Exhibit 10.1


 





Aerkomm
Inc.


COMMON
STOCK SUBSCRIPTION AGREEMENT


This
Common Stock Subscription Agreement (the “Agreement”) is made as of ______________, 201_, by and
among Aerkomm Inc., a Nevada corporation (the “Company”),
and the persons and entities named on the Schedule of Subscribers attached hereto as Exhibit A (individually, a “Subscriber”
and collectively, the “Subscribers”).


Recitals


To provide the Company
with additional resources to conduct its business and for the other uses of proceeds specified in this Agreement, the Company is
offering and selling to the Subscribers (the “Offering”) and the Subscribers are willing to purchase, in the
aggregate, up to 892,857 shares (each a “Share” and, collectively, the “Shares”) of the Company’s
Common Stock, $0.001 par value per share (“Common Stock”), for an aggregate purchase price of up to $5,000,000,
subject to the conditions specified herein. The Shares are being sold at a purchase price per Share of $5.60 (the “Per
Share Price”).


The Shares being
subscribed for pursuant to this Agreement have not been registered under the Securities Act of 1933, as amended (the “Securities
Act”). The Offering is being made exclusively to a select few “accredited investors,” as defined in Regulation
D under the Securities Act, known to the Company.


Agreement


Now,
Therefore, in consideration of the foregoing, and the representations, warranties, covenants and conditions set forth
below, the Company and each Subscriber, intending to be legally bound, hereby agree as follows:


1.                 
Subscription. Each undersigned Subscriber hereby subscribes
to purchase the number of shares of Common Stock equal to the Investment Amount set forth on its respective signature page attached
hereto divided by the Per Share Price, subject to the terms and conditions of this Agreement and based on the representations,
warranties, covenants and agreements contained herein. The Company may accept subscriptions and deposit funds in its corporate
account in one or several closings (each a “Closing”) that will occur on or before March 31, 2018. No minimum
amount must be raised for the Company to have a Closing and Subscriber funds will be deposited directly into the Company’s
operating bank account as no escrow account is being used for this Offering.


2.                 
Representations and Warranties of the Company. The Company
hereby represents and warrants to each Subscriber the following:


a.                  
Organization, Good Standing and Qualification. The Company is a corporation duly organized, validly existing and
in good standing under the laws of the State of Nevada. The Company has the requisite corporate power to own and operate its properties
and assets and to carry on its business as now conducted and as proposed to be conducted. The Company is duly qualified and is
authorized to do business and is in good standing as a foreign corporation in all jurisdictions in which the nature of its activities
and of its properties (both owned and leased) makes such qualification necessary, except for those jurisdictions in which failure
to do so would not have a material adverse effect on the Company or its business.



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b.                 
Corporate Power. The Company has all requisite corporate power to execute and deliver this Agreement and all related
agreements (the “Subscription Documents”) and to carry out and perform its obligations under the terms of the
Subscription Documents.


c.                  
Authorization. All corporate action on the part of the Company, its directors and its stockholders necessary for
the authorization of the Subscription Documents and the execution, delivery and performance of all obligations of the Company under
the Subscription Documents, including the issuance and delivery of the shares of Common Stock being subscribed for under this Agreement
(the “Shares”) has been taken or will be taken prior to the issuance of the Shares. The Subscription Documents,
when executed and delivered by the Company, shall constitute valid and binding obligations of the Company enforceable in accordance
with their terms, subject to laws of general application relating to bankruptcy, insolvency, the relief of debtors and, with respect
to rights to indemnity, subject to federal and state securities laws. The Shares, when issued in compliance with the provisions
of the Subscription Documents will be validly issued, fully paid and nonassessable and free of any liens or encumbrances and issued
in compliance with all applicable federal and securities laws.


d.                 
Governmental Consents. All consents, approvals, orders, or authorizations of, or registrations, qualifications, designations,
declarations, or filings with, any governmental authority, required on the part of the Company in connection with the valid execution
and delivery of this Agreement, the offer, sale or issuance of the Shares or the consummation of any other transaction contemplated
hereby shall have been obtained and will be effective when required by such governmental authority.


e.                  
Compliance with Laws. To its knowledge, the Company is not in violation of any applicable statute, rule, regulation,
order or restriction of any domestic or foreign government or any instrumentality or agency thereof in respect of the conduct of
its business or the ownership of its properties, which violation would materially and adversely affect the business, assets, liabilities,
financial condition or operations of the Company.


