SECURITIES PURCHASE WARRANT SPECTRUMDNA, INC.
NEITHER
THIS SECURITY NOR THE SECURITIES INTO WHICH THIS SECURITY IS EXERCISABLE HAVE
BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES
COMMISSION OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION UNDER
THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES ACT”), AND, ACCORDINGLY,
MAY NOT BE OFFERED OR SOLD EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION
STATEMENT UNDER THE SECURITIES ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM,
OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE
SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS AS
EVIDENCED BY A LEGAL OPINION OF COUNSEL TO THE TRANSFEROR TO SUCH EFFECT, WHICH
COUNSEL AND THE SUBSTANCE OF WHICH SHALL BE REASONABLY ACCEPTABLE TO THE
COMPANY. THIS SECURITY AND THE SECURITIES ISSUABLE UPON EXERCISE OF
THIS SECURITY MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT OR
OTHER LOAN SECURED BY SUCH SECURITIES.
SECURITIES
PURCHASE WARRANT
Warrant
Units: _______
THIS
SECURITIES PURCHASE WARRANT (the “Warrant”) certifies
that, for value received, _______________ (the “Holder”) is entitled,
upon the terms and subject to the limitations on exercise and the conditions
hereinafter set forth, at any time on or after the date of the final closing of
the Financing (the “Initial Exercise
Date”) and on or prior to the close of business on the five year
anniversary of the Initial Exercise Date (the “Termination Date”)
but not thereafter, to subscribe for and purchase from SpectrumDNA, Inc., a
Delaware corporation (the “Company”), up to
______ units (the “Warrant Units”), with
each Warrant Unit consisting of one share of common stock of the Company (the
“Common Stock”)
and one warrant to purchase one additional share of Common Stock (the
“Underlying Warrants”). The purchase price of one Warrant Unit shall
be equal to the Exercise Price as defined in Section 2(b). Each of
the Underlying Warrants shall have an initial exercise price of $0.25 per share
and shall be in such form as the warrant included in the Securities sold to the
investors in the Financing (except that the Underlying Warrants shall contain a
cashless exercise feature as provided in Section 2(b) hereof).
Section
1. Definitions. Capitalized
terms used and not otherwise defined herein shall have the meanings set forth in
that certain Placement Agent Agreement dated January 12, 2010, between the
Company and HFP Capital Markets LLC (“HFP”) (the “Placement Agent
Agreement”).
1
Section
2. Exercise.
a) Exercise of
Warrant. Exercise of the purchase rights represented by this
Warrant may be made, in whole or in part, at any time or times on or after the
Initial Exercise Date and on or before the Termination Date by delivery to the
Company of a duly executed facsimile copy of the Notice of Exercise Form annexed
hereto and payment of the aggregate Exercise Price of the Warrant Units thereby
purchased by wire transfer or cashier’s check drawn on a United States
bank. Notwithstanding anything herein to the contrary, the Holder
shall not be required to physically surrender this Warrant to the Company until
the Holder has purchased all of the Warrant Units available hereunder and the
Warrant has been exercised in full, in which case, the Holder shall surrender
this Warrant to the Company for cancellation along with delivery to the Company
of the final Notice of Exercise. Partial exercises of this Warrant
resulting in purchases of a portion of the total number of Warrant Units
available hereunder shall have the effect of lowering the outstanding number of
Warrant Units purchasable hereunder in an amount equal to the applicable number
of Warrant Units purchased. The Holder and the Company shall maintain
records showing the number of Warrant Units purchased and the date of such
purchases.
b) Exercise
Price. The exercise price per Warrant Unit shall be $0.10,
subject to adjustment hereunder (the “Exercise
Price”).
