( i ) has carefully read this subscription agreement and the term sheet, understands and has evaluated the risks of a purchase of the securities and has relied solely ( except as indicated in subsections ( ii ) and ( iii ) below ) on the information contained in the term sheet and this subscription agreement ; ( ii ) has not relied upon any representations or other information ( whether oral or written ) from the company, or any of its agents other than as set forth in this subscription agreement, the registration rights agreement, the warrant, the term sheet, and the sec documents ; ( iii ) has been provided an opportunity to obtain any additional information concerning the offering, the company and all other information to the extent the company possesses such information or can acquire it without unreasonable effort or expense and the company has made available to the investor all documents and information that the investor has requested relating to an investment in the company ; ( iv ) has been given the opportunity to ask questions of, and receive answers from, the company concerning the terms and conditions of the offering and other matters pertaining to this investment ; and ( v ) has carefully considered and has to the extent the investor believes such discussion necessary, discussed with the investor ’ s professional, legal, tax and financial advisers the suitability of an investment in the company for the investor ’ s particular tax and financial situation and the investor has determined that the securities are a suitable investment for the investor. principal residence address, telephone number and email : secondary residence address and telephone number : the investor has no present intention of becoming a resident of any other state or jurisdiction. name, address, telephone number and facsimile number of employer or business : length of employment or in current position : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ prior employment, positions or occupations during the past five years ( and the inclusive dates of each ) are as follows : nature of occupation position / duties from / to attach additional pages to answer any questions in greater detail, if necessary. each prospective investor should answer the following questions, which pertain to income, tax rate, net worth, liquid assets, and non - liquid assets by including spousal contribution even though the investment shall be held in single name. business or professional education and the degree ( s ) received are as follows : school degree year received nature of occupation position / duties from