Exhibit 4.1


 


THIS
PURCHASE WARRANT AND THE SECURITIES DELIVERABLE UPON EXERCISE HEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933,
AS AMENDED (THE “ACT”), OR APPLICABLE STATE LAW. THIS PURCHASE WARRANT MAY NOT BE OFFERED FOR SALE, SOLD, EXERCISED
OR OTHERWISE TRANSFERRED EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE ACT, OR PURSUANT TO AN EXEMPTION FROM
REGISTRATION UNDER THE ACT AND APPLICABLE STATE LAW WHICH, IN THE OPINION OF COUNSEL TO THE COMPANY, IS AVAILABLE.


 


COMMON
STOCK PURCHASE WARRANT


 


For
the Purchase of [●] Shares of Common Stock


 


of


 


American
BriVision (Holding) Corporation


 


1.
Purchase Warrant. THIS CERTIFIES THAT, in consideration of funds duly paid by or on behalf of [INVESTOR] (“Holder”),
as registered owner of this Purchase Warrant, to American BriVision (Holding) Corporation., a Nevada company (the “Company”),
Holder is entitled, at any time or from time to time from [●], 2020 (the “Commencement Date”), and at
or before 5:00 p.m., Eastern time, [●], 2023, (the “Expiration Date”), but not thereafter, to subscribe
for, purchase and receive, in whole or in part, up to [●] shares of of common stock of the Company, par value $0.001 (the
“Shares”), subject to adjustment as provided in Section 5 hereof. If the Expiration Date is a day on
which banking institutions are authorized by law to close, then this Purchase Warrant may be exercised on the next succeeding
day which is not such a day in accordance with the terms herein. During the period ending on the Expiration Date, the Company
agrees not to take any action that would terminate this Purchase Warrant. This Purchase Warrant is initially exercisable at $5.00
per Share; provided, however, that upon the occurrence of any of the events specified in Section 4 hereof,
the rights granted by this Purchase Warrant, including the exercise price per Share and the number of Shares to be received upon
such exercise, shall be adjusted as therein specified. The term “Exercise Price” shall mean the initial exercise
price or the adjusted exercise price, depending on the context. Capitalized terms used and not otherwise defined herein shall
have the meanings set forth in that certain Exchange Agreement, dated April 5, 2020, between the Company and the Holder (the “Agreement”)


 


2.
Exercise.


 


2.1.
Exercise Form. In order to exercise this Purchase Warrant, the exercise form attached hereto (“Notice of Exercise”)
must be duly executed and completed and delivered to the Company, together with this Purchase Warrant and payment of the Exercise
Price for the Shares being purchased payable in cash by wire transfer of immediately available funds to an account designated
by the Company or by certified check or official bank check. If the subscription rights represented hereby shall not be exercised
at or before 5:00 p.m., Eastern Time, on the Expiration Date, this Purchase Warrant shall become and be void without further force
or effect, and all rights represented hereby shall cease and expire. Notwithstanding anything herein to the contrary, the Holder
shall not be required to physically surrender this Purchase Warrant to the Company until the Holder has purchased all of the Shares
available hereunder and the Purchase Warrant has been exercised in full, in which case, the Holder shall surrender this Warrant
to the Company for cancellation within three (3) business days of the date the final notice of exercise is delivered to the Company.
Partial exercises of this Purchase Warrant resulting in purchases of a portion of the total number of Shares available hereunder
shall have the effect of lowering the outstanding number of Shares purchasable hereunder in an amount equal to the applicable
number of Shares purchased. The Holder and the Company shall maintain records showing the number of Shares purchased and the date
of such purchases; provided that the records of the Company, absent manifest error, will be conclusive with respect to the number
of Shares purchasable from time to time hereunder.


