PURCHASE TO BE EXECUTED IF WARRANT HOLDER DESIRES TO EXERCISE. THE WARRANTS EVIDENCED HEREBY The undersigned hereby irrevocably elects to exercise, on __________, ____ (the “Exercise Date”), __________ Warrants, evidenced by this Warrant Certificate, to purchase, __________ shares (the “Warrant Shares”) of Common Stock, par value of $0.0001 per share (the “Common Stock”) of Atheronova Inc., a Delaware corporation (the “Company”), and represents that on or before the Exercise Date: such Holder has tendered payment for such Warrant Shares by certified or official bank check payable to the order of the Company c/o Securities Transfer Corporation, 2000 Xxxxxx Xxxxxxx, Xxxxx 000, Xxxxxx, Xxxxx 00000, or by bank wire transfer in immediately available funds payable to the Company at Account No. , in each case in the amount of $ in accordance with the terms hereof, or [if permitted] the cancellation of such number of Warrant Shares as is necessary, in accordance with the formula set forth in subsection 3.3.7 of the Warrant Agreement, to exercise this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless exercise procedure set forth in subsection 3.3.7. The undersigned requests that said number of Warrant Shares be in fully registered form, registered in such names and delivered, all as specified in accordance with the instructions set forth below. If said number of Warrant Shares is less than all of the Warrant Shares purchasable hereunder, the undersigned requests that a new Warrant Certificate evidencing the remaining balance of the Warrants evidenced hereby be issued and delivered to the Holder of the Warrant Certificate unless otherwise specified in the instructions below. Dated: ________ __, ____ Name (Please Print) / / / / - / / / - / / / / / (Insert Social Security or Other Identifying Number of Holder) Address __________________________ __________________________ Signature __________________________ This Warrant may only be exercised by presentation to the Warrant Agent at one of the following locations: By hand at: Securities Transfer Corporation 2000 Xxxxxx Xxxxxxx, Xxxxx 000 Xxxxxx, Xxxxx 00000 By mail at: Securities Transfer Corporation 2000 Xxxxxx Xxxxxxx, Xxxxx 000 Xxxxxx, Xxxxx 00000 The method of delivery of this Warrant Certificate is at the option and risk of the exercising Holder and the delivery of this Warrant Certificate will be deemed to be made only when actually received by the Warrant Agent. If delivery is by mail, registered mail with return receipt requested, properly insured, is recommended. In all cases, sufficient time should be allowed to ensure timely delivery. (Instructions as to form and delivery of Warrant Shares and/or Warrant Certificates) Name in which Warrant Shares are to be registered if other than in the name of the Holder of this Warrant Certificate: Address to which Warrant Shares are to be mailed if other than to the address of the Holder of this Warrant Certificate as shown on the books of the Warrant Agent: (Street Address) (City and State) (Zip Code) Name in which Warrant Certificate evidencing unexercised Warrants, if any, is to be registered if other than in the name of the Holder of this Warrant Certificate: Address to which certificate representing unexercised Warrants, if any, is to be mailed if other than to the address of the Holder of this Warrant Certificate as shown on the books of the Warrant Agent: (Street Address) (City and State) (Zip Code) Dated:
Appears in 1 contract
Samples: Warrant Agreement (AtheroNova Inc.)
PURCHASE TO BE EXECUTED IF WARRANT HOLDER DESIRES TO EXERCISE. THE WARRANTS EVIDENCED HEREBY The undersigned hereby irrevocably elects to exercise, on __________, ____ (the “Exercise Date”), __________ Warrants, evidenced by this Warrant Certificate, to purchase, __________ shares (the “Warrant Shares”) of Common Stock, par value of $0.0001 0.001 per share (the “Common Stock”) of Atheronova Rxxxxx Pharmaceuticals, Inc., a Delaware corporation (the “Company”), and represents that on or before the Exercise Date: [ ] such Holder has tendered payment for such Warrant Shares by certified or official bank check payable to the order of the Company c/o Securities Transfer CorporationCorporate Stock Transfer, 2000 Inc., 3000 Xxxxxx XxxxxxxXxxxx Xxxxx Xxxxx, Xxxxx 000, Xxxxxx, Xxxxx Xxxxxxxx 00000, or by bank wire transfer in immediately available funds payable to the Company at Account No. [ ], in each case in the amount of $ $_______ in accordance with the terms hereof, or [[ ] if permitted] permitted the cancellation of such number of Warrant Shares as is necessary, in accordance with the formula set forth in subsection 3.3.7 of the Warrant Agreement, to exercise this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless exercise procedure set forth in subsection 3.3.7. The undersigned requests that said number of Warrant Shares be in fully registered form, registered in such names and delivered, all as specified in accordance with the instructions set forth below. If said number of Warrant Shares is less than all of the Warrant Shares purchasable hereunder, the undersigned requests that a new Warrant Certificate evidencing the remaining balance of the Warrants evidenced hereby be issued and delivered to the Holder of the Warrant Certificate unless otherwise specified in the instructions below. Dated: ________ __, ____ Name (Please Print) / / / / - / / / - / / / / / (Insert