Purchaser Questionnaire. You are being requested to answer questions in connection with the proposed offer and sale, pursuant to an exemption from the registration provisions of the Securities Act of 1933, as amended (the "Act") and in particular, Rule 505 of Regulation D, of shares of the Common Stock, $.002 par value per share (the "Shares') of American Film Technologies, Inc, a Delaware corporation (the "Company"). The availability of the exemption depends, in part, on a determination that each purchaser is an "accredited investor" as defined in Rule 501(a) of Regulation D. The information supplied will be used in determining whether the sale of the Shares meets such criteria. The information will be kept confidential and will not be disclosed except to the Company, its counsel, and if required, to governmental and regulatory authorities. Please PRINT your response to each question; and, where the answer to any question if "None" or "Not Applicable" please so state. I, (we), __________________________________, understand the Shares are being issued WITHOUT registration under the Act in reliance upon the private offering exemption contained in Rule 505 of Regulation D promulgated under Section 4(2) of the Securities Act, and that such reliance is based in part on the information herein supplied. For the foregoing reasons, and to induce the Company to issue and deliver the Shares to me, I represent and warrant that the information stated herein is true, accurate and complete to the best of my knowledge and belief, and I agree to notify and supply corrective information promptly if, prior to the consummation of my purchase of the Shares, any of such information becomes inaccurate and incomplete. INDIVIDUAL AND JOINT PURCHASERS SHOULD COMPLETE SECTION A CORPORATIONS, BUSINESS TRUSTS AND PARTNERSHIPS SHOULD COMPLETE SECTION B
Appears in 1 contract
Sources: Stock Purchase Agreement (American Film Technologies Inc /De/)
Purchaser Questionnaire. You are being requested This Purchaser Questionnaire (this “Questionnaire”) must be completed and delivered to answer questions in connection with BOSTON OMAHA CORPORATION, a Delaware corporation (the proposed offer “Company”), by you as a prospective purchaser of shares of Class A Common Stock of the Company (the “Shares”) and salewarrants to purchase additional shares of Class A Common Stock of the Company (“Warrants”). The purpose of this Questionnaire is to determine whether you meet the standards imposed by Section 4(2) of, pursuant to an exemption from the registration provisions of or Regulation D under, the Securities Act of 1933, as amended (the "“Securities Act") and in particular”). Eligibility is determined, Rule 505 of Regulation Damong other things, of shares by the ability of the Common Stockinvestor to evaluate the merits and risks of an investment in Shares and Warrants of the Company based on his or her knowledge and experience in financial and business matters, $.002 par value per share (the "Shares') of American Film Technologies, Inc, a Delaware corporation (the "Company")or by certain financial criteria. The availability undersigned understands that the offering of the Shares and Warrants by the Company has not been, and will not be, registered under the Securities Act, the securities of “blue sky” laws of any state or other jurisdiction, and the Shares and Warrants involved in this offering are being sold in reliance upon an exemption dependsfrom the registration requirements thereof. Please thoroughly complete, sign and date this Questionnaire, and deliver it to: Please contact ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, counsel to the Company, at (▇▇▇) ▇▇▇-▇▇▇▇ if you have any questions with respect to this Questionnaire. Incomplete answers to questions or questions answered in such a way (either singly or collectively) so as to indicate to the Company that it should ask for more information will delay the Company’s review of the Questionnaire and consideration of the proposed investment by the prospective investor. Your answers will be relied upon by the Company. Your answers will be kept confidential, except to the extent disclosure may be required under or in connection with any federal or state laws or if the contents are relevant to an issue in any action, suit or proceeding to which the Company is a party or by which it is or may be bound. However, each person who agrees to invest in the Company hereby agrees that the Company may present this completed Questionnaire or a copy of this completed Questionnaire to its attorneys or such other parties as it/they, in partits/their sole discretion, on a determination deem appropriate to ensure that each purchaser is an "accredited investor" as defined in Rule 501(a) of Regulation D. The information supplied will be used in determining whether the proposed offer and sale of the Shares meets such criteria. The information will be kept confidential and Warrants of the Company involved in this offering will not result in a violation of the registration provisions of the Securities Act or a violation of the securities or “blue sky” laws of any state or other jurisdiction. A false statement by you will constitute a violation of your representations and warranties under the Subscription Agreement and may also constitute a violation of law, for which a claim for damages may be disclosed except to made against you. This Questionnaire does not constitute an offer of Shares or Warrants by the Company, its counsel, and if required, to governmental and regulatory authoritiesbut is