 



     


     


    

 





2.2.
Mandatory Exercise. If at any time from and after the date hereof, the closing price of the Company’s common stock on the
Trading Market equals or exceeds $9.00 per share (which amount may be adjusted for certain capital events, such as stock splits,
as described herein) for twenty (20) Trading Days during any thirty (30) day period (the “Mandatory Exercise Measuring Period”),
then the Company shall have the right to require the Holder to exercise all or any portion of this Warrant still unexercised for
a cash exercise, as designated in the Mandatory Exercise Notice on the Mandatory Exercise Date (each as defined below) into fully
paid, validly issued and nonassessable shares of Common Stock in accordance with Section 2 hereof at the Exercise Price as of
the Mandatory Exercise Date (as defined below) (a “Mandatory Exercise”). The Company may exercise its right to require
exercise under this Section 2 by delivering within not more than five (5) Trading Days following the end of such Mandatory Exercise
Measuring Period a written notice thereof by electronic mail to the Holder (the “Mandatory Exercise Notice” and the
date that the Holder received such notice is referred to as the “Mandatory Exercise Notice Date”). The Mandatory Exercise
Notice shall be irrevocable. The Mandatory Exercise Notice shall state (I) the Trading Day on which the Mandatory Exercise shall
occur, which shall be the second (2nd) Trading Day following the Mandatory Exercise Notice Date (the “Mandatory Exercise
Date”) and (II) the aggregate number of Warrants which the Company has elected to be subject to such Mandatory Exercise
from the Holder (the “Mandatory Exercise Amount”) pursuant to this Section 2. If the Warrants have not been exercised
by the Mandatory Exercise Date, the Warrants shall be cancelled.


 


2.3.
Mechanics of Exercise


 


2.3.1.
Delivery of Shares upon Exercise. The Company shall use its best efforts to cause the Shares purchased hereunder to be
transmitted by the Company’s transfer agent to the Holder by crediting the account of the Holder’s prime broker with
The Depository Trust Company through its Deposit or Withdrawal at Custodian system (“DWAC”) if the Company is then
a participant in such system and either (A) there is an effective registration statement permitting the issuance of the Shares
to or resale of the Shares or (B) this Purchase Warrant is being exercised via cashless exercise, and otherwise by physical delivery
to the address specified by the Holder in the Notice of Exercise by the date that is no later than 11:00 am, Eastern time, on
the third (3rd) business day after the latest of (A) the delivery to the Company of the Notice of Exercise, (B) surrender of this
Purchase Warrant (if required) and (C) payment of the aggregate Exercise Price as set forth above (including by cashless exercise,
if permitted) (such date, the “Share Delivery Date”). The Shares shall be deemed to have been issued, and Holder
or any other person so designated to be named therein shall be deemed to have become a holder of record of such shares for all
purposes, as of the date the Purchase Warrant has been exercised, with payment to the Company of the Exercise Price (or by cashless
exercise, if permitted) and all taxes required to be paid by the Holder, if any, pursuant to Section 2.6.6 prior to the
issuance of such shares, having been paid.


 


2.3.2.
Delivery of New Purchase Warrant upon Exercise. If this Purchase Warrant shall have been exercised in part, the Company
shall, at the request of a Holder and upon surrender of this Purchase Warrant, at the time of delivery of the Shares, deliver
to the Holder a new Purchase Warrant evidencing the rights of the Holder to purchase the unpurchased Shares called for by this
Purchase Warrant, which new Purchase Warrant shall in all other respects be identical with this Purchase Warrant.


 


2.3.3.
Rescission Rights. If the Company fails to cause its transfer agent to transmit to the Holder the Shares pursuant to Section
2.6.1 by the Share Delivery Date, then the Holder will have the right to rescind such exercise.


 






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2.3.4.
No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued upon the exercise
of this Purchase Warrant. As to any fraction of a share which the Holder would otherwise be entitled to purchase upon such exercise,
the Company shall, at its election, either pay a cash adjustment in respect of such final fraction in an amount equal to such
fraction multiplied by the Exercise Price or round up to the next whole share.


 


2.3.5.
Closing of Books. The Company will not close its shareholder books or records in any manner which prevents the timely exercise
of this Purchase Warrant, pursuant to the terms hereof.


