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Escrow Agreement S5 - Puerto Rico
| Escrow Agreement Form. This is a Puerto Rico form and can be used in Securities Blue Sky Commissioner Of Financial Institutions . |
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Form S-5 05/10 Commonwealth of Puerto Rico COMMISSIONER OF FINANCIAL INSTITUTIONS Securities Regulation Division Fernandez Juncos Station PO Box 11855 San Juan, PR 00910-3855 Tel. (787) 723-3131 Fax (787) 724-2604 ESCROW AGREEMENT KNOW ALL MEN BY THESE PRESENTS: 1. That I, ________________________, of ___________________________Street, in the city of ___________________________________________, State of _____________, being a shareholder of the____________________________________________________stock in ___________________________________________, the issuer, a corporation organized under the laws of the State of __________________________________________, for the purpose of complying with Article 40 of the Regulation under de Uniform Securities Act of Puerto Rico in connection with an application for the registration by qualification or coordination of _____________________ shares of the____________________________stock of the said issuer which was filed with said Commissioner on the ______________________day of _____________, 20____, do hereby and herewith deposit with the _____________________, as escrow agent, in conformity with the requirements of said Article 40 certificate(s) numbered________________________________________________________________ representing___________________________________________________shares, respectively, of the ________________________________________stock of the said issuer, of which shares I am the sole owner. 2. That I hereby agree that the said shares represented by the said certificate(s) shall be held in escrow by the said escrow agent subject to the following conditions: (a) That there shall be no assignment, sale or disposal of any interest in any of the said shares represented by the said certificate(s) without the written consent of the said Commissioner. (b) That the said shares represented by the said certificate(s)shall not be released to me by the said Commissioner except as provided in Article 40 which rule is hereby made a part hereof in its entirety. In Witness, Whereof, I have hereunder set my hand and seal this____day of ______________________________, 20____. (Signed)____________________ (SEAL) Witness ____________________ American LegalNet, Inc. www.FormsWorkFlow.com
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