Common use of NOTICE OF CONVERSION Clause in Contracts

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4, 2011 of Hague Corp., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4, 2011 in the aggregate principal amount of $1,500,000.00 are issued by Hague Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 3 contracts

Samples: Hague Corp., Hague Corp., Hague Corp.

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NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note, due November 4February 3, 2011 2019 of Hague Corp.Amedica Corporation, a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: EXECUTION VERSION Schedule 1 CONVERSION SCHEDULE The 8% This Senior Secured Convertible Debentures Promissory Note, due on November 4February 3, 2011 2019, in the aggregate original principal amount of $1,500,000.00 are 1,132,311.40 is issued by Hague Corp.Amedica Corporation, a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: AMEDICA Corp, AMEDICA Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Series B Convertible Debenture due November 4March 31, 2011 2017 of Hague Corp.Catasys, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Series B Convertible Debentures due on November 4March 31, 2011 2017 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.Catasys, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: Catasys, Inc., Catasys, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Promissory Note due November 4May 19, 2011 2016 of Hague CannaVest Corp., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures Promissory Note due on November 4May 19, 2011 2016 in the aggregate original principal amount of $1,500,000.00 are 510,000 is issued by Hague CannaVest Corp., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestAttest Schedule 2 AMORTIZATION SCHEDULE Amortization Payment Amount Date 1 $34,000 October 19, 2015 2 $34,000 10 Trading Days after prior Amortization Payment 3 $34,000 10 Trading Days after prior Amortization Payment 4 $34,000 10 Trading Days after prior Amortization Payment 5 $34,000 10 Trading Days after prior Amortization Payment 6 $34,000 10 Trading Days after prior Amortization Payment 7 $34,000 10 Trading Days after prior Amortization Payment 8 $34,000 10 Trading Days after prior Amortization Payment 9 $34,000 10 Trading Days after prior Amortization Payment 10 $34,000 10 Trading Days after prior Amortization Payment 11 $34,000 10 Trading Days after prior Amortization Payment 12 $34,000 10 Trading Days after prior Amortization Payment 13 $34,000 10 Trading Days after prior Amortization Payment 14 $34,000 10 Trading Days after prior Amortization Payment 15 $34,000 Maturity Date

Appears in 2 contracts

Samples: CannaVEST Corp., CannaVEST Corp.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Subordinated Convertible Debenture due November 4December 31, 2011 2020 of Hague Corp.TheMaven, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 812% Senior Secured Convertible Debentures due on November 4December 31, 2011 2020 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.TheMaven, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: theMaven, Inc., theMaven, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 86% Senior Secured Convertible Debenture due November 4of Arkados Group, 2011 of Hague Corp.Inc. (formerly XXXXxx.Xxx, Inc.), a Nevada Delaware corporation (the “Company”), due on December 28 , 2008 into shares of common stock stock, par value $.0001 per share (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act, specified under Section 4 of this Debenture. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account NoAddress: Schedule 1 CONVERSION SCHEDULE The 86% Senior Secured Convertible Debentures due on November 4December 28, 2011 2008 in the aggregate principal amount of $1,500,000.00 are ________ issued by Hague Corp.Arkados Group, a Nevada corporation. Inc. (formerly XXXXxx.xxx, Inc.) This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: Arkados Group, Inc., Arkados Group, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 86% Senior Secured Convertible Debenture Note (the “Note”) due November 4April 15, 2011 2015 of Hague Corp.GrowLife, Inc. (formerly Phototron Holdings, Inc.), a Nevada Delaware corporation (the Company”), into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion Conversion, the undersigned represents and warrants to the Company that (check one): ________ its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. ________ immediately prior to giving effect to this Notice of Conversion, it owns more than 9.9% of the outstanding shares of Common Stock, as determined in accordance with Section 4 of the Note. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common StockStock pursuant to any prospectus. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Interest Accrued on Account of Conversion at Issue: Number of shares of Common Stock to be issued: issued (not less than an amount equal to the greater of (A) $35,000 of the Principal Amount the Note and any accrued but unpaid interest thereon and (B) 5,000,000 shares): Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4, 2011 in the aggregate principal amount of $1,500,000.00 are issued by Hague Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestANNEX B ORIGINAL LENDING DATES None

Appears in 2 contracts

Samples: Growlife, Inc., Growlife, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812.5% Senior Secured Convertible Debenture due November 4Note of Curative Biotechnology, 2011 of Hague Corp.Inc., a Nevada Florida corporation (the “Company”), due on March 2, 2023, into shares of common stock stock, of the Company (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act, specified under Section 4(c) of this Note. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Notes to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____________of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Address: Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 812.5% Original Issue Discount Senior Secured Convertible Debentures Note due on November 4March 2, 2011 2023 in the aggregate original principal amount of $1,500,000.00 are 1,142,857.14 is issued by Hague Corp.Curative Biotechnology, Inc., a Nevada Florida corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to To Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: Curative Biotechnology Inc, Curative Biotechnology Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture convertible promissory note due November 4March 9, 2011 2017 of Hague Lifelogger Technologies Corp., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures convertible promissory note due on November 4March 9, 2011 2017 in the aggregate original principal amount of $1,500,000.00 are 296,153 is issued by Hague Lifelogger Technologies Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: Securities Purchase Agreement (Lifelogger Technologies Corp), Lifelogger Technologies Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture due November 4convertible promissory note issued on April 7, 2011 of Hague 2017 by Lifelogger Technologies Corp., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures due convertible promissory note issued on November 4April 7, 2011 2017 in the aggregate original principal amount of $1,500,000.00 are 83,333.33 is issued by Hague Lifelogger Technologies Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: Lifelogger Technologies Corp, Lifelogger Technologies Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Convertible Debenture due November 42015 of World Moto, 2011 of Hague Corp.Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. In the event of a partial Conversion, Amortization Dates from which Amortization Amount is to be deducted: Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 812% Senior Secured Convertible Debentures due on November 4, 2011 2015 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.World Moto, Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: World Moto, Inc., World Moto, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 85% Senior Secured Original Issue Discount Convertible Debenture Promissory Note due November 430, 2011 2015 of Hague Corp.Victory Electronic Cigarettes Corporation., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock yes no If yes, $ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Appendix A Amortization Schedule Transaction Amount Timing Funding: $ 4,000,000 May 30, 2014 Amortization Payments First Payment Second Payment Third Payment Fourth payment Fifth Payment Sixth Payment Seventh Payment Eighth Payment Ninth Payment Tenth Payment Eleventh Payment Twelfth Payment Thirteenth Payment Fourteenth Payment Fifteenth Payment Sixteenth Payment Schedule 1 CONVERSION SCHEDULE The 8This 5% Senior Secured Original Issue Discount Convertible Debentures Promissory Note due on November 430, 2011 2015 in the aggregate original principal amount of $1,500,000.00 are 4,210,526.33 is issued by Hague Corp.Victory Electronic Cigarettes Corporation., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 2 contracts