Notwithstanding the foregoing, if the
fair market value of one share of Common Stock is greater than the Exercise
Price (at the date of calculation as set forth below), in lieu of exercising
this Warrant for cash, the Holder is entitled to customary cashless exercise and
may elect to receive shares (and Underlying Warrants) equal to the value (as
determined below) of this Warrant (or the portion thereof being cancelled) by
surrender of this Warrant at the principal office of the Company together with
the properly endorsed Notice of Election in which event the Company shall issue
to the holder a number of shares of Common Stock (and Underlying Warrants)
computed using the following formula:
X =
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Y (A-B)
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A
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Where
X=
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the
number of shares of Common Stock (and Underlying Warrants) to be issued to
the Holder
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Y=
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the
number of shares of Common Stock (and Underlying Warrants) purchasable
under the Warrant or, if only a portion of the Warrant is being exercised,
the portion of the Warrant being exercised (at the date of such
calculation)
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A=
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the
average of the closing sale prices of the Common Stock for the fifteen
(15) Trading Days immediately prior to (but not including) the Exercise
Date, or fair market value, whichever is
less
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B=
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Exercise
Price (as adjusted to the date of such
calculation)
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2
For
purposes of Rule 144 promulgated under the 1933 Act, it is intended, understood
and acknowledged that the shares of Common Stock issued in a cashless exercise
transaction shall be deemed to have been acquired by the Holder, and the holding
period for the shares of Common Stock shall be deemed to have commenced, on the
date this Warrant was originally issued on the date hereof.
c) Mechanics of
Exercise.
i.
Authorization of Warrant
Units. The Company covenants that all shares of Common Stock
underlying the Warrant Units which may be issued upon the exercise of the
purchase rights represented by this Warrant will, upon due exercise of the
purchase rights represented by this Warrant and payment of the applicable
Exercise Price to the Company, be duly authorized, validly issued, fully paid
and nonassessable and free from all taxes, liens and charges created by the
Company in respect of the issue thereof (other than taxes in respect of any
transfer occurring contemporaneously with such issue).
ii. Delivery of Certificates
Upon Exercise. Certificates for shares purchased hereunder
shall be transmitted by the transfer agent of the Company to the Holder by
crediting the account of the Holder’s prime broker with the Depository Trust
Company through its Deposit Withdrawal Agent Commission (“DWAC”) system if
permitted and if the Company is a participant in such system, and otherwise by
physical delivery to the address specified by the Holder in the Notice of
Exercise Form, as soon as reasonably practicable but no later than seven (7)
days after the surrender of this Warrant (if required) and payment of the
aggregate Exercise Price as set forth above (“Warrant Share Delivery
Date”). This Warrant shall be deemed to have been exercised
and the Warrant Units shall be deemed to have been issued on the date all of the
foregoing are accepted by the Company.
iii. Delivery of New Warrants
Upon Exercise. If this Warrant shall have been exercised in
part, the Company shall, at the request of a Holder and upon surrender of this
Warrant, at the time of delivery of the certificate or certificates representing
Warrant Units, deliver to Holder a new Warrant evidencing the rights of Holder
to purchase the unpurchased Warrant Units called for by this Warrant, which new
Warrant shall in all other respects be identical with this Warrant.
iv. Rescission
Rights. If the Company fails to cause its transfer agent to
transmit to the Holder a certificate or certificates representing the Warrant
Units pursuant to Section 2(c)(ii) by the Warrant Share Delivery Date, then the
Holder will have the right to rescind such exercise.
v. No Fractional Shares or
Scrip. No fractional shares or scrip representing fractional
shares shall be issued upon the exercise of this Warrant. As to any
fraction of a share which Holder would otherwise be entitled to purchase upon
such exercise, the Company shall at its election, either pay a cash adjustment
in respect of such final fraction in an amount equal to such fraction multiplied
by the Exercise Price or round up to the next whole share.
3
vi. Charges, Taxes and
Expenses. Issuance of certificates for Warrant Units shall be
made without charge to the Holder for any issue or transfer tax or other
incidental expense in respect of the issuance of such certificate, all of which
taxes and expenses shall be paid by the Company, and such certificates shall be
issued in the name of the Holder or in such name or names as may be directed by
the Holder; provided,
however, that in the event certificates for Warrant Units are to be
issued in a name other than the name of the Holder, this Warrant when
surrendered for exercise shall be accompanied by the Assignment Form attached
hereto duly executed by the Holder; and the Company may require, as a condition
thereto, the payment of a sum sufficient to reimburse it for any transfer tax
incidental thereto.
vii. Closing of
Books. The Company will not close its stockholder books or
records in any manner which prevents the timely exercise of this Warrant
pursuant to the terms hereof.
