Number of Shares Subscribed For. Total subscription price payable: ($3.00 x number of Shares): -------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- PURCHASER INFORMATION --------------------- Name of Purchaser: ------------------------------------------------------ Street Address: ------------------------------------------------------ Street Address (2): ------------------------------------------------------ City and State: ------------------------------------------------------ Zip Code: ------------------------------------------------------ Contact Name: ------------------------------------------------------ Alternate Contact: ------------------------------------------------------ Phone No.: ------------------------------------------------------ Fax No: ------------------------------------------------------ -------------------------------------------------------------------------------- CHINA GRANITE CORPORATION 6 Subscription Agreement -------------------------------------------------------------------------------- REGISTRATION INFORMATION ------------------------ Registration of the certificates representing the Shares should be made exactly as follows (if space is insufficient, attach a list): Name of Purchaser: ------------------------------------------------------ Street Address: ------------------------------------------------------ Street Address (2): ------------------------------------------------------ City and State: ------------------------------------------------------ Zip Code: ------------------------------------------------------ Contact Name: ------------------------------------------------------ Alternate Contact: ------------------------------------------------------ Phone No.: ------------------------------------------------------ Fax No: ------------------------------------------------------ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- DELIVERY OF CERTIFICATES ------------------------ The certificates representing the Shares are to be delivered as follows (if different from the address(es) set forth "Registration Information" above): Name of Purchaser: ------------------------------------------------------ Street Address: ------------------------------------------------------ Street Address (2): ------------------------------------------------------ City and State: ------------------------------------------------------ Zip Code: ------------------------------------------------------ Contact Name: ------------------------------------------------------ Alternate Contact: ------------------------------------------------------ Phone No.: ------------------------------------------------------ Fax No: ------------------------------------------------------ -------------------------------------------------------------------------------- CHINA GRANITE CORPORATION 7 Subscription Agreement -------------------------------------------------------------------------------- BENEFICIAL PURCHASER INFORMATION -------------------------------- If the Purchaser is acting for a beneficial purchaser, the name and address of such beneficial purchaser is as follows: Name of Purchaser: ------------------------------------------------------ Street Address: ------------------------------------------------------ Street Address (2): ------------------------------------------------------ City and State: ------------------------------------------------------ Zip Code: ------------------------------------------------------ Contact Name: ------------------------------------------------------ Alternate Contact: ------------------------------------------------------ Phone No.: ------------------------------------------------------ Fax No: ------------------------------------------------------ --------------------------------------------------------------------------------
Appears in 2 contracts
Sources: Subscription Agreement (China Granite Corp), Subscription Agreement (China Granite Corp)