Common use of Assignment of Warrant Clause in Contracts

Assignment of Warrant. FOR VALUE RECEIVED, _______________________ hereby sells, assigns and transfers unto _____________________________ the Warrant, dated October 17, 2017 (the “Warrant”) and the rights represented thereby, and does hereby irrevocably constitute and appoint _______________________________ Attorney, to transfer said Warrant on the books of AmeriCann, Inc., with full power of substitution. Dated: Signed: APPENDIX B WARRANT EXERCISE FORM To AmeriCann, Inc.: The undersigned hereby irrevocably elects to exercise the right of purchase represented by the Warrant, dated October 17, 2017 (the “Warrant”), for, and to purchase thereunder by the payment of the Exercise Price (as defined in the Warrant) and surrender of the Warrant, ___________ shares of common stock, par value $0.0001 (“Warrant Shares”), of AmeriCann, Inc. provided for therein. The undersigned requests that the Warrant Shares be issued in book-entry form by the Company’s transfer agent as follows: Name Address Federal Tax ID or Social Security No. and, if the number of Warrant Shares shall not be all the Warrant Shares purchasable upon exercise of the Warrant, that a new Warrant in substantially identical form (other than the number of Warrant Shares) for the balance of the Warrant Shares purchasable upon exercise of this Warrant be registered in the name set forth below indicated and delivered to the address stated below. Name (please print) Address Federal Identification or Social Security No. Dated: ___________________, ____ Signature: ______________________________

Appears in 2 contracts

Samples: AmeriCann, Inc., AmeriCann, Inc.

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Assignment of Warrant. FOR VALUE RECEIVEDThis Warrant may not be assigned by the Holder without the expressed written consent of the Corporation. In the event a transfer is requested not pursuant to an effective registration statement under the Securities Act, the transferring Holder will, if reasonably requested by the Corporation, deliver to the Corporation an opinion of counsel, satisfactory in form and substance to the Corporation, that such transfer is being made in accordance with an exemption from registration under the Securities Act; and provided further that any request for transfer be accompanied by a written instrument of transfer in form reasonably acceptable to the Corporation. Dated: December 13, 2002 LITHIUM TECHNOLOGY CORPORATION By:_______________________ hereby sells, assigns and transfers unto _____________________________ the Warrant, dated October 17, 2017 (the “Warrant”) and the rights represented thereby, and does hereby irrevocably constitute and appoint _______________________________ AttorneyXxxxx Xxxx, Chairman and Chief Executive Officer [Form of Subscription] (To be Exercised by the Holder Desiring to transfer said Exercise Warrants Evidenced by the Within Warrant on the books of AmeriCann, Inc., with full power of substitution. DatedCertificate) To: Signed: APPENDIX B WARRANT EXERCISE FORM To AmeriCann, Inc.: LITHIUM TECHNOLOGY CORPORATION The undersigned hereby irrevocably elects to exercise the right of purchase represented _____ Warrants, evidenced by the Warrant, dated October 17, 2017 (the “Warrant”)within Warrant Certificate, for, and to purchase thereunder by the payment of the Exercise Price (as defined in the Warrant) and surrender of the Warrantthereunder, ___________ shares of common stock, par value Common Stock of Lithium Technology Corporation issuable upon exercise of said Warrants and delivery of $0.0001 (“Warrant Shares”), of AmeriCann, Inc. provided for therein_____ in cash. The undersigned requests that the Warrant Shares certificates for such shares be issued in book-entry form by the Company’s transfer agent as followsname of Xxxxxxx Xxxxxxxx. ----------------------------- ----------------------------- (Signature) ----------------------------- ----------------------------- ----------------------------- Please print name and address TAX IDENTIFICATION/SOCIAL SECURITY NUMBER: Name Address Federal Tax ID or Social Security No. and, if the ----------------------------- If said number of Warrant Shares Warrants shall not be all the Warrant Shares purchasable upon exercise of the WarrantWarrants evidenced by the within Warrant Certificate, the undersigned requests that a new Warrant in substantially identical form (other than Certificate evidencing the number of Warrant Shares) for the balance of the Warrant Shares purchasable upon exercise of this Warrant Warrants not so exercised be registered issued in the name set forth below indicated of the Holder and delivered to to: ----------------------------- (Please print address) ----------------------------- ----------------------------- ----------------------------- (Signature) NOTICE: The signature on this subscription form must correspond with the address stated below. Name (please print) Address Federal Identification name as written upon the face of the within Warrant Certificate, or Social Security No. Dated: ___________________upon the assignment thereof, ____ Signature: ______________________________in every particular, without alteration, enlargement, or any change whatsoever and must be guaranteed by a bank, other than a savings bank, or trust company having an office or correspondent in Pennsylvania, or by a firm having membership on a regional securities exchange and an office in Pennsylvania.