Section
3. Certain Adjustments.
a) Stock Dividends and
Splits. If the Company, at any time while this Warrant is outstanding:
(A) pays a stock dividend or otherwise make a distribution or distributions on
shares of its Common Stock or any other equity or equity equivalent securities
payable in shares of Common Stock (which, for avoidance of doubt, shall not
include any shares of Common Stock issued by the Company upon exercise of this
Warrant), (B) subdivides outstanding shares of Common Stock into a larger number
of shares, (C) combines (including by way of reverse stock split) outstanding
shares of Common Stock into a smaller number of shares, or (D) issues by
reclassification of shares of the Common Stock any shares of capital stock of
the Company, then in each case the Exercise Price shall be multiplied by a
fraction of which the numerator shall be the number of shares of Common Stock
(excluding treasury shares, if any) outstanding immediately before such event
and of which the denominator shall be the number of shares of Common Stock
outstanding immediately after such event and the number of shares issuable upon
exercise of this Warrant (and Underlying Warrants) shall be proportionately
adjusted. Any adjustment made pursuant to this Section 3(a) shall
become effective immediately after the record date for the determination of
stockholders entitled to receive such dividend or distribution and shall become
effective immediately after the effective date in the case of a subdivision,
combination or re-classification.
4
b) Fundamental
Transaction. If after the date hereof, the Company (or any other entity,
the stock or other securities of which are at the time receivable on the
exercise of the Warrants), consolidates with or merges into another entity or
conveys all or substantially all of its assets to another entity, then, in each
such case, the Holder, upon any permitted exercise of a Warrant, at any time
after the consummation of such reorganization, consolidation, merger or
conveyance, shall be entitled to receive, in lieu of the stock or other
securities and property receivable upon the exercise of the Warrant prior to
such consummation, the stock or other securities or property to which such the
Holder would have been entitled upon the consummation of such reorganization,
consolidation, merger or conveyance if such the Holder had exercised the Warrant
immediately prior thereto, all subject to further adjustment as provided in this
Section 3. The successor or purchasing entity in any such
reorganization, consolidation, merger or conveyance (if other than the Company)
shall duly execute and deliver to the Holder a written acknowledgment of such
entity’s obligations under the Warrants and this Agreement.
c) Calculations. All
calculations under this Section 3 shall be made to the nearest cent or the
nearest 1/100th of a share, as the case may be. For purposes of this Section 3,
the number of shares of Common Stock deemed to be issued and outstanding as of a
given date shall be the sum of the number of shares of Common Stock (excluding
treasury shares, if any) issued and outstanding.
d) Voluntary Adjustment By
Company. The Company may at any time during the term of this Warrant
reduce the then current Exercise Price to any amount and for any period of time
deemed appropriate by the Board of Directors of the Company.
e) Notice to
Holder.
i.
Adjustment
to Exercise Price. Whenever the Exercise Price is adjusted pursuant to
any provision of this Section 3, the Company shall promptly mail to the Holder a
notice setting forth the Exercise Price after such adjustment and setting forth
a brief statement of the facts requiring such adjustment.
ii. Notice to Allow Exercise by
Xxxxxx. If (A) the Company shall declare a dividend (or any other
distribution in whatever form) on the Common Stock; (B) the Company shall
declare a special nonrecurring cash dividend on or a redemption of the Common
Stock; (C) the Company shall authorize the granting to all holders of the Common
Stock rights or warrants to subscribe for or purchase any shares of capital
stock of any class or of any rights; (D) the approval of any stockholders of the
Company shall be required in connection with any reclassification of the Common
Stock, any consolidation or merger to which the Company is a party, any sale or
transfer of all or substantially all of the assets of the Company, of any
compulsory share exchange whereby the Common Stock is converted into other
securities, cash or property; (E) the Company shall authorize the voluntary or
involuntary dissolution, liquidation or winding up of the affairs of the
Company; then, in each case, the Company shall cause to be mailed to the Holder
at its last address as it shall appear upon the Warrant Register of the Company,
at least 20 days prior to the applicable record or effective date hereinafter
specified, a notice stating (x) the date on which a record is to be taken for
the purpose of such dividend, distribution, redemption, rights or warrants, or
if a record is not to be taken, the date as of which the holders of the Common
Stock of record to be entitled to such dividend, distributions, redemption,
rights or warrants are to be determined or (y) the date on which such
reclassification, consolidation, merger, sale, transfer or share exchange is
expected to become effective or close, and the date as of which it is expected
that holders of the Common Stock of record shall be entitled to exchange their
shares of the Common Stock for securities, cash or other property deliverable
upon such reclassification, consolidation, merger, sale, transfer or share
exchange; provided that the failure to mail such notice or any defect therein or
in the mailing thereof shall not affect the validity of the corporate action
required to be specified in such notice. The Holder is entitled to
exercise this Warrant during the 20-day period commencing on the date of such
notice to the effective date of the event triggering such
notice.