Samples: Exchange Agreement (Electronic Cigarettes International Group, Ltd.), Victory Electronic Cigarettes Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Note due November 4October 31, 2011 of Hague Corp.2023 issued by Health-Right Discoveries, Inc., a Nevada Florida corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder bolder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount If yes, $_____ of Debenture to be Converted: Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures Note due on November 41, 2011 2023 in the aggregate original principal amount of $1,500,000.00 are 3,500,000 is issued by Hague Corp.Health-Right Discoveries, Inc., a Nevada Florida corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Converted Principal Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Applicable Conversion Price Company Attest

Appears in 1 contract

Samples: Health-Right Discoveries, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4September 12, 2011 2018 of Hague Corp.Inspyr Therapeutics, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :______________ Account No: :____________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4September 12, 2011 2018 in the aggregate principal amount of $1,500,000.00 _______ are issued by Hague Corp.Inspyr Therapeutics, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Inspyr Therapeutics, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 88.75% Senior Secured Convertible Debenture due November 4December 31, 2011 2010 of Hague Corp.Axion International Holdings, Inc., a Nevada Colorado corporation (the “Company”), into shares of common stock stock, no par value per share (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account NoAddress: Schedule 1 CONVERSION SCHEDULE The 88.75% Senior Secured Convertible Debentures due on November 4DECEMBER 31, 2011 2010 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.Axion International Holdings, Inc., a Nevada Colorado corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Harborview Master Fund Lp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Original Issue Discount Promissory Note due November 4April 19, 2011 2019, of Hague Corp.nFüsz, Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares Shares of Common Stock to be issuedIssued: Signature: Name: Address for Delivery of Common Stock Certificates: Or or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 810% Senior Secured Convertible Debentures Original Issue Discount Promissory Notes due on November 4April 19, 2011 2019 in the aggregate principal amount of $1,500,000.00 1,500,000 are issued by Hague Corp.nFüsz, Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: nFusz, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note due November 4January 15, 2011 2021 of Hague Corp.Precipio, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures Promissory Notes due on November 4January 15, 2011 2021 in the aggregate principal amount of $1,500,000.00 are 1,450,000 is issued by Hague Corp.Precipio, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Aggregate Principal Amount Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion Company Attest (or original Principal Amount) Company Attest)

Appears in 1 contract

Samples: www.precipiodx.com

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 89.0% Senior Secured Convertible Debenture due November 4February 26, 2011 2014 of Hague Corp.Jesup & Xxxxxx, Inc., a Nevada Florida corporation (the “Company”), into shares of common stock stock, par value $0.01 per share (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account NoAddress: Schedule 1 CONVERSION SCHEDULE The 89.0% Senior Secured Convertible Debentures due on November 4February 26, 2011 2014 in the aggregate principal amount of $1,500,000.00 2,000,000.00 are issued by Hague Corp.Jesup & Xxxxxx, a Nevada corporation. Inc.. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Aggregate Principal Amount Date of Conversion Amount of Remaining Company Attest (or for first entry, Conversion Subsequent to Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest)

Appears in 1 contract

Samples: Jesup & Lamont, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Promissory Note due November 4January 27, 2011 2017 of Hague Epic Stores Corp., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares Shares of Common Stock to be issuedIssued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures Promissory Note due on November 4January 27, 2011 2017 in the aggregate original principal amount of $1,500,000.00 are 271,739 is issued by Hague Epic Stores Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestAttest Schedule 2 AMORTIZATION SCHEDULE Transaction Amount Timing Principal Amount: $271,739 January 27, 2016 Amortization Payments First Payment Second Payment Third Payment Fourth payment Fifth Payment Sixth Payment Seventh Payment Eighth Payment Ninth Payment Tenth Payment Eleventh Payment Twelfth Payment

Appears in 1 contract

Samples: Epic Stores Corp.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note due November 4September [__], 2011 2016 of Hague Corp.MassRoots, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: __________________________________ Account No: _________________________________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Convertible Debentures Promissory Note due on November 4September [__], 2011 2016 in the aggregate original principal amount of $1,500,000.00 are [___] is issued by Hague Corp.MassRoots, Inc. a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: MassRoots, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 86% Senior Secured Convertible Debenture due November 428, 2011 2019 of Hague Corp.Microbot Medical Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Payment of Interest: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 86% Senior Secured Convertible Debentures due on November 428, 2011 2019 in the aggregate principal amount of $1,500,000.00 2,028,767 are issued by Hague Corp.Microbot Medical Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestAttest EXHIBIT B RIGHT TO SHARES AGREEMENT This Right to Shares Letter Agreement, dated as of November __, 2016 (this “Agreement”) constitutes an agreement between Microbot Medical Inc. (f/k/a Stemcells, Inc.)(the “Company”) and Alpha Capital Anstalt (the “Holder”).

Appears in 1 contract

Samples: Securities Exchange Agreement (Microbot Medical Inc.)

