Exhibit 10.18


 


THE
SECURITIES REPRESENTED HEREBY, INCLUDING THE SHARES ISSUABLE UPON EXERCISE HEREOF, HAVE NOT BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933, AS AMENDED (THE "ACT"), OR ANY STATE SECURITIES LAWS AND NEITHER THE SECURITIES NOR ANY INTEREST THEREIN
MAY BE OFFERED, SOLD, TRANSFERRED, PLEDGED OR OTHERWISE DISPOSED OF EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER
SUCH ACT OR SUCH LAWS OR AN EXEMPTION FROM REGISTRATION UNDER SUCH ACT AND SUCH LAWS WHICH, IN THE OPINION OF COUNSEL FOR THE
ISSUER, IS AVAILABLE.


 


WARRANT
AGREEMENT


 


No.
2


 


healthlynked
corporation


 


This
Warrant Agreement (this “Agreement”) is dated as of July 18, 2016 (the “Issue Date”)
and entered into by and between HealthLynked Corporation, a corporation organized under the laws of State of Nevada and ______________,
(together with its successors and assigns, the “ Warrant Holder”). 


 


WHEREAS, the Company and the Warrant
Holder entered into a Subscription Agreement of even date herewith (the “Subscription Agreement”), pursuant
to which, the Warrant Holder, agreed to purchase certain securities of the Company, including the Warrants evidenced by this Agreement;
and


 


WHEREAS, all of the terms and conditions
of such Subscription Agreement are incorporated herein by this reference, and all capitalized terms not separately defined in this
Warrant, shall have the same meanings as defined in the Subscription Agreement.


 


NOW, THEREFORE, in consideration
of the mutual covenants set forth in this Agreement and for other good and valuable consideration, the parties agree as follows:


 


1.       Grant of Warrant. The Company hereby, upon the terms and subject to the conditions of this Agreement,
issues to the Warrant Holder a warrant (the “Warrant”) evidenced by this Agreement to purchase up to that number
of Conversion Securities as shall be equal to 100% of such Holder’s aggregate investment in the shares at $0.08 per share
or $________ at an exercise price that is equal to a 25% premium to the current per share price paid for the securities or $0.10
per share pursuant to the terms hereof, the “Exercise Price”).


 


2.        Term and Termination of Warrant. The Warrant shall terminate
on the fifth (5th) anniversary of the Issue Date (the “Expiration Date”).







3.       Exercise
of the Warrant.


 


(a)      Exercise
and Payment. The purchase rights represented by the Warrant may be exercised by the Warrant Holder, in whole or in part at
any time following the Issue Date during the period prior to the Expiration Date, by the surrender of the Warrant (together with
a duly executed notice of exercise in the form attached hereto as Exhibit A (the "Exercise Notice") at
the principal office of the Company, and by the payment to the Company, at the option of the Warrant Holder by wire transfer of
immediately available funds, of an amount equal to (A) the number of Warrant Shares being purchased upon exercise of the Warrant
multiplied by (B) the Exercise Price (the “Warrant Price”).


 






     

     


    

 


(b)      Warrant
Shares. On or before the first (1st) Business Day (as hereafter defined) following the date on which the Company
has received an Exercise Notice, the Company shall transmit by facsimile an acknowledgment or confirmation of receipt of such
Exercise Notice to the Holder. On or before the third (3rd) Business Day following the date on which the Company has
received such Exercise Notice, so long as the Holder delivers the Aggregate Exercise Price on or prior to the second (2nd)
Business Day following the date on which the Company has received such Exercise Notice, the Company shall issue and deliver to
the Holder or, at the Holder’s instruction pursuant to the Exercise Notice, the Holder’s agent or designee, in each
case, sent by reputable overnight courier to the address as specified in the applicable Exercise Notice, a certificate, registered
in the Company’s shareholder register in the name of the Holder or its designee (as indicated in the applicable Exercise
Notice), representing the number of Warrant Shares to which the Holder is entitled pursuant to such exercise. The Company shall
be responsible for all fees and expenses related to the issuance of such Warrant Shares, if any. Upon delivery of an Exercise
Notice, the Holder shall be deemed for all corporate purposes to have become the holder of record of the Warrant Shares with respect
to which this Warrant has been exercised, irrespective of the date of delivery of the certificates evidencing such Warrant Shares.
If this Warrant is submitted in connection with any exercise pursuant to this Section 3(b) and the number of Warrant Shares represented
by this Warrant submitted for exercise is greater than the number of Warrant Shares being acquired upon an exercise, then, at
the request of the Holder, the Company shall as soon as practicable and in no event later than three (3) Business Days after any
exercise and at its own expense, issue and deliver to the Holder (or its designee) a new Warrant (in accordance with Section 11(d))
representing the right to purchase the number of Warrant Shares purchasable immediately prior to such exercise under this Warrant,
less the number of Warrant Shares with respect to which this Warrant is exercised. Fractional shares of stock are to be issued
upon the exercise of this Warrant. The Company shall pay any and all taxes and fees which may be payable with respect to the issuance
and delivery of Warrant Shares upon exercise of this Warrant. Following the exercise in full of this Warrant, the Holder shall
deliver this original Warrant certificate to the Company. For purposes of this Warrant, “Business Day” means
any day other than Saturday, Sunday or other day on which commercial banks in The City of New York are authorized or required
by law to remain closed.


