Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: _______________________ Holder’s Address: _______________________

Appears in 4 contracts

Samples: Progressive Care Inc., Progressive Care Inc., Progressive Care Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: _______________________________ Holder’s Address: ________________________________

Appears in 4 contracts

Samples: Intelligent Bio Solutions Inc., Intelligent Bio Solutions Inc., Intelligent Bio Solutions Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing ~~Warrant~~Preferred Investment Option, execute this form and supply required information. Do not use this form to exercise the Preferred Investment Option to purchase shares.) FOR VALUE RECEIVED, the foregoing ~~Warrant~~ Preferred Investment Option and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :___________________________ Holder’s Address: :___________________________

Appears in 4 contracts

Samples: Microbot Medical Inc., Microbot Medical Inc., Microbot Medical Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature~~: __~~:_____________________ Holder’s Address: :_______________________

Appears in 4 contracts

Samples: InMed Pharmaceuticals Inc., InMed Pharmaceuticals Inc., InMed Pharmaceuticals Inc.

Appears in 3 contracts

Samples: NightFood Holdings, Inc., Hemispherx Biopharma Inc, Hemispherx Biopharma Inc

Accredited Investor. 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 Investing Entity: :__________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: :____________________________________________________ Name of Authorized Signatory: :______________________________________________________________________ Title of Authorized Signatory: :_______________________________________________________________________ Date: _______________________~~________________________________________________________________~~_ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: :_______________________ Holder’s Address: :________________________

Appears in 3 contracts

Samples: Smart for Life, Inc., Smart for Life, Inc., Smart for Life, Inc.

Accredited Investor. ~~The~~ If the Warrant is being exercised via cash exercise, 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 Investing Entity: ~~______________~~__________________________________________________________ Signature of Authorized Signatory of Investing Entity: ____________________________________~~____________~~_ Name of Authorized Signatory: ~~______________~~_____________________________________________________ Title of Authorized Signatory: _____________________________________________________~~______________~~_ Date: ~~___________________________________________________________~~_____________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: ~~_______________ __, ______~~ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 3 contracts

Samples: DPW Holdings, Inc., DPW Holdings, Inc., DPW Holdings, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing ~~Warrant~~Preferred Investment Option, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing ~~Warrant~~ Preferred Investment Option and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature~~: __~~:_____________________ Holder’s Address: :_______________________

Appears in 3 contracts

Samples: InMed Pharmaceuticals Inc., InMed Pharmaceuticals Inc., InMed Pharmaceuticals Inc.

Appears in 3 contracts

Samples: Digihost Technology Inc., Digihost Technology Inc., Hoth Therapeutics, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: ~~(Please Print)~~ Phone Number: Email Address: (Please Print) ______________________________________ ______________________________________ Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 3 contracts

Samples: Smith Micro Software, Inc, Smith Micro Software Inc, Smith Micro Software Inc

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ____________________________________________________________________________________~~___~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: ____~~:___________________ Holder’s Address: ___________________~~____~~

Appears in 3 contracts

Samples: Common Stock Purchase Warrant (Motus GI Holdings, Inc.), Common Stock Purchase Warrant (Reed's, Inc.), Motus GI Holdings, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: __~~:_____________________ Holder’s Address: :_______________________

Appears in 3 contracts

Samples: InMed Pharmaceuticals Inc., InMed Pharmaceuticals Inc., InMed Pharmaceuticals Inc.

Appears in 3 contracts

Samples: ReWalk Robotics Ltd., ReWalk Robotics Ltd., ReWalk Robotics Ltd.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :________________________ Holder’s Address: :_________________________

Appears in 3 contracts

Samples: Quest Solution, Inc., Creations Inc, Creations Inc

Accredited Investor. 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 Investing Entity: :___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: ____________________________________________________ Name of Authorized Signatory: ______________________________________________________________________ Title of Authorized Signatory: ______________________________________________________________________ Date: __________________________________________________________________~~_____________________~~_ ~~EXHIBIT B~~ EXHIBITS ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: ________,__ __ Holder’s Signature: ______~~_ __, ______ Holder’s Signature:~~ _______________________ Holder’s Address: ______________________________

Appears in 3 contracts

Samples: Posting Agreement (Wizard Entertainment, Inc.), Posting Agreement (Wizard Entertainment, Inc.), Posting Agreement (Wizard Entertainment, Inc.)

