Bilfeld v. Town & Country Restaurant LLC et al

Filing 34

MOTION by Plaintiff David Bilfeld for judgment [Application For Default Judgment] (Attachments: # 1 Affidavit, # 2 Exhibit, # 3 Exhibit, # 4 Exhibit, # 5 Declaration, # 6 Exhibit, # 7 Exhibit, # 8 Exhibit, # 9 Exhibit, # 10 Exhibit, # 11 Exhibit, # 12 Exhibit, # 13 Exhibit, # 14 Exhibit, # 15 Exhibit, # 16 Text of Proposed Order)(Spak, Donald)

Bilfeld v. Town & Country Restaurant LLC et al

Doc. 34 Att. 3

SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT FOR TOWN AND COIJNTRY RESTAURANT LLC
A.
B.

SUBSCzuPTION AMOI.INT:

$

l-..:.0

o/ .',

o

(l'{o less than $100,000)

NAME OF SUBSCRIBER(S) (print name on left hand side and sign and date on right
hand side):

(r)
Print Name

Signature:

Title: Dut",

--ETl77 -

'v) /

IF SUBSCzuBER IS JOINT TENANT/TENANT IN COMMON (second party should print name on left hand side and sign and date on right hand side):
(2) Signature:

Print Name

Title:
Date:

C.

ADDRESS (and mailing address, if dffirent):

Mailing:

D.
E. F.

EMAIL ADDRESS ,
FAX NUMBER:

tt/^

v/L

TAXPAYER I.D. NUMBER OR SOCIAL SECURITY NUMBER OF EACH
SUBSCRIBER:

(l)
G.

TYPE OF OWNERSHIP:

Ft

oividual

Joint Tenants with Right of Survivorship

Tenants in Common Partnership

Community Property (check only
Employee Benefit Plan

if

resident of a Community Property State)

Corporation Other (spectfy)

Trust

Limited Liability Company

364838R/10'149.00t

Dockets.Justia.com

TOWN AND COUNTRY RESTAURANT LLC
SUBSCRIPTION AGREEMENT ACCEPTANCE PAGE

The undersigned, the Manager of Town and Country Restaurant LLC, hereby accepts the 2007 as to the entire Subscription day of foregoing subscription Amounf or portion of the Subscription Amount set forth below, as the case may be:

this

t] d

Subscriber's entire Subscription Amount
That portion of Subscriber's Subscription Amount equal to $

ftrt,c00

TOWN AND COUNTRY RESTAURANT LLC By:

364838/3/l 0749.001

9