Document:

Exhibit
10.1

AMENDED AND RESTATED GENERAL SEVERANCE
  AGREEMENT

This Amended and Restated General Severance
Agreement (the “Agreement”) is made as of the 22 day of November, 2011, between Enzon Pharmaceuticals, Inc., a Delaware
corporation, with offices in Bridgewater, New Jersey (the “Company”), and Ana I. Stancic (“Executive”),
a resident of New Jersey, and supersedes and replaces that Severance Agreement, dated as of June 8, 2011, by and between the Company
and Executive (the “Previous Agreement”).

BACKGROUND

A.     This
  Agreement is intended to specify, among other things, the financial arrangements
  that the Company will provide to the Executive upon Executive’s separation
from employment with the Company under any of the circumstances described herein.

B.     Executive
  is employed by the Company in the capacity of Executive Vice President, Chief Operating Officer, Principal Executive Officer and Chief Financial Officer,
and, as such, is a key executive of the Company.

C.     This Agreement is entered into by
the Company in the belief that it is in the best interests of the Company and its shareholders to provide stable conditions of
employment for Executive notwithstanding the possibility of, among other things, a threat or occurrence of certain types of change
in control, thereby enhancing the Company’s ability to attract and retain highly qualified people.

D.     The
  Company believes that it is important that it receive certain assurances with
  respect to its Confidential Information, proprietary information, intellectual
  property, trade secrets and Executive’s work product, and that the Company receive certain protections with respect to Executive’s
activities following termination of Executive’s employment, and the Company is willing to offer Executive the compensation,
bonuses and other benefits set forth in this Agreement in order to obtain such assurances and protections.

TERMS

To assure the Company that it will have
the continued dedication of Executive notwithstanding the possibility, threat or occurrence of a bid to take over control of the
Company, and to induce Executive to remain in the employ of the Company, in consideration of the foregoing premises and for other
good and valuable consideration, the Company and Executive agree as follows:

1.     Term of Agreement. The term
of this Agreement (“Term”) shall commence on the date hereof as first written above and shall continue through the
term of Executive’s employment with the Company; provided that in the event that there occurs, during the Term,
a Change in Control, as defined in Section 7(c) hereof, this Agreement shall continue in effect for a period of 12 months beyond
the date of such Change in Control.

(a)     The
  compensation payable to Executive during each fiscal year of the Company beginning
  after the date hereof shall be established by the Board or the Compensation
Committee of the Board following an annual performance review, but in no event
  shall the annual rate of Base Salary or the Target Bonus for any successive
  year of the Term be less than the highest annual rate of Base Salary or Target
Bonus, as applicable, in effect during the previous year of the Term.

(b)     Except
  as otherwise provided herein, the terms of the offer letter sent by the Company
  to Executive dated May 17, 2011 (the “Offer Letter”), shall
be incorporated by reference into this Agreement and shall be an integral part hereof.

2.     Severance upon Termination without
Cause or Termination by Executive for Good Reason in Connection with Change in Control. Subject to the limitation set forth
in Section 3 hereof, in the event the Company terminates Executive’s employment without Cause, or in the event of a termination
by Executive for Good Reason, and such termination occurs within the period which commences ninety (90) days before and ends one
(1) year following a Change in Control as defined in Section 7(c) (the “Change in Control Period”):

(a)     Executive
shall receive her Base Salary through the date of termination;

(b)     Executive shall receive
a pro rated portion of the Target Bonus (based on the Base Salary at the time of such termination) which would have been payable
to Executive for the fiscal year during which such termination occurs;

(c)     Executive
shall receive cash payments equal to two (2) times the sum of the following: (i) her Base Salary at the time of such
termination and (ii) the Target Bonus (based on the Base Salary immediately prior to such termination)
for the fiscal year in which such termination occurs;

(d)     Executive shall continue
to be entitled to any deferred compensation and other unpaid amounts and benefits earned and vested prior to Executive’s
termination;

(e)     if
Executive and Executive’s Family Members have medical and dental coverage on the date of such termination under a group health
plan sponsored by the Company, the Company will reimburse Executive for the total applicable
premium cost for medical and dental coverage for continuation coverage for Executive and Executive’s Family Members for a
period of twenty-four (24) months, commencing on the date of such termination; provided, that the Company shall have
no obligation to reimburse Executive for the premium cost of such continuation coverage as of the date Executive and Executive’s
Family Members become eligible to obtain comparable benefits from a subsequent employer. Any continuation coverage provided under
this subsection shall run contemporaneously with COBRA;

(f)     the Company shall provide
Executive outplacement assistance, as determined by the Company in its discretion.

 

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2A.     Severance upon Termination
without Cause or Termination by Executive for Good Reason other than in Connection with Change in Control. In the event the
Company terminates Executive’s employment without Cause, or in the event of a termination by Executive for Good Reason, and
such termination does not occur during the Change in Control Period:

(a)     Executive
shall receive her Base Salary through the date of termination;

(b)     Executive shall receive
a pro rated portion of the Target Bonus (based on the Base Salary at the time of such termination) which would have been payable
to Executive for the fiscal year during which such termination occurs;

(c)     Executive
shall receive cash payments equal to one (1) times the sum of the following: (i) her Base Salary at the time of such
termination and (ii) the Target Bonus (based on the Base Salary immediately prior to such termination)
for the fiscal year in which such termination occurs;

(d)     Executive shall continue
to be entitled to any deferred compensation and other unpaid amounts and benefits earned and vested prior to Executive’s
termination;

(e)     if
Executive and Executive’s Family Members have medical and dental coverage on the date of such termination under a group health
plan sponsored by the Company, the Company will reimburse Executive for the total applicable
premium cost for medical and dental coverage under COBRA for Executive and Executive’s Family Members for a period of twelve
(12) months, commencing on the date of such termination; provided, that the Company shall have no obligation to reimburse
Executive for the premium cost of COBRA coverage as of the date Executive and Executive’s Family Members become eligible
to obtain comparable benefits from a subsequent employer;

(f)     the Company shall provide
Executive outplacement assistance, as determined by the Company in its discretion.

For the avoidance of doubt, in no event shall Executive be
entitled to payments under both Section 2 and Section 2A.

