ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value Received, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ Signature: Holder’s Address:
Appears in 3 contracts
Samples: Warrant Agreement (EBR Systems, Inc.), Warrant Agreement (Northwest Biotherapeutics Inc), Warrant Agreement (Northwest Biotherapeutics Inc)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: ___________ , 20___ Holder’s Signature: ___________________________________________________ Holder’s Address:: ___________________________________________________
Appears in 2 contracts
Samples: Warrant Agreement (Opgen Inc), Warrant Agreement (Opgen Inc)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ Holder’s Signature: Holder’s Address:
Appears in 2 contracts
Samples: Warrant Agreement (Auddia Inc.), Warrant Agreement (Auddia Inc.)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ 2012 Holder’s Signature: Holder’s Address:
Appears in 2 contracts
Samples: Warrant Agreement (Tetralogic Pharmaceuticals Corp), Warrant Agreement (Tetralogic Pharmaceuticals Corp)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value Received, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20______________ Holder’s Signature: _____________________________________ Holder’s Address:: ______________________________________
Appears in 2 contracts
Samples: Warrant Agreement (VerifyMe, Inc.), Warrant Agreement (VerifyMe, Inc.)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ 20 Holder’s Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value Received, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ Holder’s Signature: ___________________________________________ Holder’s Address:: ____________________________________________
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ 20 Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: Address: Dated: __________, 20__ Holder’s Signature: Holder’s Address: Holder’s Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply the required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: (Please Print) Dated: ________________, 20__ Holder’s Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value Received, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20_______ Signature: Holder’s Address:Holder’s
Appears in 1 contract
Samples: Warrant Agreement (Zhongchao Inc.)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value value Received, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20______ Holder’s Signature: Holder’s Address:
Appears in 1 contract
Samples: Warrant Agreement (Mr. Mango LLC)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply the required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: (Please Print) Dated: ____________________________________, 20__ Holder’s Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing WarrantOption, execute this form and supply required information. Do not use this form to purchase shares.) For Value Received, the foregoing Warrant Option and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ Signature: Holder’s Address:
Appears in 1 contract
Samples: Option Agreement (Net Element, Inc.)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: DatedName: _______________________________ (Please Print) Address: _______________________________ (Please Print) Dated: , 20___ Holder’s Signature: Holder’s Address:
Appears in 1 contract
Samples: Securities Purchase Agreement (Acacia Research Corp)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply the required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: (Please Print) Dated: __________, 20__ 20 Holder’s Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: Address: Dated: __________, 20__ Holder’s Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value Received, the foregoing Warrant and all rights evidenced thereby are hereby assigned to to; Address: Dated: _____________, 20____ Signature: Holder’s Signature Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing WarrantOption, execute this form and supply required information. Do not use this form to purchase shares.) For Value Received, the foregoing Warrant Option and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Dated: __________, 20__ Holder’s Signature: Holder’s Address:
Appears in 1 contract
Samples: Option Agreement (Firer Oleg)
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Address: Dated: __________, 20__ Signature: Holder’s Address:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) For Value ReceivedFOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: Address: Dated: __________, 20_______ Signature: Holder’s Address::
Appears in 1 contract
Samples: Note and Warrant Purchase Agreement (Universal Security Instruments Inc)