FORM CONVERTIBLE NOTE Maturity Date: 12 Months from Note closing dateCytosorbents Corp • June 27th, 2013 • Surgical & medical instruments & apparatus
Company FiledJune 27th, 2013 IndustryFOR VALUE RECEIVED, the undersigned CytoSorbents Corporation (the “Company”), promises to pay in equity as set forth below on or before June 21, 2014, to_________________________ (“Creditor"), at New York, NY the principal sum of ____________ ($0.00) (the “Principal”), together with interest accruing thereon at the rate of 8% per annum, payable on or before maturity of the Note. This Note together with any Warrants issued hereunder shall be defined as the Securities (the “Securities”).