Common use of Date of Conversion Clause in Contracts

Date of Conversion. Applicable Conversion Price: --------------- Amount of Accrued and Unpaid Interest on the Original Issue Price to be converted, if any: ------------------------------------ Amount of Conversion Default Payments to be Converted, if any: ------------------- Number of Shares of Ordinary Shares to be Issued: -------------- Signature: --------------------------------- Name: --------------------------------------

Date of Conversion. Applicable Conversion Price: --------------- ------------------- Amount of Accrued and Unpaid Interest on the Original Issue Price Principal Amount to be converted, if any: ------------------------------------ ----------------------- Default Amount of Conversion Default Payments to be Convertedconverted, if any: ------------------- ---------------------------------------- Number of Shares of Ordinary Shares Common Stock to be Issued: -------------- ---------------------------- Signature: --------------------------------- ------------------------------------- Name: -------------------------------------------------------------------------------- Address: ---------------------------------------

Date of Conversion. Applicable Conversion Price: --------------- ---------------------------- Amount of Accrued and Unpaid Interest on the Original Issue Price Principal Amount to be converted, if any: ------------------------------------ ------------------------------------------------- Amount of Conversion Default Payments to be Converted, if any: ------------------- -------------------------------- Number of Shares of Ordinary Shares Common Stock to be Issued: -------------- ------------------------------ Signature: --------------------------------- ---------------------------------------------- Name: ----------------------------------------------------------------------------------------- Address: ------------------------------------------------

Date of Conversion. Applicable Conversion Price: --------------- ---------------------------- Amount of Accrued and Unpaid Interest on the Original Issue Price Principal Amount ("Unpaid Interest") to be converted, if any: ------------------------------------ ------------------------------------------------- Amount of Conversion Default Payments Unpaid Interest to be Convertedpaid in cash, if any: ------------------- Default Amount to be converted, if any: ----------------- Number of Shares of Ordinary Shares Common Stock to be Issued: -------------- ------------------------------ Signature: --------------------------------- ---------------------------------------------- Name: -----------------------------------------------------------------------------------------

Date of Conversion. Applicable Conversion Price: --------------- ----------------------- Amount of Accrued and Unpaid Interest on the Original Issue Price Principal Amount to be converted, if any: ------------------------------------ --------------------------------- Amount of Conversion Default Payments or Prepayment Default Payments to be Convertedconverted, if any: ------------------- --------------------------------- Number of Shares of Ordinary Shares Common Stock to be Issued: -------------- ------------------------- Signature: --------------------------------- ----------------------------------------- Name: ------------------------------------------------------------------------------------ Address: -------------------------------------------

Date of Conversion. Applicable Conversion Price: --------------- -------------------------- Amount of Accrued and Unpaid Interest on the Original Issue Price Principal Amount to be converted, if any: ------------------------------------ ---------------------------------------------- Amount of Conversion Default Payments to be Converted, if any: ------------------- ----------------------------- Number of Shares of Ordinary Shares Common Stock to be Issued: -------------- --------------------------- Signature: --------------------------------- ------------------------------------------- Name: -------------------------------------------------------------------------------------- Address: ---------------------------------------------