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4of US Dataworks, 2011 of Hague Corp.Inc., a Nevada corporation (the “Company”), into shares of common stock stock, par value $0.0001 per share (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act, specified under Section 4 of this Debenture. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Debentures to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account NoAddress: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4, 2011 in the aggregate principal amount of $1,500,000.00 are 770,000 issued by Hague Corp.US Dataworks, Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion Date of Conversion (or original (or for first entry, Amount of Principal Original Issue Date) Conversion Amount) Company Attest

Appears in 1 contract

Samples: Us Dataworks Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Note due November 4April 18, 2011 of Hague Corp.2020 and issued by BioLargo, Inc.,, a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 810% Senior Secured Convertible Debentures Note due on November 4April 18, 2011 2020 in the aggregate original principal amount of $1,500,000.00 ____________ are issued by Hague Corp.BioLargo, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Converted Principal Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Applicable Conversion Price Company Attest

Appears in 1 contract

Samples: Biolargo, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Original Issue Discount Convertible Debenture due November 4June ___, 2011 of Hague Corp.Vu1 Corporation, a Nevada California corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :__________________ Account No: :________________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Original Issue Discount Convertible Debentures due on November 4June ___, 2011 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.Vu1 Corporation, a Nevada California corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Vu1 CORP

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4, 2011 2013 of Hague Corp.SCOLR Pharma, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange ActAct and that the Holder is not otherwise an Affiliate of the Company. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock $ Accrued and Unpaid Interest on such Principal to be issuedConverted: yes no Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4, 2011 2013 in the aggregate principal amount of $1,500,000.00 $ are issued by Hague Corp.SCOLR Pharma, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount and Accrued Interest Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: SCOLR Pharma, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 816% Senior Secured Convertible Debenture due November 4March 21, 2011 2018 of Hague Corp.Vuzix Corporation, a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 816% Senior Secured Convertible Debentures due on November 4March 21, 2011 2018 in the aggregate principal amount of $1,500,000.00 200,000 are issued by Hague Corp.Vuzix Corporation, a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Vuzix Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Promissory Note due November 4December 11, 2011 2016 of Hague Corp., a Nevada corporation (the “Premier Biomedical Inc.(the "Company"), into shares of common stock (the "Common Stock"), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ noIf yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures Promissory Note due on November 4December 11, 2011 2016 in the aggregate original principal amount of $1,500,000.00 are 105,000 is issued by Hague Corp., a Nevada corporation. Premier Biomedical Inc. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or Conversion(or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or Conversion(or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Premier Biomedical Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4, 2011 February ___ 2012 of Hague Corp.American Scientific Resources Incorporated, a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4February __, 2011 2012 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp., American Scientific Resources Inc. a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: American Scientific Resources Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4March 1, 2011 2018 of Hague Corp.Legend Oil and Gas, Ltd., a Nevada Colorado corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4March 1, 2011 2018 in the aggregate principal amount of $1,500,000.00 410,788 are issued by Hague Corp.Legend Oil and Gas, Ltd., a Nevada Colorado corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Legend Oil & Gas, Ltd.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 89% Senior Subordinated Secured Convertible Debenture Note due November 4December 17, 2011 2016 of Hague Authentidate Holding Corp., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 89% Senior Subordinated Secured Convertible Debentures Note due on November 4December 17, 2011 2016 in the aggregate original principal amount of $1,500,000.00 are 950,000.00 is issued by Hague Corp., a Nevada corporation. Authentidate Holding Corp. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestAttest `

Appears in 1 contract

Samples: Security Agreement (Authentidate Holding Corp)

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture due November 413, 2011 2008 of Hague Corp.WiFiMed Holdings Company, Inc., a Nevada corporation (the "Company"), into shares of common stock (the "Common Stock"), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 810% Senior Secured Convertible Debentures Debenture due on November 413, 2011 2008 in the aggregate original principal amount of $1,500,000.00 are ____________ is issued by Hague Corp.WiFiMed Holdings Company, a Nevada corporation. Inc. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Wifimed Holdings Company, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note due November 413, 2011 2016 of Hague Corp., a Nevada corporation Force Protection Video Equipment Corp. (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The This 8% Senior Secured Convertible Debentures Promissory Note due on November 413, 2011 2016 in the aggregate original principal amount of $1,500,000.00 are 105,000 is issued by Hague Corp., a Nevada corporation. Force Protection Video Equipment Corp. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Force Protection Video Equipment Corp.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal and, if specified, interest under the 87.5% Senior Secured Convertible Debenture due November 4of Hxxxxx-Xxxx Pharmaceuticals, 2011 of Hague Corp.Inc., a Nevada corporation (the “Company”)) due on February 25, 2006, into shares of common stock stock, $0.01 par value per share (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Company’s Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act, specified under Section 4 of this Debenture. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Debentures to be Converted: Number of shares of Common Stock to be issuedIssued: Applicable Conversion Price: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account NoAddress: Schedule 1 CONVERSION SCHEDULE The 87.5% Senior Secured Convertible Debentures due on November 4February 25, 2011 2006, in the aggregate principal amount of $1,500,000.00 are $ issued by Hague Corp.Hxxxxx-Xxxx Pharmaceuticals, a Nevada corporation. Inc. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Hollis Eden Pharmaceuticals Inc /De/