 


(c)      Company’s
Failure to Timely Deliver Securities. If the Company shall fail for any reason or for no reason to issue to the Warrant Holder
within five (5) Business Days of receipt of the Exercise Notice so long as the Warrant Holder delivers the Aggregate Exercise
Price on or prior to the second (2nd) Business Day following the date on which the Company has received the Exercise
Notice, a certificate for the number of Warrant Shares to which the Warrant Holder is entitled and register such Warrant Shares
on the Company’s shareholder register, then, the Warrant Holder is entitled to all remedies available to him Nothing shall
limit the Warrant Holder’s right to pursue any remedies available to it hereunder, at law or in equity, including, without
limitation, a decree of specific performance and/or injunctive relief with respect to the Company’s failure to timely deliver
certificates representing the Warrant Shares (or to electronically deliver such Warrant Shares) upon the exercise of this Warrant
as required pursuant to the terms hereof.


 






    	 	2	 



     


    

 


(d)      Fractional
Warrant Shares. Fractional Warrant Shares will be issued in connection with any exercise hereunder.


 


(e)      Legend.
The Warrant Shares to be acquired by the Holder pursuant hereto, may not be sold or transferred unless (A) such securities
are sold pursuant to an effective registration statement under the Securities Act, or (B) the Company or its transfer agent shall
have been furnished with an opinion of counsel (which opinion shall be in form, substance and scope customary for opinions of
counsel in comparable transactions and from an attorney who regularly practices securities law) to the effect that the securities
to be sold or transferred may be sold or transferred pursuant to an exemption from such registration or (C) such securities
are sold or transferred pursuant to Rule 144 under the Securities Act (or a successor rule) (“Rule 144”) or
(D) such shares are sold or transferred outside the United States in accordance with Rule 904 of Regulation S under the Securities
Act, or (E) such shares are transferred to an “affiliate” (as defined in Rule 144) of the Company who agrees to sell
or otherwise transfer the shares only in accordance with this Section 3(e). Except as otherwise provided in this Warrant (and
subject to the removal provisions set forth below), until such time as the Warrant Shares issuable upon exercise of the Warrant
have been registered under the Act, otherwise may be sold pursuant to Rule 144 without any restriction as to the number of securities
as of a particular date that can then be immediately sold, each certificate for Warrant Shares that has not been so included in
an effective registration statement or that has not been sold pursuant to an effective registration statement or an exemption
that permits removal of the legend, shall bear a legend substantially in the following form, as appropriate:


 


THE
SECURITIES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED. THE HOLDER
HEREOF, BY PURCHASING SUCH SECURITIES, AGREES THAT SUCH SECURITIES MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED ONLY
(A) TO THE CORPORATION, (B) OUTSIDE THE UNITED STATES IN ACCORDANCE WITH RULE 904 OF REGULATION S UNDER THE U.S. SECURITIES
ACT, (C) WITHIN THE UNITED STATES AFTER REGISTRATION OR IN ACCORDANCE WITH THE EXEMPTION FROM THE REGISTRATION REQUIREMENTS
UNDER THE U.S. SECURITIES ACT PROVIDED BY RULE 144 THEREUNDER, IF APPLICABLE, AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES
LAWS, OR (D) WITHIN THE UNITED STATES IN A TRANSACTION THAT DOES NOT REQUIRE REGISTRATION UNDER THE U.S. SECURITIES ACT OR
ANY APPLICABLE STATE SECURITIES LAWS AND THE HOLDER HAS PRIOR TO SUCH SALE FURNISHED TO THE CORPORATION AN OPINION OF COUNSEL
REASONABLY SATISFACTORY TO THE CORPORATION.


