Warrant Exercise Log. Date Number of Warrant Shares Available to be Exercised Number of Warrant Shares Exercised Number of Warrant Shares Remaining to be Exercised [To be completed and signed only upon transfer of Warrant] FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto ________________________________ the right represented by the above-captioned Warrant to purchase ____________ share of Company Common Shares and appoints ________________ attorney to transfer said right on the books of the Company with full power of substitution in the premises. Dated: _______________, ____ (Signature must conform in all respects to name of holder as specified on the face of the Warrant) Address of Transferee In the presence of: NLS Pharmaceutics Ltd. __________, 2020 NLS Pharmaceutics Ltd. (the “Company”) announced today that Maxim Group LLC, the sole book-running manager in the Company’s recent public sale of _____ Common Shares, is [waiving][releasing] a lock-up restriction with respect to ____ Common Shares held by [certain officers or directors] [an officer or director] of the Company. The [waiver][release] will take effect on ____, 2020 and the Common Shares may be sold on or after such date. Referring to [(A) the resolution of the shareholders’ meeting dated [●], 2020 of NLS Pharmaceutics Ltd., with registered office in Stans, Canton of Nidwalden, Switzerland (the “Company”), which are known to the undersigned (the “Subscriber”), and according to which the Company’s share capital shall be increased by way of an ordinary capital increase in a maximum amount of CHF [●] by issuing up to [●] registered shares with a nominal value of CHF 0.02. Pursuant to such resolution, the board of directors of the Company (the “Board of Directors”) shall effectuate the capital increase within 3 months.]2 [(A) the articles of association of NLS Pharmaceutics Ltd., with registered office in Stans, Canton of Nidwalden, Switzerland (the “Company”), which are known to the undersigned (the “Subscriber”) and which authorize the board of directors of the Company (the “Board of Directors”) to effect an increase of the Company’s share capital in a maximum amount of CHF [●] by issuing up to [●] registered shares with a nominal value of CHF 0.02 each out of the Company’s authorized share capital, such authorization having been granted by resolution of the shareholders meeting of [●], 2020]3
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Warrant Exercise Log. Date Number of Warrant Shares Available to be Exercised Number of Warrant Shares Exercised Number of Warrant Shares Remaining to be Exercised [To be completed and signed only upon transfer of Warrant] FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto ________________________________ the right represented by the above-captioned Warrant to purchase ____________ share of Company Common Shares and appoints ________________ attorney to transfer said right on the books of the Company with full power of substitution in the premises. Dated: _______________, ____ (Signature must conform in all respects to name of holder as specified on the face of the Warrant) Address of Transferee In the presence of: NLS Pharmaceutics Ltd. __________, 2020 2021 NLS Pharmaceutics Ltd. (the “Company”) announced today that Maxim Group LLC, the sole book-running manager in the Company’s recent public sale of _____ Common Shares, is [waiving][releasing] a lock-up restriction with respect to ____ Common Shares held by [certain officers or directors] [an officer or director] of the Company. The [waiver][release] will take effect on ____, 2020 and the Common Shares may be sold on or after such date. Referring to [(A) the resolution of the shareholders’ meeting dated [●], 2020 2021 of NLS Pharmaceutics Ltd., with registered office in Stans, Canton of Nidwalden, Switzerland (the “Company”), which are known to the undersigned (the “Subscriber”), and according to which the Company’s share capital shall be increased by way of an ordinary capital increase in a maximum amount of CHF [●] by issuing up to [●] registered shares with a nominal value of CHF 0.02. Pursuant to such resolution, the board of directors of the Company (the “Board of Directors”) shall effectuate the capital increase within 3 months.]2 [(A) the articles of association of NLS Pharmaceutics Ltd., with registered office in Stans, Canton of Nidwalden, Switzerland (the “Company”), which are known to the undersigned (the “Subscriber”) and which authorize the board of directors of the Company (the “Board of Directors”) to effect an increase of the Company’s share capital in a maximum amount of CHF [●] by issuing up to [●] registered shares with a nominal value of CHF 0.02 each out of the Company’s authorized share capital, such authorization having been granted by resolution of the shareholders meeting of [●], 2020]32021]3
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