3.     Effect
of Change in Control. In the event of a Change of Control as defined in Section 7(c) in addition to any other consequences
provided for in this Agreement:

(a)     all
options to acquire shares of the Company held by the Executive shall become fully vested immediately
prior to the effective date of the Change in Control. Executive shall have a reasonable opportunity to exercise all or any portion
of such options prior to the effective date of the Change in Control, and any options not exercised prior to the effective date
of the Change in Control shall terminate as of the effective date of the Change in Control and will be of no further force or effect.
To the extent that this section 3(a) is inconsistent with the provisions of the relevant plan and granting instruments under which
such options were issued, the Company and Executive agree

 

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 that
    such inconsistent provisions are hereby superseded and the provisions of
    this Section 3(a) shall govern; and

(b)     all
shares of restricted stock and/or restricted stock units awarded to Executive shall fully vest immediately prior to the Change
in Control. To the extent that this section 3(b) is inconsistent with the provisions of the relevant
plan and granting instruments under which such restricted stock or restricted stock units were issued, the Company and Executive
agree that such inconsistent provisions are hereby superseded and the provisions of this Section 3(b) shall govern.

4.     Limitation.
Nothing in this Agreement or in any other plan, award or agreement of the Company applicable to the Executive shall result
in the reduction or limitation of (i) any payments under either Section 2 or Section 2A, as applicable, and/or (ii) the accelerated
vesting of options to acquire common stock and/or (iii) shares of restricted stock and/or restricted stock units under Section
3 or (iv) any other payments or benefits (the “Total Payments”) that may be deemed to be contingent upon a change in
ownership or control pursuant to Section 280G of the Internal Revenue Code (“Code”), regardless of whether the Total
Payments would be subject to the excise tax imposed by Section 4999 of the Code. If the Executive does become liable for any excise
tax under Section 4999 of the Code, such liability shall not entitle the Executive to any additional payments from the Company
to reimburse the Executive for such tax liability. The Company shall be entitled to withhold from payments due to the Executive
an amount equal to the actual amount of any excise tax under Section 4999 of the Code to which the Executive is subject, as determined
by the Company’s independent auditors.

5.     Time of Payments. Subject
to the requirements of Section 6, all payments made to Executive under any of the subsections of Section
2 which are based upon Executive’s Base Salary or Target Bonus shall be made at or as soon as practicable after the termination
of Executive’s employment but in no event later than seventy-five (75) days after such termination.

6.     Release. Notwithstanding
anything else herein to the contrary, Executive shall not be entitled to realize or receive any termination related benefits provided
for under this Agreement, including, without limitation, all post-termination payments and the acceleration of option or restricted
stock or restricted stock unit vesting schedules, unless Executive shall have executed and delivered to the Company (and does not
revoke) a full release (reasonably satisfactory to the Executive and the Company’s counsel) of all claims against the Company
and its affiliates, successors and assigns and such release becomes irrevocable within sixty (60) days following the date of Executive’s
termination of employment.

7.     Definitions.

(a)     “Base Salary”
means Executive’s annual base salary as established by the Board of Directors of the Company (“Board”) or the
Compensation Committee from time to time. Executive’s Base Salary, starting as of October 17, 2011, is $482,000.

(b)     “Cause”
means:

(i)the willful engaging
by Executive in illegal conduct or gross misconduct which is demonstrably and materially injurious to the Company; or

 

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(ii)Executive’s
refusal or inability to perform the duties of her position as an executive employed by the Company, which refusal or inability
is demonstrably and materially injurious to the Company; or

(iii)Executive’s
breach of her obligations under this Agreement or any employment agreement between the Company and Executive, which breach is demonstrably
and materially injurious to the Company; or

(iv)Executive’s failure,
where applicable, to maintain Executive’s immigration status with the U.S. Immigration and Naturalization Service or the
Executive’s failure to maintain valid employment authorization to provide services to the Company.

For purposes of this Section 7(b), no act or failure to act on Executive’s part shall be deemed “willful”
unless done, or omitted to be done, by Executive not in good faith and without reasonable belief that Executive’s action
of omission was in the best interest of the Company. Notwithstanding the foregoing, with respect to the definitions of Cause set
forth in clauses (i)-(iii) above, Executive shall not be deemed to have been terminated for Cause unless and until the Company
delivers to Executive a notice of such termination for Cause. Such notice shall be in writing, addressed to Executive, labeled
“Personal and Confidential,” and sent to the address for Executive set forth in Section 8(i) hereof. Any such notice
shall describe, with particularity, the conduct of Executive forming the basis for such termination of employment. Any such notices
shall become effective on the 30th day following delivery thereof to Executive if Executive has not cured the conduct
identified in such notice to the satisfaction of the Company, provided, however, that the Company may elect
to make such termination effective immediately, in which case Executive’s employment shall terminate immediately upon delivery
of the notice of termination, but the Company shall continue to pay Executive his or her salary during such 30-day period and the
last day of such 30-day period shall be deemed to be the date of termination of her employment for purposes of any pro rata calculations
and determination of post-termination periods under this agreement.

(c)     “Change
in Control” means the following:

(i) “Board
Change” which, for purposes of this Agreement, shall have occurred
if, over any twenty-four month period, a majority of the seats (other than vacant
seats) on the Company’s Board were to be occupied by individuals who were
neither (A) nominated by at least one-half (1/2) of the directors then in office
(but excluding, for purposes of determining directors then in office, any director
whose initial assumption of office occurs as a result of either an actual or
threatened election contest, or other actual or threatened solicitation of proxies
or consents by or on behalf of a Person (as defined herein) other than the Company
or its board of directors); nor (B) appointed by directors so nominated, or

(ii)the
acquisition by any individual, entity or group (within the meaning of Section 13(d)(3) or 14(d)(2) of the
Securities Exchange Act of 1934 (the

 

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 “Exchange Act”), (a “Person”) of beneficial ownership
  (within the meaning of Rule 13d-3 promulgated under the Exchange Act) of a majority of the then outstanding voting securities of
  the Company; provided, however, that the following acquisitions shall not constitute a Change of Control: (1) any acquisition by
  the Company, or (2) any acquisition by any employee benefit plan (or related trust) sponsored or maintained by the Company or any
  corporation controlled by the Company, or (3) any public offering or private placement by the Company of its voting securities;
  or 

(iii)a
consolidation of the Company with another entity, or a merger of the Company with another entity in which neither the Company nor
a corporation that, prior to the merger, was a subsidiary of the Company shall be the surviving
entity; or 

(iv)a merger of the Company
following which either the Company or a corporation that, prior to the merger, was a subsidiary of the Company shall be the surviving
entity and a majority of the then outstanding voting securities of the Company is beneficially owned (within the meaning of beneficial
owner, as specified below) by a Person or Persons who were not “beneficial owners,” as defined in Rule 13d-3 of the
Exchange Act, of a majority of the outstanding Company voting securities immediately prior to such merger; or

(v)a
voluntary or involuntary liquidation of the Company; 

(vi)a
sale or disposition by the Company of at least 80% of its assets in a single transaction or a
series of transactions (other than a sale or disposition of assets to a subsidiary of the Company in a transaction not otherwise
involving a Change in Control or a change in control of such subsidiary).

