above:
3. The mailing address of the Registered Holder listed in response to item 1 above:
4. The Tax Identification Number of the Registered Holder listed in response to item 1 above:
Appears in 1 contract
Sources: Securities Purchase Agreement (Cirque Energy, Inc.)
Form D Filing. The Company hereby agrees that it shall file in a timely manner a Form D relating to the sale of the Shares Securities under this Agreement, pursuant to Regulation D promulgated under the Securities Act. -- The parties hereto have executed this Agreement as of the date and year first above written. By: /s/ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ Chief Executive Officer The undersigned hereby executes and delivers to MedeFile Medefile International, Inc., the Securities Purchase Agreement (the “Agreement”) to which this signature page is attached, which Agreement and signature page, together with all counterparts of such Agreement and signature pages of the other Purchasers named in such Agreement, shall constitute one and the same document in accordance with the terms of such Agreement. Number of Shares: 400,000 100,000 Number of Warrants: Same as common after convert Signature: A&O Family LLC By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ By: ▇▇▇▇ ▇▇▇▇▇▇ Title: Manager Address: Telephone: Fax: Tax ID Number: Please provide us with the following information:
1. The exact name that the Shares Securities are to be registered in (this is the name that will appear on the stock certificate(s)). You may use a nominee name if appropriate: A&O Family LLC:
2. The relationship between the Purchaser of the Shares Securities and the Registered Holder listed in response to item 1 above:
3. The mailing address of the Registered Holder listed in response to item 1 above:
4. The Tax Identification Number of the Registered Holder listed in response to item 1 above:
Appears in 1 contract
Sources: Securities Purchase Agreement (Medefile International, Inc.)