0001654954-23-014542 Sample Contracts

PLACEMENT AGENT COMMON STOCK PURCHASE WARRANT DERMATA THERAPEUTICS, INC.
Dermata Therapeutics, Inc. • November 17th, 2023 • Pharmaceutical preparations • New York

THIS PLACEMENT AGENT COMMON STOCK PURCHASE WARRANT (the “Warrant”) certifies that, for value received, _____________ or its assigns (the “Holder”) is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter set forth, at any time on or after Stockholder Approval Date (as defined below) (the “Initial Exercise Date”) and on or prior to 5:00 p.m. (New York City time) on November 20, 2028 (the “Termination Date”) but not thereafter, to subscribe for and purchase from Dermata Therapeutics, Inc., a Delaware corporation (the “Company”), up to ______ shares (as subject to adjustment hereunder, the “Warrant Shares”) of Common Stock. The purchase price of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b). This Warrant is issued pursuant to that certain engagement letter, dated as of September 30, 2023, by and between the Company and H.C. Wainwright & Co., LLC.

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