merely a request for information. Please PRINT your response to each question; and, where the answer to any question if "None" print or "Not Applicable" please so state. I, (we), __________________________________, understand the Shares are being issued WITHOUT registration under the Act in reliance upon the private offering exemption contained in Rule 505 of Regulation D promulgated under Section 4(2) of the Securities Act, and that such reliance is based in part on the information herein supplied. For the foregoing reasons, and to induce the Company to issue and deliver the Shares to me, I represent and warrant that the information stated herein is true, accurate and complete to the best of my knowledge and belief, and I agree to notify and supply corrective information promptly if, prior to the consummation of my purchase of the Shares, any of such information becomes inaccurate and incomplete. INDIVIDUAL AND JOINT PURCHASERS SHOULD COMPLETE SECTION A CORPORATIONS, BUSINESS TRUSTS AND PARTNERSHIPS SHOULD COMPLETE SECTION Btype:
Appears in 1 contract
Purchaser Questionnaire. You are Gentlemen: The information contained herein is being requested furnished to answer questions in connection with the proposed offer and saleMOBIEYES SOFTWARE, pursuant to an exemption from the registration provisions of the Securities Act of 1933, as amended (the "Act") and in particular, Rule 505 of Regulation D, of shares of the Common Stock, $.002 par value per share (the "Shares') of American Film Technologies, Inc, a Delaware corporation INC. (the "Company")) in order that it may determine whether to accept a subscription offer for Securities made by me. The availability I understand that the information is needed for the Company to determine whether you have reasonable grounds to believe that I am an "Accredited Investor" as that term is defined in Regulation D promulgated under the Act, or am otherwise qualified to make an investment in the Company in accordance with the investment standards established by the Company, and that I have such knowledge and experience in financial and business matters that I am capable of evaluating the merits and risks of the exemption dependsproposed investment in the Company. I understand that (a) you will rely on the information contained herein for purposes of such determination, in part, on a determination that each purchaser is an "accredited investor" as defined in Rule 501(a(b) of Regulation D. The information supplied will be used in determining whether the sale of the Shares meets such criteria. The information will be kept confidential and Securities will not be disclosed except to the Company, its counsel, and if required, to governmental and regulatory authorities. Please PRINT your response to each question; and, where the answer to any question if "None" or "Not Applicable" please so state. I, (we), __________________________________, understand the Shares are being issued WITHOUT registration registered under the Act in reliance upon the private offering exemption exemptions from registration afforded under the Act, (c) the Securities will not be registered under the securities laws of any state in reliance upon similar exemptions, and (d) this questionnaire is not an offer to purchase the Securities in any case where such offer would not be legally permitted. Information contained in Rule 505 of Regulation D promulgated under Section 4(2) of the Securities Act, and that such reliance is based in part on the information herein supplied. For the foregoing reasons, and to induce this questionnaire will be kept confidential by the Company to issue and deliver the Shares to meits agents, employees or representatives. I represent and warrant understand, however, that the Company may have the need to present it to such parties as it deems advisable in order to establish the applicability under any federal or state securities laws of an exemption from registration. In accordance with the foregoing, the following representations and information stated herein are hereby made and furnished: Please answer all questions. If the answer is true, accurate and complete to the best of my knowledge and belief, and I agree to notify and supply corrective information promptly if, prior to the consummation of my purchase of the Shares, any of such information becomes inaccurate and incomplete"none" or "not applicable," please so state. INDIVIDUAL AND JOINT PURCHASERS SHOULD COMPLETE SECTION A CORPORATIONS, BUSINESS TRUSTS AND PARTNERSHIPS SHOULD COMPLETE SECTION BINFORMATION REQUIRED OF EACH PROSPECTIVE INVESTOR:
Appears in 1 contract
Purchaser Questionnaire. You are being requested to answer questions in connection with the proposed offer and sale, pursuant to an exemption from the registration provisions of the Securities Act of 1933, as amended (the "Act") and in particular, Rule 505 of Regulation D, of shares of the Common Stock, $.002 par value per share (the "Shares') of American Film Technologies, Inc,, a Delaware corporation (the "Company"). The availability of the exemption depends, in part, on a determination that each purchaser is an "accredited investor" as defined in Rule 501(a) of Regulation D. The information supplied will be used in determining whether the sale of the Shares meets such criteria. The information will be kept confidential and will not be disclosed except to the Company, its counsel, and if required, to governmental and regulatory authorities. Please PRINT your response to each question; and, where the answer to any question if "None" or "Not