Transactions in which the Executive
is part of the acquiring group do not constitute a Change in Control.

(d)     “Good Reason”
means:

(i)any material adverse
change in Executive’s status or position as an officer of the Company, including, without limitation, any diminution in Executive’s
duties, responsibilities or authority as of the Effective Date or the assignment to Executive of any duties or responsibilities
that are inconsistent with Executive’s status or position; provided, however, that none of the foregoing shall be deemed
to have occurred by virtue of a change in Executive’s reporting relationship as long as Executive maintains her then current
duties and responsibilities;

(ii)a reduction in Executive’s
then current Base Salary or Target Bonus; or

(iii)prior to Executive
being permitted to terminate her employment for Good Reason hereunder, the Company shall have failed to cure any alleged condition
described in subparagraphs (i) – (ii) above within the “Cure Period” (defined below). For purposes of this Paragraph
7(d), the term “Cure Period” means the period commencing on the date of receipt of Executive’s notice referred
to in the preceding sentence and

 

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 ending
  on the earlier of (A) sixty (60) days thereafter or (B) two weeks prior to
  the first anniversary of the relevant Change in Control.

(e)     “Target Bonus”
means the performance based cash bonus as determined under the Company’s bonus plan for management (and any successor bonus
plan covering management). The amount of Executive’s annual Target Bonus is determined by the Board or the Compensation Committee
of the Board in its discretion following consultation with Executive prior to, or within sixty (60) days after the commencement
of, each fiscal year. Executive’s initial Target Bonus is sixty percent (60%) of Base Salary. The actual amount of the Target
Bonus, if any, shall be determined within the sole discretion of the Board or Compensation Committee and may be greater than or
lower than the target. The Target Bonus shall not exceed one hundred twenty-five percent (125%) of Base Salary. Pursuant to the
terms of the Offer Letter, the Target Bonus for the first year of Executive’s employment will be prorated from June 8, 2011.

7A.     The Company shall indemnify Executive
and hold her harmless from and against any claim, liability and expense (including, without limitation, reasonable attorney fees)
made against or incurred by her in connection with her employment by the Company. Such indemnification shall be provided in a manner
and to an extent that is not less favorable to the Executive as the indemnification protection that is afforded by the Company
to any other officer of comparable title and that is consistent with industry custom and standards.

8.     Miscellaneous.

(a)     No Funding of Severance.
Nothing contained in this Agreement or otherwise shall require the Company to segregate, earmark or otherwise set aside any funds
or other assets to provide for any payments required to be made under Sections 2 or 2A hereof, and the rights of Executive to any
benefits hereunder shall be solely those of a general, unsecured creditor of the Company.

(b)     Beneficiaries.
In the event of Executive’s death, any amount or benefit payable or distributable to Executive pursuant to this Agreement
shall be paid to the beneficiary designated by Executive for such purpose in the last written instrument received by the Company
prior to Executive’s death, if any, or, if no beneficiary has been designated, to Executive’s estate, but such designation
shall not be deemed to supersede any beneficiary designation under any benefit plan of the Company.

(c)     Entire Agreement.
This Agreement contains the entire understanding between the parties hereto with respect to the subject matter hereof and supersedes
any prior understandings, agreements or representations, written or oral, relating to the subject matter hereof.

(d)     Counterparts.
This Agreement may be executed in separate counterparts, each of which will be an original and all of which taken together shall
constitute one and the same agreement, and any party hereto may execute this Agreement by signing any such counterpart.

 

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(e)     Severability.
Whenever possible, each provision of this Agreement shall be interpreted in such a manner as to be effective and valid under applicable
law but if any provision of this Agreement is held to be invalid, illegal or unenforceable under any applicable law or rule, the
validity, legality and enforceability of the other provision of this Agreement will not be affected or impaired thereby.

(f)     Successors and Assigns.
This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective heirs, personal representatives
and, to the extent permitted by Section 7(g), successors and assigns. The Company will require its successors to expressly assume
its obligations under this Agreement.

(g)     Assignability.
Neither this Agreement nor any right, remedy, obligation or liability arising hereunder or by reason hereof shall be assignable
(including by operation of law) by either party without the prior written consent of the other party to this Agreement.

(h)     Modification, Amendment,
Waiver or Termination. No provision of this Agreement may be modified, amended, waived or terminated except by an instrument
in writing signed by the parties to this Agreement. No course of dealing between the parties will modify, amend, waive or terminate
any provision of this Agreement or any rights or obligations of any party under or by reason of this Agreement. No delay on the
part of the Company in exercising any right hereunder shall operate as a waiver of such right. No waiver, express or implied, by
the Company of any right or any breach by Executive shall constitute a waiver of any other right or breach by Executive.

(i)      Notices. All
notices, consents, requests, instructions, approvals or other communications provided for herein shall be in writing and delivered
by personal delivery, overnight courier, mail, electronic facsimile or e-mail addressed to the receiving party at the address set
forth herein. All such communications shall be effective when received.

Address for the
Executive:

Ana I. Stancic

________________

________________

 

Address for the
Company:

Enzon Pharmaceuticals, Inc.

20 Kingsbridge Road

Piscataway, New Jersey 08854

Attn: Vice President and General
Counsel

 

Any party may change the address
set forth above by notice to each other party given as provided herein.

 

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(j)      Headings. The
headings contained in this Agreement are for reference purposes only and shall not in any way affect the meaning or interpretation
of this Agreement.

(k)     Governing Law.
ALL MATTERS RELATING TO THE INTERPRETATION, CONSTRUCTION, VALIDITY AND ENFORCEMENT OF THIS AGREEMENT SHALL BE GOVERNED BY THE INTERNAL
LAWS OF THE STATE OF NEW JERSEY, WITHOUT GIVING EFFECT TO ANY CHOICE OF LAW PROVISIONS THEREOF.

