Liberty Coin Award Form

This Liberty Coin Award Form and Liberty Coin Network Member/User Application (“Award Form”) certifies the undersigned award recipient (“Award Recipient”) has agreed to receive Liberty Coins (“Liberty Coin Award”) from approved members of the Liberty Coin Network (“Liberty Coin Network”) according to all terms and conditions contained in this Award Form and the Liberty Coin Network website at libertycoingold.com.

NOTICE – You will need your NFT contract address and token ID for each NFT you have purchased on opensea.io to complete this Award Form, so make sure the NFT information is available before you start filling out this Liberty Coin Award Form. You only need to complete this Award Form one time for multiple NFT purchases, provided you list all NFT contract addresses and token IDs on this Award Form. You can also upload these file types gif|png|jpg|jpeg|xlsx|xls|txt|csv|html|pdf containing the NFT contract addresses and token IDs.

Liberty Coin Network Member/User. Award Recipient of Liberty Coins is subject to approval as a Liberty Coin Network Member/User (“Liberty Coin Network Member/User”). You as a Liberty Coin Network Member/User applicant must receive your award of Liberty Coins using this Award Form.
Liberty Coin Award Type. If you purchased unbranded NFTs, you shall receive an award of one (1) unbranded Liberty Coin for each one (1) unbranded NFT coin you own. If you purchased custom-branded NFTs, you shall receive an award of one (1) custom-branded Liberty Coin for each one (1) custom-branded NFT coin you own.
Liberty Coin Award. The minimum amount of Liberty Coins that can be initially awarded is one (1) Liberty Coin. Once membership approval of Award Recipient and the initial award of Liberty Coins has been completed, a minimum of one (1) Liberty Coin may be subsequently purchased or sold using on-line forms. Award Recipient desires to receive an award of Liberty Coins as stated herein below (“Liberty Coins Awarded”).
Liberty Coins are not fractionally divisible and must be awarded in whole units.
The Liberty Coin Network charges its members transaction and account maintenance fees to facilitate Liberty Coin subsequent buy/sell transactions and usage of its network and account related services.
There are no costs or fees payable or incurred for the Liberty Coins awarded using this Award Form.
However, subsequent resale of Liberty Coins awarded shall be subject to the following transaction fee schedule (“Transaction Fees“): 10.0% fee for Liberty Coin sales up to $50,000; 7.5% fee for Liberty Coin purchases or sales from $50,001 to $100,000; 5.0% fee for Liberty Coin purchases or sales from $100,001 to $1,000,000; 3.0% fee for Liberty Coin purchases or sales over $1,000,000.
All Liberty Coin owners shall be subject to the following monthly maintenance fee schedule (“Maintenance Fees“): 1.00% fee/mo. for Liberty Coin accounts up to $50,000; 0.75% fee/mo. for Liberty Coin accounts from $50,001 to $100,000; 0.50% fee/mo. for Liberty Coin accounts from $100,001 to $1,000,000; 0.25% fee/mo. for Liberty Coin accounts over $1,000,000.
Your Liberty Coin delivery value (payoff value at maturity) is equal to (A) the value of one (1) Troy oz. of 99.95% pure gold on the New York Commodity Exchange (COMEX) on the day of physical Liberty Coin delivery (“Liberty Coin Intrinsic Gold Value“), PLUS, (B) any premium paid for your Liberty Coin as the result of its specific custom-branding, as quoted on various dealer networks, auction sites, and exchanges where the same/similar coins to your specific custom-branded coin may have previously or currently trade (“Custom-Branded Coin Premium“).
In addition to the above Liberty Coin Network transaction fee and maintenance fees, members of the Liberty Coin Network are required to pay for all third-party transactional related costs for each Liberty Coin award, purchase or sale transaction including bank service charges, credit card processing fees, international transaction fees, and currency conversion fees (collectively the “Third-Party Transaction Costs”).
Upon Liberty Coin Network approval of this Award Form you will be sent a secure email with a temporary user ID to access your Liberty Coin Network Member-User Account and Liberty Coin Award.

User Online Account & Documentation

Upon Liberty Coin Network approval of this Award Form you will receive the following information:

A link to your online Liberty Coin Network Member-User Account showing your User Account information, current Liberty Coin Award transaction, Liberty Coin performance summary, and Liberty Coin transaction history.
Liberty Coin Ownership Certificate showing the owner of record and number of Liberty Coins owned as of the certificate date.
Updated Liberty Coin Member-User Account information will be posted to your online User Account each time a transaction increases or decreases your Liberty Coin holdings.
Additionally, your online User Account is updated for each award, purchase or sales transaction you make.
Your Liberty Coin Ownership Certificate together with your online Liberty Coin Network Member-User Account provides you with comprehensive and detailed documentation regarding your current Liberty Coin transaction, Liberty Coin performance, and Liberty Coin transaction history.

Liberty Coin Network Terms & Conditions of Award, Membership and Use

Award Recipient acknowledges it has reviewed and expressly agrees to all terms and conditions contained in this Award Form and the Liberty Coin Network website at libertycoingold.com including all website text, exhibits, attachments and downloadable documents, the most important documents of which are the Liberty Coin Network Membership Agreement, Liberty Coin Purchase, Sale and Use Agreement, Liberty Coin Collateralization Agreement, Liberty Coin Financing Agreement, and Liberty Coin Privacy Agreement.

