the signature page hereof.
[Signature Page Follows]
12
IN WITNESS WHEREOF, THE UNDERSIGNED HAS EXECUTED THIS SECURITIES PURCHASE
AGREEMENT ON THE DATE SET FORTH BELOW.
The undersigned is subscribing for Series F Shares at the purchase price of $115
per Share for an aggregate investment of $_______________.
The Shares(s) is/are to be issued in the name of (check one box):
____ individual name
____ joint tenants with rights of survivorship
____ tenants in the entirety
____ corporation (an officer must sign)
____ Partnership (all general
partners must sign)
Date:
Print Name of Investor:
Signature of Investor:
(and title if signing on behalf of an entity)
Print Name of Joint Investor:
Signature of Joint Investor:
Address of Investor:
Social Security Number (if
individual):
Tax Identification Number (if entity):
State of Organization (if entity):
AGREED TO AND ACCEPTED:
As of ___________ __, 2020
BIOHITECH GLOBAL, INC.
By:
Name:
Title:
13