Financial Polis

  Expand All  |  Contact All


Effective Date        : ___________, _____, 2009

To           : Striker Gold Corporation –Las Vegas Nevada USA

Re           : TRANSACTION CODE     :

                  SELLER CODE           :

  BUYER CODE            :


I, Mr. _____, for and on behalf of _____, in respect of the above-referenced Transaction Code, Seller Code, and Buyer Code, do hereby confirm that I have requested of you and your organization, specific confidential information and documentation on behalf of myself regarding the availability of purchase of a bank instrument on a private placement basis to serve only my interest, education, and not for further distribution. I further confirm that all information received from you is in direct response to my request, and is not in any way considered or intended to be a solicitation of any sort, or any type of offering, and for my general knowledge only. I hereby affirm under penalty of perjury, that I have requested this information from you and your organization of my choice and free will and further, and that you have not solicited me in any way. I hereby represent that I am not an informant, nor am I associated with any government agency of the United States of America, or any other country, such as the Secret Service, Internal Revenue Service, Federal Bureau of Investigation, Central Intelligence Agency, Securities and Exchange Commission, Banking Commission, nor any agency whose purpose is to gather information regarding such offerings. I understand that the contemplated transaction is strictly one of private placement of a bank instrument, and is in no way relying upon, or relating to, the U.S. Securities Act of 1933, as amended, and the U.S. Exchange Act of 1934, as amended, or related laws and regulations, and does not involve the sale of securities. Further, I hereby declare that you have disclosed that you are not a licensed security trader, attorney, bank officer, certified public accountant or financial planner. Any information, work or service conducted hereunder is that of a private individual and that this is a private placement transaction that is exempt from the U.S. Securities Act of 1933, as amended, and the U.S. Exchange Act of 1934, as amended, or related laws and regulations and not intended for the general public but private use only. A period of three (3) international banking day’s exclusivity is confirmed to protect this capability. The facsimile or electronic mail transmission of this document shall be considered a binding and enforceable instrument, treated as original copy. Original may be obtained upon request.


Dated effective as of this _____day of _______, 2009:








Passport No.:

Expiry Date: