Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
032 - OFFICE OF SECURITIES
Chapter 523 - RULE REGARDING SHORT-FORM SEED CAPITAL REGISTRATIONS
Subscription Agreement
Current through 2024-38, September 18, 2024
SUBSCRIPTION AGREEMENT FUND-ME OFFERING
Name of Company: |
Offered Securities: |
Date Offering Commenced: |
Minimum Dollar Amount Of Offering: |
Maximum Dollar Amount Of Offering: |
Instructions to Investor:The Company named above is attempting to sell its Offered Securities to the public in Maine through an Offering Circular on Form FND-ME. The Offering Circular contains important information about the Company and about risks involved in purchasing the Offered Securities. You are urged to read that document very carefully. If after reading that document you wish to purchase Offered Securities, you will need to fill out this Subscription Agreement. In the Subscription Agreement, you confirm the amount of Offered Securities that you are willing to buy, and you confirm that you are aware of various risks. By filling out and signing this Subscription Agreement and submitting the signed Agreement and payment to the Company, you are making a legally binding promise that
(i) the information you have provided here is accurate to the best of your knowledge and belief;
(ii) you agree to purchase the Offered Securities in the amount you state below if the Company decides to accept you as an investor; and
(iii) you agree to provide such further identifying information to the Company as it may reasonably request.
Risks Associated with Startup Business Investing:By signing this Subscription Agreement, you acknowledge that you have been warned about the following risks of startup business investing:
The securities being offered are illiquid. No public market for the offered securities exists.
Minimum and Maximum Investment:In a startup business offering such as this, the maximum amount that the Company can accept from any one Investor is $5,000 per year (unless the investor is an accredited investor). The Company is allowed to specify a minimum investment per investor. Within that maximum and minimum range, you may offer to buy any amount of the Offered Securities.
Maximum Dollars per Investor: | $ .00 |
Company Minimum per Investor: | $ .00 |
Your Commitment:Fill in the amount of the Offered Securities you wish to purchase (not more than $5,000; not less than the minimum, if any, stated above.) Provide the information required. Then sign in the space provided.
Amount You Wish to Invest Now: | $ |
Your Full Name: | |
Your Primary Residence Address: | |
Your Phone Number (daytime or mobile): | |
Your Email Address: | |
Year in Which You Were Born: | |
Your Signature: | ............................................................ (sign here) |