5
Section
4. Transfer of
Warrant.
a) Transferability. Subject
to compliance with any applicable securities laws and the conditions set forth
in Section 4(d) hereof, this Warrant and all rights hereunder (including,
without limitation, any registration rights) are transferable, in whole or in
part, upon surrender of this Warrant at the principal office of the Company or
its designated agent, together with a written assignment of this Warrant
substantially in the form attached hereto duly executed by the Holder or its
agent or attorney and funds sufficient to pay any transfer taxes payable upon
the making of such transfer. Upon such surrender and, if required,
such payment, the Company shall execute and deliver a new Warrant or Warrants in
the name of the assignee or assignees and in the denomination or denominations
specified in such instrument of assignment, and shall issue to the assignor a
new Warrant evidencing the portion of this Warrant not so assigned, and this
Warrant shall promptly be cancelled. A Warrant, if properly assigned,
may be exercised by a new holder for the purchase of Warrant Units without
having a new Warrant issued.
b) New Warrants. This
Warrant may be divided or combined with other Warrants upon presentation hereof
at the aforesaid office of the Company, together with a written notice
specifying the names and denominations in which new Warrants are to be issued,
signed by the Holder or its agent or attorney. Subject to compliance
with Section 4, as to any transfer which may be involved in such division or
combination, the Company shall execute and deliver a new Warrant or Warrants in
exchange for the Warrant or Warrants to be divided or combined in accordance
with such notice.
c) Warrant Register. The
Company shall register this Warrant, upon records to be maintained by the
Company for that purpose (the “Warrant Register”),
in the name of the record Holder hereof from time to time. The
Company may deem and treat the registered Holder of this Warrant as the absolute
owner hereof for the purpose of any exercise hereof or any distribution to the
Holder, and for all other purposes, absent actual notice to the
contrary.
6
d) Transfer
Restrictions. If, at the time of the surrender of this Warrant in connection with
any transfer of this Warrant, the transfer of this Warrant shall not be
registered pursuant to an effective registration statement under the Securities Act and under applicable state securities or blue sky laws, the
Company may require, as a condition of allowing such transfer, that (i) the
Holder or transferee of this Warrant, as the case may be, furnish to the Company
a written opinion of counsel which is
acceptable to the Company (and which opinion
shall be in form, substance and scope customary for opinions of counsel in
comparable transactions) to the effect that such transfer may be made
without registration under the Securities
Act and under applicable state securities or blue sky laws, and (ii) the Holder or transferee execute and deliver to the Company
an investment letter in form and substance acceptable to the Company, and (iii) the
transferee be an “accredited investor” as defined in
Rule 501(a)(1), (a)(2), (a)(3), (a)(7), or (a)(8) promulgated under the
Securities Act or a “qualified institutional buyer” as defined in
Rule 144A(a) promulgated under the Securities Act.
Section
5. Miscellaneous.
a) Registration
Rights. The Holder of this Warrant shall have unlimited piggy
back registration rights as provided in Section 5(b) and all other registration
rights for the shares of Common Stock underlying this Warrant as the investors
in the Financing have been granted as provided in that certain Registration
Rights Agreement executed by the Company on January 12, 2010 in connection with
the Financing.
