Document:

ex-10.3

 

 EXCHANGE AGREEMENT
 

 THIS EXCHANGE AGREEMENT (this “Agreement”) is entered into as of February 1, 2018, by and among Holly Brothers Pictures, Inc., a Nevada corporation (the “Company”), PBC Group, LLC and Black Car, Inc. (collectively, the “Members”), and Power Blockchain LLC (“Power Blockchain”), each a “Party” and collectively the “Parties”, upon the following premises:
 

 WHEREAS, the Members collectively own 100% of the issued and outstanding membership interests of Power Blockchain (the “Membership Interests”);
 

 WHEREAS, the Company desires to acquire the Membership Interests in exchange for a 5% convertible promissory notes in aggregate principal amount of $2,200,000.00 (the “Notes”), in the form attached as Exhibit A hereto which Notes are convertible into newly issued shares of common stock, $0.001 par value of the Company (“Common Stock”) at an initial conversion price of $0.13 per share on the terms and conditions set forth in the Notes and herein (the “Exchange Offer” or the “Exchange”), so that Power Blockchain will become a wholly-owned subsidiary of the Company; and
 

 WHEREAS, the Members desire to exchange all of their Membership Interests in Power Blockchain in exchange for the Notes pursuant to the terms hereof.
 

 NOW THEREFORE, on the stated premises and for and in consideration of the mutual covenants and agreements hereinafter set forth and the mutual benefits to the Parties to be derived herefrom, it is hereby agreed as follows:
 

 ARTICLE I
 REPRESENTATIONS, COVENANTS, AND WARRANTIES OF
 POWER BLOCKCHAIN AND THE MEMBERS
 

 As an inducement to and to obtain the reliance of the Company, Power Blockchain and the Members represent and warrant as follows:
 

 Section 1.01
 Organization. Power Blockchain is a limited liability company duly organized, validly existing, and in good standing under the laws of the State of Wyoming. Power Blockchain has the corporate power and is duly authorized, qualified, franchised, and licensed under all applicable laws, regulations, ordinances, and orders of public authorities to own all of its properties and assets and to carry on its business in all material respects as it is now being conducted, including qualifications to do business as a foreign corporation in the states or countries in which the character and location of the assets owned by it or the nature of the business transacted by it requires qualification, except where failure to be so qualified would not have a material adverse effect on its business. 
 

 Section 1.02
 Capitalization. The Members holds 100% of the issued and outstanding Membership Interests of Power Blockchain. There are no other outstanding securities of Power Blockchain and upon the consummation of the transactions contemplated herein Power Blockchain will become a wholly-owned subsidiary of the Company. All issued and outstanding Membership Interests of Power Blockchain are legally issued, fully paid, and non-assessable and not issued in violation of the preemptive or other rights of any person.
 

 

 
 

 Section 1.03
 Acquisition of the Notes by the Members.
 

 (a)
 The Members are acquiring the Notes (as defined in Section 3.01), for its own account, for investment purposes only and not with a view to, or for sale in connection with, a distribution, as that term is used in Section 2(11) of the Securities Act of 1933, as amended (the “Securities Act”), in a manner which would require registration under the Securities Act or any state securities laws. The Members can bear the economic risk of investment in the Notes, has knowledge and experience in financial business matters, is capable of bearing and managing the risk of investment in the Notes and is an “accredited investor” as defined in Regulation D under the Securities Act. The Members recognizes that the Notes have not been registered under the Securities Act, nor under the securities laws of any state and, therefore, cannot be resold unless the resale of the Notes (or the Common Stock underlying the Notes) are registered under the Securities Act or unless an exemption from registration is available. The Members have carefully considered and have, to the extent they believe such discussion necessary, discussed with its professional, legal, tax and financial advisors, the suitability of an investment in the Notes for its particular tax and financial situation and its respective advisers, if such advisors were deemed necessary, have determined that the Notes are a suitable investment for it. The Members have not been offered the Notes by any form of general solicitation or advertising, including, but not limited to, advertisements, articles, notices or other communications published in any newspaper, magazine, or other similar media or television or radio broadcast or any seminar or meeting where, to each of the Member’s knowledge, those individuals that have attended have been invited by any such or similar means of general solicitation or advertising. The Members have had an opportunity to ask questions of and receive satisfactory answers from the Company, or persons acting on behalf of the Company, concerning the terms and conditions of the Notes and the Company, and all such questions have been answered to the full satisfaction of the Members. Neither the Company nor any other party, has supplied the Members any information regarding the Notes or an investment in the Notes other than as contained in this Agreement, and the Members are relying on their own investigation and evaluation of the Company and the Notes and not on any other information.
 

