Attached files

file filename
EX-3.2 - BY-LAWS - Plycrete, Inc.plycreteexhibit32.htm
EX-5 - OPINION OF COUNSEL AND CONSENT OF COUNSEL - Plycrete, Inc.plycreteexhibits5.htm
EX-23 - CONSENT OF INDEPENDENT REGISTERED CPA - Plycrete, Inc.plycreteexhibits23.htm
EX-3.1 - ARTICLES OF INCORPORATION - Plycrete, Inc.plycreteexhi9bit31.htm
EX-10 - LICENSE AGREEMENT - Plycrete, Inc.plycreteexhibits10.htm
S-1 - PLYCRETE FORM S-1 02/01/10 - Plycrete, Inc.plycretes1020110.htm


Exhibit 4
 

 
SUBSCRIPTION AGREEMENT

Plycrete, Inc.
1777, Cedar
Mascouche (Quebèc)
Canada J7L 1W6

The undersigned has received the prospectus dated __________, 2010 (“Prospectus”), and hereby subscribes for _____________ shares of $.001 par value common stock of Plycrete, Inc., a Nevada corporation (“Company”), for a subscription price of $0.30 per share (“Offered Shares”).  The undersigned hereby agrees that this subscription shall be irrevocable and shall survive the death or disability of the undersigned.  Payment of the purchase price for the Offered Shares is due upon subscription.

The undersigned acknowledges that (i) the Company has the right to accept or reject this subscription in whole or in part, (ii) this subscription shall be deemed to be accepted by the Company only when the Company signs this Subscription Agreement; and (iii) the undersigned has relied only on that information specified in the Prospectus.

Number of Offered Shares: _________________.  Subscription Amount: ___________ (number of Offered Shares multiplied by $0.30)

Make check payable to:                                           “Plycrete, Inc.

Please print name(s) or title, residence address, and SSN or Tax ID for which the Offered Shares are to be registered.  Please notify the Company in writing if your address changes before you either receive your shares or are notified that your subscription has not been accepted.

 
                 
Name
               
Street
               
City
     
State
     
Zip Code
SSN or Tax ID No. (For joint ownership, both parties must provide a Social Security Number or similar tax  identification)


Indicate type of ownership:


    o
  Individual Ownership
    o
  Joint Tenants with Right of Survivorship
       
    o
  Community Property
    o
  Tenants in Common
       
    o
  Tenants by the Entirety
    o
  Corporate Ownership
       
    o
  Partnership Ownership
    o
  Custodian for a Minor
       
    o
  Trust (see below)
    o
  IRA or Pension Plan

Date Trust Established:                                                              
Name of Trustee or other Administrator                                        




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Each subscriber represents that:

(a)  
The information contained herein is complete and accurate and may be relied upon, and

(b)  
The undersigned will notify the Company immediately of any material change in any such information occurring prior to the acceptance of the undersigned’s subscription, including any changes in address or other contact information.

IN WITNESS WHEREOF, the undersigned has executed this Subscription Agreement as of this ______ day of ____________ 2010.

FOR INDIVIDUALS:

         
Print Name
   
 
 
 
   
 
 
Signature
   
 
 


NAME AND SIGNATURE OF JOINT TENANT OR TENANT IN COMMON


         
Print Name
   
 
 
 
   
 
 
Signature
   
 
 


FOR TRUSTS, CORPORATIONS, PARTNERSHIPS


     
Print Name of Entity
 
 
By:      
 
 
    Print name and capacity (Trustee, President or General Partner) of person making investment decision    
     
Signature
 
 


Agreed to and accepted:

By:           Plycrete, Inc.,
a Nevada corporation


By:          ______________________
Clement Guevremont
Its:           President
 
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