(l)      Arbitration.
Any claim or controversy arising out of or relating to this Agreement or the breach hereof shall be settled by arbitration in accordance
with the laws of the State of New Jersey. Such arbitration shall be conducted in the State of New Jersey in accordance with the
rules then existing of the American Arbitration Association. Judgment upon the award rendered by the arbitrators may be entered
in any court having jurisdiction thereof. In the event of any dispute arising under this Agreement, the respective parties shall
be responsible for the payment of their own legal fees and disbursements.

(m)     Third-Party Benefit.
Nothing in this Agreement, express or implied, is intended to confer upon any third party any rights, remedies, obligations or
liabilities of any nature whatsoever.

(n)     Withholding Taxes.
The Company may withhold from any benefits payable under this Agreement or any other agreement all federal, state, city or other
taxes as shall be required pursuant to any law or governmental regulation or ruling. Executive hereby agrees to indemnify and hold
harmless the Company should the Company fail to withhold tax from any such payment from which tax is required to be withheld.

(o)     No Right to Continued
Employment. Executive understands that this Severance Agreement is not an employment contract and nothing contained herein
creates any right to continuous employment with the Company, or to employment by the Company for any specified period of time.

(p)     Termination of Previous
Agreement. The Previous Agreement is hereby superseded and replaced by this Agreement and shall have no further force or effect.

(q)     Section 409A.
The parties agree that this Agreement is intended to comply with the requirements of Section 409A of the Internal Revenue Code
and the regulations and other guidance promulgated thereunder (“Section 409A”) or any exemption from Section 409A.
Notwithstanding anything in this Agreement to the contrary, if Executive is a “specified employee” (as described in
Section 409A) on the date of Executive’s termination of employment, any amount to which the Executive would otherwise be
entitled to receive during the first six (6) months following a separation of service that constitutes nonqualified deferred compensation
within the meaning of Section 409A and that is therefore not exempt from Section 409A as

 

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 involuntary
  separation pay or a short-term deferral will be accumulated and paid as a single
  lump sum payment (without interest) on the earlier of (i) the first business
  day of the seventh month following the date of such “separation from service” (as defined under Section 409A) or (ii)
  the date of Executive’s death, and any remaining payments and benefits
  due under this Agreement shall be paid or provided in accordance with the normal
  payment dates specified for them herein. For purposes of this Agreement, each
  amount to be paid or benefit to be provided hereunder shall be construed as
  a separate identified payment for purposes of Section 409A.

Any payment or benefit due upon
a termination of Executive’s employment that represents a “deferral of compensation” within the meaning of and
subject to Section 409A shall be paid or provided to Executive only upon a “separation of service” as defined in Treas.
Reg. Section 1.409A-1(h). Except to the extent any reimbursement, payment or entitlement under this Agreement does not constitute
a “deferral of compensation” within the meaning of and subject to Section 409A, (i) the amount of expenses eligible
for reimbursement or the provision of any in-kind benefit (as defined in Section 409A) to Executive during any calendar year will
not affect the amount of expenses eligible for reimbursement or provided as in-kind benefits to Executive in any other calendar
year (subject to any lifetime and other annual limits provided under the Company’s health plans), (ii) the reimbursements
for expenses for which Executive is entitled to shall be made on or before the last day of the calendar year following the calendar
year in which the applicable expense is incurred, (iii) the right to payment or reimbursement of in-kind benefits may not be liquidated
or exchanged for any other benefit and (iv) in no event shall the Company’s obligations to make such reimbursements or to
provide such in-kind benefits apply later than Executive’s remaining lifetime (of if longer, through the 20th
anniversary of the effective date of this Agreement).

 

 

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IN WITNESS WHEREOF, the parties hereto have executed
this Agreement as of the date first set forth above.

ENZON PHARMACEUTICALS, INC.

By:  /s/ Andrew Rackear

Andrew Rackear

Vice President and General
Counsel

 

EXECUTIVE

 

/s/ Ana I. Stancic

Ana I. Stancic

 

 

 

 

11form8k111811ex10-1.htm

RANGER GOLD CORP.

REGULATION S SUBSCRIPTION AGREEMENT

AND INVESTMENT REPRESENTATION

SECTION 1.

1.1           Subscription.                                The undersigned, intending to be legally bound, hereby irrevocably subscribes for and agrees to purchase ________ shares (the “Shares”) of the common stock (the “Common Stock”) of Ranger Gold Corp., a Nevada corporation (the "Company") in a transaction exempt from the registration requirements of the Securities Act of 1933, as amended (the “Securities
Act”).

1.2           Purchase of Shares.                                The undersigned understands and acknowledges that the purchase price to be remitted to the Company in exchange for the Shares shall be an aggregate of _______________________ ($_______) or $______ per Share.  The Company shall deliver the Shares to the undersigned promptly after the acceptance of this Subscription Agreement by the Company.

1.3           Acceptance or Rejection.

(a)           The undersigned understands and agrees that the Company reserves the right to reject this subscription for the Shares if, in its reasonable judgment, it deems such action in the best interest of the Company, at any time prior to the Closing, notwithstanding prior receipt by the undersigned of notice of acceptance of the undersigned's subscription.

(b)           The undersigned understands and agrees that its subscription for the Shares is irrevocable.

(c)           In the event the sale of the Shares subscribed for by the undersigned is not consummated by the Company for any reason (in which event this Subscription Agreement shall be deemed to be rejected), this Subscription Agreement and any other agreement entered into between the undersigned and the Company relating to this subscription shall thereafter have no force or effect and the Company shall promptly return or cause to be returned to the undersigned the purchase price remitted to the Company by the undersigned, without interest thereon or deduction therefrom, in exchange for the Shares.

SECTION 2.

2.1           Closing.  The closing (the "Closing") of the purchase and sale of the Shares, shall occur simultaneously with the acceptance by the Company of the undersigned's subscription, as evidenced by the Company's execution of this Subscription Agreement.

  

  

  

SECTION 3.

3.1           Investor Representations and Warranties.   The undersigned hereby acknowledges, represents and warrants to, and agrees with, the Company and its affiliates as follows:

(a)           Investment Purposes.  The undersigned is acquiring the Shares for his own account as principal, not as a nominee or agent, for investment purposes only, and not with a view to, or for, resale, distribution or fractionalization thereof in whole or in part and no other person has a direct or indirect beneficial interest in such Shares or any portion thereof.  Further, the undersigned does not have any contract, undertaking, agreement or arrangement with any person to sell, transfer or grant participations to such
person or to any third person, with respect to the Shares for which the undersigned is subscribing or any part of the Shares.

(b)           Authority.  The undersigned has full power and authority to enter into this Agreement, the execution and delivery of this Agreement has been duly authorized, if applicable, and this Agreement constitutes a valid and legally binding obligation of the undersigned.