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase ~~shares~~Warrant Shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ______________~~________~~_ Holder’s Address: _______________~~________~~

Appears in 3 contracts

Samples: G Medical Innovations Holdings Ltd., G Medical Innovations Holdings Ltd., G Medical Innovations Holdings Ltd.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: :_________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) ~~Phone Number: Email Address:~~ Dated: _______________ , __, _________________________ Holder’s Signature: _______________________________ Holder’s Address: ________________________________

Appears in 3 contracts

Samples: Common Stock Purchase Warrant (Endexx Corp), Common Stock Purchase Warrant (Endexx Corp), Endexx Corp

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: __________________________________________________ Name of Authorized Signatory: ____________________________________________________________________ Title of Authorized Signatory: _____________________________________________________________________ Date: _________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) ~~Phone Number: Email Address:~~ Dated: _______________ __, ______ Holder’s Signature: ___________________________________________ Holder’s Address: ____________________________________________ EXHIBIT C WIRE TRANSFER INSTRUCTIONS For: Vycor Medical, Inc. 0000 Xxxxxxxx Xxx, Xxx 000 Boca Raton, FL 33487 Citibank, N.A. Boca Via Xxxxxx Boca Raton, FL 33432 Xxxxx: CitiUS33 ABA: 000000000 Account#: 9118592146 EIN#: 00-0000000

Appears in 3 contracts

Samples: Vycor Medical Inc, Vycor Medical Inc, Vycor Medical Inc

Accredited Investor. 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 Investing Entity: ______________________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: ________________________________________________________________ Name of Authorized Signatory: __________________________________________________________________________________ Title of Authorized Signatory: ___________________________________________________________________________________ Date: _______________________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to exercise the Warrant to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: _____________________~~__ Holder’s Address: _______________________~~

Appears in 2 contracts

Samples: eFFECTOR Therapeutics, Inc., eFFECTOR Therapeutics, Inc.

Accredited Investor. 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 Investing Entity: _______________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________________ Name of Authorized Signatory: ___________________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________________ Date: _______________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address: _~~______________________~~

Appears in 2 contracts

Samples: Securities Purchase Agreement (Biostage, Inc.), Biostage, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ________________~~______~~_ Holder’s Address: ___________________~~____~~

Appears in 2 contracts

Samples: Ensysce Biosciences, Inc., Ensysce Biosciences, Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 2 contracts

Samples: NextPlat Corp, CIPHERLOC Corp

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: __~~:_____________________ Holder’s Address: :_______________________

Appears in 2 contracts

Samples: Notice of Exercise (AYRO, Inc.), Lion Group Holding LTD

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: _~~:______________________ Holder’s Address: _______________________

Appears in 2 contracts

Samples: Taronis Fuels, Inc., Meridian Waste Solutions, Inc.

Accredited Investor. 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 Investing Entity: :________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: :__________________________________________________ Name of Authorized Signatory: :____________________________________________________________________ Title of Authorized Signatory: :_____________________________________________________________________ Date: ___________________________~~____________________________________________________________~~_ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: __~~:_____________________ Holder’s Address: _______________________

Appears in 2 contracts

Samples: Smart for Life, Inc., Smart for Life, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, _‚ ______ Holder’s Signature~~: ___~~:____________________ Holder’s Address: :_______________________

Appears in 2 contracts

Samples: Ensysce Biosciences, Inc., Ensysce Biosciences, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: _________________________ Holder’s Address: __________________________

Appears in 2 contracts

Samples: Lexaria Bioscience Corp., Lexaria Bioscience Corp.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: __________________ __, _________ Holder’s Signature: ~~___~~____________________ Holder’s Address: _______________________

Appears in 2 contracts

Samples: Hemispherx Biopharma Inc, Hemispherx Biopharma Inc

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: _______________________ Holder’s Address: _______________________

Appears in 2 contracts

Samples: Common Stock Purchase Warrant (Qualigen Therapeutics, Inc.), Akso Health Group

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 2 contracts

Samples: Guided Therapeutics Inc, Guided Therapeutics Inc

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: ___~~:____________________ Holder’s Address: :_______________________

Appears in 2 contracts

Samples: Bright Green Corp, Staffing 360 Solutions, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ ~~EXHIBIT B~~ ‌ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: Phone Number:Email Address: (Please Print~~) Phone Number: Email Address:~~ )____________________________________________________________________________ Dated: _______________ __, ______ Holder’s ~~Signature: _______________________~~ Signature: Holder’s ~~Address: _______________________~~Address:

Appears in 2 contracts

Samples: Agile Therapeutics Inc, Agile Therapeutics Inc

Appears in 2 contracts

Samples: Pure Bioscience, Inc., Pure Bioscience, Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: . _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: __________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, ~~the~~ he foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: ________________ ____, ______ Holder’s Signature: __________________________ Holder’s Address: ____________________~~___~~

Appears in 2 contracts

Samples: Sigyn Therapeutics, Inc., Sigyn Therapeutics, Inc.