Appears in 1 contract

Samples: Lithium Technology Corp

Assignment of Warrant. FOR VALUE RECEIVED, ____________________________ hereby sells, assigns and transfers unto _____________________________ the Warrant, dated October 17, 2017 (the “Warrant”) within Warrant and the rights represented thereby, and does hereby irrevocably constitute and appoint Attorney, to transfer said Warrant on the books of the Company, with full power of substitution. Dated: ____________________________ Signed: ____________________________ Signature guaranteed: _________________________________ Attorney, to transfer said Warrant on the books of AmeriCann, Inc., with full power of substitution. Dated: Signed: APPENDIX B WARRANT SUBSCRIPTION AGREEMENT FOR THE EXERCISE FORM To AmeriCann, Inc.: OF WARRANTS The undersigned hereby irrevocably elects to exercise subscribes for the right purchase of purchase represented by the Warrant, dated October 17, 2017 (the “Warrant”), for, and to purchase thereunder by the payment of the Exercise Price (as defined in the Warrant) and surrender of the Warrant, ___________ shares __Shares pursuant to and in accordance with the terms and conditions of common stockthis Warrant, par value $0.0001 (“Warrant Shares”), of AmeriCann, Inc. provided for thereinwhich Shares should be delivered to the undersigned at the address stated below. The undersigned requests that the Warrant Shares be issued in book-entry form by the Company’s transfer agent as follows: Name Address Federal Tax ID or Social Security No. and, if the If said number of Warrant Shares shall are not be all of the Warrant Shares purchasable upon exercise of the Warranthereunder, that a new Warrant in substantially identical form (other than the number of Warrant Shares) like tenor for the balance of the Warrant remaining Shares purchasable upon exercise of this Warrant hereunder should be registered in the name set forth below indicated and delivered to the undersigned at the address stated below. Name The undersigned elects to pay the aggregate Purchase Price for such Shares in the following manner: [ ]by the enclosed cash or check made payable to the Company in the amount of $__________________; or [ ]by wire transfer of United States funds to the account of the Company in the amount of $__________________, which transfer has been made before or simultaneously with the delivery of this Notice pursuant to the instructions of the Company; or [ ]by cashless exercise pursuant to the terms of the Warrant. The undersigned agrees that: (please print1) Address Federal Identification the undersigned will not offer, sell, transfer or Social Security Nootherwise dispose of any Shares unless either (a) a registration statement, or post-effective amendment thereto, covering the Shares has been filed with the Securities and Exchange Commission pursuant to the Securities Act of 1933, as amended (the “Act”), such sale, transfer or other disposition is accompanied by a prospectus meeting the requirements of Section 10 of the Act forming a part of such registration statement, or post-effective amendment thereto, which is in effect under the Act covering the Shares to be so sold, transferred or otherwise disposed of, and all applicable state securities laws have been complied with, or (b) counsel reasonably satisfactory to Wytec International, Inc. has rendered an opinion in writing and addressed to Wytec International, Inc. that such proposed offer, sale, transfer or other disposition of the Shares is exempt from the provisions of Section 5 of the Act in view of the circumstances of such proposed offer, sale, transfer or other disposition; (2) Wytec International, Inc. may notify the transfer agent for the Shares that the certificates for the Shares acquired by the undersigned are not to be transferred unless the transfer agent receives advice from Wytec International, Inc. that one or both of the conditions referred to in (1)(a) and (1)(b) above have been satisfied; and (3) Wytec International, Inc. may affix the legend set forth in Section 3 of this Warrant to the certificates for the Shares hereby subscribed for, if such legend is applicable. Dated: Date:___________________, _________________ SignatureSigned: ______________________________ Signature guaranteed: _______________________ Address:_____________________________