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Promissory Note due November 422, 2011 2016 of Hague Corp., a Nevada corporation (the “Premier Biomedical Inc.(the "Company"), into shares of common stock (the "Common Stock"), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ noIf yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures Promissory Note due on November 422, 2011 2016 in the aggregate original principal amount of $1,500,000.00 are 78,750 is issued by Hague Corp., a Nevada corporation. Premier Biomedical Inc. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or Conversion(or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or Conversion(or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Premier Biomedical Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4October 31, 2011 2010 of Hague Corp.Blink Logic Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: 27 Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4October 31, 2011 2010 in the aggregate principal amount Principal Amount of $1,500,000.00 _______ are issued by Hague Corp.Blink Logic Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Blink Logic Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Promissory Note due November 4April 1, 2011 2017 of Hague Epic Stores Corp., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares Shares of Common Stock to be issuedIssued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures Promissory Note due on November 4April 1, 2011 2017 in the aggregate original principal amount of $1,500,000.00 are 266,000 is issued by Hague Epic Stores Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Epic Stores Corp.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 85% Senior Secured Original Issue Discount Convertible Debenture Promissory Note due November 4of Electronic Cigarettes International Group, 2011 of Hague Corp.Ltd., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: ____________ Account No:___________ Appendix A Amortization Schedule Transaction Amount Timing Funding: $ Amortization Payments First Payment Second Payment Third Payment Fourth payment Fifth Payment Sixth Payment Seventh Payment Eighth Payment Ninth Payment Tenth Payment Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4, 2011 in the aggregate principal amount of $1,500,000.00 are issued by Hague Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest1

Appears in 1 contract

Samples: Electronic Cigarettes International Group, Ltd.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4June 18, 2011 2022 of Hague Corp.Inspyr Therapeutics, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :______________ Account No: :____________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4June 18, 2011 2022 in the aggregate principal amount of $1,500,000.00 [*] are issued by Hague Corp.Inspyr Therapeutics, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Inspyr Therapeutics, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal and interest under the 8% Senior Secured Unsecured Subordinated Convertible Debenture due November 4Promissory Notes of Heritage Distilling Holding Company, 2011 of Hague Corp.Inc., a Nevada Delaware corporation (the “Company”), into shares of its common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock: ☐ Yes ☐ No If yes, $ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Signature Printed Name Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Unsecured Subordinated Convertible Debentures Promissory Note due on November 4July 31, 2011 2024, unless otherwise extended pursuant to the terms of the Note, in the aggregate original principal amount of $1,500,000.00 are $ is issued by Hague Corp.Heritage Distilling Holding Company, Inc., a Nevada corporationDelaware corporation (the “Company”). This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Original Principal Amount) Company Attest

Appears in 1 contract

Samples: Heritage Distilling Holding Company, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 80% Senior Secured Convertible Debenture due November 4October 1, 2011 of Hague Corp.OXIS International, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 80% Senior Secured Convertible Debentures due on November 4October 1, 2011 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.OXIS International, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Oxis International Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Original Issue Discount Convertible Debenture due November 4March 15, 2011 2018 of Hague Corp.Progreen US, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Conversion Price: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: ___________________ Account No: __________________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Original Issue Discount Convertible Debentures Debenture due on November 4March 15, 2011 2018 in the aggregate original principal amount of $1,500,000.00 are 105,000 is issued by Hague Corp.Progreen US, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Original Principal Amount) Company Attest

Appears in 1 contract

Samples: Securities Purchase Agreement (Progreen US, Inc.)

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 85% Senior Secured Original Issue Discount Convertible Debenture Promissory Note due November 4of Electronic Cigarettes International Group, 2011 of Hague Corp.Ltd., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 5% Senior Secured Original Issue Discount Convertible Debentures Promissory Note due on November 4, 2011 in the aggregate original principal amount of $1,500,000.00 are $ is issued by Hague Corp.Electronic Cigarettes International Group, Ltd., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Electronic Cigarettes International Group, Ltd.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 85% Senior Secured Convertible Debenture due November 4August 28, 2011 2008 of Hague Corp.Adrenalina, a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :______________ Account No: :______________ Schedule 1 CONVERSION SCHEDULE The 85% Senior Secured Convertible Debentures due on November 4August 28, 2011 2008 in the aggregate principal amount of $1,500,000.00 2,500,000.00 are issued by Hague Corp.Adrenalina, a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Adrenalina

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4March 23, 2011 2012 of Hague Corp.American Scientific Resources Incorporated, a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4March 23, 2011 2012 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp., American Scientific Resources Inc. a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: American Scientific Resources Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Subordinated Secured Convertible Debenture due November 4, 2011 Note of Hague Corp.Pipeline Data Inc., a Nevada Delaware corporation (the “Company”), due on September 30, 2008, into shares of common stock stock, par value $0.001 (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act, specified under Section 4 of this Note. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Notes to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account NoAddress: Schedule 1 CONVERSION SCHEDULE The 8% Senior Subordinated Secured Convertible Debentures Notes due on November 4September 30, 2011 2008, in the aggregate principal amount of $1,500,000.00 are 2,000,000 issued by Hague Corp.Pipeline Data Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Pipeline Data Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Convertible Debenture Promissory Note, due November 4August 23, 2011 2023 of Hague Corp., a Nevada corporation Endexx Corporation (the “Company”), ) into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company Companies in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company Companies that its ownership of the Common Stock does not exceed the amounts specified under Section 4 5 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: ANNEX A Schedule 1 CONVERSION SCHEDULE The 8This 12% Senior Secured Convertible Debentures Promissory Note, due on November 4August 23, 2011 2023, in the aggregate original principal amount of $1,500,000.00 are __________ is issued by Hague Corp., a Nevada corporationEndexx Corporation (the “Company”). This Conversion Schedule with respect to the Common Stock of the Company reflects conversions made under Section 4 5 of the above above-referenced DebentureNote. Dated: August 23, 2022 Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestCompany’s Attest SCHEDULE 1 EXHIBIT 8(K)

Appears in 1 contract

Samples: Endexx Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4October___, 2011 2018 of Hague Corp.Gopher Protocol, Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Conversion Price: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: ___________________ Account No: __________________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Convertible Debentures Debenture due on November 4October ____, 2011 2018 in the aggregate original principal amount of $1,500,000.00 are 750,000 is issued by Hague Corp.Gopher Protocol Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Original Principal Amount) Company Attest