 






    	 	3	 



     


    

 


(f)       Removal
of Legend. The legend set forth above shall be removed and the Company shall issue to the Holder a new certificate therefor
free of any transfer legend if (A) the Company shall have received an opinion of counsel, in form, substance and scope customary
for opinions of counsel in comparable transactions, to the effect that a public sale or transfer of such Securities may be made
without registration under the Act and the shares are so sold or transferred, or (B) (C) in the case of the Conversion Securities
issuable upon exercise of the Warrant, such security is registered for sale by the Holder under an effective registration statement
filed under the Act or otherwise may be sold pursuant to Rule 144 without any restriction as to the number of securities as of
a particular date that can then be immediately sold. The Company shall cause its counsel to issue a legal opinion promptly after
the effective date of any registration statement under the Act registering the resale of the Conversion Securities issuable upon
exercise of the Warrant if required to effect the removal of the legend hereunder.


  


4.       Securities
Fully Paid; Reservation of Warrant Interests. All of the
Warrant Shares issuable upon the exercise of the Warrant will, upon issuance and receipt of the Warrant Price for such Warrant
Shares, be duly authorized, validly issued, fully paid and non-assessable, and will be free and clear of all taxes, liens, encumbrances
and charges with respect to the issue.


 


5.       Rights
of the Warrant Holder. The Warrant Holder shall have no
voting rights as a member or rights to dividends or other distributions with respect to Warrant Shares subject to this Agreement
until payment in full of the Warrant Price for Warrant Shares being issued and such securities are issued.


 


6.       Adjustment
of Exercise Price and Number of Warrant Shares. The Exercise
Price and the number of Warrant Shares purchasable upon any exercise of the Warrant shall be subject to adjustment from time to
time upon the occurrence of certain events described in this Section 6 if such events occur within the three year period following
the Issue Date.


 


(a)      Subdivision
or Combination of Ownership Shares; Equity Dividend and Interest Conversion.


 


(i)       In
the event the Company should at any time or from time to time fix a record date for the determination of the holders of Ownership
Shares entitled to receive a dividend or other distribution payable in additional Ownership Shares or other securities or rights
directly or indirectly convertible into or exercisable or exchangeable, or rights that entitle the holders of Ownership Shares
to purchase, Ownership Shares (hereinafter referred to as “Ownership Share Equivalents”), without payment of
any consideration by such holders for the additional Ownership Shares or the Ownership Share Equivalents (including the additional
Ownership Shares issuable upon conversion or exercise thereof), then, as of such record date (or the date of such dividend distribution,
split or subdivision if no record date is fixed), (y) the Exercise Price of the Warrant Shares shall be appropriately decreased
or (z) the number of Warrant Shares shall be increased in proportion to such increase of outstanding Ownership Shares and Ownership
Shares issuable with respect to Ownership Share Equivalents.


 






    	 	4	 



     


    

 


(ii)       If
the number of Ownership Shares outstanding at any time after the Issue Date is decreased by a combination of the outstanding Ownership
Shares, then, upon the record date of such combination, (A) the Exercise Price shall be appropriately increased, or (B) the number
of Warrant Shares shall be decreased in proportion to such decrease in outstanding Ownership Shares.


 


(iii)     The Company will not modify its articles of organization or effect any reorganization, recapitalization, transfer of assets, consolidation,
merger, dissolution, issue or sale of securities in a manner that negates or avoids the rights of the Warrant Holder to exercise
its rights hereunder, but will at all times assist in the carrying out of all the provisions of this Agreement and in the taking
of all such actions as may be necessary or appropriate in order to protect the Warrant Holder against impairment.


