Private Placement Memorandum for Film - Individual Subscriber Acknowledgment

Form acknowledging individual subscription for PPM in film production - notarization required.

ACKNOWLEDGMENT FOR INDIVIDUAL SUBSCRIBERS

STATE OF

COUNTY OF

On this ____ day of _______________, ____, before me, the undersigned, a Notary Public of said State, duly commissioned and sworn, personally appeared _______________________, known to me to be the person (or persons) whose name is (or whose names are) subscribed to on the within instrument and acknowledged that he (or she or they) executed the same.

IN WITNESS WHEREOF, I have hereunto set my hand and affirmed my official seat the day and year in this certificate first above written.

Notary Public

Address:

My commission expires:

Public Document

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