Appears in 1 contract

Samples: Gopher Protocol Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4convertible promissory note dated July 14, 2011 of Hague Corp.2016 issued by Cachet Financial Solutions, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4This convertible promissory note with an original issue date of July __, 2011 2016 in the aggregate original principal amount of $1,500,000.00 are 240,000.00 is issued by Hague Corp.Cachet Financial Solutions, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Cachet Financial Solutions, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4April 21, 2011 2017 of Hague Corp.Soupman, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: ____________ Account No: ___________ Schedule 1 CONVERSION SCHEDULE The This 8% Original Issue Discount Senior Secured Convertible Debentures Debenture due on November 4April 1, 2011 2018 in the aggregate original principal amount of $1,500,000.00 are 120,750 is issued by Hague Corp.Soupman, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Soupman, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 85% Senior Original Issue Discount Secured Convertible Debenture Promissory Note due November 4April 6, 2011 2018 of Hague Corp.COPsync, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock of the Company (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion Conversion, the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock, if the resale of any such shares of Common Stock are covered by and are being sold pursuant to an effective Registration Statement. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares Shares of Common Stock to be issuedIssued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 5% Senior Original Issue Discount Secured Convertible Debentures Promissory Note due on November 4April 6, 2011 2018 in the aggregate principal amount of $1,500,000.00 are ______ is issued by Hague Corp.COPsync, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: COPsync, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Original Issue Discount Convertible Debenture due November 4March 17, 2011 2018 of Hague Corp.The Chron Organization, Inc.., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Conversion Price: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: ___________________ Account No: __________________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Original Issue Discount Convertible Debentures Debenture due on November 4March 17, 2011 2018 in the aggregate original principal amount of $1,500,000.00 are 82,500 is issued by Hague Corp.The Chron Organization, a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Original Principal Amount) Company Attest

Appears in 1 contract

Samples: South American Properties, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810.75% Senior Secured Convertible Debenture due November 4June 18, 2011 2013 of Hague Corp.Teton Energy Corporation, a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 810.75% Senior Secured Convertible Debentures due on November 4June 18, 2011 2013 in the aggregate principal amount of $1,500,000.00 40,000,000 are issued by Hague Corp.Teton Energy Corporation, a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion Date of Conversion (or original (or for first entry, Amount of Principal Original Issue Date) Conversion Amount) Company Attest

Appears in 1 contract

Samples: Teton Energy Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 86% Senior Secured Convertible Debenture due November 428, 2011 2019 of Hague Corp.Microbot Medical Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Payment of Interest: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 86% Senior Secured Convertible Debentures due on November 428, 2011 2019 in the aggregate principal amount of $1,500,000.00 2,028,767 are issued by Hague Corp.Microbot Medical Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Microbot Medical Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Convertible Debenture Promissory Note, due November March 4, 2011 2022 of Hague Corp., a Nevada corporation Endexx Corporation (the “Company”), ) into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company Companies in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company Companies that its ownership of the Common Stock does not exceed the amounts specified under Section 4 5 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: ANNEX A Schedule 1 CONVERSION SCHEDULE The 8This 12% Senior Secured Convertible Debentures Promissory Note, due on November March 4, 2011 2022, in the aggregate original principal amount of $1,500,000.00 are 300,000.00 is issued by Hague Corp., a Nevada corporationEndexx Corporation (the “Company”). This Conversion Schedule with respect to the Common Stock of the Company reflects conversions made under Section 4 5 of the above above-referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestCompany’s Attest SCHEDULE 1

Appears in 1 contract

Samples: Endexx Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4January 1, 2011 2017 of Hague Corp.PFO Global, Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :_____________ Account No: _____________ Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4January 1, 2011 2017 in the aggregate principal amount of $1,500,000.00 1,120,000.00 are issued by Hague Corp.PFO Global, Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: PFO Global, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Promissory Note due November 4December 7, 2011 2016 of Hague Corp., a Nevada corporation (the “Premier Biomedical Inc.(the "Company"), into shares of common stock (the "Common Stock"), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures Promissory Note due on November 4December 7, 2011 2016 in the aggregate original principal amount of $1,500,000.00 are 78,750 is issued by Hague Corp., a Nevada corporation. Premier Biomedical Inc.This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or Conversion(or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or Conversion(or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Premier Biomedical Inc

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NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4July 28, 2011 2010 of Hague Corp.Blink Logic Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4July 28, 2011 2010 in the aggregate principal amount Principal Amount of $1,500,000.00 _______ are issued by Hague Corp.Blink Logic Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Blink Logic Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 89.33% Senior Secured Convertible Debenture due November 4, 2011 of Hague Corp.180 Connect Inc., a Nevada Delaware corporation (the “Company”), due on March 22, 2011, into shares of common stock stock, no par value per share (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act, specified under Section 4 of this Debenture. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Conversion Price: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account NoAddress: Schedule 1 CONVERSION SCHEDULE The 89.33% Senior Secured Convertible Debentures due on November 4March 22, 2011 2011, in the aggregate principal amount of $1,500,000.00 are ___ issued by Hague Corp., a Nevada corporation. 180 Connect Inc. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion Date of Conversion (or original (or for first entry, Amount of Principal Original Issue Date) Conversion Amount) Company Attest