 


(b)      Other
Notices. In the event that the Company shall propose at any time: (i) to declare any dividend or distribution upon any
class or series of securities, whether in cash, property, stock or other securities (including, without limitation, pursuant to
a subdivision of the outstanding shares of capital stock); (ii) to effect any reclassification or recapitalization of its
Ownership Shares outstanding involving a change in such securities; or (iii) to merge or consolidate with or into any other
corporation, or to sell, lease or convey all or substantially all of its property or business, or to liquidate, dissolve or wind
up; then, in connection with each such event, the Company shall mail to the Warrant Holder notice of such transaction:


 


(A)       at
least five (5) business days’ prior written notice in accordance with Section 10 of the date on which a record shall
be taken for such dividend or distribution (and specifying the date on which the holder of the affected class or series of capital
stock shall be entitled thereto) or for determining the rights to vote, if any, in respect of the matters referred to in (c)(ii)
and (c)(iii) above; and


 


(B)       in
the case of the matters referred to in (c)(ii) and (c)(iii) above, written notice of such impending transaction not later than
ten (10) business days’ prior to any shareholders’ meeting called to approve such transaction, or ten (10) business
days’ prior to the closing of such transaction, whichever is earlier, and shall also notify the Warrant Holder in writing
in accordance with Section 10 of the final approval of such transaction by the stockholders of the Company (if such approval
is required). The first of such notices shall describe the terms and conditions of the impending transaction that are material
to a holder of Ownership Shares (as determined by the Board of Directors of the Company (the “Board”) in good
faith) and specify the date on which a holder of Ownership Shares shall be entitled to exchange his, her or its Ownership Shares
for securities or other property deliverable upon the occurrence of such event) and the Company shall thereafter give such holder
prompt notice of any changes in such terms or conditions that are material to a holder of Ownership Shares (as determined by the
Board in good faith). The Company acknowledges that any record date must be set at a date that would permit the Warrant Holder
effectively to exercise its rights hereunder.


 






    	 	5	 



     


    

 


(c)      Changes
in Ownership Shares. In case at any time prior to the Expiration Date, the Company shall be a party to any transaction (including,
without limitation, a merger, consolidation, sale of all or substantially all of the Company’s assets or recapitalization
of its capital stock) in which the previously outstanding Ownership Shares shall be changed into or exchanged for different securities
of the Company or other securities of another corporation or interests in a non-corporate entity or other property (including
cash) or the Company shall make a distribution on its Ownership Shares, other than regular cash dividends on its outstanding Ownership
Shares, or any combination of any of the foregoing (each such transaction being herein called the “Transaction”
and the date of consummation of the Transaction being herein called the “Consummation Date”), then as a condition
of the consummation of such Transaction, lawful and adequate provisions shall be made so that the Warrant Holder, upon the exercise
hereof at any time on or after the Consummation Date and prior to the Expiration Date, shall be entitled to receive, and this
Agreement shall thereafter represent the right to receive, in lieu of the Warrant Shares issuable upon such exercise prior to
the Consummation Date, the highest amount of securities or other property to which the Warrant Holder would actually have been
entitled as a member upon the consummation of the Transaction if the Warrant Holder had exercised the Warrant immediately prior
thereto. The provisions of this Section 6(c) shall similarly apply to successive Transactions.


  


7.       Taxes.
The Warrant Holder acknowledges that upon exercise of the Warrant the Warrant Holder may be deemed to have taxable income in respect
of the Warrant and/or the Warrant Shares. The Warrant Holder acknowledges that any income or other taxes due from it with respect
to the Warrant or the Warrant Interests issuable pursuant to the Warrant shall be the Warrant Holder’s responsibility.


 


8.       Reserved.


 


9.       Representations
and Warranties.


 


(a)       Representations
and Warranties by the Warrant Holder. The representations and warranties of the Warrant Holder set forth in Section 3 and
4 of the Subscription Agreement are true and correct in all material respects as of the Issue Date.


 


10.     Non-circumvention.
The Company hereby covenants and agrees that the Company will not, by amendment of its articles of organization or operating agreement,
or through any reorganization, transfer of assets, consolidation, merger, scheme of arrangement, dissolution, issue or sale of
securities, or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms of this Warrant,
and will at all times in good faith carry out all the provisions of this Warrant and take all action as may be required to protect
the rights of the Holder.


