Exhibit 10.13


 


THIS WARRANT AND THE UNDERLYING SECURITIES
HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES ACT”) OR THE SECURITIES LAWS
OF ANY STATE OF THE UNITED STATES. THE SECURITIES MAY NOT BE SOLD, OFFERED FOR SALE, PLEDGED, HYPOTHECATED, TRANSFERRED OR ASSIGNED IN
THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT FOR SUCH TRANSACTION UNDER APPLICABLE SECURITIES LAWS OR UNLESS OFFERED, SOLD, PLEDGED,
HYPOTHECATED OR TRANSFERRED PURSUANT TO AN AVAILABLE EXEMPTION FROM THE REGISTRATION REQUIREMENTS OF THOSE LAWS. THE COMPANY SHALL BE
ENTITLED TO REQUIRE AN OPINION OF COUNSEL SATISFACTORY TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED.


 


REVELATION
BIOSCIENCES, INC.


 


COMMON STOCK WARRANT


 


January 31, 2021


 


Void After January 31, 2027


 


THIS CERTIFIES THAT, for value received
and subject to the terms and conditions set forth below, National Securities Corporation, or assigns (the “Holder”),
is entitled to subscribe for and purchase at the Exercise Price (defined below) from Revelation Biosciences, Inc., a Delaware corporation
(the “Company”), Sixty-One Thousand Six-Hundred (61,600) fully-paid and non-assessable shares of Common Stock
of the Company. This Warrant is being issued pursuant to that certain Placement Agent Agreement by and between the National Securities
Corporation and the Company, dated January 27, 2021 (the “Agreement”).


 


		1.	DEFINITIONS. As used herein, the following terms shall have the following respective meanings:



 


“Common Stock” shall
mean the Company’s Common Stock, par value $0.001 per share.


 


“Exercise Period” shall
mean the period commencing on the date of issuance and ending six years after the date of issuance, January 31, 2027, unless sooner terminated
as provided below.


 


“Exercise Price” shall
mean $7.31 per share of Common Stock.


 


“Sale of the Company”
shall mean (i) a transaction or series of related transactions with one or more non-affiliates, pursuant to which such non-affiliate(s)
acquires capital stock of the Company or the surviving entity, in either case, possessing the voting power to elect a majority of the
board of directors or a majority of the outstanding capital stock of the Company or the surviving entity (whether by merger, consolidation,
sale or transfer of the Company’s outstanding capital stock or otherwise); or (ii) the sale, lease or other disposition (including
exclusive license) of all or substantially all of the Company’s assets or any other transaction resulting in all or substantially
all of the Company’s assets being converted into securities of any other entity or cash; provided, however, that the sale by the
Company of capital stock for the purpose of financing its business shall not be deemed to be a Sale of the Company.


 


“Warrant Shares” shall
mean the shares of the Company’s Common Stock issuable upon exercise of this Warrant, subject to adjustment pursuant to the terms
herein, including but not limited to adjustment pursuant to Section 5 below.


 


		2.	EXERCISE OF WARRANT.



 


(a) Method of Exercise. The rights represented
by this Warrant may be exercised in whole or in part at any time during the Exercise Period, by delivery of the following to the Company:


 


		i)	an executed Notice of Exercise in the form attached hereto;



 


		ii)	this Warrant; and



 


		iii)	Payment:



 






     


     


    

 


(1) Payment of the then-applicable Exercise Price
per share multiplied by the number of Warrant Shares being purchased upon exercise of the Warrant (such amount, the “Aggregate
Exercise Price”) made in the form of cash, or by certified check, bank draft or money order payable in lawful money of the
United States of America or in the form of a Cashless Exercise to the extent permitted in Section 2(a)(iii)(2) below.