Appears in 1 contract

Samples: 180 Connect Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4March 1, 2011 2018 of Hague Corp.Legend Oil and Gas, Ltd., a Nevada Colorado corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: _________________ Account No: _________________ Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4March 1, 2011 2018 in the aggregate principal amount of $1,500,000.00 302,500 are issued by Hague Corp.Legend Oil and Gas, Ltd., a Nevada Colorado corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Legend Oil & Gas, Ltd.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4March 31, 2011 2015 of Hague Corp.Anpath Group, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4March 31, 2011 2015 in the aggregate principal amount of $1,500,000.00 215,250 are issued by Hague Corp.Anpath Group, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Anpath Group, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4March 1, 2011 2017 of Hague Corp.PFO Global, Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: ________ Account No: ________ Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4March 1, 2011 2017 in the aggregate principal amount of $1,500,000.00 616,000 are issued by Hague Corp.PFO Global, Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: PFO Global, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4March 1, 2011 2016 of Hague Corp.Legend Oil and Gas, Ltd., a Nevada Colorado corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4March 1, 2011 2016 in the aggregate principal amount of $1,500,000.00 340,000 are issued by Hague Corp.Legend Oil and Gas, Ltd., a Nevada Colorado corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Legend Oil & Gas, Ltd.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4October 1, 2011 2010 of Hague Corp.Ecotality, Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :________________ Account No: :_______________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4October 1, 2011 2010 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.Ecotality, a Nevada corporation. Inc. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Ecotality, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 89% Senior Secured Convertible Debenture due November 4June , 2011 2016 of Hague Authentidate Holding Corp., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 89% Senior Secured Convertible Debentures Debenture due on November 4June , 2011 2016 in the aggregate original principal amount of $1,500,000.00 are $ is issued by Hague Corp., a Nevada corporation. Authentidate Holding Corp. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Authentidate Holding Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Convertible Debenture Note due November 4February __, 2011 2017 of Hague Corp.Snap Interactive, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Interest to be converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 812% Senior Secured Convertible Debentures Note due on November 4February 13, 2011 2017 in the aggregate principal amount of $1,500,000.00 are 3,000,000 is issued by Hague Corp.Snap Interactive, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Snap Interactive, Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4August 31, 2011 2045 of Hague Corp.Cesca Therapeutics Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4August 31, 2011 2045 in the aggregate principal amount of $1,500,000.00 3,500,000.00 are issued by Hague Corp.Cesca Therapeutics Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Cesca Therapeutics Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Convertible Debenture Note due November 4February 28, 2011 of Hague Corp.2020 issued by Hemp Naturals Inc.., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock ___ yes ___ no If yes, $ ______ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: _________________ Account No: ________________ Schedule 1 CONVERSION SCHEDULE The 812% Senior Secured Convertible Debentures Note due on November 4February 28, 2011 2020 in the aggregate original principal amount of $1,500,000.00 are 65,000 as issued by Hague Corp.Hemp Naturals Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Converted Principal Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Applicable Conversion Price Company AttestAttest Dated:

Appears in 1 contract

Samples: Hemp Naturals, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal and interest under the 8% Senior Secured Convertible Debenture Promissory Note due November 4August __, 2011 2023 of Hague Corp., a Nevada corporation LuxUrBan Hotels Inc. (the “Company”), into shares of its common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: _____________________________________ Principal Amount of Debenture Note to be Converted: ________________________ Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for __________________ Signature Name Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% This Senior Secured Convertible Debentures Promissory Note due on November 4August __, 2011 2023 in the aggregate original principal amount of $1,500,000.00 are 2,079,686.13 is issued by Hague Corp., a Nevada corporationLuxUrBan Hotels Inc. (the “Company”). This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Luxurban Hotels Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812.5% Senior Secured Convertible Debenture due November 4April 21, 2011 2020 of Hague Corp.Social Reality, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: __________ Account No: __________ Schedule 1 CONVERSION SCHEDULE The 812.5% Senior Secured Convertible Debentures Debenture due on November 4April 21, 2011 in the aggregate principal amount of $1,500,000.00 2020 are issued by Hague Corp.Social Reality, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestAttest Schedule 2

Appears in 1 contract

Samples: SOCIAL REALITY, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4May 1, 2011 2017 of Hague Corp.PFO Global, Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: ____________________ Account No: __________________ Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4May 1, 2011 2017 in the aggregate principal amount of $1,500,000.00 828,800 are issued by Hague Corp.PFO Global, Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: PFO Global, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 89% Senior Secured Convertible Debenture due November 4August __, 2011 2014 of Hague Corp.OCZ Technology Group, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 89% Senior Secured Convertible Debentures Debenture due on November 4August , 2011 2014 in the aggregate original principal amount of $1,500,000.00 are $ is issued by Hague Corp.OCZ Technology Group, a Nevada corporation. Inc. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Ocz Technology Group Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture Promissory Note due November 4April 1, 2011 2017 of Hague Epic Stores Corp., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares Shares of Common Stock to be issuedIssued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8This 10% Senior Secured Convertible Debentures Promissory Note due on November 4April 1, 2011 2017 in the aggregate original principal amount of $1,500,000.00 are 271,739 is issued by Hague Epic Stores Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Epic Stores Corp.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note, due November 4_________________ of Data443 Risk Mitigation, 2011 of Hague Corp., a Nevada corporation Inc. (the “Company”), ) into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company Companies in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company Companies that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Convertible Debentures Promissory Note, due on November 4_________________, 2011 in the aggregate original principal amount of $1,500,000.00 are 300,000 is issued by Hague Corp.Data443 Risk Mitigation, a Nevada corporationInc. (the “Company”). This Conversion Schedule with respect to the Common Stock of the Company reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Company’s Attest

Appears in 1 contract

Samples: Data443 Risk Mitigation, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note due November 4August 29, 2011 2024 of Hague Corp.SRAX, Inc., Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :___________________ Account No: :__________________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Convertible Debentures Promissory Note due on November 4August 29, 2011 2024 in the aggregate original principal amount of $1,500,000.00 are 100,000 is issued by Hague Corp.SRAX, Inc. a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: SRAX, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal and interest under the 815% Senior Secured Cumulative Convertible Debenture due November 4December 31, 2011 2012 of Hague Concentric Energy Corp., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Payment of Interest in Common Stock yes: o no: o If yes, $ of Interest Accrued on Account as of the Conversion Date. Number of shares of Common Stock to be issued: Signature: Name: Signature(s): Name(s): Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 815% Senior Secured Cumulative Convertible Debentures due on November 4December 31, 2011 2012 in the aggregate principal amount of $1,500,000.00 ___are issued by Hague Corp., a Nevada corporation. Concentric Energy Corp. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion Date of Conversion (or original (or for first entry, Amount of Principal Original Issue Date) Conversion Amount) Company Attest