Appears in 2 contracts

Samples: iFresh Inc, Synthesis Energy Systems Inc

Appears in 2 contracts

Samples: ReWalk Robotics Ltd., ReWalk Robotics Ltd.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :____________________________ Holder’s Address: _____________________________

Appears in 2 contracts

Samples: Vivos Therapeutics, Inc., Vivos Therapeutics, Inc.

Accredited Investor. 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 Investing Entity: _________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: ___________________________________________________ Name of Authorized Signatory: _____________________________________________________________________ Title of Authorized Signatory: ______________________________________________________________________ Date: _________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to exercise the Warrant to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 2 contracts

Samples: Longeveron Inc., Cancer Genetics, Inc

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: _________________________~~______________________________________________________________~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to to: Name: _______________________________ (Please Print) Address: _______________________________ (Please Print) ~~Phone Number: Email Address:~~ Dated: _______________ __, ______ Holder’s Signature: _______________________________ Holder’s Address: _______________________________ The Assignee agrees to be bound by the terms of the Warrant. Signature: _______________________________ Witness: _______________________________

Appears in 2 contracts

Samples: Dynaresource Inc, Dynaresource Inc

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: ___________________ __, ______ Holder’s Signature: _________________________ Holder’s Address: __________________________

Appears in 2 contracts

Samples: enVVeno Medical Corp, enVVeno Medical Corp

Accredited Investor. 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 Investing Entity:~~ _____________________________________ [SIGNATURE OF HOLDER] Name of Investing Entity: _________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________~~_______________________________________________________________~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: _______________________ Holder’s Address: ________________________

Appears in 2 contracts

Samples: Creatd, Inc., Creatd, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: ~~(Please Print)~~ Phone Number: Email Address: (Please Print) ______________________________________ ______________________________________ Dated: _______________ __, ______ Holder’s Signature~~: _______________________ Holder’s Address: _______________________~~:

Appears in 2 contracts

Samples: JanOne Inc., JanOne Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: ____~~:___________________ Holder’s Address: :____________________~~___~~

Appears in 2 contracts

Samples: AYRO, Inc., Iveda Solutions, Inc.

Appears in 2 contracts

Samples: Citius Pharmaceuticals, Inc., Vinco Ventures, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :_______________________ Holder’s Address: :________________________

Appears in 2 contracts

Samples: Creatd, Inc., Hancock Jaffe Laboratories, Inc.

Accredited Investor. 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 Investing Entity: __________________________________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: ____________________________________________________________________________ Name of Authorized Signatory: ______________________________________________________________________________________________ Title of Authorized Signatory: _______________________________________________________________________________________________ Date: __________________________________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) ~~Phone Number: Email Address:~~ Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 2 contracts

Samples: Ceres, Inc., Ceres, Inc.

Accredited Investor. 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 Investing Entity: ______________________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: ________________________________________________________________ Name of Authorized Signatory: __________________________________________________________________________________ Title of Authorized Signatory: ___________________________________________________________________________________ Date: _______________________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to exercise the Warrant to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: __________________~~_____ Holder’s Address: _______________________~~

Appears in 2 contracts

Samples: eFFECTOR Therapeutics, Inc., eFFECTOR Therapeutics, Inc.

Appears in 2 contracts

Samples: Notice of Exercise (Iconic Brands, Inc.), Uppercut Brands, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: ___________________~~___~~_ Holder’s Address: ____________________~~___~~

Appears in 2 contracts

Samples: Rennova Health, Inc., Rennova Health, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ____________________________________________ (Please Print) Address: ____________________________________________ (Please Print) Phone Number: ____________________________________________ Email Address: ____________________________________________ Dated: _______________ __, ______ Holder’s Signature: _______________________ Holder’s Address: _______________________

Appears in 2 contracts

Samples: Securities Purchase Agreement (Microbot Medical Inc.), Securities Purchase Agreement (Microbot Medical Inc.)