f.                  
Compliance with Other Instruments. The Company is not in violation or default of any term of its certificate of incorporation
or bylaws, or of any provision of any mortgage, indenture or contract to which it is a party and by which it is bound or of any
judgment, decree, order or writ, other than such violations that would not individually or in the aggregate have a material adverse
effect on the Company. The execution, delivery and performance of the Subscription Documents, and the consummation of the transactions
contemplated by the Subscription Documents will not result in any such violation or be in conflict with, or constitute, with or
without the passage of time and giving of notice, either a default under any such provision, instrument, judgment, decree, order
or writ or an event that results in the creation of any lien, charge or encumbrance upon any assets of the Company or the suspension,
revocation, impairment, forfeiture, or nonrenewal of any material permit, license, authorization or approval applicable to the
Company, its business or operations or any of its assets or properties. The sale of the Shares is not and will not be subject to
any preemptive rights or rights of first refusal that have not been properly waived or complied with.



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g.                 
Offering. Assuming the accuracy of the representations and warranties of the Subscribers contained in Section 3
hereof, the offer, issue, and sale of the Shares is exempt from the registration and prospectus delivery requirements of the Securities
Act, and has been registered or qualified (or is exempt from registration and qualification) under the registration, permit, or
qualification requirements of all applicable state securities laws.


h.                 
Use of Proceeds. The Company shall use the proceeds of sale and issuance of the Shares for the development and operation
of its business and for general corporate and working capital purposes.


3.                 
Representations and Warranties of the Subscriber. Each
Subscriber represents and warrants to the Company the following:


a.                  
Purchase for Own Account. Each Subscriber represents that it is acquiring the Shares solely for its own account and
beneficial interest for investment and not for sale or with a view to distribution of the Shares or any part thereof, has no present
intention of selling (in connection with a distribution or otherwise), granting any participation in, or otherwise distributing
the same, and does not presently have reason to anticipate a change in such intention.


b.                 
Information and Sophistication. Without lessening or obviating the representations and warranties of the Company
set forth in Section 2, each Subscriber hereby: (i) acknowledges that it has received all the information it has requested from
the Company and it considers necessary or appropriate for deciding whether to acquire the Shares, (ii) represents that it has had
an opportunity to ask questions and receive answers from the Company regarding the terms and conditions of the offering of the
Shares and to obtain any additional information necessary to verify the accuracy of the information given the Subscriber, (iii)
further represents that it has such knowledge and experience in financial and business matters that it is capable of evaluating
the merits and risk of this investment, and (iv) acknowledges that it has carefully reviewed the risk factors associated with an
investment in the Company, which may be found in the section captioned “Risk Factors” of the Company’s registration
statement on Form S-1, Amendment No. 2, which was filed with the U.S. Securities and Exchange Commission (the “SEC”)
on September 13, 2017 and available at https://www.sec.gov/Archives/edgar/data/1590496/000147793217004442/akom_s1a.htm or by searching
under the Company’s name on www.sec.gov.


c.                  
Ability to Bear Economic Risk. Each Subscriber acknowledges that investment in the Securities involves a high degree
of risk, and represents that it is able, without materially impairing its financial condition, to hold the Securities for an indefinite
period of time and to suffer a complete loss of its investment.



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d.                 
Further Limitations on Disposition. Without in any way limiting the representations set forth above, each Subscriber
further agrees not to make any disposition of all or any portion of the Securities unless and until:


		i.	There is then in effect a Registration Statement under the Securities Act or a qualified offering
statement under Regulation A (“Regulation A”) of the Securities Act covering such proposed disposition and such
disposition is made in accordance with such Registration Statement or qualified offering statement; or



		ii.	The Subscriber shall have notified the Company of the proposed disposition and shall have furnished
the Company with a detailed statement of the circumstances surrounding the proposed disposition, and if reasonably requested by
the Company, such Subscriber shall have furnished the Company with an opinion of counsel, reasonably satisfactory to the Company,
that such disposition will not require registration under the Securities Act or any applicable state securities laws, provided
that no such opinion shall be required for dispositions in compliance with Rule 144, except in unusual circumstances.



		iii.	Notwithstanding the provisions of paragraphs (a) and (b) above, no such registration statement
or opinion of counsel shall be necessary for a transfer by such Subscriber to a partner (or retired partner) or member (or retired
member) of such Subscriber in accordance with partnership or limited liability company interests, or transfers by gift, will or
intestate succession to any spouse or lineal descendants or ancestors, if all transferees agree in writing to be subject to the
terms hereof to the same extent as if they were Subscribers hereunder.



e.                  
Accredited Investor Status. Each Subscriber is an “accredited investor” as such term is defined in Rule
501 under the Act.