Appears in 1 contract

Samples: Concentric Energy Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Original Issue Discount Senior Secured Convertible Debenture due November 4June 12, 2011 2010 of Hague Corp.Blink Logic Inc., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Original Issue Discount Senior Secured Convertible Debentures due on November 4June 12, 2011 2010 in the aggregate principal amount Principal Amount of $1,500,000.00 444,400 are issued by Hague Corp.Blink Logic Inc., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Blink Logic Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Convertible Debenture due November 4, 2011 2014 of Hague Corp.NewLead Holdings Ltd., a Nevada Bermuda corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :_________________ Account No: :________________ Schedule 1 CONVERSION SCHEDULE The 812% Senior Secured Convertible Debentures due on November 4, 2011 2014 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.NewLead Holdings Ltd., a Nevada Bermuda corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: NewLead Holdings Ltd.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 427, 2011 2013 of Hague Corp.T3 Motion, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :_____________ Account No: ___________ Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 427, 2011 2013 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.T3 Motion, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: T3 Motion, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 85% Senior Secured Original Issue Discount Convertible Debenture Promissory Note due November 4of Electronic Cigarettes International Group, 2011 of Hague Corp.Ltd., a Nevada corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: :__________________ Account No:________________ Appendix A Amortization Schedule Transaction Amount Timing Funding: $ Amortization Payments First Payment Second Payment Third Payment Fourth payment Fifth Payment Sixth Payment Seventh Payment Eighth Payment Ninth Payment Tenth Payment Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4, 2011 in the aggregate principal amount of $1,500,000.00 are issued by Hague Corp., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest1

Appears in 1 contract

Samples: Electronic Cigarettes International Group, Ltd.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture due November 4Note of Gaming Technologies, 2011 of Hague Corp.Inc., a Nevada Delaware corporation (the “Company”), due on November 18, 2022, into shares of common stock stock, of the Company (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act, specified under Section 4 of this Note. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Notes to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____________of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Address: Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 810% Original Issue Discount Senior Secured Convertible Debentures Note due on November 418, 2011 2022 in the aggregate original principal amount of $1,500,000.00 are 1,666,666.67 is issued by Hague Corp.Gaming Technologies, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to To Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Gaming Technologies, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note due November 4February [__], 2011 2018 of Hague Corp.MassRoots, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Convertible Debentures Promissory Note due on November 4February [__], 2011 2018 in the aggregate original principal amount of $1,500,000.00 are [___] is issued by Hague Corp.MassRoots, Inc. a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: MassRoots, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture due November 4June 30, 2011 2019 of Hague Corp.TheMaven, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 810% Senior Secured Convertible Debentures due on November 4June 30, 2011 2019 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.TheMaven, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: theMaven, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Subordinated Convertible Debenture due November 4December 31, 2011 2020 of Hague Corp.TheMaven, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: __________ Account No: _________ Schedule 1 CONVERSION SCHEDULE The 812% Senior Secured Convertible Debentures due on November 4December 31, 2011 2020 in the aggregate principal amount of $1,500,000.00 ____________ are issued by Hague Corp.TheMaven, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: theMaven, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 812% Senior Secured Convertible Debenture Promissory Note, due November 4January 22, 2011 2022 of Hague Corp., a Nevada corporation Endexx Corporation (the “Company”), ) into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company Companies in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company Companies that its ownership of the Common Stock does not exceed the amounts specified under Section 4 5 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: ANNEX A Schedule 1 CONVERSION SCHEDULE The 8This 12% Senior Secured Convertible Debentures Promissory Note, due on November 4January 21, 2011 2022, in the aggregate original principal amount of $1,500,000.00 are 1,250,000.00 is issued by Hague Corp., a Nevada corporationEndexx Corporation (the “Company”). This Conversion Schedule with respect to the Common Stock of the Company reflects conversions made under Section 4 5 of the above above-referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestCompany’s Attest SCHEDULE 1 EXHIBIT 8(K) M2B Funding Corp.: Repayment of November 15 Note ($593,250 plus extension fee) = $ 678,678 Repayment of December 21 Note ($290,000 plus extension fee) = $ 313,548 $ 992,226 Odin Associates, LLC: Repayment of loan = $ 65,790 Cxxxx Hxxx LLP: Legal fees = $ 15,000 (est.) The Company: Marketing and other operating expenditures for DX xxxxxxx = $ 176,984 EXHIBIT 8(K)

Appears in 1 contract

Samples: Endexx Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4, 2011 of Hague US Energy Corp., a Nevada Wyoming corporation (the “Company”), due on February__, 2008, into shares of common stock stock, $0.01 par value per share (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Principal Amount to be Converted and applied to the next Six Month Redemption Amount: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account NoAddress: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4February__, 2011 2005, in the aggregate principal amount of $1,500,000.00 are ________ issued by Hague Corp., a Nevada corporation. US Energy Corp. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Us Energy Corp

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note due November 4February 7, 2011 2018 of Hague Corp., a Nevada corporation Force Protection Video Equipment Corp. (the “Company”), into shares of common stock of the Company (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares Shares of Common Stock to be issuedIssued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The This 8% Senior Secured Convertible Debentures Promissory Note due on November 4September [30], 2011 2017 in the aggregate original principal amount of $1,500,000.00 are 78,750 is issued by Hague Corp., a Nevada corporation. Force Protection Video Equipment Corp. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Force Protection Video Equipment Corp.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note due November 4March 18, 2011 2017 of Hague Corp., CLS Holdings USA Inc. a Nevada Florida corporation (the “Company”), into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply offer for sale and sell the Common Stock in compliance with all applicable securities laws, including but not limited to, offering the Common Stock for sale in accordance with the "plan of distribution" contained in the Registration Statement, suspending sales if the Company advises that the Prospectus is no longer effective or current, and complying with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ yes __ no If yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares Shares of Common Stock to be issuedIssued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The This 8% Senior Secured Convertible Debentures Promissory Note due on November 4March 18, 2011 2017 in the aggregate original principal amount of $1,500,000.00 are 200,000 is issued by Hague Corp.CLS HOLDINGS USA INC., a Nevada corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestAttest Schedule 2 AMORTIZATION SCHEDULE Transaction Amount Timing Principal Amount: $200,000 March 18, 2016 Amortization Payments First Payment Second Payment Third Payment Fourth payment Fifth Payment Sixth Payment