b) If,
at any time, the Company proposes to register any of its securities under the
Securities Act for sale to the public for its own account or for the account of
other security holders (except with registration statements on Forms S-4 or S-8
or another form not available for registering securities for sale to the
public), each such time it will give written notice thereof to Holder of its
intention so to do (such notice to be given at least fifteen (15) days prior to
the filing thereof). Upon the written request of any such Holder
(which request shall specify the number of shares of Common Stock underlying the
Warrant Units intended to be disposed of by such Holder and the intended method
of disposition thereof), received by the Company within ten (10) days after
giving of any such notice by the Company, to register any of the shares of
Common Stock underlying such Holder’s Warrant Units, the Company will use its
reasonable efforts, to cause the shares of Common Stock underlying the Warrant
Units as to which registration shall have been so requested to be
included in the securities to be covered by the registration statement proposed
to be filed by the Company, all to the extent requisite to permit the sale or
other disposition by the Holder (in accordance with its written request) of such
shares of Common Stock so registered (“Piggyback Registration Rights”); provided, that if, at
any time after giving written notice of its intention to register any securities
pursuant to this Section 5(b) and prior to the effective date of the
Registration Statement filed in connection with such registration, the Company
shall determine for any reason not to register such securities, the Company
shall give written notice to all Holders and, thereupon, shall be relieved of
its obligation to register any Registrable Securities in connection with such
registration. If a registration pursuant to this Section 5(b)
involves an underwritten public offering, any Holder requesting to be included
in such registration may elect, in writing prior to the effective date of the
registration statement filed in connection with such registration, not to
register such securities in connection with such registration. The
foregoing provisions notwithstanding, the Company may withdraw any registration
statement referred to in this without thereby incurring any liability to the
Holders.
7
c) No Rights as Shareholder
Until Exercise. This Warrant does not entitle the Holder to
any voting rights or other rights as a shareholder of the Company prior to the
exercise hereof.
d) Loss, Theft, Destruction or
Mutilation of Warrant. The Company covenants that upon receipt by the
Company of evidence reasonably satisfactory to it of the loss, theft,
destruction or mutilation of this Warrant or any stock certificate relating to
the Warrant Units, and in case of loss, theft or destruction, of indemnity or
security reasonably satisfactory to it (which, in the case of the Warrant, shall
not include the posting of any bond), and upon surrender and cancellation of
such Warrant or stock certificate, if mutilated, the Company will make and
deliver a new Warrant or stock certificate of like tenor and dated as of such
cancellation, in lieu of such Warrant or stock certificate.
e) Saturdays, Sundays,
Holidays, etc. If the last or appointed day for the taking of
any action or the expiration of any right required or granted herein shall not
be a business day, then such action may be taken or such right may be exercised
on the next succeeding business day.
f) Authorized
Shares.
The
Company covenants that during the period the Warrant is outstanding, it will
reserve from its authorized and unissued Common Stock a sufficient number of
shares to provide for the issuance of the shares of Common Stock underlying this
Warrant upon the exercise of any purchase rights under this
Warrant. The Company further covenants that its issuance of this
Warrant shall constitute full authority to its officers who are charged with the
duty of executing stock certificates to execute and issue the necessary
certificates for the Warrant Units upon the exercise of the purchase rights
under this Warrant. The Company will take all such reasonable action
as may be necessary to assure that such Warrant Units may be issued as provided
herein without violation of any applicable law or regulation.
Except
and to the extent as waived or consented to by the Holder, the Company shall not
by any action, including, without limitation, amending its articles of
incorporation or through any reorganization, transfer of assets, consolidation,
merger, dissolution, issue or sale of securities or any other voluntary action,
avoid or seek to avoid the observance or performance of any of the terms of this
Warrant, but will at all times in good faith assist in the carrying out of all
such terms and in the taking of all such actions as may be necessary or
appropriate to protect the rights of Holder as set forth in this Warrant against
impairment. Without limiting the generality of the foregoing, the
Company will (a) not increase the par value of any Warrant Units above the
amount payable therefor upon such exercise immediately prior to such increase in
par value, (b) take all such action as may be necessary or appropriate in order
that the Company may validly and legally issue fully paid and nonassessable
Warrant Units upon the exercise of this Warrant, and (c) use commercially
reasonable efforts to obtain all such authorizations, exemptions or consents
from any public regulatory body having jurisdiction thereof as may be necessary
to enable the Company to perform its obligations under this
Warrant.