 


2.4.
General Terms.


 


3.
New Purchase Warrants to be Issued.


 


3.1.
Partial Exercise or Transfer. Subject to the restrictions in Section 3 hereof, this Purchase Warrant may be exercised
or assigned in whole or in part. In the event of the exercise or assignment hereof in part only, upon surrender of this Purchase
Warrant for cancellation, together with the duly executed exercise or assignment form and funds sufficient to pay any Exercise
Price and/or transfer tax if exercised pursuant to Section 2.1 hereto, the Company shall cause to be delivered to the Holder
without charge a new Purchase Warrant of like tenor to this Purchase Warrant in the name of the Holder evidencing the right of
the Holder to purchase the number of Shares purchasable hereunder as to which this Purchase Warrant has not been exercised or
assigned.


 


3.2.
Lost Certificate. Upon receipt by the Company of evidence satisfactory to it of the loss, theft, destruction or mutilation
of this Purchase Warrant and of reasonably satisfactory indemnification or the posting of a bond, the Company shall execute and
deliver a new Purchase Warrant of like tenor and date. Any such new Purchase Warrant executed and delivered as a result of such
loss, theft, mutilation or destruction shall constitute a substitute contractual obligation on the part of the Company.


 


4.
Adjustments.


 


4.1.
Adjustments to Exercise Price and Number of Securities. The Exercise Price and the number of Shares underlying the Purchase
Warrant shall be subject to adjustment from time to time as hereinafter set forth:


 


4.1.1.
Share Dividends; Split Ups. If, after the date hereof, and subject to the provisions of Section 5.3 below, the number
of outstanding Shares is increased by a share dividend payable in Shares or by a split up of Shares or other similar event, then,
on the effective day thereof, the number of Shares purchasable hereunder shall be increased in proportion to such increase in
outstanding Shares, and the Exercise Price shall be proportionately decreased.


 


4.1.2.
Aggregation of Shares. If, after the date hereof, and subject to the provisions of Section 5.3 below, the number
of outstanding Shares is decreased by a consolidation, combination or reclassification of Shares or other similar event, then,
on the effective date thereof, the number of Shares purchasable hereunder shall be decreased in proportion to such decrease in
outstanding Shares, and the Exercise Price shall be proportionately increased.


 






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4.1.3.
Replacement of Securities Upon Reorganization, etc. In case of any reclassification or reorganization of the outstanding
Shares other than a change covered by Section 5.1.1 or Section 5.1.2 hereof or that solely affects the par value
of such Shares, or in the case of any share reconstruction or amalgamation or consolidation of the Company with or into another
corporation (other than a consolidation or share reconstruction or amalgamation in which the Company is the continuing corporation
and that does not result in any reclassification or reorganization of the outstanding Shares), or in the case of any sale or conveyance
to another corporation or entity of the property of the Company as an entirety or substantially as an entirety in connection with
which the Company is dissolved, this Purchase Warrant shall, immediately after such reorganization, reclassification, consolidation,
merger, sale or similar transaction, remain outstanding and shall thereafter, in lieu of or in addition to (as the case may be)
the number of Shares then exercisable under this Purchase Warrant, be exercisable for the kind and number of shares of stock or
other securities or assets of the Company or of the successor person resulting from such transaction to which the Holder would
have been entitled upon such reorganization, reclassification, consolidation, merger, sale or similar transaction if the Holder
had exercised this Warrant in full immediately prior to the time of such reorganization, reclassification, consolidation, merger,
sale or similar transaction and acquired the applicable number of Shares then issuable hereunder as a result of such exercise
(without taking into account any limitations or restrictions on the exercisability of this Purchase Warrant); and, in such case,
appropriate adjustment shall be made with respect to the Holder’s rights under this Purchase Warrant to insure that the
provisions of this Section 5.1.3 hereof shall thereafter be applicable, as nearly as possible, to this Purchase Warrant
in relation to any shares of stock, securities or assets thereafter acquirable upon exercise of this Purchase Warrant (including,
in the case of any consolidation, merger, sale or similar transaction in which the successor or purchasing person is other than
the Company, an immediate adjustment in the Exercise Price to the value per share reflected by the terms of such consolidation,
merger, sale or similar transaction, and a corresponding immediate adjustment to the number of Shares acquirable upon exercise
of this Purchase Warrant without regard to any limitations or restrictions on exercise, if the value so reflected is less than
the Exercise Price in effect immediately prior to such consolidation, merger, sale or similar transaction). The provisions of
this Section 4.1.3 shall similarly apply to successive reorganizations, reclassifications, consolidations, mergers, sales
or similar transactions. The Company shall not affect any such reorganization, reclassification, consolidation, merger, sale or
similar transaction unless, prior to the consummation thereof, the successor person (if other than the Company) resulting from
such reorganization, reclassification, consolidation, merger, sale or similar transaction, shall assume, by written instrument
substantially similar in form and substance to this Purchase Warrant and satisfactory to the Holder, the obligation to deliver
to the Holder such shares of stock, securities or assets which, in accordance with the foregoing provisions, such Holder shall
be entitled to receive upon exercise of this Warrant.