Appears in 1 contract

Samples: CLS Holdings USA, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 810% Senior Secured Convertible Debenture due November 4September 30, 2011 of Hague Corp.Etelos, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 810% Senior Secured Convertible Debentures due on November 4September 30, 2011 in the aggregate principal amount of $1,500,000.00 $ are issued by Hague Corp.Etelos, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Etelos, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture due November 4, 2011 of Hague Corp.CollPlant Holdings Ltd., a Nevada corporation company organized under the laws of the State of Israel (the “Company”), into shares of common stock American Depositary Shares (the “Common StockADSs”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock ADSs are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock Ordinary Shares underlying the ADSs does not exceed the amounts specified under Section 4 of this Debenture, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common StockADSs. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture to be Converted: Number of shares of Common Stock Conversion ADSs to be issued: Signature: Name: Address for Delivery of Common Stock ADSs Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured Convertible Debentures due on November 4, 2011 in the aggregate principal amount of $1,500,000.00 1,000,000 are issued by Hague Corp.CollPlant Holdings Ltd., a Nevada corporationcompany organized under the laws of the State of Israel. This Conversion Schedule reflects conversions made under Section 4 of the above referenced Debenture. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestAttest Exhibit A Form of Prefunded Warrant

Appears in 1 contract

Samples: CollPlant Holdings Ltd.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note, due November 4_________________ of Data443 Risk Mitigation, 2011 of Hague Corp., a Nevada corporation Inc. (the “Company”), ) into shares of common stock (the “Common Stock”), ) of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company Companies in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company Companies that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Convertible Debentures Promissory Note, due on November 4June 30, 2011 2024, in the aggregate original principal amount of $1,500,000.00 are 812,500.00 is issued by Hague Corp.Data443 Risk Mitigation, a Nevada corporationInc. (the “Company”). This Conversion Schedule with respect to the Common Stock of the Company reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Company’s Attest

Appears in 1 contract

Samples: Data443 Risk Mitigation, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Original Issue Discount Convertible Debenture Promissory Note due November 4April 21, 2011 2018 of Hague Corp.Cardiff International, Inc., a Nevada Florida corporation (the "Company"), into shares of common stock (the "Common Stock"), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock_ yes _ no If yes, $ of Interest Accrued on Account of Conversion at Issue. Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% Senior Secured This Original Issue Discount Convertible Debentures Promissory Note due on November 4April 21, 2011 2018 in the aggregate original principal amount of $1,500,000.00 are 330,000 is issued by Hague Corp.Cardiff International, Inc., a Nevada Florida corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: Cardiff International Inc

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture Promissory Note, due November 4February 28, 2011 2019 of Hague Corp.DPW Holdings, Inc., a Nevada Delaware corporation (the “Company”), into shares of common stock of the Company (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion Conversion, the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Payment of Interest in Common Stock __ Yes __ No If Yes, $_____ of Interest Accrued on Account of Conversion at Issue. Number of shares Shares of Common Stock to be issuedIssued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The 8% This Senior Secured Convertible Debentures Promissory Note, due on November 4February 28, 2011 2019, in the aggregate original principal amount of $1,500,000.00 are 2,000,000 is issued by Hague Corp.DPW Holdings, Inc., a Nevada Delaware corporation. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company AttestAttest Schedule 2(e) Mandatory Prepayment On May 15, 2018, the Company entered into a Securities Purchase Agreements with certain institutional investors (the “Investors”) for the sale and issuance of up to an aggregate of $6,000,000 of shares (the “Shares”) of the Company’s Class A common stock (the “Common Stock”) and five-year warrants (the “Warrants”) to purchase such number of shares of Series A or B Common Stock equal to the Shares purchased by each Investor (collectively, the “Warrant Shares”), with an exercise price of $0.94 per share. On February 27, 2018, the Company entered into a Sales Agreement with H.X. Xxxxxxxxxx & Co., LLC (“HCW”) to sell shares of its Common Stock, par value $0.001, having an aggregate offering price of up to $50,000,000 from time to time, through an “at the market offering” program under which HCW will act as sales agent. The Company shall not be obligated to pay to the Holder any amounts raised from the Sales Agreement for a period of ninety (90) days from the Original Issue Date, but shall be required to pay the Holder fifty percent (50%) of any net proceeds raised therefrom thereafter.

Appears in 1 contract

Samples: DPW Holdings, Inc.

NOTICE OF CONVERSION. The undersigned hereby elects to convert principal under the 8% Senior Secured Convertible Debenture ORIGINAL ISSUE DISCOUNT SENIOR SECURED CONVERTIBLE PROMISSORY NOTE due November 4May 7, 2011 2017 of Hague Corp.DSG Global, a Nevada corporation Inc. (the “Company”), into shares of common stock (the “Common Stock”), of the Company according to the conditions hereof, as of the date written below. If shares of Common Stock are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to the Company that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this DebentureNote, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion: Principal Amount of Debenture Note to be Converted: Number of shares of Common Stock to be issued: Signature: Name: Address for Delivery of Common Stock Certificates: Or DWAC Instructions: Broker No: Account No: Schedule 1 CONVERSION SCHEDULE The This 8% Senior Secured Convertible Debentures ORIGINAL ISSUE DISCOUNT SENIOR SECURED CONVERTIBLE PROMISSORY NOTE due on November 4May 7, 2011 2017 in the aggregate original principal amount of $1,500,000.00 are 138,888.89 is issued by Hague Corp.DSG Global, a Nevada corporation. Inc. This Conversion Schedule reflects conversions made under Section 4 of the above referenced DebentureNote. Dated: Date of Conversion (or for first entry, Original Issue Date) Amount of Conversion Aggregate Principal Amount Remaining Subsequent to Conversion (or original Principal Amount) Company Attest

Appears in 1 contract

Samples: DSG Global Inc.

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