Common use of IN WITNESS WEREOF Clause in Contracts

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 CONFIDENTIAL FOR INVESTORS THAT ARE INDIVIDUALS: Date: Oct 26, 2013 Signature: /s/ Xxxxxx X. Xxxxxx, Xx. Marital Status: Married ¨ Not Married ¨ /s/ Xxxxxxxx X. Xxxxxx Social Security Number: Name (please print): Xxxxxx X. Xxxxxx, Xx. Xxxxxxxx X. Xxxxxx Principal Amount of Note: $200,000.00 Address: FOR INVESTORS THAT ARE TRUSTS: Date: Name of Trust: Address: Social Security Number or other Signature of Trustee Taxpayer Identification Number: If applicable: Principal Amount of Note: $ Signature of Co-Trustee: FOR INVESTORS THAT ARE CORPORATIONS, LIMITED LIABILITY COMPANIES OR PARTNERSHIPS: Date: Name of Entity: Address: Signature: Taxpayer Identification Number: Title of Signatory: Principal Amount of Note: $ CONFIDENTIAL SCHEDULE I SCHEDULE OF INVESTORS Name and Address of Investor Closing Date Original Principal Amount of the Note Number of Shares of Common Stock Subject to the Warrant Xxxxxx X. Xxxxxx, Xx. and Xxxxxxxx X. Xxxxxx November 4, 2013 $ 200,000 6,112 TOTALS: $ 200,000.00 6,112

Appears in 1 contract

Samples: Note and Warrant Purchase Agreement (NeuroSigma, Inc.)

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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 CONFIDENTIAL FOR INVESTORS THAT ARE INDIVIDUALS: Date: Oct 26, 1 November 2013 Signature: /s/ Xxxxxx X. XxxxxxXxxx, Xx. Marital Status: Married ¨ Not Married ¨ /s/ Xxxxxxxx Xxxxxx X. Xxxxxx Xxxx Social Security Number: Name (please print): Xxxxxx X. XxxxxxXxxx, Xx. Xxxxxxxx & Xxxxxx X. Xxxxxx Xxxx, JTWROS Principal Amount of Note: $200,000.00 150,000.00 Address: FOR INVESTORS THAT ARE TRUSTS: Date: Name of Trust: Address: Social Security Number or other Signature of Trustee Taxpayer Identification Number: If applicable: Principal Amount of Note: $ Signature of Co-Trustee: FOR INVESTORS THAT ARE CORPORATIONS, LIMITED LIABILITY COMPANIES OR PARTNERSHIPS: Date: Name of Entity: Address: Signature: Taxpayer Identification Number: Title of Signatory: Principal Amount of Note: $ CONFIDENTIAL SCHEDULE I SCHEDULE OF INVESTORS Name and Address of Investor Closing Date Original Principal Amount of the Note Number of Shares of Common Stock Subject to the Warrant Xxxxxx X. XxxxxxXxxx, Xx. and Xxxxxxxx Xxxxxx X. Xxxxxx Xxxx, Joint Tenants with Right of Survivorship November 41, 2013 $ 200,000 6,112 150,000 4,584 TOTALS: $ 200,000.00 6,112150,000.00 4,584

Appears in 1 contract

Samples: 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 CONFIDENTIAL FOR INVESTORS THAT ARE INDIVIDUALS: Date: Oct 26, 2013 23 January 2014 Signature: /s/ Xxxxxx X. XxxxxxXxxx, Xx. /s/ Xxxxxx X. Xxxx Marital Status: Married ¨ Not Married ¨ /s/ Xxxxxxxx X. Xxxxxx Social Security Number: Name (please print): Social Security Number: Xxxxxx X. XxxxxxXxxx, Xx. Xxxxxxxx & Xxxxxx X. Xxxxxx Xxxx, JTWROS Principal Amount of Note: $200,000.00 Address: FOR INVESTORS THAT ARE TRUSTS: Date: Name of Trust: Address: Social Security Number or other Signature of Trustee Taxpayer Identification Number: If applicable: Principal Amount of Note: $ Signature of Co-Trustee: FOR INVESTORS THAT ARE CORPORATIONS, LIMITED LIABILITY COMPANIES OR PARTNERSHIPS: Date: Name of Entity: Address: Signature: Taxpayer Identification Number: Title of Signatory: Principal Amount of Note: $ CONFIDENTIAL SCHEDULE I SCHEDULE OF INVESTORS Name and Address of Investor Closing Date Original Principal Amount of the Note Number of Shares of Common Stock Subject to the Warrant Xxxxxx X. XxxxxxXxxx, Xx. and Xxxxxxxx Xxxxxx X. Xxxxxx November 4Xxxx, 2013 Joint Tenants with Right of Survivorship January 28, 2014 $ 200,000 6,112 6,002 TOTALS: $ 200,000.00 6,1126,002

Appears in 1 contract

Samples: 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 CONFIDENTIAL FOR INVESTORS THAT ARE INDIVIDUALS: Date: 25 Oct 26, 2013 Signature: /s/ Xxxxxx X. Xxxxxx, Xx. Xxxxxx Marital Status: Married ¨ Not Married ¨ /s/ Xxxxxxxx X. Xxxxxx Social Security Number: Name (please print): Social Security Number: Xxxxxx X. Xxxxxx, Xx. Xxxxxxxx X. Xxxxxx Address: Principal Amount of Note: $200,000.00 Address: 100,000.00 FOR INVESTORS THAT ARE TRUSTS: Date: Name of Trust: Address: Social Security Number or other Signature of Trustee Taxpayer Identification Number: If applicable: Principal Amount of Note: $ Signature of Co-Trustee: FOR INVESTORS THAT ARE CORPORATIONS, LIMITED LIABILITY COMPANIES OR PARTNERSHIPS: Date: Name of Entity: Address: Signature: Taxpayer Identification Number: Title of Signatory: Principal Amount of Note: $ CONFIDENTIAL SCHEDULE I SCHEDULE OF INVESTORS Name and Address of Investor Closing Date Original Principal Amount of the Note Number of Shares of Common Stock Subject to the Warrant Xxxxxx X. Xxxxxx, Xx. and Xxxxxxxx X. Xxxxxx November 4October 25, 2013 $ 200,000 6,112 100,000 3,056 TOTALS: $ 200,000.00 6,112100,000.00 3,056

