ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 11 contracts
Samples: Senior Secured Note Purchase Agreement (Novation Companies, Inc.), Guerrilla RF, Inc., CNS Pharmaceuticals, Inc.
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: _____________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 5 contracts
Samples: Common Stock Purchase Warrant (Mechanical Technology Inc), Common Stock Purchase Agreement (Valicert Inc), Common Stock and Warrants Purchase Agreement (Focus Enhancements Inc)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 2 contracts
Samples: HyperSpace Communications, Inc., HyperSpace Communications, Inc.
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _________________. Dated: ______________, _______ Holder's Signature: _________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s 's Address: _________________________________ _________________________________ Signature Guaranteed: ___________________________________________
Appears in 2 contracts
Samples: MAGELLAN GOLD Corp, MAGELLAN GOLD Corp
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 2 contracts
Samples: LabStyle Innovations Corp., Celsion CORP
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) AVALANCHE INTERNATIONAL CORP. FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 2 contracts
Samples: Common Stock Purchase Warrant (Digital Power Corp), Common Stock Purchase Warrant (Digital Power Corp)
ASSIGNMENT FORM. (To assign the foregoing warrantWarrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [_______] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to Name: (Please Print) Address: Phone Number: Email Address: (Please Print) _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ ______________________________________ Signature GuaranteedDated: _______________ __, ______________________________ Holder’s Signature: Holder’s Address:
Appears in 2 contracts
Samples: Common Stock Purchase Warrant (Ascent Solar Technologies, Inc.), Ascent Solar Technologies, Inc.
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) MABVAX THERAPEUTICS HOLDINGS, INC. FOR VALUE RECEIVED, [[ _____ ] all of or [[ ________ ] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: __________________________________ Holder’s Address: __________________________________ __________________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Common Stock Purchase Warrant (Mabvax Therapeutics Holdings, Inc.)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to whose address is _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ____________________________________________ Dated: , Holder’s Signature: Holder’s Address: Signature Guaranteed:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) Moveaction Co., Ltd. FOR VALUE RECEIVED, [____[ ] all of or [_______[ ] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ _whose address is ____________________________________________________________________. Dated:_______________________________________________________________ Dated: ______________, __________ Holder’s Signature: ___________________________________ Holder’s Address: _____________________________ _____________________________ Signature GuaranteedSigned in the presence of: ___________________________________________
Appears in 1 contract
Samples: HeartCore Enterprises, Inc.
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to ______________________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ . Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Nuvel Holdings, Inc.
ASSIGNMENT FORM. (To assign the foregoing warrantWarrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Common Stock Purchase Warrant (Troika Media Group, Inc.)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrantWarrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Common Stock Purchase Warrant (Forward Industries Inc)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: :_____________________________ Holder’s Address: :_____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: :_____________________________ Holder’s Address: :_____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is ________________________________________________________________. ________________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: _________________________________ Holder’s 's Address: _________________________________ _________________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Nhancement Technologies Inc
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) TEGO CYBER INC. FOR VALUE RECEIVED, [______] all of or [_____________] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________. Dated: ________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _______________________________ Holder’s Address: _______________________________ _______________________________ _______________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Tego Cyber, Inc.
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _________________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________:
Appears in 1 contract
Samples: Note and Warrant Purchase Agreement (Geospatial Corp)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: _______________________________ Holder’s 's Address: _______________________________ _______________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Common Stock and Warrants Purchase Agreement (Focus Enhancements Inc)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Common Stock Purchase Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is to: Name: _______________________________________________________________. _____ Address: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Dated: ______________, _______ Holder’s SignatureBy: _____________________________ Holder’s AddressName: _____________________________ _____________________________ Title: (Signature must conform in all respects to the name of the holder as specified on the face of the Warrant) Signature Guaranteed: ___________________________________________:
Appears in 1 contract
Samples: Common Stock Purchase Warrant (SQL Technologies Corp.)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ . Dated: ______________, _______ Holder’s 's Signature: _____________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Stemcells Inc
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: :_____________________________ Holder’s 's Address: :_____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Stemcells Inc
ASSIGNMENT FORM. (To assign the foregoing warrant, execute executed this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _ _______________________________________________________________ . Dated: ______________, _______ Holder’s 's Signature: _____________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrantpurchase shares.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to ______________________________________________________________ whose address is ______________________________________________________________________________. ______________________________________________________________________________ Dated: ______________, _______ 199 Holder’s 's Signature: _____________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Sciclone Pharmaceuticals Inc
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. __ ______________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: ___:__________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Stemcells Inc
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to to: ___________________________________________________ whose address is _______________________________________________________________. ___ __________________________________________________________________ Dated: ____________________, _______ Holder’s 's Signature: _____________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Marketing Worldwide Corp
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to ___________________________________________________________ whose address is _____________________________________________________________________________. _____________________________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: _____________________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ______________________________________________________
Appears in 1 contract
Samples: Vasogen Inc
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is ___________________________________________________________________________. ___________________________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Underwriting Agreement (Torchlight Energy Resources Inc)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to to: whose address is: . Dated: , Holder’s Signature _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: _______________________________________ _______________________________________ Signature Guaranteed:
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) SIMPLICITY ESPORTS AND GAMING COMPANY FOR VALUE RECEIVED, [_____________] all of or [_________________] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ _______whose address is ______________________________________________________________________. Dated:_______________________________________________________________ Dated: ______________, _______ Holder’s Signature: __________________,___________ Holder’s Signature: Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: SIMPLICITY ESPORTS & GAMING Co
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: _____________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: DARA BioSciences, Inc.
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) T2 BIOSYSTEMS, INC. FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: :_____________________________ Holder’s Address: :_____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: T2 Biosystems, Inc.
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Series A Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ , whose address is is: _______________________________________________________________. __ ______________________________________________________________ Dated: ______________, ______, 20__ Holder’s Xxxxxx's Signature: _____________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ______________________________________________
Appears in 1 contract
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s Signature: _____________________________ Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________:
Appears in 1 contract
Samples: Posting Agreement (XTI Aircraft Co)
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrant.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is ________________________________________________________________. ________________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: ____________________________________ Holder’s 's Address: ____________________________________ ____________________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Ion Networks Inc
ASSIGNMENT FORM. (To assign the foregoing warrant, execute this form and supply required information. Do not use this form to exercise the warrantpurchase shares.) FOR VALUE RECEIVED, [____] all of or [_______] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ whose address is _______________________________________________________________. ______________________________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: _____________________________ Holder’s 's Address: :_____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Samples: Sgi International
