Common use of Omnibus Signature Page Clause in Contracts

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUP, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ --------------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ Title: Vice President and Chief Financial Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18June 2, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUP, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18JUNE 2, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ --------------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18May 27, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ---------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUPPRIVATE EQUITY FUND II, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18MAY 27, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ --------------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18May 27, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ---------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUPILLUMINATION FUND, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18MAY 27, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇--------------------------- -------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18May 27, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUP, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18May 27, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇--------------------------- -------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18June 2, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUP, ILLUMINATION FUND LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18JUNE 2, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇--------------------------- -------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18June 2, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUPPRIVATE EQUITY ACCREDITED FUND III, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18JUNE 2, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. --------------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18June 2, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUPPRIVATE EQUITY FUND I, LLC LP ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18JUNE 2, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇--------------------------- -------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18June 2, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUPPRIVATE EQUITY FUND II, LLC LP ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18JUNE 2, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇--------------------------- -------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18May 27, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUPPRIVATE EQUITY FUND I, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18May 27, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇--------------------------- -------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18June 21, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUP, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18JUNE 21, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇--------------------------- -------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 1813, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUP, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 1813, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ --------------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ Title: Vice President and Chief Financial Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)

Omnibus Signature Page. This Subscription Agreement is intended to be read and construed in conjunction with the Warrant Agreement, the Security Agreement, the Note and the Warrant. Accordingly, pursuant to the terms and conditions of this Subscription Agreement and such related agreements it is hereby agreed that the execution by the Lender of this Subscription Agreement, in the place set forth herein, shall constitute agreement to be bound by the terms and conditions hereof and the terms and conditions of the Warrant Agreement and the Security Agreement (as amended pursuant to Section 6 of this Subscription Agreement), with the same effect as if each of such separate but related agreement were separately signed. VYTERIS HOLDINGS (NEVADA), INC. OMNIBUS SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT, WARRANT AGREEMENT AND SECURITY AGREEMENT Date (NOTE: To be completed by subscriber): July 18May 27, 2005 -------------------------------------------------------------------------------- If the Purchaser is an INDIVIDUAL, and if purchased as JOINT TENANTS, as TENANTS IN COMMON, or as COMMUNITY PROPERTY: ---------------------------- ------------------------------ PRINT NAME(S) SOCIAL SECURITY NUMBER(S) --------------------------- ---------------------------- ------------------------------ SIGNATURE(S) OF SUBSCRIBER(S) SIGNATURE ---------------------------- ------------------------------ DATE ADDRESS If the Purchaser is a PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY or TRUST: ▇▇▇▇▇▇▇ ▇▇▇▇▇ SPECIALTY GROUPPRIVATE ACCREDITED EQUITY FUND III, LLC ---------------------------- ------------------------------ NAME OF PARTNERSHIP, FEDERAL TAXPAYER CORPORATION, LIMITED IDENTIFICATION NUMBER LIABILITY COMPANY OR TRUST BY: /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ DELAWARE NEW YORK ------------------------- ------------------------------ NAME: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ STATE OF ORGANIZATION TITLE: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, JULY 18MAY 27, 2005 ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ---------------------------- ------------------------------ DATE ADDRESS VYTERIS HOLDINGS (NEVADA), INC. By: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ --------------------------- Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ , Ph.D. Title: Vice President and Chief Financial Executive Officer ACCREDITED INVESTOR CERTIFICATION Initial the appropriate item(s) THE UNDERSIGNED FURTHER REPRESENTS AND WARRANTS AS INDICATED BELOW BY THE UNDERSIGNED'S INITIALS: A. INDIVIDUAL LENDER: (Please INITIAL one or more of the following five statements) 1. I certify that I am an accredited investor because I have had individual income (exclusive of any income earned by my spouse) of more than $200,000 in each of the most recent two years and I reasonably expect to have an individual income in excess of $200,000 for the current year. 2._____ I certify that I am an accredited investor because I have had joint income with my spouse in excess of $300,000 in each of the most recent two years and reasonably expect to have joint income with my spouse in excess of $300,000 for the current year.

Appears in 1 contract

Sources: Subscription Agreement (Vyteris Holdings (Nevada), Inc.)