Appears in 1 contract

Samples: 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 CONFIDENTIAL FOR INVESTORS THAT ARE INDIVIDUALS: Date: Oct 26, 2013 10/14/2013 Signature: /s/ Xxxxxx Xxxxx X. XxxxxxXxxx, Xx. Marital Status: Married ¨ Not Married ¨ /s/ Xxxxxxxx X. Xxxxxx Social Security Number: Name (please print): Xxxxxx Social Security Number: Xxxxx X. XxxxxxXxxx, Xx. Xxxxxxxx X. Xxxxxx Address: Principal Amount of Note: $200,000.00 Address: 301,500 FOR INVESTORS THAT ARE TRUSTS: Date: Name of Trust: Address: Social Security Number or other Signature of Trustee Taxpayer Identification Number: If applicable: Principal Amount of Note: $ Signature of Co-Trustee: FOR INVESTORS THAT ARE CORPORATIONS, LIMITED LIABILITY COMPANIES OR PARTNERSHIPS: Date: Name of Entity: Address: Signature: Taxpayer Identification Number: Title of Signatory: Principal Amount of Note: $ CONFIDENTIAL SCHEDULE I SCHEDULE OF INVESTORS Name and Address of Investor Closing Date Original Principal Amount of the Note Number of Shares of Common Stock Subject to the Warrant Xxxxxx Xxxxx X. XxxxxxXxxx, Xx. and Xxxxxxxx X. Xxxxxx November 4October 14, 2013 $ 200,000 6,112 301,500 9,215 TOTALS: $ 200,000.00 6,112301,500.00 9,215

Appears in 1 contract

Samples: Note and Warrant Purchase Agreement (NeuroSigma, Inc.)

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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 CONFIDENTIAL FOR INVESTORS THAT ARE INDIVIDUALS: Date: Oct 26, 2013 10-24-13 Signature: /s/ Xxxxxx X. Xxxxxx, Xx. Xxxxxxx Xxxx Marital Status: Married ¨ Not Married ¨ /s/ Xxxxxxxx X. Xxxxxx Social Security Number: Name (please print): Xxxxxx X. Xxxxxx, Xx. Xxxxxxxx X. Xxxxxx Social Security Number: Xxxxxxx Xxxx Address: Principal Amount of Note: $200,000.00 Address: 50000.00 FOR INVESTORS THAT ARE TRUSTS: Date: Name of Trust: Address: Social Security Number or other Signature of Trustee Taxpayer Identification Number: If applicable: Principal Amount of Note: $ Signature of Co-Trustee: FOR INVESTORS THAT ARE CORPORATIONS, LIMITED LIABILITY COMPANIES OR PARTNERSHIPS: Date: Name of Entity: Address: Signature: Taxpayer Identification Number: Title of Signatory: Principal Amount of Note: $ CONFIDENTIAL SCHEDULE I SCHEDULE OF INVESTORS Name and Address of Investor Closing Date Original Principal Amount of the Note Number of Shares of Common Stock Subject to the Warrant Xxxxxx X. Xxxxxx, Xx. and Xxxxxxxx X. Xxxxxx November 4Xxxxxxx Xxxx October 24, 2013 $ 200,000 6,112 50,000 1,528 TOTALS: $ 200,000.00 6,11250,000.00 1,528

Appears in 1 contract

Samples: 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 CONFIDENTIAL FOR INVESTORS THAT ARE INDIVIDUALS: Date: Oct 26, 2013 10/23/2013 Signature: /s/ Xxxxxxx Xxxxxx X. Xxxxxx, Xx. Marital Status: Married ¨ Not Married ¨ /s/ Xxxxxxxx X. Xxxxxx Social Security Number: Name (please print): Social Security Number: Xxxxxxx Xxxxxx X. Xxxxxx, Xx. Xxxxxxxx X. Xxxxxx Address: Principal Amount of Note: $200,000.00 Address: 80,000.00 FOR INVESTORS THAT ARE TRUSTS: Date: Name of Trust: Address: Social Security Number or other Signature of Trustee Taxpayer Identification Number: If applicable: Principal Amount of Note: $ Signature of Co-Trustee: FOR INVESTORS THAT ARE CORPORATIONS, LIMITED LIABILITY COMPANIES OR PARTNERSHIPS: Date: Name of Entity: Address: Signature: Taxpayer Identification Number: Title of Signatory: Principal Amount of Note: $ CONFIDENTIAL SCHEDULE I SCHEDULE OF INVESTORS Name and Address of Investor Closing Date Original Principal Amount of the Note Number of Shares of Common Stock Subject to the Warrant Xxxxxx X. Xxxxxx, Xx. and Xxxxxxxx X. Xxxxxxx Xxxxxx November 4October 28, 2013 $ 200,000 6,112 80,000 2,445 TOTALS: $ 200,000.00 6,11280,000.00 2,445

Appears in 1 contract

Samples: Note and Warrant Purchase Agreement (NeuroSigma, Inc.)

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