Social Security or Other Identifying Number of Holder) Address __________________________ __________________________ Signature __________________________ This Warrant may only be exercised by presentation to the Warrant Agent at one of the following locations: By hand at: Securities Transfer Corporation 2000 Corporate Stock Transfer, Inc. 3000 Xxxxxx XxxxxxxXxxxx Xxxxx Xxxxx, Xxxxx 000 Xxxxxx, Xxxxx Xxxxxxxx 00000 By mail at: Securities Transfer Corporation 2000 Corporate Stock Transfer, Inc. 3000 Xxxxxx XxxxxxxXxxxx Xxxxx Xxxxx, Xxxxx 000 Xxxxxx, Xxxxx Xxxxxxxx 00000 The method of delivery of this Warrant Certificate is at the option and risk of the exercising Holder and the delivery of this Warrant Certificate will be deemed to be made only when actually received by the Warrant Agent. If delivery is by mail, registered mail with return receipt requested, properly insured, is recommended. In all cases, sufficient time should be allowed to ensure timely delivery. (Instructions as to form and delivery of Warrant Shares and/or Warrant Certificates) Name in which Warrant Shares are to be registered if other than in the name of the Holder of this Warrant Certificate: Address to which Warrant Shares are to be mailed if other than to the address of the Holder of this Warrant Certificate as shown on the books of the Warrant Agent: (Street Address) (City and State) (Zip Code) Name in which Warrant Certificate evidencing unexercised Warrants, if any, is to be registered if other than in the name of the Holder of this Warrant Certificate: Address to which certificate representing unexercised Warrants, if any, is to be mailed if other than to the address of the Holder of this Warrant Certificate as shown on the books of the Warrant Agent: (Street Address) (City and State) (Zip Code) Dated:: Signature: Signature must conform in all respects to the name of the Holder as specified on the face of this Warrant Certificate. If Warrant Shares, or a Warrant Certificate evidencing unexercised Warrants, are to be issued in a name other than that of the Holder hereof or are to be delivered to an address other than the address of such Holder as shown on the books of the Warrant Agent, the above signature must be guaranteed by a an Eligible Guarantor Institution (as that term is defined in Rule 17Ad-15 of the Securities Exchange Act of 1934, as amended). SIGNATURE GUARANTEE Name of Firm Address Area Code and Number Authorized Signature Name Title Dated: _____________, 20__ ASSIGNMENT (FORM OF ASSIGNMENT TO BE EXECUTED IF WARRANT HOLDER DESIRES TO TRANSFER WARRANTS EVIDENCED HEREBY) FOR VALUE RECEIVED, ____________ HEREBY SELL(S), ASSIGN(S) AND TRANSFER(S) UNTO (Please print name and address including zip code of assignee) (Please insert social security or other identifying number of assignee) the rights represented by the within Warrant Certificate and does hereby irrevocably constitute and appoint ____________ Attorney to transfer said Warrant Certificate on the books of the Warrant Agent with full power of substitution in the premises. Dated: Signature (Signature must conform in all respects to the name of the Holder as specified on the face of this Warrant Certificate and must bear a signature guarantee by an Eligible Guarantor Institution (as that term is defined in Rule 17Ad-15 of the Securities Exchange Act of 1934, as amended). SIGNATURE GUARANTEE Name of Firm Address Area Code and Number Authorized Signature Name Title Dated: _____________, 20__
Appears in 1 contract
Samples: Warrant Agency Agreement (Ritter Pharmaceuticals Inc)
PURCHASE TO BE EXECUTED IF WARRANT HOLDER DESIRES TO EXERCISE. THE WARRANTS EVIDENCED HEREBY The undersigned hereby irrevocably elects to exercise, on __________, ____ (the “Exercise Date”), __________ Warrants, evidenced by this Warrant Certificate, to purchase, __________ shares (the “Warrant Shares”) of Common Stock, par value of $0.0001 0.001 per share (the “Common Stock”) of Atheronova Advaxis, Inc., a Delaware corporation (the “Company”), and represents that on or before the Exercise Date: o such Holder has tendered payment for such Warrant Shares by certified or official bank check payable to the order of the Company c/o Securities Transfer Corporation, 2000 Xxxxxx Xxxxxxx, Xxxxx 000, Xxxxxx, Xxxxx 00000, or by bank wire transfer in immediately available funds payable to the Company at Account No. [●], in each case in the amount of $ $[●] in accordance with the terms hereof, or o [if permitted] the cancellation of such number of Warrant Shares as is necessary, in accordance with the formula set forth in subsection 3.3.7 of the Warrant Agreement, to exercise this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless exercise procedure set forth in subsection 3.3.7. The undersigned requests that said number of Warrant Shares be in fully registered form, registered in such names and delivered, all as specified in accordance with the instructions set forth below. If said number of Warrant Shares is less than all of the Warrant Shares purchasable hereunder, the undersigned requests that a new Warrant Certificate evidencing the remaining balance of the Warrants evidenced hereby be issued and delivered to the Holder of the Warrant Certificate unless otherwise specified in the instructions below. Dated: ________ __, ____ Name (Please Print) / / / / - / / / - / / / / / (Insert Social