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: __________________ __, _________ Holder’s Signature: ______________________________ Holder’s Address: _______________________________

Appears in 2 contracts

Samples: Common Stock Purchase Warrant (NetBrands Corp.), Global Diversified Marketing Group Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: _____________________________________________________________~~__________________________~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: ~~(Please Print)~~ Phone Number: Email Address: ~~Dated:~~ (Please Print) _______________ _~~_, ______ Holder’s Signature:~~ _______________________ ~~Holder’s Address:~~ ______________________________________ Dated: _______________ ________, ______ Holder’s Signature:

Appears in 2 contracts

Samples: Context Therapeutics Inc., Context Therapeutics Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: Phone Number: (Please Print) ~~Phone Number:~~ Email Address: Dated: :_______________ _______, _____________ Holder’s Signature: ________________________________ Holder’s Address: _________________________________

Appears in 2 contracts

Samples: Common Stock Purchase Warrant (Marizyme Inc), Common Stock Purchase Warrant (Marizyme Inc)

Accredited Investor. 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 Investing Entity~~The Warrant Shares shall be delivered to the following DWAC Account Number: _______________________________ _______________________________ _______________________________ [SIGNATURE OF HOLDER] Name of Investing Entity: __________________________________________________ Signature of Authorized Signatory of Investing Entity: __________________________~~______________________~~_ Name of Authorized Signatory: ~~______________________~~_____________________________________________ Title of Authorized Signatory: _____________________________________________~~______________________~~_ Date: ~~________________________________________________________________________________________ EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to ~~purchase shares~~exercise the Warrant.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 2 contracts

Samples: Hanmi Pharmaceutical Co., Ltd., Aptose Biosciences Inc.

Appears in 2 contracts

Samples: Bright Green Corp, Rennova Health, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: __~~:_____________________ Holder’s Address: :_____________________________

Appears in 2 contracts

Samples: NightFood Holdings, Inc., NightFood Holdings, Inc.

Accredited Investor. 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 Investing Entity: ~~________________~~________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________~~_______________~~_ Name of Authorized Signatory: ___________________________________________________~~_______________~~_ Title of Authorized Signatory: ~~_______________~~_____________________________________________________ Date: ________________________________________________________________________~~_______________~~_ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: _________________~~_____~~_ Holder’s Address: __________________~~_____~~

Appears in 2 contracts

Samples: Amyris, Inc., Amyris, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: __________________________________________________ Name of Authorized Signatory: ____________________________________________________________________ Title of Authorized Signatory: _____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing ~~Warrant~~Preferred Investment Option, execute this form and supply required information. Do not use this form to exercise the Preferred Investment Option to purchase shares.) FOR VALUE RECEIVED, the foregoing ~~Warrant~~ Preferred Investment Option and all rights evidenced thereby are hereby assigned to Name: ________________________________________________ (Please Print) Address: ________________________________________________ (Please Print) Phone Number: ________________________________________________ Email Address: ________________________________________________ Dated: _______________ __, ______ Holder’s Signature: __________________________ Holder’s Address: ___________________________

Appears in 2 contracts

Samples: Microbot Medical Inc., Microbot Medical Inc.

Appears in 2 contracts

Samples: Neuralstem, Inc., Neuralstem, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :_____________________________ Holder’s Address: _____________________________

Appears in 2 contracts

Samples: Propanc Biopharma, Inc., Propanc Biopharma, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ________________________________ (Please Print) Address: ________________________________ (Please Print) ______________________________________ Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: ________________________ Holder’s Address: __________________________

Appears in 2 contracts

Samples: Genius Brands International, Inc., Genius Brands International, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address: ~~_______________________~~[Please add acknowledgment by transference of its obligations and that it has received a copy of the relevant Transaction Documents.]

Appears in 2 contracts

Samples: SOBR Safe, Inc., SOBR Safe, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase ~~shares~~Warrant ADSs.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :___________________ Holder’s Address:______________________~~_ Holder’s Address: _______________________~~

Appears in 2 contracts

Samples: Genetic Technologies LTD, Genetic Technologies LTD

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: __________________________________________________ Name of Authorized Signatory: ____________________________________________________________________ Title of Authorized Signatory: _____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to exercise the Warrant to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __~~, _~~,_____ Holder’s Signature: __________________________ Holder’s Address: ___________________________

Appears in 2 contracts

Samples: Longeveron Inc., Longeveron Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: _________________________ Holder’s Address: :__________________________

Appears in 2 contracts

Samples: Smart for Life, Inc., Smart for Life, Inc.