(c)           No General Solicitation.  The undersigned is not subscribing for the Shares as a result of or subsequent to any advertisement, article, notice or other communication published in any newspaper, magazine or similar media or broadcast over television or radio, or presented at any seminar or meeting, or any solicitation of a subscription by person previously not known to the undersigned in connection with investment securities generally.

(d)           No Obligation to Register Shares.  The undersigned understands that the Company is under no obligation to register the Shares under the Securities Act, or to assist the undersigned in complying with the Securities Act or the securities laws of any state of the United States or of any foreign jurisdiction.

(e)           Investment Experience.  The undersigned is (i) experienced in making investments of the kind described in this Agreement, (ii) able, by reason of the business and financial experience of its officers (if an entity) and professional advisors (who are not affiliated with or compensated in any way by the Company or any of its affiliates or selling agents), to protect its own interests in connection with the transactions described in this Agreement, and (iii) able to afford the entire loss of its investment in the
Shares.

(f)           Exemption from Registration.  The undersigned acknowledges his understanding that the offering and sale of the Shares is intended to be exempt from registration under the Securities Act.  In furtherance thereof, in addition to the other representations and warranties of the undersigned made herein, the undersigned further represents and warrants to and agrees with the Company and its affiliates as follows:

(1)           The undersigned realizes that the basis for the exemption may not be present if, notwithstanding such representations, the undersigned has in mind merely acquiring the Shares for a fixed or determinable period in the future, or for a market rise, or for sale if the market does not rise.  The undersigned does not have any such intention;

  

  

  

(2)           The undersigned has the financial ability to bear the economic risk of his investment, has adequate means for providing for his current needs and personal contingencies and has no need for liquidity with respect to his investment in the Company; and

(3)           The undersigned has such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of the prospective investment in the Shares.  The undersigned also represents it has not been organized for the purpose of acquiring the Shares; and

(4)           The undersigned has been provided an opportunity for a reasonable period of time prior to the date hereof to obtain additional information concerning the offering of the Shares, the Company and all other information to the extent the Company possesses such information or can acquire it without unreasonable effort or expense.

(g)           Economic Considerations.  The undersigned is not relying on the Company, or its affiliates or agents with respect to economic considerations involved in this investment.  The undersigned has relied solely on its own advisors.

(h)           No Other Company Representations.  No representations or warranties have been made to the undersigned by the Company, or any officer, employee, agent, affiliate or subsidiary of the Company, other than the representations of the Company contained herein, and in subscribing for Shares the undersigned is not relying upon any representations other than those contained herein.

(i)           Compliance with Laws.  Any resale of the Shares during the ‘distribution compliance period’ as defined in Rule 902(f) to Regulation S shall only be made in compliance with exemptions from registration afforded by Regulation S.  Further, any such sale of the Shares in any jurisdiction outside of the United States will be made in compliance with the securities laws of such jurisdiction.  The Investor will not offer to sell or sell the Shares in any jurisdiction unless the Investor obtains all
required consents, if any.

(j)           Regulation S Exemption.  The undersigned understands that the Shares are being offered and sold to him in reliance on an exemption from the registration requirements of United States federal and state securities laws under Regulation S promulgated under the Securities Act and that the Company is relying upon the truth and accuracy of the representations, warranties, agreements, acknowledgments and understandings of the Investor set forth herein in order to determine the applicability of such exemptions and the suitability of
the Investor to acquire the Shares.  In this regard, the undersigned represents, warrants and agrees that:

(1)           The undersigned is not a U.S. Person (as defined below) and is not an affiliate (as defined in Rule 501(b) under the Securities Act) of the Company and is not acquiring the Shares for the account or benefit of a U.S. Person.  A U.S. Person means any one of the following:

	
  

	
(A)

	
any natural person resident in the United States of America;

  

  

  

(B)           any partnership or corporation organized or incorporated under the laws of the United States of America;

	
  

	
(C)

	
any estate of which any executor or administrator is a U.S. person;

	
  

	
(D)

	
any trust of which any trustee is a U.S. person;

(E)           any agency or branch of a foreign entity located in the United States of America;

(F)           any non-discretionary account or similar account (other than an estate or trust) held by a dealer or other fiduciary for the benefit or account of a U.S. person;

(G)           any discretionary account or similar account (other than an estate or trust) held by a dealer or other fiduciary organized, incorporated or (if an individual) resident in the United States of America; and

	
  

	
(H)

	
any partnership or corporation if:

(i) organized or incorporated under the laws of any foreign jurisdiction; and

(ii)           formed by a U.S. person principally for the purpose of investing in securities not registered under the Securities Act, unless it is organized or incorporated, and owned, by accredited investors (as defined in Rule 501(a) under the Securities Act) who are not natural persons, estates or trusts.

(2)           At the time of the origination of contact concerning this Agreement and the date of the execution and delivery of this Agreement, the undersigned was outside of the United States.

(3)           The undersigned will not, during the period commencing on the date of issuance of the Shares and ending on the first anniversary of such date, or such shorter period as may be permitted by Regulation S or other applicable securities law (the “Restricted Period”), offer, sell, pledge or otherwise transfer the Shares in the United States, or to a U.S. Person for the account or for the benefit of a U.S. Person, or otherwise in a manner that is not in compliance with Regulation S.

(4)           The undersigned will, after expiration of the Restricted Period, offer, sell, pledge or otherwise transfer the Shares only pursuant to registration under the Securities Act or an available exemption therefrom and, in accordance with all applicable state and foreign securities laws.

  

  

  

(5)           The undersigned was not in the United States, engaged in, and prior to the expiration of the Restricted Period will not engage in, any short selling of or any hedging transaction with respect to the Shares, including without limitation, any put, call or other option transaction, option writing or equity swap.

(6)           Neither the undersigned nor or any person acting on his behalf has engaged, nor will engage, in any directed selling efforts to a U.S. Person with respect to the Shares and the Investor and any person acting on his behalf have complied and will comply with the “offering restrictions” requirements of Regulation S under the Securities Act.

(7)           The transactions contemplated by this Agreement have not been pre-arranged with a buyer located in the United States or with a U.S. Person, and are not part of a plan or scheme to evade the registration requirements of the Securities Act.