 (b)
 The Members understand and agree that a legend has been or will be placed on any certificate(s) or other document(s) evidencing the Notes (or the Shares underlying the Notes) in substantially the following form:
 

 “THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED OR ANY STATE SECURITIES ACT. THE SECURITIES HAVE BEEN ACQUIRED FOR INVESTMENT AND MAY NOT BE SOLD, TRANSFERRED, PLEDGED OR HYPOTHECATED UNLESS (I) THEY SHALL HAVE BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED AND ANY APPLICABLE STATE SECURITIES ACT, OR (II) THE CORPORATION SHALL HAVE BEEN FURNISHED WITH AN OPINION OF COUNSEL, SATISFACTORY TO COUNSEL FOR THE CORPORATION, THAT REGISTRATION IS NOT REQUIRED UNDER ANY SUCH ACTS.”
 

 

 

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 ARTICLE II
 REPRESENTATIONS, COVENANTS, AND WARRANTIES OF THE COMPANY
 

 As an inducement to, and to obtain the reliance of the Members, the Company represents and warrants as follows:
 

 Section 2.01
 Organization. The Company is a corporation duly organized, validly existing, and in good standing under the laws of the state of Nevada and has the corporate power and is duly authorized, qualified, franchised, and licensed under all applicable laws, regulations, ordinances, and orders of public authorities to own all of its properties and assets, to carry on its business in all material respects as it is now being conducted and as contemplated after the Exchange, and except where failure to be so qualified would not have a material adverse effect on its business, there is no jurisdiction in which it is not qualified in which the character and location of the assets owned by it or the nature of the business transacted by it requires qualification. 
 

 

 ARTICLE III
 PLAN OF EXCHANGE
 

 Section 3.01
 The Exchange. 
 

 (a) 
 On the terms and subject to the conditions set forth in this Agreement, on the Closing Date (as defined below), the Members shall accept the Exchange Offer described herein and shall assign, transfer and deliver, free and clear of all liens, pledges, encumbrances, charges, restrictions or known claims of any kind, nature, or description, the Membership Interests of Power Blockchain set forth herein, in the aggregate constituting no less than 100% of the issued and outstanding Membership Interests of Power Blockchain. 
 

 (b)
 The Company shall accept the Exchange Offer, and shall, on the terms and conditions set forth in this Agreement, issue the Members the Notes. 
 

 Section 3.02
 Closing. The closing (“Closing”) of the transaction contemplated by this Agreement shall occur automatically, and without any further required action from either Party, upon the completion of the Exchange Offer (the “Closing Date”).
 

 Section 3.03
 Termination.
 

 (a)
 This Agreement may be terminated in the mutual agreement of all Parties for any reason, or by either the Board of Directors of the Company, Power Blockchain or the Members at any time prior to the Closing Date, if:
 

 (i)
 there shall be any actual or threatened action or proceeding before any court or any governmental body which shall seek to restrain, prohibit, or invalidate the transactions contemplated by this Agreement and which, in the judgment of the Company or Members, made in good faith and based upon the advice of its legal counsel, makes it inadvisable to proceed with the Exchange;
 

 

 

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 (ii)
 any of the transactions contemplated hereby are disapproved by any regulatory authority whose approval is required to consummate such or in the judgment of the Company or the Members, made in good faith and based on the advice of counsel, there is substantial likelihood that any such approval will not be obtained or will be obtained only on a condition or conditions which would be unduly burdensome, making it inadvisable to proceed with the Exchange; or
 

 In the event of termination pursuant to this paragraph, no obligation, right or liability shall arise hereunder, and each party shall bear all of the expenses incurred by it in connection with the negotiation, drafting, and execution of this Agreement and the transactions herein contemplated.
 