 


(2) If at the time of exercise there is no effective
registration statement for the resale of the Warrant Shares, or the prospectus contained therein is not available for use, the Holder
may, in its sole discretion, exercise all or any part of the Warrant in a “cashless” or “net-issue” exercise (a
“Cashless Exercise”) by delivering to the Company (A) the Notice of Exercise and (B) the original Warrant, pursuant
to which the Holder shall surrender the right to receive upon exercise of this Warrant, a number of Warrant Shares having a value (as
determined below) equal to the Aggregate Exercise Price, in which case, the number of Warrant Shares to be issued to the Holder upon such
exercise shall be calculated using the following formula:


X = Y * (A - B)


A


 


	 	with:	X =	the number of Warrant Shares to be issued to the Holder



 


		Y =	the number of Warrant Shares with respect to which the Warrant is being exercised



 


		A =	the fair value per share of Common Stock on the date of exercise of this Warrant



 


		B =	the then-current Exercise Price of the Warrant



 


Solely for the purposes of this paragraph, “fair
value” per share of Common Stock shall mean the average Closing Price (as defined below) per share of Common Stock for the
twenty (20) Trading Days immediately preceding the date on which the Notice of Exercise is deemed to have been sent to the Company. “Closing
Price” means, for any date, the price determined by the first of the following clauses that applies:  (a) if the
Common Stock is then listed or quoted on the NASDAQ Capital Market or any other national securities exchange, the closing price per share
of the Common Stock for such date (or the nearest preceding date) on the primary eligible market or exchange on which the Common Stock
is then listed or quoted; (b) if prices for the Common Stock are then quoted on the OTC Bulletin Board or any tier of the OTC Markets,
the closing bid price per share of the Common Stock for such date (or the nearest preceding date) so quoted; or (c) if prices for the
Common Stock are then reported in the “Pink Sheets” published by the National Quotation Bureau Incorporated (or a similar
organization or agency succeeding to its functions of reporting prices), the most recent closing bid price per share of the Common Stock
so reported. If the Common Stock is not publicly traded as set forth above, the “fair value” per share of Common Stock shall
be reasonably and in good faith determined by the Board of Directors of the Company as of the date which the Notice of Exercise is deemed
to have been sent to the Company. “Trading Day” means a day on which the Common Stock is traded on an applicable
national securities exchange, on the OTC Bulletin Board or otherwise.


 


For purposes of Rule 144 promulgated under the Securities Act, it is
intended, understood and acknowledged that the Warrant Shares issued in a cashless exercise transaction shall be deemed to have been acquired
by the Holder, and the holding period for such shares shall be deemed to have commenced, on the date of issuance of this Warrant.


 


(b) Partial Exercise. If this Warrant is
exercised in part only, the Company shall, upon surrender of this Warrant, execute and deliver, within 10 days of the date of exercise,
a new Warrant evidencing the rights of the Holder, or such other person as shall be designated in the Notice of Exercise, to purchase
the balance of the Warrant Shares purchasable hereunder. If the Holder exercises this Warrant or attempts to exercise this Warrant before
the Company shall have delivered to the Holder a new Warrant as contemplated above, then the Holder shall be deemed to have validly exercised
this Warrant pursuant to this Section 2 without having complied with the requirements of Section 2(a)(ii). In
no event shall this Warrant be exercised for a fractional Warrant Share, and the Company shall not distribute a Warrant exercisable for
a fractional Warrant Share. Fractional Warrant Shares shall be treated as provided in Section 7 hereof.


 


(c) Effect of Exercise. Upon the exercise
of the rights represented by this Warrant, shares of Common Stock shall be issued for the Warrant Shares so purchased, and shall be registered
in the name of the Holder or persons affiliated with the Holder, if the Holder so designates, on or before the second (2nd) business
day after the rights represented by this Warrant shall have been so exercised and shall be issued in certificate or book-entry form and
delivered to the Holder, if so requested. The person in whose name any Warrant Shares are to be issued upon exercise of this Warrant shall
be deemed to have become the holder of record of such shares on the date on which this Warrant was surrendered and payment of the Exercise
Price was made, irrespective of the date of issuance of the shares of Common Stock, except that, if the date of such surrender and payment
is a date when the stock transfer books of the Company are closed, such person shall be deemed to have become the holder of such shares
at the close of business on the next succeeding date on which the stock transfer books are open.


 






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		3.	COVENANTS OF THE COMPANY.



 


(a) Covenants as to Warrant Shares. If
at any time the number of authorized but unissued shares of Common Stock shall not be sufficient to permit exercise of this Warrant, the
Company will take such corporate action as may, in the opinion of its counsel, be necessary to increase its authorized but unissued shares
of Common Stock (or other securities as provided herein) to such number of shares as shall be sufficient for such purposes.


