Stock Escrow Agreement Form - 2003 printable pdf download

Stock Escrow Agreement Form - 2003

Oregon Department of Consumer & Business Services

Division of Finance & Corporate Securities

350 Winter St. NE, Rm. 410, Salem, Oregon 97301-3881

Mailing address: P.O. Box 14480, Salem, OR 97309-0405

(503) 378-4140 Fax: (503) 947-7862 TTY: (503) 378-4100

STOCK ESCROW AGREEMENT

This agreement, made and entered into this

day of

, 20

by and between

, hereinafter referred to as “the company” and

, as individuals and as organizers of the company,

hereinafter referred to as “the promoters” and

hereinafter referred to as “the escrow agent.”

The company has applied to the director of the Department of Consumer and Business Services of the State of Oregon,

hereinafter referred to as “the director,” for registration of the following securities for sale to the public under the Oregon

Securities Law:

upon such terms, conditions, limitations, and restrictions as the director may deem appropriate to make the issue fair, just,

and equitable.

Promoters have been issued shares of promotional stock in the amounts listed below for a consideration substantially

different from the public offering price or for a consideration other than cash. Promotional stock is to be deposited in

escrow pursuant to ORS 59.085(3)(a), upon the terms approved by the director as set forth in this agreement.

Total shares

Shares free

Consideration

Name and address

issued

escrowed

of escrow

for all shares

Page 1 of 4

440-3438 (10/03/COM/WEB)

Stock Escrow Agreement Form - 2003