(8)           Neither the undersigned nor any person acting on his behalf has undertaken or carried out any activity for the purpose of, or that could reasonably be expected to have the effect of, conditioning the market in the United States, its territories or possessions, for any of the Shares.  The undersigned agrees not to cause any advertisement of the Shares to be published in any newspaper or periodical or posted in any public place and not to issue any circular relating to the Shares, except such advertisements that include the statements required by Regulation S under the Securities Act, and
only offshore and not in the U.S. or its territories, and only in compliance with any local applicable securities laws.

(9)           Each certificate representing the Shares shall be endorsed with the following legends, in addition to any other legend required to be placed thereon by applicable federal or state securities laws:

(A)           “THE SECURITIES ARE BEING OFFERED TO INVESTORS WHO ARE NOT U.S. PERSONS (AS DEFINED IN REGULATION S UNDER THE SECURITIES ACT OF 1933, AS AMENDED (“THE SECURITIES ACT”)) AND WITHOUT REGISTRATION WITH THE UNITED STATES SECURITIES AND EXCHANGE COMMISSION UNDER THE SECURITIES ACT IN RELIANCE UPON REGULATION S PROMULGATED UNDER THE SECURITIES ACT.”

(B)           “TRANSFER OF THESE SECURITIES IS PROHIBITED, EXCEPT IN ACCORDANCE WITH THE PROVISIONS OF REGULATION S, PURSUANT TO REGISTRATION UNDER THE SECURITIES ACT, OR PURSUANT TO AVAILABLE EXEMPTION FROM REGISTRATION.  HEDGING TRANSACTIONS MAY NOT BE CONDUCTED UNLESS IN COMPLIANCE WITH THE SECURITIES ACT.”

(10)           The undersigned consents to the Company making a notation on its records or giving instructions to any transfer agent of the Company in order to implement the restrictions on transfer of the Shares set forth in this Section 2.

  

  

  

Check if applicable, otherwise cross out:

(k)           Accredited Investor.  The undersigned is an “accredited investor” as that term is defined in Rule 501 of the General Rules and Regulations under the Securities Act by reason of Rule 501(a)(3).

(l)           Potential Loss of Investment; Risk Factors.  The undersigned understands that an investment in the Shares is a speculative investment which involves a high degree of risk and the potential loss of his entire investment. The undersigned understands that the following factors, among others, could cause the loss of any or all of his investment.

(1)           The Company is a development stage company with no operating history for the undersigned to evaluate its business.  The Company was incorporated in the State of Nevada and is only in the very early stages of development.  Because the Company has no operating history, it is difficult to evaluate its business and future prospects.  The undersigned has also considered the uncertainties and difficulties frequently encountered by companies, such as the Company, in their early stages of development.  The Company’s revenue and income potential is non-existent
and its business model is still emerging.  If its business model does not prove to be profitable, the undersigned may lose all of his investment.

(2)           The Company currently does not have enough working capital to satisfy its capital needs.  The Company is dependent upon its management team to fund its ongoing operations, and cannot be certain that future financing will be available to it on acceptable terms when it needs it.  The Company can give no assurances that it will be able to sell any portion of this offering or that management will continue to fund its ongoing operations.  This, along with the possibility of other factors and circumstances the Company cannot predict, may require it to seek additional
financing faster than anticipated.  If the Company is unable to obtain financing to meet its needs, the undersigned may lose of his investment.

(3)           The Company’s officers and directors will only devote a limited amount of time to the Company.  Their divided interests may hinder the Company's ability to generate revenue.  This could result in missed business opportunities and worse-than-expected operating results.  The undersigned may lose his entire investment.

(m)           Investment Commitment.  The undersigned's overall commitment to investments which are not readily marketable is not disproportionate to the undersigned's net worth, and an investment in the Shares will not cause such overall commitment to become excessive.

(n)           Receipt of Information.  The undersigned has received all documents, records, books and other information pertaining to the undersigned’s investment in the Company that has been requested by the undersigned.

(o)           Investor Questionnaire.  The undersigned represents and warrants to the Company that all information that the undersigned has provided to the Company, including, without limitation, the information in the Investor Questionnaire attached hereto or previously provided to the Company (the “Investor Questionnaire”), is correct and complete as of the date hereof.

  

  

  

(p)           No Reliance.  Other than as set forth herein, the undersigned is not relying upon any other information, representation or warranty by the Company or any officer, director, stockholder, agent or representative of the Company in determining to invest in the Shares.  The undersigned has consulted, to the extent deemed appropriate by the undersigned, with the undersigned’s own advisers as to the financial, tax, legal and related matters concerning an investment in the Shares and on that basis believes that his
or its investment in the Shares is suitable and appropriate for the undersigned.

(q)           No Governmental Review.  The undersigned is aware that no federal or state agency has (i) made any finding or determination as to the fairness of this investment, (ii) made any recommendation or endorsement of the Shares or the Company, or (iii) guaranteed or insured any investment in the Shares or any investment made by the Company.

(r)           Price of Shares.  The undersigned understands that the price of the Shares offered hereby bear no relation to the assets, book value or net worth of the Company and were determined arbitrarily by the Company.  The undersigned further understands that there is a substantial risk of further dilution on his or its investment in the Company.

SECTION 4.

4.1           Company’s Representations and Warranties.  The Company represents and warrants to the undersigned as follows:

(a)            Organization of the Company.  The Company is a corporation duly organized and validly existing and in good standing under the laws of the State of Nevada.

(b)           Authority.   (a)  The Company has the requisite corporate power and authority to enter into and perform its obligations under this Agreement and to issue the Shares; (b) the execution and delivery of this Agreement by the Company and the consummation by it of the transactions contemplated hereby and thereby have been duly authorized by all necessary corporate action and no further consent or authorization of the Company or its Board of Directors or stockholders is required; and (c) this Agreement has been duly
executed and delivered by the Company and constitutes a valid and binding obligation of the Company enforceable against the Company in accordance with its terms, except as such  enforceability  may be limited by applicable bankruptcy, insolvency, or similar laws relating to, or affecting generally the enforcement of, creditors' rights and remedies or by other equitable principles of general application.

  

  

  

(c)           Exemption from Registration; Valid Issuances.  The sale and issuance of the Shares, in accordance with the terms and on the bases of the representations and warranties of the undersigned set forth herein, may and shall be properly issued by the Company to the undersigned pursuant to any applicable federal or state law. When issued and paid for as herein provided, the Shares shall be duly and validly issued, fully paid, and nonassessable. Neither the sales of the Shares pursuant to, nor the Company's performance of its
obligations under, this Agreement shall (a) result in the creation or imposition of any liens, charges, claims or other encumbrances upon the Shares or any of the assets of the Company, or (b) entitle the other holders of the Common Stock of the Company to preemptive or other rights to subscribe to or acquire the Common Stock or other securities of the Company. The Shares shall not subject the undersigned to personal liability by reason of the ownership thereof.