 


		4.	Further Agreements



a.                  
Registration Rights. The Company hereby grants the following registration rights to each Subscriber.


		i.	Registration Statement. The Company shall file with the SEC not later than ninety (90) days
after the date of the final Closing a registration statement on an appropriate form (the “Registration Statement”)
covering the resale of the Shares and shall use its commercially reasonable efforts to cause the Registration Statement to be declared
effective within one hundred eighty (180) days following the final Closing. Notwithstanding anything to the contrary herein, at
any time, the Company may delay the disclosure of material, non-public information concerning the Company the disclosure of which
at the time is not, in the good faith opinion of the Board of Directors of the Company, in the best interest of the Company and
otherwise required (a “Grace Period”); provided, that the Company shall promptly: (i) notify the Subscribers
in writing of the existence of material, non-public information giving rise to a Grace Period (provided that in each notice the
Company will not disclose the content of such material, non-public information to the Subscribers) and the date on which the Grace
Period will begin, and (ii) use commercially reasonable efforts to resolve any issue that makes disclosure of the material,
non-public information not in the best interests of the Company.







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		ii.	Registration Procedures. In connection with the Registration Statement, the Company will:



		1.	Prepare and file with the SEC such amendments and supplements to the Registration Statement and
the prospectus used in connection therewith as may be necessary to keep such Registration Statement effective with respect to the
Subscriber until all the Shares owned by such Subscriber may be resold without restriction under the Securities Act; and



		2.	Immediately notify the Subscribers when the prospectus included in the Registration Statement is
required to be delivered under the Securities Act, of the happening of any event of which the Company has knowledge as a result
of which the prospectus contained in such Registration Statement, as then in effect, includes an untrue statement of a material
fact or omits to state a material fact required to be stated therein or necessary to make the statements therein not misleading
in light of the circumstances then existing. If the Company notifies the Subscribers to suspend the use of any prospectus until
the requisite changes to such prospectus have been made, then the Subscribers shall suspend use of such prospectus. In such event,
the Company will use its commercially reasonable efforts to update such prospectus as promptly as is practicable.



		iii.	Provision of Documents etc. In connection with the Registration Statement, the Subscriber
will furnish to the Company in writing such information and representation letters with respect to itself and the proposed distribution
by it as reasonably shall be necessary in order to assure compliance with federal and applicable state securities laws. The Company
may require the Subscriber, upon five business days’ notice, to furnish to the Company a certified statement as to, among
other things, the number of Shares and the number of other shares of the Company’s Common Stock beneficially owned by such
Subscriber and the person that has voting and dispositive control over such shares. The Subscriber covenants and agrees that it
will comply with the prospectus delivery requirements of the Securities Act, if applicable, in connection with sales of Shares
pursuant to the Registration Statement.



		iv.	Expenses. All expenses incurred by the Company in complying with this section, including,
without limitation, all registration and filing fees, printing expenses, fees and disbursements of counsel and independent public
accountants for the Company, fees of transfer agents and registrars are called “Registration Expenses.” All
underwriting discounts and selling commissions applicable to the sale of the Shares, including any fees and disbursements of any
counsel to the Subscriber, are called “Selling Expenses.” The Company will pay all Registration Expenses in
connection with the Registration Statement. Selling Expenses in connection with the Registration Statement shall be borne by the
applicable Subscriber.



		v.	Indemnification and Contribution.



		1.	The Company will, to the extent permitted by law, indemnify and hold harmless each Subscriber,
and, as applicable, each officer of each Subscriber, each director of each Subscriber, and each other person, if any, who controls
each Subscriber within the meaning of the Securities Act, against any losses, claims, damages or liabilities, joint or several,
to which such Subscriber or such other person (a “controlling person”) may become subject under the Securities
Act or otherwise, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) (“Claims”)
arise out of or are based upon any untrue statement or alleged untrue statement of any material fact contained in the Registration
Statement at the time of its effectiveness, any preliminary prospectus or final prospectus contained therein, or any amendment
or supplement thereof, or arise out of or are based upon the omission or alleged omission to state therein a material fact required
to be stated therein or necessary to make the statements therein not misleading in light of the circumstances when made, and will,
subject to the limitations herein, reimburse such Subscriber and each such controlling person for any legal or other expenses reasonably
incurred by them in connection with investigating or defending any such Claim; provided, however, that the Company shall not be
liable to a Subscriber to the extent that any Claim arises out of or is based upon an untrue statement or alleged untrue statement
or omission or alleged omission made in conformity with information furnished by such Subscriber or any such controlling person
in writing specifically for use in the Registration Statement or related prospectus, as amended or supplemented.




