ISSUE TO. (NAME OF HOLDER) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) DELIVER TO: -------------------------------------------------------------------- (NAME OF HOLDER) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) Dated: , 200 [NAME OF HOLDER] ------------ - By ------------------------------------- Name: Title: EXHIBIT B to Common Stock Purchase Warrant [FORM OF] ASSIGNMENT FOR VALUE RECEIVED, the undersigned hereby sells, assigns, and transfers unto the Assignee named below all of the rights of the undersigned to purchase Common Stock, par value $__________ per share ("Common Stock") of XANODYNE PHARMACEUTICALS, INC. represented by the Warrant, with respect to the number of shares of Common Stock set forth below: Name of Assignee Address No. of Shares ---------------- ------- ------------- and does hereby irrevocably constitute and appoint ___________ Attorney to make such transfer on the books of XANODYNE PHARMACEUTICALS, INC. maintained for that purpose, with full power of substitution in the premises. Dated: , 200 [NAME OF HOLDER] ------------ - By: ------------------------------------ Name: Title: EXHIBIT C to Common Stock Purchase Warrant
Appears in 2 contracts
Samples: Financing Agreement (Xanodyne Pharmaceuticals Inc), Financing Agreement (Xanodyne Pharmaceuticals Inc)
ISSUE TO. (NAME OF HOLDER) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) DELIVER TO: -------------------------------------------------------------------- --------------------------------------------------------------------- (NAME OF HOLDER) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) Dated: , 200 [NAME OF HOLDER] ------------ - --------------------------- By ------------------------------------- --------------------------------- Name: Title: __________________, as transfer agent and registrar of the Common Stock, is hereby authorized and directed to issue the above number of shares of Common Stock in the name of the above referenced entity or person and to deliver the certificates representing such shares using an overnight delivery service. NTN COMMUNICATIONS, INC. By: --------------------------------- Name: Title: EXHIBIT B to Common Stock Purchase Warrant [FORM OF] ASSIGNMENT FOR VALUE RECEIVED, the undersigned hereby sells, assigns, and transfers unto the Assignee named below all of the rights of the undersigned to purchase Common Stock, par value $__________ .005 per share ("Common Stock") of XANODYNE PHARMACEUTICALSNTN COMMUNICATIONS, INC. represented by the Warrant, with respect to the number of shares of Common Stock set forth below: Name of Assignee Address No. of Shares ---------------- ------- ------------- and does hereby irrevocably constitute and appoint ___________ as Attorney to make such transfer on the books of XANODYNE PHARMACEUTICALSNTN COMMUNICATIONS, INC. maintained for that purpose, with full power of substitution in the premises. Dated: , 200 [NAME OF HOLDER] ------------ - By: ------------------------------------ --------------------------- By --------------------------------- Name: Title: EXHIBIT C to Common Stock Purchase WarrantREGISTRATION RIGHTS AGREEMENT REGISTRATION RIGHTS AGREEMENT (this "AGREEMENT"), dated as of November 14, 2000, by and among NTN Communications, Inc., a Delaware corporation, with headquarters located at 5966 Xx Xxxxx Xxxxx, Xxxxxxxx, Xxxxxxxxxx 00000 (xxe "COMPANY"), and the undersigned buyers (each, a "BUYER" and collectively, the "BUYERS").
Appears in 1 contract
Samples: Securities Purchase Agreement (NTN Communications Inc)
ISSUE TO. (NAME) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) -------------------------------------------------------------------------------- (SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER) DELIVER TO: --------------------------------------------------------------------- (NAME) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) If the number of shares of Common Stock purchased hereby is less than the number of shares of Common Stock covered by the Tranche of the Warrant be exercised, the undersigned requests that a new Warrant covering the number of shares of Common Stock not purchased be issued and delivered as follows: ISSUE TO: ----------------------------------------------------------------------- (NAME OF HOLDERHOLDXX) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) DELIVER TO: -------------------------------------------------------------------- --------------------------------------------------------------------- (NAME OF HOLDERHOLDXX) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) Dated: , 200 ------------------------------------ [NAME OF HOLDERHOLDXX] ------------ - By ------------------------------------- By: ------------------------------- Name: Title: EXHIBIT B ------------------------------------- 1 Name of Holder must conform in all respects to Common Stock Purchase Warrant [FORM OF] ASSIGNMENT FOR VALUE RECEIVED, name of Holdxx xx specified on the undersigned hereby sells, assigns, and transfers unto the Assignee named below all face of the rights of the undersigned to purchase Common Stock, par value $__________ per share ("Common Stock") of XANODYNE PHARMACEUTICALS, INC. represented by the Warrant, with respect to the number of shares of Common Stock set forth below: Name of Assignee Address No. of Shares ---------------- ------- ------------- and does hereby irrevocably constitute and appoint ___________ Attorney to make such transfer on the books of XANODYNE PHARMACEUTICALS, INC. maintained for that purpose, with full power of substitution in the premises. Dated: , 200 [NAME OF HOLDER] ------------ - By: ------------------------------------ Name: Title: EXHIBIT C to Common Stock Purchase Warrant.