(e)           No General Solicitation or Advertising in Regard to this Transaction. Neither the Company nor any of its affiliates nor any person acting on its or their behalf (a) has conducted or will conduct any general solicitation (as that term is used in Rule 502(c) of Regulation D) or general advertising with respect to any of the Shares, or (b) made any offers or sales of any security or solicited any offers to buy any security under any circumstances that would require registration of the Common Stock under the Securities Act.

SECTION 5.

5.1             Indemnity.  The undersigned agrees to indemnify and hold harmless the Company, its officers and directors, employees and its affiliates and their respective successors and assigns and each other person, if any, who controls any thereof, against any loss, liability, claim, damage and expense whatsoever (including, but not limited to, any and all expenses whatsoever reasonably incurred in investigating, preparing or defending against any litigation commenced or threatened or any claim whatsoever) arising out of or based upon any false representation or warranty
or breach or failure by the undersigned to comply with any covenant or agreement made by the undersigned herein or in any other document furnished by the undersigned to any of the foregoing in connection with this transaction.

5.2           Modification.  Neither this Agreement nor any provisions hereof shall be modified, discharged or terminated except by an instrument in writing signed by the party against whom any waiver, change, discharge or termination is sought.

5.3           Notices.  Any notice, demand or other communication which any  party hereto may be required, or may elect, to give to anyone interested hereunder shall be sufficiently given if (a) deposited, postage prepaid, in a United States mail letter box, registered or certified mail, return receipt requested, addressed to such address as may be given herein, or (b) delivered personally at such address.

5.4           Counterparts.  This Agreement may be executed through the use of separate signature pages or in any number of counterparts and by facsimile, and each of such counterparts shall, for all purposes, constitute one agreement binding on all parties, notwithstanding that all parties are not signatories to the same counterpart. Signatures may be facsimiles.

  

  

  

5.5           Binding Effect.  Except as otherwise provided herein, this Agreement shall be binding upon and inure to the benefit of the parties and their heirs, executors, administrators, successors, legal representatives and assigns.  If the undersigned is more than one person, the obligation of the undersigned shall be joint and several and the agreements, representations, warranties and acknowledgments herein contained shall be deemed to be made by and be binding upon each such person and his heirs, executors, administrators and successors.

5.6           Entire Agreement.  This Agreement and the documents referenced herein contain the entire agreement of the parties and there are no representations, covenants or other agreements except as stated or referred to herein and therein.

5.7           Assignability.  This Agreement is not transferable or assignable by the undersigned.

5.8           Applicable Law.  This Agreement shall be governed by and construed in accordance with the laws of the State of Nevada, without giving effect to conflicts of law principles.

5.9           Pronouns.  The use herein of the masculine pronouns "him" or "his" or similar terms shall be deemed to include the feminine and neuter genders as well and the use herein of the singular pronoun shall be deemed to include the plural as well.

5.10           Further Assurances.  Upon request from time to time, the undersigned shall execute and deliver all documents, take all rightful oaths and do all other acts that may be necessary or desirable, in the reasonable opinion of the Company or its counsel, to effect the subscription for the Shares in accordance herewith.

  

  

  

IN WITNESS WHEREOF, the undersigned has executed this Agreement on the 18th day of November, 2011.

Amount of Investment:

$__________________

INDIVIDUAL INVESTOR:

______________________

Name:

PARTNERSHIP, CORPORATION, TRUST,

CUSTODIAL ACCOUNT, OTHER INVESTOR

______________________________

By:           __________________

Name:

Title:

Address:

Taxpayer Identification Number:_____________

  

  

  

ACCEPTANCE OF SUBSCRIPTION

(to be filed out only by the Company)

The Company hereby accepts the above application for subscription for Shares on behalf of the Company.

Dated: November 18, 2011

RANGER GOLD CORP.

By:______________________________

	
Name:

	
Gurpartap Singh Basrai

	
Title:

	
President, CEO

  

  

  

RANGER GOLD CORP.

INVESTOR QUESTIONNAIRE

	
A.

	
General Information

 

	  
	  	  	  
	
1.

	
Print Full Name of Investor:

	
Individual:

	  	  	
______________________________

	  	  	
First, Middle, Last

	  	  	  
	  	  	
Partnership, Corporation, Trust, Custodial Account, Other:

	  	  	  
	  	  	
____________________________________________________________

	  	  	
Name of Entity

	  	  	  
	
2.

	
Address for Notices:

	
____________________________________________________________

	  	  	
______________________________

	  	  	
____________________________________________________________

	  	  	  
	
3.

	
Name of Primary Contact Person:

Title:

	
____________________________________________________________

	  	  	  
	
4.

	
Telephone Number:

	
______________________________

	  	  	  
	
5.

	
E-Mail Address:

	
____________________________________________________________

	  	  	  
	
6.

	
Facsimile Number:

Permanent Address:

 

	
____________________________________

	
 

7.

	
 

Permanent Address:

(if different from Address for Notices above)

 

	
 

____________________________________________________________

  

  

  

	
8.

	
Authorized Signatory:

Title:

	
____________________________________

____________________________________

	  	
Telephone Number:

	
____________________________________

	  	
Facsimile Number:

 

	
____________________________________

B.           Accredited Investor Status

The Investor represents and warrants that the Investor is an “accredited investor” within the meaning of Rule 501 of Regulation D under the Securities Act of 1933, as amended (the “Securities Act”), and has checked the box or boxes below which are next to the categories under which the Investor qualifies as an accredited investor:

 

	
FOR INDIVIDUALS:

 

	
o

	
A natural person with individual net worth (or joint net worth with spouse) in excess of $1 million. For purposes of this item, “net worth” means the excess of total assets at fair market value, including home, home furnishings and automobiles (and including property owned by a spouse), over total liabilities.

	  	  
	
o

	
A natural person with individual income (without including any income of the Investor’s spouse) in excess of $200,000, or joint income with spouse of $300,000, in each of the two most recent years and who reasonably expects to reach the same income level in the current year.

	  	  	  
	
FOR ENTITIES:

	  	  
	
o

	
A bank as defined in Section 3(a)(2) of the Securities Act or any savings and loan association or other institution as defined in Section 3(a)(5)(A) of the Securities Act, whether acting in its individual or fiduciary capacity.