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		2.	Each Subscriber severally but not jointly will, to the extent permitted by law, indemnify and hold
harmless the Company, and each person, if any, who controls the Company within the meaning of the Securities Act, each underwriter,
each officer of the Company who signs the Registration Statement and each director of the Company against all Claims to which the
Company or such officer, director, underwriter or controlling person may become subject under the Securities Act or otherwise,
insofar as such Claims arise out of or are based upon any untrue statement or alleged untrue statement of any material fact contained
in the Registration Statement, any preliminary prospectus or final prospectus contained therein, or any amendment or supplement
thereof, or the omission or alleged omission to state therein a material fact required to be stated therein or necessary to make
the statements therein not misleading, and will reimburse the Company and each such officer, director, underwriter and controlling
person for any legal or other expenses reasonably incurred by them in connection with investigating or defending any such loss,
claim, damage, liability or action, provided, however, that such Subscriber will be liable hereunder in any such case if and only
to the extent that any such Claim arises out of or is based upon an untrue statement or alleged untrue statement or omission or
alleged omission made in reliance upon and in conformity with information pertaining to such Subscriber, as such, furnished in
writing to the Company by such Subscriber specifically for use in the Registration Statement or related prospectus, as amended
or supplemented.



		3.	Promptly after receipt by an indemnified party hereunder of notice of the commencement of any action,
such indemnified party shall, if a claim in respect thereof is to be made against the indemnifying party hereunder, notify the
indemnifying party in writing thereof, but the omission so to notify the indemnifying party shall not relieve it from any liability
which it may have to such indemnified party other than under this section and shall only relieve it from any liability which it
may have to such indemnified party under this section except and only if and to the extent the indemnifying party is materially
prejudiced by such omission. In case any such action shall be brought against any indemnified party and it shall notify the indemnifying
party of the commencement thereof, the indemnifying party shall be entitled to participate in and, to the extent it shall wish,
to assume and undertake the defense thereof with counsel satisfactory to such indemnified party, and, after notice from the indemnifying
party to such indemnified party of its election so to assume and undertake the defense thereof, the indemnifying party shall not
be liable to such indemnified party under this section for any legal expenses subsequently incurred by such indemnified party in
connection with the defense thereof other than reasonable costs of investigation and of liaison with counsel so selected; provided,
however, that, if the defendants in any such action include both the indemnified party and the indemnifying party and the indemnified
party shall have reasonably concluded that there may be reasonable defenses available to it which are different from or additional
to those available to the indemnifying party or if the interests of the indemnified party reasonably may be deemed to conflict
with the interests of the indemnifying party, the indemnified parties, as a group, shall have the right to select one separate
counsel and to assume such legal defenses and otherwise to participate in the defense of such action, with the reasonable expenses
and fees of such separate counsel and other expenses related to such participation to be reimbursed by the indemnifying party as
incurred. The indemnifying party shall not be liable for any settlement of any such proceeding affected without its written consent,
which consent shall not be unreasonably withheld.



		4.	In order to provide for just and equitable contribution in the event of joint liability under the
Securities Act in any case in which either (i) a Subscriber, or any controlling person of a Subscriber, makes a claim for indemnification
pursuant to this section but it is judicially determined (by the entry of a final judgment or decree by a court of competent jurisdiction
and the expiration of time to appeal or the denial of the last right of appeal) that such indemnification may not be enforced in
such case notwithstanding the fact that this section provides for indemnification in such case, or (ii) contribution under the
Securities Act may be required on the part of the Subscriber or controlling person of the Subscriber in circumstances for which
indemnification is not provided under this section, then, and in each such case, the Company and the Subscriber will contribute
to the aggregate losses, claims, damages or liabilities to which they may be subject (after contribution from others) in a manner
that reflects, as near as practicable, the economic effect of the foregoing provisions of this section. Notwithstanding the foregoing,
no person or entity guilty of fraudulent misrepresentation (within the meaning of Section 10(f) of the Securities Act) will be
entitled to contribution from any person or entity who was not guilty of such fraudulent misrepresentation.







