FORM OF WARRANT TO PURCHASE SHARESCNS Response, Inc. • March 1st, 2011 • Services-misc health & allied services, nec • California
Company FiledMarch 1st, 2011 Industry JurisdictionThis Warrant is issued to [__________] (“Holder”) by CNS Response, Inc., a Delaware corporation (the “Company”), in connection with the contemporaneous issuance to the Holder of a Note in the aggregate principal amount of $[__________] (the “Note”). All capitalized terms not defined in this Warrant shall have the meaning ascribed to them in the Note.
NOTE AND WARRANT PURCHASE AGREEMENTNote and Warrant Purchase Agreement • March 1st, 2011 • CNS Response, Inc. • Services-misc health & allied services, nec • California
Contract Type FiledMarch 1st, 2011 Company Industry JurisdictionTHIS NOTE AND WARRANT PURCHASE AGREEMENT (this “Agreement”) is made as of January 20, 2011 by and between CNS Response, Inc., a Delaware corporation (the “Company”), and the investors listed on Schedule A hereto (each, an “Investor” and together, the “Investors”).