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S-1/A - PDK ENERGY INC.pdks1aam8final.htm
EX-99 - PDK ENERGY INC.exhibit2099.htm
EX-3 - PDK ENERGY INC.pdkarticles.htm
EX-3 - PDK ENERGY INC.corpbylawspdk.htm
EX-5 - PDK ENERGY INC.pdklegalapr112011.htm
EX-23 - PDK ENERGY INC.consentapril112011.htm

EXHIBIT 1.1

SUBSCRIPTION AGREEMENT

PDK ENERGY INC.  SUBSCRIPTION AGREEMENT


Gentlemen:

 

The Investor  named below, by payment of the purchase price for such Common Shares, by the delivery of a check payable to PDK ENERGY INC hereby subscribes for the purchase of the number of Restricted Common Shares indicated below of PDK ENERGY INC.

 

By such payment, the named Investor further acknowledges receipt of the Prospectus and the Subscription Agreement, the terms of which govern the investment in the Common Shares being subscribed for hereby.

 

A.

INVESTMENT:

 

(1)

Number of Shares ___________________________

 

 

 

 

 

  

  

  

(2)

Total Contribution $__________

  

  

  

  

  

  

  

  

  

Date of Investor’s check ___________

  

  

  

  

  

B.

REGISTRATION:

  

  

  

  

  

  

  

  

  

  

  

(3)

Registered owner: __________________________

  

  

  

  

  

  

  

  

  

Co-Owner: __________________________________

  

  

  

  

  

  

  

  

(4)

Mailing address: ___________________________

  

  

  

  

  

  

  

  

  

City, State & zip: _________________________

  

  

  

  

  

  

  

  

(5)

Residence Address (if different from above):

  

  

  

  

  

  

  

  

  

============================================

  

  

  

  

  

  

  

  

(6)

Birth Date: ______/______/______

  

  

  

  

  

  

  

  

(7)

Employee or Affiliate: Yes ______ No ______

  

  

  

  

  

  

  

  

(8)

Social Security: #: ______/______/______

  

  

  

  

  

  

  

  

  

U.S. Citizen o Other o

  

  

  

  

  

  

  

  

  

Co-Owner Social Security:

  

  

  

  

  

  

  

  

  

#: ______/______/______

  

  

  

  

  

  

  

  

  

U.S. Citizen o Other o

  

  

  

  

  

  

  

  

  

Corporate or Custodial:

  

  

  

  

  

  

  

  

  

Taxpayer ID #: ______/______/______

  

  

  

  

  

  

  

  

  

U.S. Citizen o Other o

  

  

  

  

  

  

  

  

(9)

Telephone (H) (            ) ______________________

 

C.

OWNERSHIP

  

o

Individual Ownership

o

IRA or Keogh







  

  

  

  

  

  

  

  

  

  

o

Joint Tenants with Rights of Survivorship

  

  

  

  

  

  

  

  

o

Trust/Date Trust Established____________

  

  

  

  

  

  

  

  

o

Pension/Trust (S.E.P.)

  

  

  

  

  

  

  

  

o

Tenants in Common

o

Tenants by the

Entirety

  

  

  

  

  

  

  

  

  

  

o

Corporate Ownership

o

Partnership

  

  

  

  

  

  

  

  

  

  

o

Other_____________________

  

  

  

  

  

  

  

  

  

 

 

 


 

 

D.

SIGNATURES

  

  

  

  

  

 

Registered Owner: _____________________________

 

Co-Owner: _____________________________

 

Print Name of Custodian or Trustee: _____________________________

 

Authorized Signature: _____________________________

 

Date: _____________________

 

Signature: ___________________________________

 

MAIL TO:

 

PDK Energy Inc

2911 Hilltop Drive

Ann Arbor, MI 48103

Telephone: 734-274-9403

Telecopier: 734-424-2624

 

____________________________________________________________________

FOR OFFICE USE ONLY:

 

Date Received: ________________________________________________

 

Date Accepted/Rejected ________________________________________

 

Subscriber’s Check Amount: _______________________

 

Check No. ___________________ Date Check ________________

 

Deposited ________________________________

 

MR #________________




 

____________________________________________________________________

We have not authorized any dealer, salesperson or other person to give any information or represent anything not contained in this prospectus. You must not rely on any unauthorized information. This prospectus does not offer to sell or buy any shares in any jurisdiction where it is unlawful. The information in this prospectus is current only as of the date of this prospectus.