 


4.1.4.
Changes in Form of Purchase Warrant. This form of Purchase Warrant need not be changed because of any change pursuant to
this Section 4.1, and Purchase Warrants issued after such change may state the same Exercise Price and the same number
of Shares as are stated in the Purchase Warrants initially issued pursuant to this Agreement. The acceptance by any Holder of
the issuance of new Purchase Warrants reflecting a required or permissive change shall not be deemed to waive any rights to an
adjustment occurring after the Commencement Date or the computation thereof.


 


4.2.
Substitute Purchase Warrant. In case of any consolidation of the Company with, or share reconstruction or amalgamation
of the Company with or into, another corporation (other than a consolidation or share reconstruction or amalgamation which does
not result in any reclassification or change of the outstanding Shares), the corporation formed by such consolidation or share
reconstruction or amalgamation shall execute and deliver to the Holder a supplemental Purchase Warrant providing that the holder
of each Purchase Warrant then outstanding or to be outstanding shall have the right thereafter (until the stated expiration of
such Purchase Warrant) to receive, upon exercise of such Purchase Warrant, the kind and amount of shares and other securities
and property receivable upon such consolidation or share reconstruction or amalgamation, by a holder of the number of Shares of
the Company for which such Purchase Warrant might have been exercised immediately prior to such consolidation, share reconstruction
or amalgamation, sale or transfer. Such supplemental Purchase Warrant shall provide for adjustments which shall be identical to
the adjustments provided for in this Section 5. The above provision of this Section shall similarly apply to successive
consolidations or share reconstructions or amalgamations.


 






     4


     


    

 


4.3.
Elimination of Fractional Interests. The Company shall not be required to issue certificates representing fractions of
Shares upon the exercise of the Purchase Warrant, nor shall it be required to issue scrip or pay cash in lieu of any fractional
interests, it being the intent of the parties that all fractional interests shall be eliminated by rounding any fraction up or
down, as the case may be, to the nearest whole number of Shares or other securities, properties or rights.


 


5.
Reservation and Listing.


 


5.1.
The Company shall at all times reserve and keep available out of its authorized Shares, solely for the purpose of issuance upon
exercise of the Purchase Warrants, such number of Shares or other securities, properties or rights as shall be issuable upon the
exercise thereof. The Company covenants and agrees that, upon exercise of the Purchase Warrants and payment of the Exercise Price
therefor, in accordance with the terms hereby, all Shares and other securities issuable upon such exercise shall be duly and validly
issued, fully paid and non-assessable, free from all taxes, liens and charges in respect of the issue thereof (other than taxes
in respect of any transfer occurring contemporaneously with such issue) and not subject to preemptive rights of any shareholder.
As long as the Purchase Warrants shall be outstanding, the Company shall use its best efforts to cause all Shares issuable upon
exercise of the Purchase Warrants to be listed (subject to official notice of issuance) on all national securities exchanges (or,
if applicable, quoted on the OTC Bulletin Board or any successor trading market) on which the Company’s shares of common
stock may then be listed and/or quoted.