Appears in 1 contract
Samples: Warrant Agreement (Dove Audio Inc)
ISSUE TO. (NAME OF HOLDER) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) DELIVER TO: -------------------------------------------------------------------- --------------------------------------------------------------------- (NAME OF HOLDER) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) Dated: , 200 [NAME OF HOLDER] ------------ HOLDER ------------- - By ------------------------------------- By: ----------------------------------------- Name: --------------------------------------- Title: EXHIBIT B to Common Stock Purchase Warrant [FORM OF] -------------------------------------- 32 ASSIGNMENT FOR VALUE RECEIVED, the undersigned hereby sells, assigns, and transfers unto the Assignee named below all of the rights of the undersigned to purchase Common Stock, par value $__________ .0001 per share ("Common Stock") of XANODYNE PHARMACEUTICALS, INC. HYPERCOM Corporation represented by the Warrant, with respect to the number of shares of Common Stock set forth below: Name of Assignee Address No. of Shares NAME OF ASSIGNEE ADDRESS NUMBER OF SHARES ---------------- ------- ------------- ---------------- ---------------------- ---------------------- ------------------------------- ---------------------- ---------------------- ------------------------------- ---------------------- ---------------------- ------------------------------- ---------------------- ---------------------- ------------------------------- ---------------------- ---------------------- ------------------------------- and does hereby irrevocably constitute and appoint ___________ Attorney Hypercom Corporation to make such transfer on the its books of XANODYNE PHARMACEUTICALS, INC. maintained for that purpose, with full power of substitution in the premises. Dated: , 200 [NAME OF HOLDER] ------------ ABLECO HOLDING LLC --------------- - Signature Guaranteed By: ------------------------------------ ------------------------------- ----------------------------------------- Name: ------------------------------- --------------------------------------- Title: EXHIBIT C to Common Stock Purchase Warrant--------------------------------------
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ISSUE TO. (NAME OF HOLDERHOLDER(1)) -------------------------------------------------------------------------------- --------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) DELIVER TO: -------------------------------------------------------------------- ---------------------------------------------------------------- (NAME OF HOLDERHOLDER(1)) -------------------------------------------------------------------------------- --------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) Dated: _____________, 200 20__ [NAME OF HOLDERHOLDER(1)] ------------ - By ------------------------------------- By: ------------------------------- Name: Title: --------------------------------- (1) Name of Holder must conform in all respects to name of holder as specified on the face of the Warrant. EXHIBIT B to Common Stock Series C Convertible Preferred Shares Purchase Warrant [FORM OF] ASSIGNMENT FOR VALUE RECEIVED, the undersigned hereby sells, assigns, and transfers unto the Assignee named below all of the rights of the undersigned to purchase Common Series C Convertible Preferred Stock, par value $__________ per share ("Common StockSeries C Shares") of XANODYNE PHARMACEUTICALS, GILAT-TO-HOME INC. represented by the Warrant, with respect to the number of shares of Common Stock Series C Shares set forth below: Name of Assignee Address No. of Shares ---------------- ------- ------------- and does hereby irrevocably constitute and appoint ___________ Attorney to make such transfer on the books of XANODYNE PHARMACEUTICALS, GILAT-TO-HOME INC. maintained for that purpose, with full power of substitution in the premises. Dated: _______________, 200 20__ [NAME OF HOLDERHOLDER(1)] ------------ - By: ------------------------------------ Name: Title: EXHIBIT C to Common Stock Purchase Warrant----------------------------------
Appears in 1 contract