	  	  
	
o

	
An insurance company as defined in Section 2(13) of the Securities Act.

	  	  
	
o

	
A broker-dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934.

	  	  
	
o

	
An investment company registered under the Investment Company Act of 1940, as amended (the “Investment Company Act”). If an Investor has checked this box, please contact David Lubin, Esq. at (516) 569-9629 for additional information that will be required.

	  	  

  

  

  

	
o

	
A business development company as defined in Section 2(a)(48) of the Investment Company Act.

	  	  
	
o

	
A small business investment company licensed by the Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958.

	  	  
	
o

	
A private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940. If an Investor has checked this box, please contact David Lubin, Esq. at (516) 569-9629 for additional information that will be required.

	  	  
	
o

	
An organization described in Section 501(c)(3) of the Internal Revenue Code, a corporation, Massachusetts or similar business trust, or partnership, not formed for the specific purpose of acquiring the Shares, with total assets in excess of $5 million.

	  	  
	
o

	
A trust with total assets in excess of $5 million not formed for the specific purpose of acquiring the Shares, whose purchase is directed by a person with such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of an investment in the Company and the purchase of the Shares.

	  	  
	
o

	
An employee benefit plan within the meaning of ERISA if the decision to invest in the Shares is made by a plan fiduciary, as defined in Section 3(21) of ERISA, which is either a bank, savings and loan association, insurance company, or registered investment adviser, or if the employee benefit plan has total assets in excess of $5 million or, if a self-directed plan, with investment decisions made solely by persons that are accredited investors.

	  	  
	
o

	
A plan established and maintained by a state, its political subdivisions, or any agency or instrumentality of a state or its political subdivisions, for the benefit of its employees, if the plan has total assets in excess of $5 million.

	  	  
	
o

	
An entity, including a grantor trust, in which all of the equity owners are accredited investors as determined under any of the foregoing paragraphs (for this purpose, a beneficiary of a trust is not an equity owner, but the grantor of a grantor trust is an equity owner).

  

  

  

C.           Confirmation of Relationship

(For Directors, Senior Officers and Control Persons and 

Their Close Personal Friends, Close Business Associates and Relatives)

 

The Subscriber represents and warrants to the Company that the Subscriber has read the following definitions from Multilateral Instrument 45-103 Capital Raising Exemptions and certifies that the Subscriber has the relationship(s) to the Company or its directors, senior officers or control persons by virtue of the Subscriber being:

 

(initial one or more as appropriate)

 

	
  

	
_____(a)a director, senior officer or control person of the Company, or of an affiliate of the Company;

 

	
  

	
_____

	
(b)

	
a spouse, parent, grandparent, brother, sister or child of a director, senior officer or control person of the Company, or of an affiliate of the company;

 

	
  

	
_____

	
(c)

	
a close personal friend of a director, senior officer or control person of the Company, or of an affiliate of the Company;

 

	
  

	
_____

	
(d)

	
a close business associate of a director, senior officer or control person of the Company, or of an affiliate of the Company;

 

	
  

	
_____

	
(e)

	
a person or company that is wholly-owned by any combination of persons or companies described in paragraphs (a) to (d),

 

	
  

	
and if (b), (c), (d) or (e) is initialed the director, senior officer or control person is:

 

	
  

	
________________________________________

	
  

	
(Print name of director, senior officer or control person)

 

The foregoing representations and warranties are true and accurate as of the date of this certificate and will be true and accurate as of Closing.  If any such representations and warranties shall not be true and accurate prior to Closing, the Subscriber shall give immediate written notice of such fact to the Company.

 

For the purposes hereof, the following definitions are included for convenience:

 

	
a.  

	
“close business associate” means an individual who has had sufficient prior business dealings with the director, senior officer or control person to be in a position to assess the capabilities and trustworthiness of the director, senior officer or control person.

 

A casual business associate or a person introduced or solicited for the purpose of purchasing securities is not a close business associate.  An individual is not a close business associate solely because the individual is a client or former client.  For example, an individual is not a close business associate of a registrant or former registrant solely because the individual is a client or former client of that registrant or former registrant.

  

  

  

 

The relationship between the purchaser and the director, senior officer or control person must be direct.  For example, the exemption is not available for a close business associate of a close business associate or a director, senior officer or control person.

 

	
b.  

	
“close personal friend” means an individual who has known the director, senior officer or control person for a sufficient period of time to be in a position to assess the capabilities and trustworthiness of the director, senior officer or control person.

 

An individual is not a close personal friend solely because

 

	
·  

	
the individual is a member of the same organization, association or religious group, or

 

	
·  

	
the individual is a client or former client.

 

The relationship between the purchaser and the director, senior officer or control person must be direct.  For example, the exemption is not available for a close personal friend or a close personal friend of the director, senior officer or control person.

 

	
c.  

	
“company” means any corporation, incorporated association, incorporated syndicate or other incorporated organization.

 

	
d.  

	
“person” means and individual, partnership, unincorporated association, unincorporated syndicate, unincorporated organization, trust, trustee, executor, administrator or other legal representative.

 

	
e.  

	
“spouse” means, in relation to an individual, another individual to whom that individual is married, or another individual of the opposite sex or the same sex with whom that individual is living in a conjugal relationship outside marriage.

  

  

  

The Investor understands that the foregoing information will be relied upon by the Company for the purpose of determining the eligibility of the Investor to purchase the Shares. The Investor agrees to notify the Company immediately if any representation or warranty contained in this Subscription Agreement, including this Investor Questionnaire, becomes untrue at any time. The Investor agrees to provide, if requested, any additional information that may reasonably be required to substantiate the Investor’s status as an accredited investor or to otherwise determine the eligibility of the Investor to purchase the Shares. The Investor agrees to indemnify and hold harmless the Company and each officer, director,
shareholder, agent and representative of the Company and their respective affiliates and successors and assigns from and against any loss, damage or liability due to or arising out of a breach of any representation, warranty or agreement of the Investor contained herein.

	  	
INDIVIDUAL:

	  	  
	  	
____________________________________

	  	
(Signature)

	  	  
	  	
____________________________________

	  	
(Print Name)

	  	  
	  	
PARTNERSHIP, CORPORATION, TRUST, CUSTODIAL ACCOUNT, OTHER:

	  	  
	  	
___________________________________

	  	
(Name of Entity)

	  	  
	  	
By:  ________________________________

	  	
(Signature)

	  	  
	  	
       ________________________________

	  	
(Print Name and Title)

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