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		vi.	Delivery of Unlegended Shares.



		1.	Within three business days (such business day, the “Unlegended Shares Delivery Date”)
after the business day on which the Company has received (i) a notice that Shares have been sold either pursuant to, and in compliance
with, the Registration Statement or Rule 144 under the Securities Act and (ii) in the case of sales under Rule 144, customary representation
letters of the Subscriber and Subscriber’s broker regarding compliance with the requirements of Rule 144, the Company at
its expense, (A) shall deliver the Shares so sold without any restrictive legends relating to the Securities Act (the “Unlegended
Shares”); and (B) shall cause the transmission of the certificates representing the Unlegended Shares together with a
legended certificate representing the balance of the unsold Shares, if any, to the Subscriber at the address specified in the notice
of sale, via express courier, by electronic transfer or otherwise on or before the Unlegended Shares Delivery Date. Transfer fees
shall be the responsibility of the Subscriber.



		2.	In lieu of delivering physical certificates representing the Unlegended Shares, if the Company’s
transfer agent is participating in the Depository Trust Company (“DTC”) Fast Automated Securities Transfer program,
upon request of a Subscriber, so long as the certificates therefor do not bear a legend and the Subscriber is not obligated to
return such certificate for the placement of a legend thereon, the Company shall use its best efforts to cause its transfer agent
to electronically transmit the Unlegended Shares by crediting the account of Subscriber’s broker with DTC through its Deposit/Withdrawal
at Custodian system. Such delivery must be made on or before the Unlegended Shares Delivery Date but is subject to the cooperation
of the Subscriber’s broker (the so-called DTC participant).



		3.	The Subscriber, severally and not jointly, agrees that the removal of the restrictive legend from
certificates representing the Shares as set forth in this section is predicated upon the Company’s reliance that the Subscriber
will sell any Shares pursuant to either the registration requirements of the Securities Act, including any applicable prospectus
delivery requirements, or an exemption therefrom.



b.                 
“Market Stand-Off” Agreement. Each Subscriber agrees that such Subscriber shall not sell, transfer, make
any short sale of, grant any option for the purchase of, or enter into any hedging or similar transaction with the same economic
effect as a sale, any Common Stock (or other securities) of the Company held by such Subscriber (other than those included in the
registration) during the 180-day period following the effective date of the Company’s first firm commitment underwritten
public offering of its Common Stock registered under the Securities Act (or such longer period as the underwriters or the Company
shall request in order to facilitate compliance with FINRA Rule 2711 or NYSE Member Rule 472 or any successor or similar rule or
regulation), provided that all officers and directors of the Company are bound by and have entered into similar agreements. Each
Subscriber agrees to execute and deliver such other agreements as may be reasonably requested by the Company or the underwriters
that are consistent with the Subscriber’s obligations under Section 4(b) or that are necessary to give further effect to
this Section 4(b). In addition, if requested by the Company or the representative of the underwriters of Common Stock (or other
securities) of the Company, each Subscriber shall provide, within 10 days of such request, such information as may be required
by the Company or such representative in connection with the completion of any public offering of the Company’s securities
pursuant to a registration statement filed under the Act. The obligations described in this Section 4(b) shall not apply to a registration
relating solely to employee benefit plans on Form S-1 or Form S-8 or similar forms that may be promulgated in the future, or a
registration relating solely to a transaction on Form S-4 or similar forms that may be promulgated in the future.


c.                  
Further Assurances. Each Subscriber agrees and covenants that at any time and from time to time it will promptly
execute and deliver to the Company such further instruments and documents and take such further action as the Company may reasonably
require to carry out the full intent and purpose of this Agreement and to comply with state or federal securities laws or other
regulatory approvals.



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		5.	Miscellaneous



a.                  
Binding Agreement. The terms and conditions of this Agreement shall inure to the benefit of and be binding upon the
respective successors and assigns of the parties. Nothing in this Agreement, expressed or implied, is intended to confer upon any
third party any rights, remedies, obligations, or liabilities under or because of this Agreement, except as expressly provided
in this Agreement.