Accredited Investor. 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 Investing Entity: ~~___________~~_____________________________________________________________ Signature of Authorized Signatory of Investing Entity: ______________________________________~~__________~~_ Name of Authorized Signatory: ________________________________________________________~~__________~~_ Title of Authorized Signatory: ~~__________~~__________________________________________________________ Date: ____________________________________________________________________________~~___________~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: __________________________________ (Please Print) Address: __________________________________ (Please Print) ~~Phone Number: Email Address:~~ Dated: _______________ __, ______ Holder’s Signature: :_____________________________ Holder’s Address: :______________________________

Appears in 2 contracts

Samples: Agent Warrant (NXT-Id, Inc.), NXT-Id, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________________ (Please Print) Address: ~~(Please Print)~~ ______________________________________________ Phone Number: Email Address: (Please Print) ______________________________________ ______________________________________ Dated: _______________ __, ______ Holder’s Signature: _______________________________ Holder’s Address: :_______________________________

Appears in 1 contract

Samples: Brain Scientific Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: ______________~~_ __, ______ Holder’s Signature:~~ ___________ ________, ____________ Holder’s Signature: Holder’s Address~~: _______________________~~:

Appears in 1 contract

Samples: TFF Pharmaceuticals, Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: __________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: _______________________ Holder’s Address: _______________________

Appears in 1 contract

Samples: Creatd, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ____________________________________________ (Please Print) Address: ____________________________________________ (Please Print) Phone Number: ____________________________________________ Email Address: ____________________________________________ Dated: _______________ __, ______ Holder’s Signature~~: _______________________ Holder’s Address:~~ :______________________________

Appears in 1 contract

Samples: Novus Therapeutics, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s 's Signature: _______________________ Holder’s 's Address: _______________________

Appears in 1 contract

Samples: Volcon, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B A ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ___________________________ Holder’s Address: ____________________________

Appears in 1 contract

Samples: Palisade Bio, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: __________________________________________________ Name of Authorized Signatory: ____________________________________________________________________ Title of Authorized Signatory: _____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ___________________________ Holder’s Address: ____________________________

Appears in 1 contract

Samples: Biofrontera Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) ~~Phone Number: Email Address:~~ Dated: _______________ __, ______ Holder’s Signature: ___________________________ Holder’s Address: ____________________________

Appears in 1 contract

Samples: Oroplata Resources, Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing ~~Warrant~~Preferred Investment Option, execute this form and supply required information. Do not use this form to exercise the Preferred Investment Option to purchase shares.) FOR VALUE RECEIVED, the foregoing ~~Warrant~~ Preferred Investment Option and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :_______________________ Holder’s Address: :________________________

Appears in 1 contract

Samples: Microbot Medical Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ________________ Holder’s Signature: :_________________________ Holder’s Address: :__________________________

Appears in 1 contract

Samples: Connexa Sports Technologies Inc.

Accredited Investor. 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 Investing Entity: ____________________________________________________________________ _____ Signature of Authorized Signatory of Investing Entity: _______________________________________________ ___ Name of Authorized Signatory: __________________________________________________________ __________ Title of Authorized Signatory: __________________________________________________________ ___________ Date: ____________________________________________________________________________ _____________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 1 contract

Samples: China Ceramics Co., LTD

Accredited Investor. 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 Investing Entity: ~~____~~____________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________~~___~~_ Name of Authorized Signatory: _______________________________________________________________~~___~~_ Title of Authorized Signatory: ~~___~~_________________________________________________________________ Date: ____________________________________________________________________________________~~___~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: Phone Number: Email Address: (Please Print) )____________________________________________________________________________ Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: _______________________ Holder’s Address:~~ :_______________________

Appears in 1 contract

Samples: Energy Focus, Inc/De

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ 0351000012585192 EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) ~~Phone Number: Email Address:~~ Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address: ~~_______________________~~0351000012585192

Appears in 1 contract

Samples: Oxis International Inc

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to exercise the Warrant to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________________ (Please Print) Address: ______________________________________________ (Please Print) Phone Number: ______________________________________________ Email Address: ______________________________________________ Dated: _______________ __, ______ Holder’s Signature: :___________________________ Holder’s Address: :____________________________

Appears in 1 contract

Samples: Aridis Pharmaceuticals, Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ _________, ________ Holder’s Signature: _____________________________ Holder’s Address: ______________________________

Appears in 1 contract

Samples: Lion Group Holding LTD

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :________________________ Holder’s Address: :_________________________

Appears in 1 contract

Samples: Freight Technologies, Inc.