 


11.     Reissuance
Of Warrants.


 


(a)      Transfer
of Warrant. If this Warrant is to be transferred, the Warrant Holder shall surrender this Warrant to the Company and an opinion
of counsel from an attorney regularly engaged in the practice of securities law, whereupon the Company will forthwith issue and
deliver upon the order of the Warrant Holder a new Warrant (in accordance with Section 11(d)), registered as the Warrant Holder
may request, representing the right to purchase the number of Warrant Shares being transferred by the Warrant Holder and, if less
than the total number of Warrant Shares then underlying this Warrant is being transferred, a new Warrant (in accordance with Section
11(d)) to the Warrant Holder representing the right to purchase the number of Warrant Shares not being transferred.


 






    	 	6	 



     


    

 


(b)      Lost,
Stolen or Mutilated Warrant. Upon receipt by the Company of evidence reasonably satisfactory to the Company of the loss, theft,
destruction or mutilation of this Warrant, and, in the case of loss, theft or destruction, of any indemnification and payment
of any required bond undertaking by the Warrant Holder to the Company in customary form and, in the case of mutilation, upon surrender
and cancellation of this Warrant, the Company shall execute and deliver to the Warrant Holder a new Warrant (in accordance with
Section 11(d)) representing the right to purchase the Warrant Shares then underlying this Warrant.


 


(c)      Exchangeable
for Multiple Warrants. This Warrant is exchangeable, upon the surrender hereof by the Warrant Holder at the principal office
of the Company, for a new Warrant or Warrants (in accordance with Section 11(d)) representing in the aggregate the right to purchase
the number of Warrant Shares then underlying this Warrant, and each such new Warrant will represent the right to purchase such
portion of such Warrant Shares as is designated by the Warrant Holder at the time of such surrender.


 


(d)      Issuance
of New Warrants. Whenever the Company is required to issue a new Warrant pursuant to the terms of this Warrant, such new Warrant
(i) shall be of like tenor with this Warrant, (ii) shall represent, as indicated on the face of such new Warrant, the right to
purchase the Warrant Shares then underlying this Warrant (or in the case of a new Warrant being issued pursuant to Section 11(a)
or Section 11(c), the Warrant Shares designated by the Warrant Holder which, when added to the number of Conversion Securities
underlying the other new Warrants issued in connection with such issuance, does not exceed the number of Warrant Shares then underlying
this Warrant), (iii) shall have an issuance date, as indicated on the face of such new Warrant which is the same as the Issuance
Date, and (iv) shall have the same rights and conditions as this Warrant.


 


12.     Amendment
And Waiver. Except as otherwise provided herein, the provisions
of this Warrant may be amended and the Company may take any action herein prohibited, or omit to perform any act herein required
to be performed by it, only if the Company has obtained the written consent of the Warrant Holder.


 


13.     Dispute
Resolution.


 


(a)      This
Warrant shall be governed by, and construed in accordance with, the internal laws of the State of Florida without regard to the
choice of law principles thereof. Each of the parties of the Warrant hereto irrevocably submits to the exclusive jurisdiction
of the courts of the State of Florida located in Dade County and the United States District Court for the Southern District of
Florida in Miami for the purpose of any suit, action, proceeding or judgment relating to or arising out of this Warrant. Service
of process in connection with any such suit, action or proceeding may be served on each party hereto anywhere in the world by
the same methods as are specified for the giving of notices under the Subscription Agreement. Each of the parties of this Warrant
irrevocably consents to the jurisdiction of any such court in any such suit, action or proceeding and to the laying of venue in
such court. Each party hereto irrevocably waives any objection to the laying of venue of any such suit, action or proceeding brought
in such courts and irrevocably waives any claim that any such suit, action or proceeding brought in any such court has been brought
in an inconvenient forum. EACH OF THE PARTIES HERETO WAIVES ANY RIGHT TO REQUEST A TRIAL BY JURY IN ANY LITIGATION WITH RESPECT
TO THIS WARRANT AND REPRESENTS THAT COUNSEL HAS BEEN CONSULTED SPECIFICALLY AS TO THIS WAIVER.


 






    	 	7	 



     


    

 


(b)      Each
party shall bear its own expenses in any litigation conducted under this section.


 


(c)      The
Company consents to accept service of process by the certified mail, return receipt requested in the event of litigation. The
Company further consents to accept service of process via recognized international courier in the case that the Company is not
able to accept service by the certified mail provided a receipt of delivery is available. 