 ARTICLE IV
 SPECIAL COVENANTS
 

 Section 4.01
 Delivery of Books and Records and Bank Accounts. At the Closing, Power Blockchain shall deliver to the Company copies of the corporate minute books, books of account, contracts, records, and all other books or documents including the bank accounts of Power Blockchain now in the possession of Power Blockchain or its representatives. 
  
 ARTICLE V
 MISCELLANEOUS
 

 Section 5.01
 Governing Law. This Agreement shall be governed by, enforced, and construed under and in accordance with the laws of the United States of America and, with respect to the matters of state law, with the laws of the State of Nevada without giving effect to principles of conflicts of law thereunder. 
 

 Section 5.02
 Entire Agreement. This Agreement represents the entire agreement between the parties relating to the subject matter thereof and supersedes all prior agreements, term sheets, understandings and negotiations, written or oral, with respect to such subject matter.
 

 Section 5.03
 Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original and all of which taken together shall be but a single instrument.
 

 Section 5.04
 Best Efforts. Subject to the terms and conditions herein provided, each Party shall use its reasonable best efforts to perform or fulfill all conditions and obligations to be performed or fulfilled by it under this Agreement so that the transactions contemplated hereby shall be consummated as soon as practicable. Each Party also agrees that it shall use its reasonable best efforts to take, or cause to be taken, all actions and to do, or cause to be done, all things necessary, proper or advisable under applicable laws and regulations to consummate and make effective this Agreement and the transactions contemplated herein.
 

 

 

 

 

 

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 Section 5.05
 Remedies. The Parties agree that the covenants and obligations contained in this Agreement relate to special, unique and extraordinary matters and that a violation of any of the terms hereof or thereof would cause irreparable injury in an amount which would be impossible to estimate or determine and for which any remedy at law would be inadequate. As such, the Parties agree that if either Party fails or refuses to fulfill any of its obligations under this Agreement or to make any payment or deliver any instrument required hereunder or thereunder, then the other Party shall have the remedy of specific performance, which remedy shall be cumulative and nonexclusive and shall be in addition to any other rights and remedies otherwise available under any other contract or at law or in equity and to which such Party might be entitled.
 

 Section 5.06
 Construction. The Parties acknowledge that each of them has had the benefit of legal counsel of its own choice and has been afforded an opportunity to review this Agreement with its legal counsel and that this Agreement shall be construed as if jointly drafted by the Parties hereto. In this Agreement, the word “include”, “includes”, “including” and “such as” are to be construed as if they were immediately followed by the words, without limitation.
 

 Section 5.07
 Severability. The invalidity or unenforceability of any term, phrase, clause, paragraph, restriction, covenant, agreement or other provision of this Agreement shall in no way affect the validity or enforcement of any other provision or any part thereof.
 

 Section 5.08
 Headings; Gender. The paragraph headings contained in this Agreement are for convenience only, and shall in no manner be construed as part of this Agreement. All references in this Agreement as to gender shall be interpreted in the applicable gender of the Parties.
 

 Section 5.09
 Effect of Facsimile and Photocopied Signatures. This Agreement may be executed in several counterparts, each of which is an original. It shall not be necessary in making proof of this Agreement or any counterpart hereof to produce or account for any of the other counterparts. A copy of this Agreement signed by one Party and faxed or scanned and emailed to another Party (as a PDF or similar image file) shall be deemed to have been executed and delivered by the signing Party as though an original. A photocopy or PDF of this Agreement shall be effective as an original for all purposes
 

 

 

 

 

 [Remainder of page left intentionally blank. Signature page follows.]
 

 

 

 

 

 

 

 

 

 

 

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 IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed as of the date first-above written.
 

 (“Company”)
 

 Holly Brothers Pictures, Inc.
 

 

 By: /s/ Brent Willson
 

 Its: CEO
 

 Printed Name: Brent Willson
 

 (“Power Blockchain”)
 

 Power Blockchain, LLC
 

 

 By: /s/ Steve Bond
 

 Its: CFO
 

 Printed Name: Steve Bond
 

 (“Members”)
 

 PBC Group, LLC
 

 

 By: /s/ J. Camarillo
 

 Its: Manager
 

 Printed Name: J. Camarillo
 

 Black Car, Inc.
 