ISSUE TO. (NAME OF HOLDERNAME) -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) -------------------------------------------------------------------------------- (SOCIAL SECURITY OR OTHER TAX IDENTIFICATION NUMBER -------------------------------------------------------------------------------- DELIVER TO: -------------------------------------------------------------------- -------------------------------------------------------------------------------- (NAME OF HOLDERNAME) at -------------------------------------------------------------------------------- (ADDRESS, INCLUDING ZIP CODE) Dated: If the number of Warrants hereby exercised is less than all the Warrants represented by this Warrant Certificate, 200 [NAME OF HOLDER] ------------ - By ------------------------------------- Name: Title: EXHIBIT B the undersigned requests that a new Warrant Certificate representing the number of full Warrants not exercised be issued and delivered as set forth below. In full payment of the purchase price with respect to Common Stock Purchase Warrant the Warrants exercised and transfer taxes, if any, the undersigned hereby tenders payment of $ ____by certified check or money order payable in United States currency to the order of the Company. [FORM OF] ASSIGNMENT FOR VALUE RECEIVED, the undersigned hereby sells, assigns, and transfers unto the Assignee named below all of the rights of the undersigned to purchase Common Stock, par value $__________ per share ("Common Stock") of XANODYNE PHARMACEUTICALS, INC. represented by the Warrantwithin Warrant Certificate, with respect to the number of shares of Common Stock Warrants set forth below: Name of Assignee Address No. of Shares Warrants ---------------- ------- ------------- --------------- and does hereby irrevocably constitute and appoint ___________ Attorney to make such transfer on the books of XANODYNE PHARMACEUTICALS, INC. Del Global Technologies Corp. maintained for that purpose, with full power of substitution in the premises. Dated: ------------------------------------- -------------------------------------------- Signature -------------------------------------------- Signature NOTICE: The signature(s) on this assignment must correspond with the name(s) as written upon the face of the Certificate, 200 [NAME OF HOLDER] ------------ - By: ------------------------------------ Name: Title: EXHIBIT C to Common Stock Purchase Warrantin every particular, without alteration or enlargement or any change whatever.
Appears in 1 contract
ISSUE TO. (NAME OF HOLDERName) -------------------------------------------------------------------------------- --------------------------------------------------- (ADDRESSAddress, INCLUDING ZIP CODEincluding Zip Code) DELIVER TO--------------------------------------------------- (Social Security or Tax Identification Number) Deliver to: -------------------------------------------------------------------- --------------------------------------------------- (NAME OF HOLDERName) -------------------------------------------------------------------------------- --------------------------------------------------- (ADDRESSAddress, INCLUDING ZIP CODEincluding Zip Code) Dated: , 200 [NAME OF HOLDER] ------------ - By ------------------------------------- Name: Title: EXHIBIT B In full payment of the aggregate purchase price with respect to Common Stock Purchase Warrant [FORM OF] ASSIGNMENT FOR VALUE RECEIVEDthe number of shares being purchased upon exercise of this Warrant, the undersigned hereby sells, assigns, and transfers unto the Assignee named below all (check applicable payment method): (i) / / tenders payment of the rights of the undersigned to purchase Common Stock, par value $__________ per share ("Common Stock") of XANODYNE PHARMACEUTICALS, INC. represented by the Warrant, with respect cashier's check payable to the number order of shares of Common Stock set forth below: Name of Assignee Address No. of Shares ---------------- ------- ------------- and does Parallel Petroleum Corporation or (ii) / / hereby irrevocably constitute and appoint ___surrenders to the Company, Warrants to purchase ________ Attorney shares of Common Stock. If the Warrant is exercised hereby (and, if applicable, surrendered to make such transfer purchase shares of Common Stock) so as to purchase fewer than all the shares of Common Stock that may be purchased pursuant to this Warrant, the undersigned requests that a new Warrant representing the number of full shares for which the Warrant has not been exercised or surrendered be issued and delivered as set forth below. Name of Warrant holder or Assignee: ----------------------------- (Please Print) Address: ----------------------------------------------------------------- ----------------------------------------------------------------- Signature Dated: (Signature must conform in all respects to name of holder as specified on the books face of XANODYNE PHARMACEUTICALS, INC. maintained for that purpose, with full power of substitution in the premises. Dated: , 200 [NAME OF HOLDER] ------------ - By: ------------------------------------ Name: Title: EXHIBIT C to Common Stock Purchase Warrant)
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