 


(b) No Impairment. Except and to the extent
as waived or consented to by the Holder or otherwise in accordance with Section 2 hereof, the Company will not, by amendment
of its Certificate of Incorporation (as such may be amended from time to time), or through any means, avoid or seek to avoid the observance
or performance of any of the terms to be observed or performed hereunder by the Company, but will at all times in good faith assist in
the carrying out of all the provisions of this Warrant and in the taking of all such action as may be necessary or appropriate in order
to protect the exercise rights of the Holder against impairment.


 


(c) Notices of Record Date. In the event
of any taking by the Company of a record of the holders of any class of securities for the purpose of determining the holders thereof
who are entitled to receive any dividend (other than a cash dividend which is the same as cash dividends paid in previous quarters) or
other distribution, the Company shall mail to the Holder, at least ten (10) days prior to the record date, a notice specifying the
date on which any such record is to be taken for the purpose of such dividend or distribution.


 


		4.	REPRESENTATIONS OF HOLDER.



 


(a) Acquisition of Warrant for Personal Account.
The Holder represents and warrants that it is acquiring the Warrant and the Warrant Shares solely for its account for investment and not
with a present view toward the public distribution of said Warrant or Warrant Shares or any part thereof and has no intention of selling
or distributing said Warrant or Warrant Shares or any arrangement or understanding with any other persons regarding the sale or distribution
of said Warrant or Warrant Shares, except as would not result in a violation of the Securities Act. The Holder will not, directly or indirectly,
offer, sell, pledge, transfer or otherwise dispose of (or solicit any offers to buy, purchase or otherwise acquire or take a pledge of)
the Warrant except in accordance with the Securities Act and will not, directly or indirectly, offer, sell, pledge, transfer or otherwise
dispose of (or solicit any offers to buy, purchase or otherwise acquire or take a pledge of) the Warrant Shares except in accordance with
the provisions of the Securities Act.


 


(b) Securities Are Not Registered.


 


The Holder understands that the offer and sale
of the Warrant or the Warrant Shares have not been registered under the Securities Act on the basis that no distribution or public offering
of such securities of the Company is to be effected. The Holder realizes that the basis for the exemption may not be present if, notwithstanding
its representations, the Holder has a present intention of acquiring the securities for a fixed or determinable period in the future,
selling (in connection with a distribution or otherwise), granting any participation in, or otherwise distributing the securities. The
Holder has no such present intention.


 


The Holder recognizes that the Warrant and the
Warrant Shares may have to be held indefinitely unless the resale thereof is subsequently registered under the Securities Act or an exemption
from such registration is available. Except as provided in a separate registration rights agreement between the Holder and the Company,
the Holder recognizes that the Company has no obligation to register the Warrant or the Warrant Shares, or to comply with any exemption
from such registration.


 


The Holder is aware that neither the Warrant nor
the Warrant Shares may be sold pursuant to Rule 144 adopted under the Securities Act unless certain conditions are met, including, among
other things, the availability of certain current public information about the Company and the required holding period under Rule 144
being satisfied. Holder is aware that any such sale made in reliance on Rule 144, if Rule 144 is available, may be made only in accordance
with the terms of Rule 144.


 


(c) Disposition of Warrant and Warrant Shares.
The Holder understands and agrees that all certificates evidencing the Warrant Shares to be issued to the Holder may bear a legend in
substantially the following form:


 


THESE SECURITIES HAVE NOT BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933 OR ANY APPLICABLE STATE SECURITIES LAWS. THEY MAY NOT BE SOLD, OFFERED FOR SALE, PLEDGED OR HYPOTHECATED IN THE ABSENCE OF
A REGISTRATION STATEMENT IN EFFECT WITH RESPECT TO THE RESALE OF THE SECURITIES UNDER SUCH ACT OR APPLICABLE STATE SECURITIES LAWS OR
AN OPINION OF COUNSEL SATISFACTORY TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED OR UNLESS SOLD PURSUANT TO RULE 144 OR RULE 144A
OF SUCH ACT.


 









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		5.	CHANGES IN OUTSTANDING SHARES.