 

 By: /s/ Keith Williams
 

 Its: President
 

 Printed Name: Keith Williams
 

 

 

 

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 Exhibit Aex-10.4

 THIS NOTE HAS BEEN ACQUIRED FOR INVESTMENT PURPOSES ONLY AND MAY NOT BE TRANSFERRED UNTIL (i) A REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “ACT”) SHALL HAVE BECOME EFFECTIVE WITH RESPECT THERETO OR (ii) RECEIPT BY THE COMPANY OF AN OPINION OF COUNSEL REASONABLY SATISFACTORY TO THE COMPANY TO THE EFFECT THAT REGISTRATION UNDER THE ACT IS NOT REQUIRED IN CONNECTION WITH SUCH PROPOSED TRANSFER NOR IS IN VIOLATION OF ANY APPLICABLE STATE SECURITIES LAWS. 
 

 Holly Brothers Pictures, Inc.
 

 5% UNSECURED CONVERTIBLE PROMISSORY NOTE
 

 	 	
	 $1,100,000.00
	 February 1, 2018

 

 FOR VALUE RECEIVED,  Holly Brothers Pictures, Inc., a Nevada corporation (the “Company”), promises to pay to the order of [                ] (the “Payee” or the “Holder”) or registered assigns, the principal amount of One Million One Hundred Thousand and 00/dollars ($1,100,000.00) (the “Principal Amount”) and interest on the Principal Amount (as set forth in Section 1), in such coin or currency of the United States of America as at the time of payment shall be legal tender for the payment of public and private debts.  Interest on this Note shall accrue on the Principal Amount outstanding from time to time at a rate per annum computed in accordance with Section 1 hereof.  
 

 1.
 Interest Rate and Payments; Prepayment.
 

 A.
 The balance of principal outstanding from time to time under this Note shall bear interest at the rate of five percent (5.0%) per annum (the “Interest Rate”), computed on the basis of a three hundred sixty (360) day year composed of twelve (12) months of thirty (30) days each.
 

 B.
 On each of the second, third, fourth, and fifth anniversaries of this Note, payments of 25% of the Principal Amount plus interest on such Principal Amount shall be payable in arrears. To the extent any conversions pursuant to Section 2 below occur prior to any of the foregoing payment dates, all conversions shall first be applied to accrued and unpaid interest on the Note, and then shall be applied against the next payment of principal due pursuant to this Section 1.B.
 

 C.
 The entire outstanding Principal Amount, and all other amounts due under this Note, together with all accrued and unpaid interest thereon, shall be due and payable in full on the five-year anniversary of the date hereof, unless accelerated due to the occurrence of an Event of Default (the earlier of such dates is referred to as the “Maturity Date”).
 

 2.
 Voluntary Conversion and No Forced Conversion.
 

 A.
 Subject to Section 2.B. below, this Note shall be convertible at any time, in whole or in part, into shares of Company common stock (the “Common Stock”) at a conversion price equal to $0.13 per share (the “Conversion Price”), which Conversion Price shall be proportionately adjusted for stock splits, stock dividends or similar events. The Holder shall effect conversions by delivering to the Company a Notice of Conversion, the form of which is attached hereto as Annex A (each, a “Notice of Conversion”), specifying therein the interest or Principal Amount of this Note to be converted and the date on which such conversion shall be effected (such date, the “Conversion Date”). If no Conversion Date is specified in a Notice of Conversion, the Conversion Date shall be the date that such Notice of Conversion is deemed delivered hereunder.  Upon conversion, the Common Stock deliverable hereunder shall be issued within four (4) business days of the conversion date.
 