8
Before
taking any action which would result in an adjustment in the number of Warrant
Units for which this Warrant is exercisable or in the Exercise Price, the
Company shall obtain all such authorizations or exemptions thereof, or consents
thereto, as may be necessary from any public regulatory body or bodies having
jurisdiction thereof.
g) Jurisdiction. All
questions concerning the construction, validity, enforcement and interpretation
of this Warrant shall be determined in accordance with the provisions of the
Purchase Agreement.
h) Restrictions. The
Holder acknowledges that the Warrant Units acquired upon the exercise of this
Warrant, and securities underlying the Warrant Units, if not registered, will
have restrictions upon resale imposed by state and federal securities
laws.
i)
Notices. Any
notice, request or other document required or permitted to be given or delivered
to the Holder by the Company shall be delivered to the Holder in accordance with
the notice provisions of the Placement Agent Agreement.
j)
Limitation of
Liability. No provision hereof, in the absence of any
affirmative action by Holder to exercise this Warrant to purchase Warrant Units,
and no enumeration herein of the rights or privileges of Holder, shall give rise
to any liability of Holder for the purchase price of any Common Stock or as a
stockholder of the Company, whether such liability is asserted by the Company or
by creditors of the Company.
k) Successors and
Assigns. Subject to applicable securities laws, this Warrant
and the rights and obligations evidenced hereby shall inure to the benefit of
and be binding upon the successors of the Company and the successors and
permitted assigns of Holder. The provisions of this Warrant are
intended to be for the benefit of all Holders from time to time of this Warrant
and shall be enforceable by any such Holder or holder of Warrant
Units.
l)
Amendment. This
Warrant may be modified or amended or the provisions hereof waived with the
written consent of both the Company and the Holder.
m) Severability. Wherever
possible, each provision of this Warrant shall be interpreted in such manner as
to be effective and valid under applicable law, but if any provision of this
Warrant shall be prohibited by or invalid under applicable law, such provision
shall be ineffective to the extent of such prohibition or invalidity, without
invalidating the remainder of such provisions or the remaining provisions of
this Warrant.
9
n) Headings. The
headings used in this Warrant are for the convenience of reference only and
shall not, for any purpose, be deemed a part of this Warrant.
[SIGNATURE
PAGE FOLLOWS]
10
IN
WITNESS WHEREOF, the Company has caused this Warrant to be executed by its
officer thereunto duly authorized as of the date first above
indicated.
By:
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Name:
Xxxxx X. Xxxxxxxx
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Title: CEO
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11
NOTICE
OF EXERCISE
(1) The
undersigned hereby elects to purchase ________ Warrant Units of the Company
pursuant to the terms of the attached Warrant (only if exercised in full), and
tenders herewith payment of the exercise price in full, together with all
applicable transfer taxes, if any.
(2) Payment
shall take the form of (check applicable box):
o in lawful money of the
United States; or
o [if permitted] the
cancellation of such number of Warrant Units as is necessary, in accordance with
the formula set forth in subsection 2(b), to exercise this Warrant with respect
to the maximum number of Warrant Units purchasable pursuant to the cashless
exercise procedure set forth in subsection 2(b).
(3) Please
issue a certificate or certificates representing said Warrant Units in the name
of the undersigned or in such other name as is specified below:
______________________________________
The
Warrant Units shall be delivered to the following DWAC Account Number (if
permitted and if the Company is a participant in such system) or by physical
delivery of a certificate to:
_____________________________________
DWAC
Acct. #: _________________
_____________________________________
_____________________________________
(4) The undersigned agrees and
acknowledges that the undersigned is an “accredited investor” as defined in
Regulation D promulgated under the Securities Act of 1933, as
amended.
[SIGNATURE
OF HOLDER]
NAME OF
XXXXXX
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Signature
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Dated: ____________ ___,
_______
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Print
Name and Title (if applicable)
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ASSIGNMENT
FORM
(To
assign the foregoing warrant, execute
this form
and supply required information.
Do not
use this form to exercise the warrant.)
FOR VALUE
RECEIVED, ____ all of or _______ Units of the foregoing Warrant and all rights
evidenced thereby are hereby assigned to
__________________________________________
__________________________________________
__________________________________________
NAME OF
XXXXXX
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Signature
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Name
and Title (if applicable)
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Dated: ____________ ___,
_______
NOTE: The
signature to this Assignment Form must correspond with the name as it appears on
the face of the Warrant, without alteration or enlargement or any change
whatsoever, and must be guaranteed by a bank or trust
company. Officers of corporations and those acting in a fiduciary or
other representative capacity should file proper evidence of authority to assign
the foregoing Warrant.