 


14.     Remedies,
Other Obligations, Breaches And Injunctive Relief. The remedies
provided in this Warrant shall be cumulative and in addition to all other remedies available under this Warrant and the Subscription
Agreement, at law or in equity (including a decree of specific performance and/or other injunctive relief), and nothing herein
shall limit the right of the Warrant Holder to pursue actual damages for any failure by the Company to comply with the terms of
this Warrant. The Company acknowledges that a breach by it of its obligations hereunder will cause irreparable harm to the Warrant
Holder and that the remedy at law for any such breach may be inadequate. The Company therefore agrees that, in the event of any
such breach or threatened breach, the holder of this Warrant shall be entitled, in addition to all other available remedies, to
an injunction restraining any breach, without the necessity of showing economic loss and without any bond or other security being
required. The Company shall provide all information and documentation to the Warrant Holder that is requested by the Holder to
enable the Holder to confirm the Company’s compliance with the terms and conditions of this Warrant (including, without
limitation, compliance with Section 6 hereof).


 


15.     Transfer.This
Warrant may be offered for sale, sold, transferred or assigned without the consent of the Company.


 


16.     Severability.
If any provision of this Warrant is prohibited by law or otherwise determined to be invalid or unenforceable by a court of competent
jurisdiction, the provision that would otherwise be prohibited, invalid or unenforceable shall be deemed amended to apply to the
broadest extent that it would be valid and enforceable, and the invalidity or unenforceability of such provision shall not affect
the validity of the remaining provisions of this Warrant so long as this Warrant as so modified continues to express, without
material change, the original intentions of the parties as to the subject matter hereof and the prohibited nature, invalidity
or unenforceability of the provision(s) in question does not substantially impair the respective expectations or reciprocal obligations
of the parties or the practical realization of the benefits that would otherwise be conferred upon the parties. The parties will
endeavor in good faith negotiations to replace the prohibited, invalid or unenforceable provision(s) with a valid provision(s),
the effect of which comes as close as possible to that of the prohibited, invalid or unenforceable provision(s).


 


17.     Assignability.
Notwithstanding anything contained herein to the contrary, subject to the transfer and securities law restrictions set forth in
this Agreement, the Warrant Holder may assign, convey or transfer, in whole or in part, its rights under this Agreement and provide
written notice to Company of any such assignment, conveyance or transfer. Upon any transfer, assignment, pledge, hypothecation
or other disposition of the Warrant or of any rights granted hereunder in accordance with the terms of this Section 17,
the Company shall if necessary issue or re-issue warrant agreements reflecting the appropriate rights and entitlements of the
Warrant Holder and any transferee, assignee or pledgee after giving effect to such transfer, assignment or pledge.


 


18.     Notice.
Any notice to be provided hereunder, unless otherwise herein specified, shall be provided in the manner set forth in Exhibit A
signature page of the Subscription Agreement. 


 


[signatures
on following page]


 






    	 	8	 



     


    

 





IN
WITNESS WHEREOF, the undersigned hereby execute this Agreement as of the day and year first above written.


 


	 	COMPANY:
	 	 	 
	 	HEALTHLYNKED
    CORPORATION
	 	 	 
	 	By:	     
	 	 	Name:
	 	 	Title:
	 	 	 
	 	WARRANT
    HOLDER:
	 	 	 
	 	By:	 
	 	 	Name:         


 


 


 


 


 


 


 


 


 


[Signature
Page – Warrant Agreement]


 






     

     


    

 


EXHIBIT
A


 


NOTICE
OF EXERCISE


 


The
undersigned holder hereby exercises the right to purchase _________________ shares of ______________ (“Warrant
Shares”) of HealthLynked Corporation, a Nevada Corporation (the “Company”), evidenced by the
attached Warrant No.  __ (the “Warrant”). Capitalized terms used herein and not otherwise defined shall
have the respective meanings set forth in the Warrant.


  


1.
Form of Exercise Price. The Warrant Holder intends that payment of the Exercise Price shall be made as:


 


____________a
“Cash Exercise” with respect to _________________ Warrant Shares.


  


2.
Payment of Exercise Price. The holder shall pay the Aggregate Exercise Price in the sum of $___________ to the Company in accordance
with the terms of the Warrant.


 


3.
Delivery of Warrant Shares. The Company shall deliver to the holder __________ Warrant Shares in accordance with the terms of
the Warrant.


 


Date:
_______________ __, ______


 


	 	 
	Name
    of Registered Holder	 
	 	 	 
	By:	 	 
	 	Name:	 
	 	Title: