IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: Name: Title: [Signature Page for Note and Warrant Purchase Agreement] INVESTOR: [NAME] By: Name: Title:
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Samples: Note and Warrant Purchase Agreement (NeuroSigma, Inc.), Note and Warrant Purchase Agreement (NeuroSigma, Inc.)
IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] By: Name/s/ Xxxxxxx Xxxx Address: TitleFacsimile:
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Samples: Common Stock Purchase Agreement (NeuroSigma, Inc.), Common Stock Purchase Agreement (NeuroSigma, Inc.)
IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] By: Name/s/ Xxxxxx X. Xxxx Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] Xxxx Xxxxxx By: Name/s/ Xxxx X. Xxxxxx Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] By: Name/s/ Xxxxxx X. Xxxx, Xx. Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] Xxxxxxxx XxXxxxxx By: Name/s/ Xxxxxxxx XxXxxxxx Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] By: Name/s/ Xxx Xxxxxx Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] By: Name/s/ Xxxxxxxx Xxxxxx Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] By: Name/s/ Xxxxxxx Xxxxxx Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: Name: Title: [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAMEName of Investor] By: NameAddress: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] Xxxxxxx Xxxxxx By: Name/s/ Xxxxxxx Xxxxxx Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] By: Name/s/ X. Xxxxxxx Xxxx III Address: TitleFacsimile:
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IN WITNESS WEREOF. the parties have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as of the date and year first written above. COMPANY: NEUROSIGMA, INC. a Delaware corporation By: /s/ Xxxx Xxxxxxx Name: Xxxx Xxxxxxx Title: President & CEO [Signature Page page for Note and Warrant Common Stock Purchase Agreement] INVESTOR: [NAME] Xxx Xxxxxx By: Name/s/ Xxx Xxxxxx Address: TitleFacsimile:
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