 


In the event of changes in the outstanding Common
Stock by reason of stock dividends, split-ups, recapitalizations, reclassifications, combinations or exchanges of shares, separations,
reorganizations, liquidations, or the like, the number and class of shares available under the Warrant in the aggregate and the Exercise
Price shall be correspondingly adjusted to give the Holder of the Warrant, on exercise for the same aggregate Exercise Price, the total
number, class, and kind of shares as the Holder would have owned had the Warrant been exercised prior to the event and had the Holder
continued to hold such shares until after the event requiring adjustment. The form of this Warrant need not be changed because of any
adjustment in the number, class, and kind of shares subject to this Warrant. The Company shall promptly provide a certificate from an
authorized officer notifying the Holder in writing of any adjustment in the Exercise Price and/or the total number, class, and kind of
shares issuable upon exercise of this Warrant, which certificate shall specify the Exercise Price and number, class and kind of shares
under this Warrant after giving effect to such adjustment.


 


		6.	SALE OF THE COMPANY.



 


In the event of a Sale of the Company, then the Company shall ensure
that lawful and adequate provision shall be made whereby the Holder shall thereafter have the right to purchase and receive upon the basis
and upon the terms and conditions herein specified and in lieu of the Warrant Shares immediately theretofore issuable upon exercise of
this Warrant only as provided for in Section 2(a)(iii)(1), such shares of stock, securities or assets (including cash) as would have been
issuable or payable with respect to or in exchange for a number of Warrant Shares equal to the number of Warrant Shares immediately theretofore
issuable upon exercise of this Warrant, had such Sale of the Company not taken place, and in any such case appropriate provision shall
be made with respect to the rights and interests of the Holder to the end that the provisions hereof (including, without limitation, provision
for adjustment of the Exercise Price) shall thereafter be applicable, as nearly equivalent as may be practicable in relation to any share
of stock, securities or assets (including cash) thereafter deliverable upon the exercise thereof. The Company shall not effect any Sale
of the Company unless prior to or simultaneously with the consummation thereof the successor entity (if other than the Company) resulting
from such Sale of the Company, or the entity purchasing or otherwise acquiring such assets or other appropriate corporation or entity
shall assume the obligation to deliver to the Holder, at the last address of the Holder appearing on the books of the Company, such shares
of stock, securities or assets (including cash) as, in accordance with the foregoing provisions, the Holder may be entitled to purchase,
and the other obligations under this Warrant. The provisions of this Section 6 shall similarly apply to successive Sales of
the Company.


 


		7.	FRACTIONAL SHARES, ADJUSTMENT OF EXERCISE PRICE.



 


No fractional shares shall be issued upon the exercise of this Warrant
as a consequence of any adjustment pursuant hereto. All Warrant Shares (including fractions) issuable upon exercise of this Warrant may
be aggregated for purposes of determining whether the exercise would result in the issuance of any fractional share. If, after aggregation,
the exercise would result in the issuance of a fractional share, the Company shall, in lieu of issuance of any fractional share, pay the
Holder otherwise entitled to such fraction a sum in cash equal to the product resulting from multiplying the then current fair market
value of a Warrant Share by such fraction. No adjustment in the Exercise Price shall be required unless such adjustment would require
an increase or decrease of at least $0.0001; provided, however, that any adjustments which by reason of this Section 7 are not
required to be made shall be carried forward and taken into account in any subsequent adjustment. All calculations under this Section
7 shall be made to the $0.0001 or to the nearest 1/100th of a share, as the case may be.


 


		8.	NO STOCKHOLDER RIGHTS.



 


This Warrant in and of itself shall not entitle the Holder to any voting
rights or, except as otherwise set forth herein, other rights as a stockholder of the Company.


 


		9.	RESERVATION OF SHARES.



 


The Company shall at all times reserve and keep available out of its
authorized but unissued shares Common Stock no less than 100% of the maximum number of shares of Common Stock issuable upon full exercise
of the Warrant.


 


		10.	TRANSFER OF WARRANT.



 


Subject to applicable laws and compliance with Section 4(c)
hereof, this Warrant and all rights hereunder are transferable, by the Holder in person or by duly authorized attorney, upon delivery
of this Warrant and the form of assignment attached hereto to any transferee designated by Holder.


 






    4


     


    

 


		11.	LOST, STOLEN, MUTILATED OR DESTROYED WARRANT.



 


If this Warrant is lost, stolen, mutilated or destroyed, the Company
may, on such terms as to indemnity or otherwise as it may reasonably impose (which shall, in the case of a mutilated Warrant, include
the surrender thereof), issue a new Warrant of like denomination and tenor as the Warrant so lost, stolen, mutilated or destroyed. Any
such new Warrant shall constitute an original contractual obligation of the Company, whether or not the allegedly lost, stolen, mutilated
or destroyed Warrant shall be at any time enforceable by anyone.


