Common use of PURCHASE FORM Clause in Contracts

PURCHASE FORM. (To be executed upon exercise of Warrant) To BioTime, Inc.: The undersigned hereby irrevocably elects to exercise the right of purchase represented by the within Warrant Certificate for, and to purchase thereunder, _______ shares of Common Stock, as provided for therein, and tenders herewith payment of the Warrant Price in full in the form of a bank wire transfer to the account of the Company or by bank cashier's check in the amount of $______________. Please issue a certificate or certificates for such shares of Common Stock in the name of, and pay any cash for any fractional share to: ____________________________________ (Please Print Name) ____________________________________ (Please Print Address) ____________________________________ (Social Security Number or Other Taxpayer Identification Number) ____________________________________ (Signature) NOTE: The above signature should correspond exactly with the name on the face of this Warrant Certificate or with the name of the assignee appearing in the assignment form below. And, if said number of shares shall not be all the shares purchasable under the within Warrant Certificate, a new Warrant Certificate is to be issued in the name of said undersigned for the balance remaining of the share purchasable thereunder less any fraction of a share paid in cash.

Appears in 2 contracts

Samples: Warrant Agreement (Biotime Inc), Common Stock Purchase (Biotime Inc)

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PURCHASE FORM. (To be executed upon exercise of Warrant) To BioTimeAsterias Biotherapeutics, Inc.: The undersigned hereby irrevocably elects to exercise the right of purchase represented by the within Warrant Certificate for, and to purchase thereunder, _______ shares of Series B Common Stock, as provided for therein, and tenders herewith payment of the Warrant Price in full in the form of a bank wire transfer to the account of the Company or by bank cashier's check in the amount of $______________. Please issue a certificate or certificates for such shares of Series B Common Stock in the name of, and pay any cash for any fractional share to: ____________________________________ (Please Print Name) ____________________________________ (Please Print Address) ____________________________________ (Social Security Number or Other Taxpayer Identification Number) ____________________________________ (Signature) NOTE: The above signature should correspond exactly with the name on the face of this Warrant Certificate or with the name of the assignee appearing in the assignment form below. And, if said number of shares shall not be all the shares purchasable under the within Warrant Certificate, a new Warrant Certificate is to be issued in the name of said undersigned for the balance remaining of the share purchasable thereunder less any fraction of a share paid in cash.

Appears in 2 contracts

Samples: Warrant Agreement (Asterias Biotherapeutics, Inc.), Warrant Agreement (Asterias Biotherapeutics, Inc.)

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PURCHASE FORM. (To be executed upon exercise of Warrant) To BioTime, Inc.: The undersigned hereby irrevocably elects to exercise the right of purchase represented by the within Warrant Certificate for, and to purchase thereunder, _______ shares of Common Stock, as provided for therein, and tenders herewith payment of the Warrant Price purchase price in full in the form of cash or a bank wire transfer to the account of the Company certified or by bank cashier's check in the amount of $______________. Please issue a certificate or certificates for such shares of Common Stock in the name of, and pay any cash for any fractional share to: ___PLEASE INSERT SOCIAL SECURITY NAME_________________________________ OR OTHER IDENTIFYING NUMBER (Please Print NameName & OF ASSIGNEE Address) ___________________________ Address______________________________ (Please Print Address) ___________________________ Signature____________________________ (Social Security Number or Other Taxpayer Identification Number) ____________________________________ (Signature) NOTE: The above signature should correspond exactly with the name on the face of this Warrant Certificate or with the name of the assignee appearing in the assignment form below. And, if said number of shares shall not be all the shares purchasable under the within Warrant Certificate, a new Warrant Certificate is to be issued in the name of said undersigned for the balance remaining of the share purchasable thereunder less any fraction of a share paid in cash.

Appears in 1 contract

Samples: Warrant Agreement (Greenway Partners L P)

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