COMMON STOCK PURCHASE WARRANT To Purchase [________] Shares of Common Stock of WIZE PHARMA, INC.Wize Pharma, Inc. • February 6th, 2018 • Pharmaceutical preparations • Delaware
THIS COMMON STOCKPURCHASE WARRANT (this “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 or from time to time on or after the date of issuance of this Warrant (such date, the “Initial Exercise Date”) and on or prior to 5:00 p.m., New York time, on November 16, 2020 (the “Expiration Date”) but not thereafter, to subscribe for and purchase from Wize Pharma, Inc., a Delaware corporation (the “Company”), up to [___________] (the “Warrant Shares”) shares of Common Stock, par value $ 0.001 per share, of the Company (the “Common Stock”). The purchase price of one Warrant Share (the “Exercise Price”) under this Warrant shall be $0.082, subject to adjustment hereunder. The Exercise Price and the number of Warrant Shares for which the Warrant is exercisable shall be subject to adjustment as provided herein.