 


		12.	MODIFICATIONS AND WAIVER.



 


Provisions of this Warrant may be amended or modified, or a provision
or requirement hereof waived, only with the written consent of the Company and the Holder.


 


		13.	NOTICES, ETC.



 


All notices required or permitted hereunder shall be in writing and
shall be deemed effectively given as specified in the Placement Agent Agreement.


 


		14.	ACCEPTANCE.



 


Receipt of this Warrant by the Holder shall constitute acceptance of
and agreement to all of the terms and conditions contained herein.


 


		15.	GOVERNING LAW.



 


This Warrant shall be construed and enforced in accordance with, and
all questions concerning the construction, validity, interpretation and performance of this Warrant shall be governed by, the internal
laws of the State of New York, without giving effect to any choice of law or conflict of law provision or rule (whether of the State of
New York or any other jurisdictions) that would cause the application of the laws of any jurisdictions other than the State of New York.
The Company hereby irrevocably submits to the exclusive jurisdiction of the state and federal courts sitting in The City of New York,
Borough of Manhattan, for the adjudication of any dispute hereunder or in connection herewith or with any transaction contemplated hereby
or discussed herein, and hereby irrevocably waives, and agrees not to assert in any suit, action or proceeding, any claim that it is not
personally subject to the jurisdiction of any such court, that such suit, action or proceeding is brought in an inconvenient forum or
that the venue of such suit, action or proceeding is improper. Nothing contained herein shall be deemed to limit in any way any right
to serve process in any manner permitted by law. Nothing contained herein shall be deemed or operate to preclude the Holder from bringing
suit or taking other legal action against the Company in any other jurisdiction to collect on the Company’s obligations to the Holder,
to realize on any collateral or any other security for such obligations, or to enforce a judgment or other court ruling in favor of the
Holder. EACH OF THE PARTIES HERETO HEREBY IRREVOCABLY WAIVES ANY RIGHT SUCH PARTY MAY HAVE TO, AND AGREES NOT TO REQUEST, A JURY TRIAL
FOR THE ADJUDICATION OF ANY DISPUTE HEREUNDER OR IN CONNECTION WITH OR ARISING OUT OF THIS NOTE OR ANY TRANSACTION CONTEMPLATED HEREBY.


 


		16.	DESCRIPTIVE HEADINGS.



 


The descriptive headings of the several paragraphs of this Warrant
are inserted for convenience only and do not constitute a part of this Warrant. The language in this Warrant shall be construed as to
its fair meaning without regard to which party drafted this Warrant.


 


		17.	SEVERABILITY.



 


The invalidity or unenforceability of any provision of this Warrant
in any jurisdiction shall not affect the validity or enforceability of such provision in any other jurisdiction, or affect any other provision
of this Warrant, which shall remain in full force and effect.


 


		18.	ENTIRE AGREEMENT.



 


This Warrant and the Placement Agent Agreement between the Holder and
the Company dated January 27, 2021, constitute the entire agreement between the parties pertaining to the subject matter contained in
it and supersede all prior and contemporaneous agreements, representations, and undertakings of the parties, whether oral or written,
with respect to such subject matter.


 


[Signature Page Follows]


 









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IN WITNESS WHEREOF, the Company has caused
this Warrant to be executed by its duly authorized officer as of January 31, 2021.


 


	 	rEVELATION BIOSCIENCES, INC.
	 	 
	 	By:	 
	 	Name:	 Chester S. Zygmont, III
	 	Title: 	Chief Financial Officer
	 	 
	 	Address for Notice:
	 	 
	 	Revelation Biosciences
	 	350 Sharon Park Drive, R4
	 	Menlo Park, CA 94025
	 	Attention: James Rolke, Chief Executive Officer



 


	National Securities corporation	 
	 	 
	By:	 	 
	Name: 	Jeff Sacher 	 
	Title: 	Senior Managing Director	 
	 	 
	Address for Notice:	 
	 	 
	National Securities Corporation 	 
	200 Vesey Street, 25th Floor	 
	New York, NY 10281	 
	Jeff Sacher, Senior Managing Director	 



 


[Signature Page to Warrant]


 






     


     


    

 


NOTICE OF EXERCISE


 


TO: revelation BIOSCIENCES,
INC.