b.                 
Governing Law; Consent to Jurisdiction. This Agreement shall be governed by and construed under the laws of the State
of California as applied to agreements among California residents, made and to be performed entirely within the State of California,
without giving effect to conflicts of laws principles. Each party to this Agreement hereby irrevocably submits to the non-exclusive
jurisdiction of the state and federal courts sitting in the city of San Francisco for the adjudication of any dispute hereunder
or in connection with any transaction contemplated hereby, and hereby irrevocably waives, and agrees not to assert in any suit,
action or proceeding, any claim that it is not personally subject to the jurisdiction of any such court, that such suit, action
or proceeding is brought in an inconvenient forum or that the venue of such suit, action or proceeding is improper. Each party
hereby irrevocably waives personal service of process and consents to process being served in any such suit, action or proceeding
by mailing a copy thereof (certified or registered mail, return receipt requested) to such party at the address in effect for notices
to it under this agreement and agrees that such service shall constitute good and sufficient service of process and notice thereof.
Nothing contained herein shall be deemed to limit in any way any right to serve process in any manner permitted by law.


c.                  
Counterparts. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original,
but all of which together shall constitute one and the same instrument.


d.                 
Titles and Subtitles. The titles and subtitles used in this Agreement are used for convenience only and are not to
be considered in construing or interpreting this Agreement.


e.                  
Notices. All notices required or permitted hereunder shall be in writing and shall be deemed effectively given: (a) upon
personal delivery to the party to be notified, (b) when sent by confirmed electronic mail or facsimile if sent during normal
business hours of the recipient, if not, then on the next business day, (c) five days after having been sent by registered
or certified mail, return receipt requested, postage prepaid, or (d) one day after deposit with a nationally recognized overnight
courier, specifying next day delivery, with written verification of receipt. All communications shall be sent to the Company at
the address on the signature page below, and to Subscriber at the addresses set forth on the Schedule of Subscribers attached hereto
or at such other addresses as the Company or Subscriber may designate by 10 days advance written notice to the other parties hereto.


f.                  
Modification; Waiver. No modification or waiver of any provision of this Agreement or consent to departure therefrom
shall be effective only upon the written consent of the Company and the holders of a majority of the Shares being sold under this
Agreement.


g.                 
Expenses. The Company and each Subscriber shall each bear its respective expenses and legal fees incurred with respect
to this Agreement and the transactions contemplated herein.



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h.                 
Delays or Omissions. It is agreed that no delay or omission to exercise any right, power or remedy accruing to each
Subscriber, upon any breach or default of the Company under the Subscription Documents shall impair any such right, power or remedy,
nor shall it be construed to be a waiver of any such breach or default, or any acquiescence therein, or of or in any similar breach
or default thereafter occurring; nor shall any waiver of any single breach or default be deemed a waiver of any other breach or
default theretofore or thereafter occurring. It is further agreed that any waiver, permit, consent or approval of any kind or character
by Subscriber of any breach or default under this Agreement, or any waiver by any Subscriber of any provisions or conditions of
this Agreement must be in writing and shall be effective only to the extent specifically set forth in writing and that all remedies,
either under this Agreement, or by law or otherwise afforded to the Subscriber, shall be cumulative and not alternative.


i.                   
Entire Agreement. This Agreement and the exhibits and schedules hereto constitute the full and entire understanding
and agreement between the parties with regard to the subjects hereof and no party shall be liable or bound to any other party in
any manner by any representations, warranties, covenants and agreements except as specifically set forth herein.


 


 


[Signature pages follow]









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In
Witness Whereof, the parties have executed this Subscription Agreement
as of the date first written above.


 


	Company:	 	 
	 	 	 
	Aerkomm Inc.	 	 
	 	 	 
	By:	      	 	 
	Name:	 	 
	Title:	 	 



 


923 Incline Way #39


Incline Village, NV 89451


 









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In
Witness Whereof, the parties have executed this Subscription Agreement
as of the date first written above.


 


SUBSCRIBER:


 





	Signature block for individuals:	 	 
	 	Printed Name of Individual	 
	 	 	 
	 	 	 
	 	Signature of Individual	 
	 	 	 
	 	 	 
	Signature block for entities:	 	 
	 	Printed Name of Entity	 
	 	 	 
	 	By:	         	 
	 	 	 
	 	Name:	     	 
	 	 	 
	 	Title:	 	 
	 	 	 
	 	 	 
	Investment Amount: $_______________	 	 
	 	 	 
	 	 	 
	Address:	 	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 
	Phone Number:	                              	 	 



 







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EXHIBIT A


 


Schedule of Subscribers


(Subscribers)


 


 


 


	Name	Address	Number of Shares of Common Stock Purchased	Aggregate Common Purchase Price
	 	 	 	 
	 	 	 	 
	 	 	 	 
	 	 	 	 
	 	 	 	 
	TOTAL	 	 	 


 








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