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 6 contracts
Sources: Warrant Agreement (Guerrilla RF, Inc.), Security Agreement (Digital Power Corp), Security Agreement (Cerebain Biotech 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 4 contracts
Sources: Common Stock Purchase Agreement (Valicert Inc), Common Stock and Warrants Purchase Agreement (Focus Enhancements Inc), Warrant Agreement (Ives Health Co 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
Sources: Security Agreement (Digital Power Corp), Securities Transfer Agreement (Digital Power 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 [_______] ______ 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
Sources: Common Stock Purchase Warrant (Synergy CHC Corp.), Common Stock Purchase Warrant (Synergy CHC 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
Sources: Common Stock Purchase Warrant (HyperSpace Communications, Inc.), Common Stock Purchase Warrant (HyperSpace Communications, 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 warrant.) FOR VALUE RECEIVED, [____] all of or [_______] ______ 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
Sources: Security Agreement (60 Degrees 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 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
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: ________________________________. _______________________________________________________________ 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
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
Sources: Common Stock Purchase Warrant (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 Signature: __________________________________ Holder’s Address: __________________________________ __________________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Sources: Securities Agreement (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 _______________________________________________________________. _______________________________________________________________ Dated: ______________, _______ Holder’s 's Signature: _______________________________ Holder’s 's Address: _______________________________ _______________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Sources: 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 '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
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
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
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: ___________________________________________, ________ Holder’s Address: Signed in the presence of: _______________________________
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
Sources: Stock Purchase Warrant (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.) 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
Sources: Secured Promissory Note Amendment (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:_______________________________________________________________ Dated: ______________, _______ Holder’s Signature: __________________,___________ Holder’s Signature: Holder’s Address: _____________________________ _____________________________ Signature Guaranteed: ___________________________________________
Appears in 1 contract
Sources: Security Agreement (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 Series A Warrant and all rights evidenced thereby are hereby assigned to _______________________________________________ , whose address is is: _______________________________________________________________. __ ______________________________________________________________ Dated: ______________, ______, 20__ Holder’s ▇▇▇▇▇▇'s Signature: _____________________________ Holder’s 's Address: _____________________________ _____________________________ Signature Guaranteed: ______________________________________________
Appears in 1 contract
Sources: Security Agreement (Pokertek, 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
Sources: Warrant Agreement (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 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:_______________________________________________________________ Dated: ______________, __________ Holder’s Signature: ___________________________________ Holder’s Address: _____________________________ _____________________________ Signature GuaranteedSigned in the presence of: ___________________________________________
Appears in 1 contract