Our Privacy Pledge. Your personal information including your email address and phone number will always remain private and confidential. We will never sell, share or disclose any of your personal information to any person, company or entity not directly related to your award, purchase or sale transactions, your Liberty Coin holdings or your Liberty Coin Network account. We will never engage in solicitation or marketing activities concerning you or your account. Our website and our communication with you will never contain any form of third party advertising or external or embedded marketing links or cookies.

The Liberty Coin Network, on behalf of its members, reserves the right to change the terms and conditions of this Award Form, Liberty Coin Award, and award, purchase and sale, or membership and use of the Liberty Coin Network.

Liberty Coin Award Form Instructions

All Award Recipients must complete this Award Form.
Incomplete Award Forms will be rejected.
You will need your NFT contract address and token ID for each NFT you have purchased on opensea.io to complete this Award Form, so make sure the NFT information is available before you start filling out this Award Form.
Upon Liberty Coin Network approval of this Award Form you will be sent a secure email with an Invoice and Liberty Coin Award statement for the number of Liberty Coins to be awarded and which authorizes the Liberty Coin Network to facilitate your Liberty Coin Award transaction.

NOTICE: This Award Form requests a significant amount of information for security and identity verification purposes. The depth and breadth of information requested in this Award Form when combined with our multi-step Liberty Coin Award approval process allows us to positively verify your identity as the NFT and Liberty Coin owner of record and prevent unauthorized account access, theft or fraud. As stated in Our Privacy Pledge, once you become a member of the Liberty Coin Network your personal information will not be utilized for any purpose other than to positively identify you as the owner of your Liberty Coin Network Account and your NFT and Liberty Coin holdings.

Please contact us with any questions you may have at [email protected].

U.S. Representative:

Liberty Coin, 1390 Market Street, Suite 200, San Francisco, CA 94102

775.295.5482 l libertycoingold.com

Username *Enter your username using your primary email address, and write it down.

Temporary Password *Enter a temporary password comprised of a combination of eight (8) letters and numbers and one (1) special character (!, #, $, *), and write it down.

Full Name / Name of Person Completing Form *Enter your full name as Award Recipient or the full name of the person completing this form for a corporation.

First Name (Given Name) *

Last Name (Surname) *

Company/Trust NameThis must be the exact legal name including type of entity; Inc., Ltd., LLC, Trust, etc.

Title of Authorized Corporate Signer

State/Province and Country Incorporated

Award Recipient Physical Address Street Address *

Street Address Line 2

City *

Region/Province/State*

Postal/Zip Code *

Country *

Country of Citizenship *Must be completed for Award Recipient if an individual or the person completing form on behalf of a corporation/trust.

Phone Number Insert the primary phone number to be used for your account. Please include your country code and complete phone number including area code for phone numbers outside the USA.

Country code

Complete Phone Number Including Area Code*

Email Address *Notice: This is the primary email address where important and time sensitive communication and information will be sent.

Preferred Language *Insert your preferred language.

Second Language *Insert your second language or the word NONE if you do not have a second language.

Understanding of Spoken English *Insert your understanding of Spoken English on a scale of 5 to 0, where 5 means your are fluent in English and 0 means you have no understanding of English.

Understanding of Written English *Insert your understanding of Written English on a scale of 5 to 0, with 5 meaning you have full understanding of written English and 0 means you have no understanding of written English.

Certification of Award Recipient Current and Projected Future Income and Net Worth. Individual Award Recipients select from the first two items. Corporate/Trust Award Recipients select third item. (Notice: Only select an item if you meet or exceed the stated requirements).*

My individual INCOME exceeded $200,000 USD in each of the last two years or my joint INCOME together with my spouse exceeded $300,000 USD in each of those years and income for the current year is reasonably expected to equal or exceed prior year income.‎‎‎

My individual NET WORTH or my joint NET WORTH together with my spouse exceeds $1,000,000 USD (fair value of personal and real property less liabilities), EXCLUDING the market value of my primary residence and any mortgages on that residence.‎‎‎
The NET WORTH of the company/trust that is the Award Recipient exceeds $5,000,000 USD (fair value of personal and real property less total liabilities).‎

What is your favorite sport? *This is a security question.

What city were you born? *This is a security question.

What is the first name of your best friend? *This is a security question.

What is your mother's maiden name (original last name/surname)? *This is a security question.

Type or paste your NFT contract address and token ID for each NFT you have purchased on opensea.io to complete the Award Form.As shown in section below, you can also upload multiple file types containing your NFT contract addresses and token IDs.

Upload your files containing your NFT contract address and token ID for each NFT you have purchased on opensea.io here.You can upload multiple file types gif|png|jpg|jpeg|xlsx|xls|txt|csv|html|pdf, limited to 5MB per file.

Terms of Award Form and Liberty Coin Network Membership/Use Application *

Award Recipient acknowledges it has reviewed and expressly agrees to all terms and conditions contained in this Award Form and the Liberty Coin Network website at libertycoingold.com including all website text, exhibits, attachments and downloadable documents and information. Award Recipient hereby unconditionally certifies its ownership and usage of this Liberty Coin Award will not be for speculative purposes.‎

Date Signed *

Award Recipient Electronic Signature *Enter your full name.

Award Recipient - Questions / Comments / Instructions

Please enter the total of the two numbers in the box below so we know you are a real person completing this form. *48/4=?

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