Appears in 1 contract

Samples: Propanc Biopharma, Inc.

Accredited Investor. 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 Investing Entity: ~~______________~~__________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________~~___~~_ Name of Authorized Signatory: _________________________________________________________~~_________~~_ Title of Authorized Signatory: ~~__________~~__________________________________________________________ Date: ________________________________________________________________~~_______________________~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: _______________________________________________ (Please Print) Address: _______________________________________________ (Please Print) Phone Number: _______________________________________________ Email Address: _______________________________________________ Dated: _______________ __, ______ Holder’s Signature: __________________________ Holder’s Address: _______________________________

Appears in 1 contract

Samples: SOS LTD

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ____________________________ (Please Print) Address: ____________________________ (Please Print) ~~Phone Number: Email Address:~~ Dated: _______________ __, ______ Holder’s Signature: _________________~~_____~~_ Holder’s Address: __________________~~_____~~

Appears in 1 contract

Samples: Novelos Therapeutics, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: __________________________________________________ Name of Authorized Signatory: ____________________________________________________________________ Title of Authorized Signatory: _____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ______________________________________ Holder’s Address: _______________________________________

Appears in 1 contract

Samples: Northwest Biotherapeutics Inc

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: _______________________________________________ (Please Print) Address~~: (Please Print) Phone Number: Email Address: Dated~~: _______________________________________________ (Please Print) Phone Number: _______________________________________________ Email Address: _______________________________________________ Dated: ____________, _______ , Holder’s Signature: _______________________ Holder’s Address: ________________________

Appears in 1 contract

Samples: Soluna Holdings, Inc

Accredited Investor. 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 Investing Entity: ~~_______________~~_________________________________________________________ Signature of Authorized Signatory of Investing Entity: __________________________________~~______________~~_ {2723477.DOCX;} 1 Name of Authorized Signatory: ~~_________~~__________________________________________________________ Title of Authorized Signatory: ~~_________~~___________________________________________________________ Date: ______________________________________________________________________________~~_________~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: ~~(Please Print)~~ Phone Number: Email Address: (Please Print) ______________________________________ ______________________________________ Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 1 contract

Samples: Arcadia Biosciences, Inc.

Accredited Investor. 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 Investing Entity: ~~_______~~_________________________________________________________________ Signature of Authorized Signatory of Investing Entity: __________________________________________~~______~~_ Name of Authorized Signatory: ____________________________________________________________~~______~~_ Title of Authorized Signatory: ~~______~~______________________________________________________________ Date: _________________________________________________________________________________~~______~~_ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: ~~(Please Print)~~ Phone Number: Email Address: (Please Print) ______________________________________ ______________________________________ Dated: _______________ __, ______ Holder’s Signature: ~~_______________________~~ Holder’s Address~~: _______________________~~:

Appears in 1 contract

Samples: Arcadia Biosciences, Inc.

Accredited Investor. 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 Investing Entity: :_______________________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: :_________________________________________________________________ Name of Authorized Signatory: :___________________________________________________________________________________ Title of Authorized Signatory: :____________________________________________________________________________________ Date: :________________________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: , Holder’s Signature:____________~~___ __, ______ Holder’s Signature:~~ _______________________ Holder’s Address: :_____________________________________

Appears in 1 contract

Samples: Very Good Food Co Inc.