 
 

 B.
 Notwithstanding anything to the contrary contained in this Note, this Note shall not be convertible into Common Stock to the extent (but only to the extent) that the Holder or any of its affiliates would beneficially own in excess of 4.99% (the “Maximum Percentage”) of the Common Stock. To the extent the conversion provisions of Section 2.A. would be limited by this Section 2.B, the portion of this Note not converted shall be converted into Common Stock at a later date or dates, provided that at such later date or dates the limitation in Section 2.B would no longer apply to the Holder because such Holder would no longer own in excess of the Maximum Percentage. For the purposes of this paragraph, beneficial ownership and all determinations and calculations (including, without limitation, with respect to calculations of percentage ownership) shall be determined in accordance with Section 13(d) of the Securities Exchange Act of 1934, as amended, and the rules and regulations promulgated thereunder.  The provisions of this paragraph shall be implemented in a manner otherwise than in strict conformity with the terms of this paragraph to correct this paragraph (or any portion hereof) which may be defective or inconsistent with the intended Maximum Percentage beneficial ownership limitation herein contained or to make changes or supplements necessary or desirable to properly give effect to such Maximum Percentage limitation. The holders of Common Stock shall be third party beneficiaries of this paragraph and the Company may not amend or waive this paragraph without the consent of holders of a majority of its Common Stock.
 

 C.
 The Note Holder shall not be compelled to convert any amount of the Note to Common Stock.  Any conversion of the Note to Common Stock shall be done at the sole discretion of the Note Holder.  
 

 3.
 Covenants of Company
 

 A.
 Affirmative Covenants.  The Company covenants and agrees that, so long as this Note shall be outstanding, it will perform the obligations set forth in this Section 3.A.:
 

 (i)
 Maintenance of Existence.  The Company will do or cause to be done all things reasonably necessary to preserve and keep in full force and effect its corporate existence, rights and franchises and comply with all laws applicable to the Company, except where the failure to comply would not have a material adverse effect on the Company.
 

 4.
 Events of Default
 

 A.
 The term “Event of Default” shall mean any of the events set forth in this Section 4.A.:
 

 (i)
 Non-Payment of Obligations.  The Company shall default in the payment of the Principal Amount or accrued interest of this Note as and when the same shall become due and payable, whether by acceleration or otherwise.
 

 (ii)
 Non-Performance of Affirmative Covenants.  The Company shall materially default in the due observance or performance of any covenant set forth in Section 3.A.
 

 (iii)
 Bankruptcy, Insolvency, etc.  The Company shall:
 

 (a)
 apply for, consent to, or acquiesce in, the appointment of a trustee, receiver, sequestrator or other custodian for the Company, or make a general assignment for the benefit of creditors; or
 

 

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 (b)
 permit or suffer to exist the commencement of any bankruptcy, reorganization, debt arrangement or other case or proceeding under any bankruptcy or insolvency law, or any dissolution, winding up or liquidation proceeding, in respect of the Company, and, if such case or proceeding is not commenced by the Company or converted to a voluntary case, such case or proceeding shall be consented to or acquiesced in by the Company or shall result in the entry of an order for relief.
 

 B.
 Action if Bankruptcy.  If any Event of Default described in clause (iii) of Section 4.A. shall occur, the outstanding Principal Amount of this Note and all other obligations hereunder shall automatically be and become immediately due and payable, without notice or demand.
 

 C.
 Action if Other Event of Default.  Upon the occurrence of an Event of Default that goes uncured for more than 10 days after written notice thereof by Holder to the Company (other than any Event of Default described in clause (iii) of Section 4.A.) the entire outstanding principal of the Note together with the interest accrued thereon shall be immediately due and payable.  The Company hereby waives any and all notices including notice of breach, notice of default, notice of intent to accelerate, notice of acceleration or any other demand or presentment that may be required.
 

 5.
 Miscellaneous.
 

 A.
 Parties in Interest.  All covenants, agreements and undertakings in this Note binding upon the Company or the Payee shall bind and inure to the benefit of the successors and permitted assigns of the Company and the Payee, respectively, whether so expressed or not.
 

 

 B.
 Governing Law.   This Note shall be governed by the laws of the State of Nevada as applied to contracts entered into and to be performed entirely within the State of Nevada. 
 