 


5.2.
Except and to the extent as waived or consented to by the Holder, the Company shall not by any action, including, without limitation,
amending its certificate of incorporation or through any reorganization, transfer of assets, consolidation, merger, 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 Purchase Warrant, but will at all times in good faith assist in the carrying out of all such terms and in the taking
of all such actions as may be necessary or appropriate to protect the rights of Holder as set forth in this Purchase Warrant against
impairment. Without limiting the generality of the foregoing, the Company will (i) not increase the par value of any Shares above
the amount payable therefor upon the exercise of this Purchase Warrant, (ii) take all such action as may be necessary or appropriate
in order that the Company may validly and legally issue fully paid and nonassessable Shares upon the exercise of this Purchase
Warrant and (iii) use commercially reasonable efforts to obtain all such authorizations, exemptions or consents from any public
regulatory body having jurisdiction thereof, as may be, necessary to enable the Company to perform its obligations under this
Purchase Warrant.


 


5.3.
Before taking any action which would result in an adjustment in the number of Shares for which this Purchase Warrant is exercisable
or in the Exercise Price, the Company shall obtain all such authorizations therefor, exemptions thereof, or consents thereto,
as may be necessary from any regulatory body having jurisdiction thereof


 


6.
Certain Notice Requirements.


 


6.1.
Holder’s Right to Receive Notice. Nothing herein shall be construed as conferring upon the Holders the right to vote
or consent or to receive notice as a shareholder for the election of directors or any other matter, or as having any rights whatsoever
as a shareholder of the Company. If, however, at any time prior to the expiration of the Purchase Warrants and their exercise,
any of the events described in Section 6.2 shall occur, then, in one or more of said events, the Company shall give written
notice of such event at least ten (10) days prior to the date fixed as a record date or the date of closing the transfer books
for the determination of the shareholders entitled to such dividend, distribution, conversion or exchange of securities or subscription
rights, or entitled to vote on such proposed dissolution, liquidation, winding up or sale. Such notice shall specify such record
date or the date of the closing of the transfer books, as the case may be. Notwithstanding the foregoing, the Company shall deliver
to each Holder a copy of each notice given to the other shareholders of the Company at the same time and in the same manner that
such notice is given to the shareholders.


 






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6.2.
Events Requiring Notice. The Company shall be required to give the notice described in this Section 6 upon one or
more of the following events: (i) if the Company shall take a record of the holders of its Shares for the purpose of entitling
them to receive a dividend or distribution payable otherwise than in cash, or a cash dividend or distribution payable otherwise
than out of retained earnings, as indicated by the accounting treatment of such dividend or distribution on the books of the Company,
(ii) the Company shall offer to all the holders of its Shares any additional shares of capital stock of the Company or securities
convertible into or exchangeable for shares of capital stock of the Company, or any option, right or warrant to subscribe therefor,
or (iii) a dissolution, liquidation or winding up of the Company (other than in connection with a consolidation or share reconstruction
or amalgamation) or a sale of all or substantially all of its property, assets and business shall be proposed.


 


6.3.
Notice of Change in Exercise Price. The Company shall, promptly after an event requiring a change in the Exercise Price
pursuant to Section 4 hereof, send notice to the Holders of such event and change (“Price Notice”).
The Price Notice shall describe the event causing the change and the method of calculating same and shall be certified as being
true and accurate by the Company’s Chief Financial Officer.