Accredited Investor. 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 Investing Entity: :__________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: :____________________________________________________ Name of Authorized Signatory: :______________________________________________________________________ Title of Authorized Signatory: :_______________________________________________________________________ Date: :__________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: :________________ __, _______ Holder’s Signature~~: _~~:______________________ Holder’s Address: :_______________________

Appears in 1 contract

Samples: Sigyn Therapeutics, Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase ~~shares~~Warrant ADSs.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: ______________________________________ (Please Print) Address: ______________________________________ (Please Print) Phone Number: ______________________________________ Email Address: ______________________________________ Dated: _______________ __, ______ Holder’s Signature: _____________________________ Holder’s Address: ______________________________

Appears in 1 contract

Samples: TC BioPharm (Holdings) PLC

Accredited Investor. The undersigned certifies that it is an “accredited investor” as defined in Regulation D promulgated under the Securities Act of 1933, as amended. [SIGNATURE OF HOLDER] Name of Investing Entity: :_________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: :___________________________________________________ Name of Authorized Signatory: :_____________________________________________________________________ Title of Authorized Signatory: :______________________________________________________________________ Date: :_________________________________________________________________________________________ ~~EXHIBIT B~~ ASSIGNMENT FORM (To assign the foregoing ~~Warrant~~warrant, execute this form and supply required information. Do not use this form to ~~purchase shares~~exercise the warrant.) FOR VALUE RECEIVED, _________ shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to ~~Name: (Please Print) Address: (Please Print) Phone Number: Email Address:~~ _________________________________whose address is ____________________________________________________________________________________________________________________________. Dated: _______________ , __, ______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________

Appears in 1 contract

Samples: Common Stock Purchase Warrant (Omnireliant Holdings, Inc.)

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B A ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature~~: _~~:______________________ Holder’s Address: :________________________

Appears in 1 contract

Samples: Palisade Bio, Inc.

Accredited Investor. 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 Investing Entity~~: _____~~:___________________________________________________________________ Signature of Authorized Signatory of Investing Entity~~: __~~:_______________________________________________ Name of Authorized Signatory~~: __~~:_________________________________________________________________ Title of Authorized Signatory~~: _~~:___________________________________________________________________ Date~~: _~~:_______________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :________________________________ Holder’s Address: :_________________________________

Appears in 1 contract

Samples: ZyVersa Therapeutics, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing ~~Warrant~~Preferred Investment Option, execute this form and supply required information. Do not use this form to exercise the Preferred Investment Option to purchase shares.) FOR VALUE RECEIVED, the foregoing ~~Warrant~~ Preferred Investment Option and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :________________________ Holder’s Address: ________________________

Appears in 1 contract

Samples: Microbot Medical Inc.

Accredited Investor. 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 Investing Entity: __________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: ____________________________________________________ Name of Authorized Signatory: ______________________________________________________________________ Title of Authorized Signatory: _______________________________________________________________________ Date: __________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: ______________________________ Holder’s Address: _______________________________

Appears in 1 contract

Samples: Movano Inc.

Accredited Investor. 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 Investing Entity: ___________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _____________________________________________________ Name of Authorized Signatory: _______________________________________________________________________ Title of Authorized Signatory: ________________________________________________________________________ Date: ___________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Class A Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Class A Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: ____________ ____ _, __, ________ Holder’s Signature~~: _~~:______________________ Holder’s Address: :_______________________

Appears in 1 contract

Samples: Hemispherx Biopharma Inc

Accredited Investor. The undersigned represents and warrants that it is an “accredited investor” as defined in Regulation D promulgated under the Securities Act of 1933, as amended. [SIGNATURE OF HOLDER] Name of Investing Entity: ~~________________________________________________________________________~~ Signature of Authorized Signatory of Investing Entity: ~~_________________________________________________~~ Name of Authorized Signatory~~: _____________________________~~:______________________________________ Title of Authorized Signatory: ~~______~~______________________________________________________________ Date: _________________________________________________________________________________~~______~~_ ~~EXHIBIT~~ ANNEX B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: Phone Number:Email Address: (Please Print~~) Phone Number: Email Address:~~ )__________________________________________________________________________ Dated: _______________ __, ______ Holder’s Signature~~: __~~:_____________________ Holder’s Address: :_______________________

Appears in 1 contract

Samples: Oblong, Inc.

Accredited Investor. 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 Investing Entity: ________________________________________________________________________ Signature of Authorized Signatory of Investing Entity: _________________________________________________ Name of Authorized Signatory: ___________________________________________________________________ Title of Authorized Signatory: ____________________________________________________________________ Date: ________________________________________________________________________________________ EXHIBIT B ASSIGNMENT FORM (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.) FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: (Please Print) Phone Number: Email Address: Dated: _______________ __, ______ Holder’s Signature: :_________________________________ Holder’s Address: :_________________________________

Appears in 1 contract

Samples: Synthesis Energy Systems Inc

Common use of Accredited Investor Clause in Contracts