Applicable" please so state. I, (we), __________________________________, understand the Shares are being issued WITHOUT registration under the Act in reliance upon the private offering exemption contained in Rule 505 of Regulation D promulgated under Section 4(2) of the Securities Act, and that such reliance is based in part on the information herein supplied. For the foregoing reasons, and to induce the Company to issue and deliver the Shares to me, I represent and warrant that the information stated herein is true, accurate and complete to the best of my knowledge and belief, and I agree to notify and supply corrective information promptly if, prior to the consummation of my purchase of the Shares, any of such information becomes inaccurate and incomplete. INDIVIDUAL AND JOINT PURCHASERS SHOULD COMPLETE SECTION A CORPORATIONS, BUSINESS TRUSTS AND PARTNERSHIPS SHOULD COMPLETE SECTION B
Appears in 1 contract
Sources: Stock Purchase Agreement (American Film Technologies Inc /De/)
Purchaser Questionnaire. You are being requested This Purchaser Questionnaire (this “Questionnaire”) must be completed and delivered to answer questions in connection with BOSTON OMAHA CORPORATION, a Delaware corporation (the proposed offer and sale“Company”), pursuant by you as a prospective purchaser of shares of Common Stock of the Company (the “Shares”). The purpose of this Questionnaire is to an exemption from determine whether you meet the registration provisions of standards imposed by Section 4(2) of, or Regulation D under, the Securities Act of 1933, as amended (the "“Securities Act") and in particular”). Eligibility is determined, Rule 505 of Regulation Damong other things, of shares by the ability of the Common Stockinvestor to evaluate the merits and risks of an investment in Shares of the Company based on his or her knowledge and experience in financial and business matters, $.002 par value per share (the "Shares') of American Film Technologies, Inc, a Delaware corporation (the "Company")or by certain financial criteria. The availability undersigned understands that the offering of the Shares by the Company has not been, and will not be, registered under the Securities Act, the securities of “blue sky” laws of any state or other jurisdiction, and the Shares involved in this offering are being sold in reliance upon an exemption dependsfrom the registration requirements thereof. Please thoroughly complete, sign and date this Questionnaire, and deliver it to: Please contact ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, counsel to the Company, at (▇▇▇) ▇▇▇-▇▇▇▇ if you have any questions with respect to this Questionnaire. Incomplete answers to questions or questions answered in such a way (either singly or collectively) so as to indicate to the Company that it should ask for more information will delay the Company’s review of the Questionnaire and consideration of the proposed investment by the prospective investor. Your answers will be relied upon by the Company. Your answers will be kept confidential, except to the extent disclosure may be required under or in connection with any federal or state laws or if the contents are relevant to an issue in any action, suit or proceeding to which the Company is a party or by which it is or may be bound. However, each person who agrees to invest in the Company hereby agrees that the Company may present this completed Questionnaire or a copy of this completed Questionnaire to its attorneys or such other parties as it/they, in partits/their sole discretion, on a determination deem appropriate to ensure that each purchaser is an "accredited investor" as defined in Rule 501(a) of Regulation D. The information supplied will be used in determining whether the proposed offer and sale of the Shares meets such criteria. The information will be kept confidential and of the Company involved in this offering will not result in a violation of the registration provisions of the Securities Act or a violation of the securities or “blue sky” laws of any state or other jurisdiction. A false statement by you will constitute a violation of your representations and warranties under the Subscription Agreement and may also constitute a violation of law, for which a claim for damages may be disclosed except to made against you. This Questionnaire does not constitute an offer of Shares by the Company, its counsel, and if required, to governmental and regulatory authoritiesbut is merely a request for information. Please PRINT your response to each question; and, where the answer to any question if "None" print or "Not Applicable" please so state. I, (we), __________________________________, understand the Shares are being issued WITHOUT registration under the Act in reliance upon the private offering exemption contained in Rule 505 of Regulation D promulgated under Section 4(2) of the Securities Act, and that such reliance is based in part on the information herein supplied. For the foregoing reasons, and to induce the Company to issue and deliver the Shares to me, I represent and warrant that the information stated herein is true, accurate and complete to the best of my knowledge and belief, and I agree to notify and supply corrective information promptly if, prior to the consummation of my purchase of the Shares, any of such information becomes inaccurate and incomplete. INDIVIDUAL AND JOINT PURCHASERS SHOULD COMPLETE SECTION A CORPORATIONS, BUSINESS TRUSTS AND PARTNERSHIPS SHOULD COMPLETE SECTION Btype:
Appears in 1 contract
Sources: Common Stock Subscription Agreement (BOSTON OMAHA Corp)