 


6.4.
Transmittal of Notices. All notices, requests, consents and other communications under this Purchase Warrant shall be in
writing and shall be deemed to have been duly made when hand delivered, or mailed by express mail or private courier service:
(i) if to the registered Holder of the Purchase Warrant, to the address of such Holder as shown on the books of the Company, or
(ii) if to the Company, to following address or to such other address as the Company may designate by notice to the Holders:


 


American
BriVision (Holding) Corporation


44370
Old Warm Springs Blvd.


Fremont,
CA 94538


Attn:
Howard Doong, CEO


Fax
No.: [●]


 


With
a copy (which shall not constitute notice) to:


 


Hunter
Taubman Fischer & Li LLC


1450
Broadway, 26 FL


New
York, NY10018


Attn:
Joan Wu, Esq.


Fax
No.: (212) 202-6380


 


6.5.
Amendments. This Warrant may be modified or amended or the provisions hereof waived with the written consent of the Company
and the Holder.


 


6.6.
Headings. The headings contained herein are for the sole purpose of convenience of reference, and shall not in any way
limit or affect the meaning or interpretation of any of the terms or provisions of this Purchase Warrant.


 


6.7.
Entire Agreement. This Purchase Warrant (together with the other agreements and documents being delivered pursuant to or
in connection with this Purchase Warrant) constitutes the entire agreement of the parties hereto with respect to the subject matter
hereof, and supersedes all prior agreements and understandings of the parties, oral and written, with respect to the subject matter
hereof.


 






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6.8.
Limitation of Liability. No provision hereof, in the absence of affirmative action by the Holder sufficient to exercise
this Purchase Warrant to purchase Shares, and no enumeration herein of the rights or privileges of the Holder, shall give rise
to any liability of the Holder for the purchase price of any shares of common stock or as a stockholder of the Company, whether
such liability is asserted by the Company or by creditors of the Company.


 


6.9.
Severability. Wherever possible, each provision of this Purchase Warrant shall be interpreted in such manner as to be effective
and valid under applicable law, but if any provision of this Purchase Warrant shall be prohibited by or invalid under applicable
law, such provision shall be ineffective to the extent of such prohibition or invalidity, without invalidating the remainder of
such provision or the remaining provisions of this Purchase Warrant.


 


6.10.
Binding Effect. This Purchase Warrant shall inure solely to the benefit of and shall be binding upon, the Holder and the
Company and their permitted assignees, respective successors, legal representative and assigns, and no other person shall have
or be construed to have any legal or equitable right, remedy or claim under or in respect of or by virtue of this Purchase Warrant
or any provisions herein contained.


 


6.11.
Governing Law; Submission to Jurisdiction; Trial by Jury. This Purchase Warrant shall be governed by and construed and
enforced in accordance with the laws of the State of New York, without giving effect to conflict of laws principles thereof. Each
of the Company and the Holder hereby agrees that any action, proceeding or claim against it arising out of, or relating in any
way to this Purchase Warrant shall be brought and enforced in the New York Supreme Court, County of New York, or in the United
States District Court for the Southern District of New York, and irrevocably submits to such jurisdiction, which jurisdiction
shall be exclusive. Each of the Company and the Holder hereby waives any objection to such exclusive jurisdiction and that such
courts represent an inconvenient forum. Any process or summons to be served upon the Company or the Holder may be served by transmitting
a copy thereof by registered or certified mail, return receipt requested, postage prepaid, addressed to it at the address set
forth in Section 8 hereof. Such mailing shall be deemed personal service and shall be legal and binding upon the Company and the
Holder in any action, proceeding or claim. The Company and the Holder agree that the prevailing party(ies) in any such action
shall be entitled to recover from the other party(ies) all of its reasonable attorneys’ fees and expenses relating to such
action or proceeding and/or incurred in connection with the preparation therefor. The Company (on its behalf and, to the extent
permitted by applicable law, on behalf of its shareholders and affiliates) and the Holder hereby irrevocably waive, to the fullest
extent permitted by applicable law, any and all right to trial by jury in any legal proceeding arising out of or relating to this
Agreement or the transactions contemplated hereby.


