Subscription Form
Subscription Form
SUBSCRIPTION AGREEMENT
I shall pay the subscription amount to the cooperative upon signing of this agreement and commit to pay the full
subscription on a monthly installment basis within the specified term as follows:
I understand that my failure to pay the minimum and the full subscription price may affect my rights and the status of
my membership in accordance with the cooperative By-Laws and cooperative laws
______________________________
Name and Signature of Subscriber
CONFORME:
____________________________________
Represented by: Chairperson of the Board
_________________________ ______________________
1
ACKNOWLEDGMENT
I certify that on this ______________________ in ________________, before me a Notary Public duly authorized in the
city named above to take acknowledgments, personally appeared:
Who were identified by me through competent evidence of identity to be the same persons described in the foregoing Subscription
Agreement, who acknowledged before me that their respective signatures on the Subscription Agreement were voluntarily affixed
by them for the purposes stated therein, and who declared to me that they are duly authorized to enter into this Subscription
Agreement and have executed the Subscription Agreement as their free and voluntary act and deed and of the Cooperative that they
represent.
IN WITNESS WHEREOF, I affixed my notarial seal on the date and at the place above-written.
Notary Public
Doc. No.________;
Page No. _______;
Book No. _______;
Series of 2015.