assurance that the actual results anticipated by the Company will be realized
or, even if substantially realized, that they will have the expected
consequences to or effects on the Company or its business or operations.
ARTICLE XI
BLUE SKY LEGENDS
NASAA UNIFORM LEGEND
IN MAKING AN INVESTMENT DECISION INVESTORS MUST RELY ON THEIR OWN EXAMINATION OF
THE COMPANY AND THE TERMS OF THE BRIDGE OFFERING, INCLUDING THE MERITS AND RISKS
INVOLVED. THESE SECURITIES HAVE NOT BEEN RECOMMENDED BY ANY FEDERAL OR STATE
SECURITIES COMMISSION OR REGULATORY AUTHORITY. FURTHERMORE, THE FOREGOING
AUTHORITIES HAVE NOT CONFIRMED THE ACCURACY OR DETERMINED THE ADEQUACY OF THIS
DOCUMENT. ANY REPRESENTATION TO THE CONTRARY IS A CRIMINAL OFFENSE. THESE
SECURITIES ARE SUBJECT TO RESTRICTIONS ON TRANSFERABILITY AND RESALE AND MAY NOT
BE TRANSFERRED OR RESOLD EXCEPT AS PERMITTED UNDER THE SECURITIES ACT OF 1933,
AS AMENDED, AND THE APPLICABLE STATE SECURITIES LAWS, PURSUANT TO REGISTRATION
OR EXEMPTION THEREFROM. INVESTORS SHOULD BE AWARE THAT THEY WILL BE REQUIRED TO
BEAR THE FINANCIAL RISKS OF THIS INVESTMENT FOR AN INDEFINITE PERIOD OF TIME.
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IN WITNESS WHEREOF, the parties have executed this Stock and Note Purchase
Agreement as of the day and year set forth below.
(a)
Signature of Investor
Signature of Co-Investor
Printed Name of Investor
Printed Name of Co-Investor
Address of Investor
Address of Co-Investor
Social Security Number of Investor
Social Security Number of Co-Investor
(b)
If Entity Investor:
By:
Name:
Title:
Address of Investor
Taxpayer Identification Number of Investor
(c)
Number of Bridge Units
$
Amount of Investment
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*If Investor is a Registered Representative with a FINRA member firm, have the
following acknowledgement signed by the appropriate party:
Subscription Accepted:
HemoBioTech, Inc.
The undersigned FINRA member firm acknowledges receipt of the notice required by
Rule 3050 of the FINRA Conduct Rules.
By:
Arthur P. Bollon, Ph.D., President
& Chief Executive Officer
Name of FINRA Member Firm
By:
Authorized Officer
30