 


6.12.
Waiver, etc. The failure of the Company or the Holder to at any time enforce any of the provisions of this Purchase Warrant
shall not be deemed or construed to be a waiver of any such provision, nor to in any way affect the validity of this Purchase
Warrant or any provision hereof or the right of the Company or any Holder to thereafter enforce each and every provision of this
Purchase Warrant. No waiver of any breach, non-compliance or non-fulfillment of any of the provisions of this Purchase Warrant
shall be effective unless set forth in a written instrument executed by the party or parties against whom or which enforcement
of such waiver is sought; and no waiver of any such breach, non-compliance or non-fulfillment shall be construed or deemed to
be a waiver of any other or subsequent breach, non-compliance or non-fulfillment. Without limiting any other provision of this
Purchase Warrant or the Agreement, if the Company willfully and knowingly fails to comply with any provision of this Purchase
Warrant, which results in any damages to the Holder, the Company shall pay to the Holder such amounts as shall be sufficient to
cover any costs and expenses including, but not limited to, reasonable attorneys’ fees, including those of appellate proceedings,
incurred by the Holder in collecting any amounts due pursuant hereto or in otherwise enforcing any of its rights, powers or remedies
hereunder.


 


[Signature
Page Follows]


 




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IN
WITNESS WHEREOF, the Company has caused this Purchase Warrant to be signed by its duly authorized officer as of the [●]
day of [●], 2020.


 


	American
    BriVision (Holding) Corporation	 
	 	 
	By:	 	 
	 	 
		Name:Chihliang An	 
		Title:Chief Financial Officer	 




 




     


     


    


 


[FORM
TO BE USED TO EXERCISE PURCHASE WARRANT]


 


Date: ________________


 


The
undersigned hereby elects irrevocably to exercise the Purchase Warrant for [●] shares of common stock, par value $0.001
(the “Shares”), of American BriVision (Holding) Corporation, a Nevada company (the “Company”),
and hereby makes payment of $ [●] (at the rate of $[●] per Share) in payment of the Exercise Price pursuant thereto.
Please issue the Shares as to which this Purchase Warrant is exercised in accordance with the instructions given below and, if
applicable, a new Purchase Warrant representing the number of Shares for which this Purchase Warrant has not been exercised.


 


Please
issue the Shares as to which this Purchase Warrant is exercised in accordance with the instructions given below and, if applicable,
a new Purchase Warrant representing the number of Shares for which this Purchase Warrant has not been converted.


 


	Signature	 	 



 


	Signature Guaranteed	 	 




 


INSTRUCTIONS
FOR REGISTRATION OF SECURITIES


 


	Name: 	 	 
	 	(Print in Block Letters)	 
	 	 	 
	Address:	 	 
	 	 	 
	 	 	 
	 	 	 





 


NOTICE:
The signature to this form must correspond with the name as written upon the face of the Purchase Warrant without alteration or
enlargement or any change whatsoever, and must be guaranteed by a bank, other than a savings bank, or by a trust company or by
a firm having membership on a registered national securities exchange.


 




     


     


    


 


[FORM
TO BE USED TO ASSIGN PURCHASE WARRANT]


 


ASSIGNMENT


 


(To
be executed by the registered Holder to effect a transfer of the within Purchase Warrant):


 


FOR
VALUE RECEIVED, [●] does hereby sell, assign and transfer unto the right to purchase shares of common stock, par value $0.001,
of American BriVision (Holding) Corporation, a Nevada company (the “Company”), evidenced by the Purchase Warrant
and does hereby authorize the Company to transfer such right on the books of the Company.


 


	Dated	 	 
	 	 
	Signature	 	 



 


	Signature Guaranteed	 	 




 


NOTICE:
The signature to this form must correspond with the name as written upon the face of the within Purchase Warrant without alteration
or enlargement or any change whatsoever, and must be guaranteed by a bank, other than a savings bank, or by a trust company or
by a firm having membership on a registered national securities exchange.