EX-1.1 2 a2054270zex-1_1.txt EXHIBIT 1.1 EXHIBIT 1.1 Tari, 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 Tari, Inc., hereby subscribes for the purchase of the number of Common Shares indicated below (minimum of twenty five thousand shares) of Tari, Inc. at a purchase of $0.05 per Share as set forth in the Prospectus. 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 ($0.05/Share) $__________ 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 [ ] Other [ ] Co-Owner Social Security: #: ______/______/______ U.S. Citizen [ ] Other [ ] Corporate or Custodial: Taxpayer ID #: ______/______/______ U.S. Citizen [ ] Other [ ] (9) Telephone (H) ( ) _________________________ C. OWNERSHIP [ ] Individual Ownership [ ] IRA or Keogh [ ] Joint Tenants with Rights of Survivorship [ ] Trust/Date Trust Established_______________ [ ] Pension/Trust (S.E.P.) [ ] Tenants in Common [ ] Tenants by the Entirety [ ] Corporate Ownership [ ] Partnership [ ] Other_____________________ D. SIGNATURES: By signing below, I/we represent that I/we meet the suitability standards set forth in the Prospectus. Registered Owner: _____________________________ Co-Owner: _____________________________ Print Name of Custodian or Trustee: _____________________________ Authorized Signature: _____________________________ Date: _____________________ Signature: ___________________________________ MAIL TO: Tari, Inc. 1102 Wolfe Avenue Vancouver, B. C. V6H 1V8 Canada ----------------------------------------------- FOR OFFICE USE ONLY: Date Received: ________________________________________________ Date Accepted/Rejected ________________________________________ Subscriber's Check Amount: _______________________ Check No. ___________________ Date Check ________________ Deposited ________________________________ MR #________________