Appears in 1 contract

Samples: Subscription Agreement (Wytec International Inc)

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Assignment of Warrant. FOR VALUE RECEIVED, _______________________ hereby sells, assigns and transfers unto _____________________________ the Warrant, dated October 17, 2017 (the “Warrant”) within Warrant and the rights represented thereby, and does hereby irrevocably constitute and appoint _______________________________ Attorney, to transfer said Warrant on the books of AmeriCann, Inc.the Company, with full power of substitution. Dated: Signed: APPENDIX B WARRANT EXERCISE FORM To AmeriCann, Inc.: The undersigned hereby irrevocably elects to exercise the right of purchase represented by the Warrant, dated October 17, 2017 (the “Warrant”), for, and to purchase thereunder by the payment of the Exercise Price (as defined in the Warrant) and surrender of the Warrant, ___________ shares of common stock, par value $0.0001 (“Warrant Shares”), of AmeriCann, Inc. provided for therein. The undersigned requests that the Warrant Shares be issued in book-entry form by the Company’s transfer agent as follows: Name Address Federal Tax ID or Social Security No. and, if the number of Warrant Shares shall not be all the Warrant Shares purchasable upon exercise of the Warrant, that a new Warrant in substantially identical form (other than the number of Warrant Shares) for the balance of the Warrant Shares purchasable upon exercise of this Warrant be registered in the name set forth below indicated and delivered to the address stated below. Name (please print) Address Federal Identification or Social Security No. Dated: ___________________, ____ Signature: _______________________________________ Signed: ______________________________________ Signature guaranteed: ____________________________________________ APPENDIX A [NAME] WARRANT EXERCISE FORM To [Name]: The undersigned hereby irrevocably elects to exercise the right of purchase represented by the within Warrant (“Warrant”) for, and to purchase thereunder by the payment of the Warrant Price and surrender of the Warrant, _______________ shares of Common Stock (“Warrant Shares”) provided for therein, and requests that certificates for the Warrant Shares be issued as follows: _______________________________ Name ________________________________ Address ________________________________ ________________________________ Federal Tax ID or Social Security No. and delivered by (certified mail to the above address, or (electronically (provide DWAC Instructions:___________________), or (other (specify): __________________________________________). and, if the number of Warrant Shares shall not be all the Warrant Shares purchasable upon exercise of the Warrant, that a new Warrant for the balance of the Warrant Shares purchasable upon exercise of this Warrant be registered in the name of the undersigned Holder or the undersigned’s Assignee as below indicated and delivered to the address stated below. Dated: ___________________, ____ Signature:______________________________ ______________________________ Name (please print) ______________________________ ______________________________ Address ______________________________ Federal Identification or Social Security No. Assignee: _______________________________ _______________________________ _______________________________ APPENDIX B [NAME] NET ISSUE ELECTION NOTICE To: [Name] Date:[_________________________] The undersigned hereby elects under Section 1.3 of this Warrant to surrender the right to purchase [____________] shares of Common Stock pursuant to this Warrant and hereby requests the issuance of [_____________] shares of Common Stock. The certificate(s) for the shares issuable upon such net issue election shall be issued in the name of the undersigned or as otherwise indicated below. _________________________________________ Signature _________________________________________ Name for Registration _________________________________________ Mailing Address

Appears in 1 contract

Samples: Ante5, Inc.

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