Security or Other Identifying Number of Holder) Address __________________________ __________________________ Signature __________________________ This Warrant may only be exercised by presentation to the Warrant Agent at one of the following locations: By hand at: Securities Transfer Corporation 2000 Xxxxxx Xxxxxxx, Xxxxx 000 Xxxxxx, Xxxxx 00000 By mail at: Securities Transfer Corporation 2000 Xxxxxx Xxxxxxx, Xxxxx 000 Xxxxxx, Xxxxx 00000 The method of delivery of this Warrant Certificate is at the option and risk of the exercising Holder and the delivery of this Warrant Certificate will be deemed to be made only when actually received by the Warrant Agent. If delivery is by mail, registered mail with return receipt requested, properly insured, is recommended. In all cases, sufficient time should be allowed to ensure timely delivery. (Instructions as to form and delivery of Warrant Shares and/or Warrant Certificates) Name in which Warrant Shares are to be registered if other than in the name of the Holder of this Warrant Certificate: Address to which Warrant Shares are to be mailed if other than to the address of the Holder of this Warrant Certificate as shown on the books of the Warrant Agent: (Street Address) (City and State) (Zip Code) Name in which Warrant Certificate evidencing unexercised Warrants, if any, is to be registered if other than in the name of the Holder of this Warrant Certificate: Address to which certificate representing unexercised Warrants, if any, is to be mailed if other than to the address of the Holder of this Warrant Certificate as shown on the books of the Warrant Agent: (Street Address) (City and State) (Zip Code) Dated:
Appears in 1 contract
Samples: Warrant Agreement (Advaxis, Inc.)
PURCHASE TO BE EXECUTED IF WARRANT HOLDER DESIRES TO EXERCISE. THE WARRANTS EVIDENCED HEREBY The undersigned hereby irrevocably elects to exercise, on __________, ____ (the “Exercise Date”), __________ Warrants, evidenced by this Warrant Certificate, to purchase, __________ shares (the “Warrant Shares”) of Common Stock, par value of $0.0001 0.001 per share (the “Common Stock”) of Atheronova Rxxxxx Pharmaceuticals, Inc., a Delaware corporation (the “Company”), and represents that on or before the Exercise Date: [ ] such Holder has tendered payment for such Warrant Shares by certified or official bank check payable to the order of the Company c/o Securities Transfer CorporationCorporate Stock Transfer, 2000 Inc., 3000 Xxxxxx XxxxxxxXxxxx Xxxxx Xxxxx, Xxxxx 000, Xxxxxx, Xxxxx Xxxxxxxx 00000, or by bank wire transfer in immediately available funds payable to the Company at Account No. [ ], in each case in the amount of $ $_______ in accordance with the terms hereof, or [[ ] if permitted] permitted the cancellation of such number of Warrant Shares as is necessary, in accordance with the formula set forth in subsection 3.3.7 of the Warrant Agreement, to exercise this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless exercise procedure set forth in subsection 3.3.7. The undersigned requests that said number of Warrant Shares be in fully registered form, registered in such names and delivered, all as specified in accordance with the instructions set forth below. If said number of Warrant Shares is less than all of the Warrant Shares purchasable hereunder, the undersigned requests that a new Warrant Certificate evidencing the remaining balance of the Warrants evidenced hereby be issued and delivered to the Holder of the Warrant Certificate unless otherwise specified in the instructions below. Dated: ________ __, ____ Name (Please Print) / / / / - / / / - / / / / / (Insert Social Security or Other Identifying Number of Holder) Address __________________________ __________________________ Signature __________________________ This Warrant may only be exercised by presentation to the Warrant Agent at one of the following locations: By hand at: Securities Transfer Corporation 2000 Xxxxxx Xxxxxxx, Xxxxx 000 Xxxxxx, Xxxxx 00000 By mail at: Securities Transfer Corporation 2000 Xxxxxx Xxxxxxx, Xxxxx 000 Xxxxxx, Xxxxx 00000 The method of delivery of this Warrant Certificate is at the option and risk of the exercising Holder and the delivery of this Warrant Certificate will be deemed to be made only when actually received by the Warrant Agent. If delivery is by mail, registered mail with return receipt requested, properly insured, is recommended. In all cases, sufficient time should be allowed to ensure timely delivery. (Instructions as to form and delivery of Warrant Shares and/or Warrant Certificates) Name in which Warrant Shares are to be registered if other than in the name of the Holder of this Warrant Certificate: Address to which Warrant Shares are to be mailed if other than to the address of the Holder of this Warrant Certificate as shown on the books of the Warrant Agent: (Street Address) (City and State) (Zip Code) Name in which Warrant Certificate evidencing unexercised Warrants, if any, is to be registered if other than in the name of the Holder of this Warrant Certificate: Address to which certificate representing unexercised Warrants, if any, is to be mailed if other than to the address of the Holder of this Warrant Certificate as shown on the books of the Warrant Agent: (Street Address) (City and State) (Zip Code) Dated:
Appears in 1 contract
Samples: Warrant Agency Agreement (Ritter Pharmaceuticals Inc)