Subscription to LLC Interest Short Form
The undersigned hereby subscribes for _________ [% or number] of membership interest in a limited liability company to be organized under the laws of the State of _____, to be known as ___________, LLC, and agrees to pay for the interest in cash in the amount of ___________ upon acceptance by the LLC's managers of this subscription and call for payment thereof. Certificates for the membership interest shall be issued to the undersigned, in a manner designated by the LLC, as fully paid and non-assessable. Dated this ___ day of __________, 200_:
__________________________________ SIGNATURE OF SUBSCRIBER __________________________________ PRINTED NAME OF SUBSCRIBER __________________________________ STREET ADDRESS __________________________________ CITY STATE ZIP __________________________________ SIGNATURE OF SPOUSE (if purchasing jointly) __________________________________ PRINTED NAME OF SPOUSE (if applicable) ACCEPTED BY: [LLC] by:___________________________ [Member/Manager] ______ Date