 C.
 Arbitration.  Any dispute, claim or controversy arising out of or relating to this Note or the breach, termination, enforcement, interpretation or validity thereof, including the determination of the scope or applicability of this agreement to arbitrate, shall be determined by arbitration in San Diego, California before a single arbitrator.  Company shall be responsible for all arbitration costs of securing JAMS prior to the Award.  The arbitration shall be administered by JAMS pursuant to its Comprehensive Arbitration Rules and Procedures (“Rules”) and in accordance with the Expedited Procedures in those Rules, including Rules 16.1 and 16.2 of those Rules.  Judgment on the Award (as defined in the Rules) may be entered in any court having jurisdiction.  The Company and Holder shall each select one independent arbitrator expert in the subject matter of the dispute (the arbitrators so selected shall be referred to herein as “Company’s Arbitrator” and “Holder’s Arbitrator,” respectively).  In the event that either such party fails to select an independent arbitrator as set forth herein within 20 days from delivery of a notice of arbitration, then the matter shall be resolved by the arbitrator selected by the other party.  Company’s Arbitrator and Holder’s Arbitrator shall select a third independent arbitrator expert in the subject matter of the dispute, and the three arbitrators so selected shall resolve the matter according to the procedures set forth in this section.  If Company’s Arbitrator and Holder’s Arbitrator are unable to agree on a third arbitrator within 20 days after their selection, Company’s Arbitrator and Holder’s Arbitrator shall each prepare a list of three independent arbitrators.  Company’s Arbitrator and Holder’s Arbitrator shall each have the opportunity to designate as objectionable and eliminate one arbitrator from the other arbitrator’s list within seven days after submission thereof, and the third arbitrator shall then be selected by lot from the arbitrators remaining on the lists submitted by Company’s Arbitrator and Holder’s Arbitrator.
 

 

 

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 The parties shall maintain the confidential nature of the arbitration proceeding and the Award, including the hearing, except as may be necessary to prepare for or conduct the arbitration hearing on the merits, or except as may be necessary in connection with a court application for a preliminary remedy, a judicial challenge to an Award or its enforcement, or unless otherwise required by law or judicial decision. The parties acknowledge that this Note evidences a transaction involving interstate commerce. Notwithstanding the provision in the preceding section with respect to applicable substantive law, any arbitration conducted pursuant to the terms of this Note shall be governed by the Federal Arbitration Act.
 

 D.
 Notice.  All notices shall be in writing, and shall be deemed given when actually delivered to a party at its address set forth herein personally, by a reputable overnight messenger.
 

 E.
 No Waiver.  No delay in exercising any right hereunder shall be deemed a waiver thereof, and no waiver shall be deemed to have any application to any future default or exercise of rights hereunder.
 

 F.
 Assignability of Note by Holder.  Holder shall be permitted to assign the Note to any party or person as it sees fit in its sole discretion.  Assignee will be bound by the same terms and conditions as Note Holder, as set forth herein, following any assignment of the Note.
 

 

 IN WITNESS WHEREOF, this Note has been executed and delivered on the date specified above by the duly authorized representative of the Company.
 

 Holly Brothers Pictures, Inc.
 

 

 By:________________________________
       Brent Willson, Chief Executive Officer
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 ANNEX A
  
 NOTICE OF CONVERSION
 

 The undersigned hereby elects to convert principal and interest under the 5% Convertible Note of Holly Brothers Pictures, Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any.
 

 If required by applicable law, the undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock.
 

 

 Date to Effect Conversion: ____________________________
 

 Principal Amount  of Note to be Converted: $__________________
 

 Accrued Interest to be Converted: $__________________________
 

 Number of shares to be issued: ______________________________
 

 Signature: _________________________________________
 

 Name: ____________________________________________
 

 Address for Delivery of Common Stock Certificates: __________
 _____________________________________________________
 ____________________________________________________
 

 

 The undersigned is an “accredited investor” as defined in Regulation D promulgated under the Securities Act of 1933, as amended, or a non- “U.S. Person” within the meaning of Rule 902 of Regulation S promulgated under the Securities Act of 1933.
 

 [SIGNATURE OF HOLDER]
 

 Name of Investing Entity:_____________________________________________________
 

 Signature of Authorized Signatory of Investing Entity: ______________________________
 

 Name of Authorized Signatory: _________________________________________________
 

 Title of Authorized Signatory: __________________________________________________
 

 Date: ______________________________________________________________________

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