 


(1) The undersigned hereby irrevocably elects to exercise this
Warrant and to purchase thereunder, ___________________ full shares of Revelation Biosciences, Inc. Common Stock issuable upon exercise
of the Warrant and delivery of:


 


		●	$_________ (in cash as provided for in the foregoing Warrant) and any applicable taxes payable by the
undersigned pursuant to such Warrant; and



 


		●	__________ shares of Common Stock (pursuant to a Cashless Exercise in accordance with Section 2(a)(iii)(2)
of the Warrant) (check here if the undersigned desires to deliver an unspecified number of shares equal the number sufficient to effect
a Cashless Exercise [___]).



 


(2) Please issue a certificate or certificates representing
said shares of Common Stock in the name of the undersigned or in such other name as is specified below:


 


 








(Name)


 


 








(Address)


 


(3) If the shares issuable upon this exercise
of the Warrant are not all of the Warrant Shares which the Holder is entitled to acquire upon the exercise of the Warrant, the undersigned
requests that a new Warrant evidencing the rights not so exercised be issued in the name of and delivered to:


 


 






(Name)


 


 








(Address and social security or federal employer identification number
(if applicable))


 


(4) The undersigned represents that (i) the aforesaid shares
of Common Stock are being acquired for the account of the undersigned for investment and not with a view to, or for resale in connection
with, the distribution thereof and that the undersigned has no present intention of distributing or reselling such shares in violation
of the Securities Act of 1933, as amended (the “Securities Act”); (ii) the undersigned is aware of the
Company’s business affairs and financial condition and has acquired sufficient information about the Company to reach an informed
and knowledgeable decision regarding its investment in the Company; (iii) the undersigned is experienced in making investments of
this type and has such knowledge and background in financial and business matters that the undersigned is capable of evaluating the merits
and risks of this investment and protecting the undersigned’s own interests; (iv) the undersigned understands that the issuance
of the shares of Common Stock upon exercise of this Warrant has not been registered under the Securities Act by reason of a specific exemption
from the registration provisions of the Securities Act, which exemption depends upon, among other things, the bona fide nature of the
investment intent as expressed herein, and, because the issuance of such securities has not been registered under the Securities Act,
such securities must be held indefinitely unless the resale thereof is subsequently registered under the Securities Act or an exemption
from such registration is available; (v) the undersigned is aware that the aforesaid shares of Common Stock may not be sold pursuant
to Rule 144 adopted under the Securities Act unless certain conditions are met and until the undersigned has held the shares for the time
period prescribed by Rule 144, that among the conditions for use of Rule 144 is the availability of current information to the public
about the Company; and (vi) the undersigned agrees not to make any disposition of all or any part of the aforesaid shares of Common
Stock unless and until there is then in effect a registration statement under the Securities Act covering such proposed disposition and
such disposition is made in accordance with said registration statement, or the undersigned has furnished the Company with an opinion
of counsel, reasonably satisfactory to the Company, to the effect that such disposition is not required to be registered pursuant to the
Securities Act or any applicable state securities laws; provided, that no opinion shall be required for any disposition made or
to be made in accordance with the provisions of Rule 144.


 


	Date:	 		Signature:	 
	 	 	 
		 	Print Name: 	 



 









     


     


    

 


ASSIGNMENT FORM


 


(To assign the foregoing Warrant, subject to compliance with Section
4(c) hereof, execute this form and supply required information. Do not use this form to purchase shares.)


 


FOR VALUE RECEIVED, the foregoing Warrant and all rights evidenced
thereby are hereby assigned to:


 


 








(Name)


 


 






(Address)


 


Dated: ________________, 20___


 


	 	Holder’s Name:	 
		Holder’s Signature: 	 
	 	Holder’s Address:	 
	 	 	 
	 	 	 



 


NOTE: The signature to this Assignment Form must correspond
with the name as it appears on the face of the Warrant, without alteration or enlargement or any change whatever. Officers of corporations
and those acting in a fiduciary or other representative capacity should file proper evidence of authority to assign the foregoing Warrant.