Document:

Form of Debenture dated August 29, 2008

 EXHIBIT 4.8 
 THESE SECURITIES HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR THE SECURITIES LAWS OF ANY STATE AND MAY NOT BE SOLD OR OFFERED FOR SALE IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT
FOR THE SECURITIES OR AN OPINION OF COUNSEL OR OTHER EVIDENCE ACCEPTABLE TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED. 
  

			
	No. 08-03-01	  	US $xxx,xxx.xx

 OMNICOMM SYSTEMS, INC.

 10% CONVERTIBLE DEBENTURE SERIES 08 
 DUE August 29, 2010 
 FOR VALUE RECEIVED, OMNICOMM SYSTEMS,
INC., a corporation organized and existing under the laws of the State of Delaware (the “Company”), promises to pay to XXXXXXX, the registered holder hereof (the “Holder”), the principal sum of XXXXXXXX and
00/100 Dollars (US $xxx,xxx.xx) on August 29, 2010 (the “Maturity Date”) and to pay interest on the principal sum outstanding from time to time in arrears at the rate of 10% per annum, accruing from August 29, 2008 the date
of initial issuance of this Debenture (the “Issue Date”), on the date (each, an “Interest Payment Date”) which is the earlier of (i) the next Conversion Date (as defined below), (ii) the date which is three months from
the Issue Date and every three months thereafter, or (iii) the Maturity Date, as the case may be. Interest shall accrue monthly (pro-rated on a daily basis for any period longer or shorter than a month) from the later of the Issue Date or the
previous Interest Payment Date and shall be payable, subject to the other provisions of this Debenture, in cash or in Common Stock. If not paid in full on an Interest Payment Date, interest shall be fully cumulative and shall accrue on a daily
basis, based on a 365-day year, monthly or until paid, whichever is earlier. Additional provisions regarding the payment of interest are provided in Section 4(D) below (the terms of which shall govern as if this sentence were not included in
this Debenture). 
 This Debenture is subject to the following additional provisions: 
 1. The Debentures will initially be issued in denominations determined by the Company, but are exchangeable for an equal aggregate principal amount of
Debentures of different denominations, as requested by the Holder surrendering the same. No service charge will be made for such registration or transfer or exchange. 
  

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 2. The Company shall be entitled to withhold from all payments of principal of, and interest on, this
Debenture any amounts required to be withheld under the applicable provisions of the United States income tax laws or other applicable laws at the time of such payments, and Holder shall execute and deliver all required documentation in connection
therewith. 
 3. This Debenture has been issued subject to investment representations of the original purchaser hereof and may be transferred
or exchanged only in compliance with the Securities Act of 1933, as amended (the “Act”), and other applicable state and foreign securities laws. In the event of any proposed transfer of this Debenture, the Company may require, prior to
issuance of a new Debenture in the name of such other person, that it receive reasonable transfer documentation that is sufficient to evidence that such proposed transfer complies with the Act and other applicable state and foreign securities laws
and the terms of the Securities Purchase Agreement. Prior to due presentment for transfer of this Debenture, the Company and any agent of the Company may treat the person in whose name this Debenture is duly registered on the Company’s
Debenture Register as the owner hereof for the purpose of receiving payment as herein provided and for all other purposes, whether or not this Debenture be overdue, and neither the Company nor any such agent shall be affected by notice to the
contrary. 
 4. A. (i) At any time on or after the Issue Date and prior to the time this Debenture is paid in full in accordance with its
terms (including, without limitation, after the occurrence of an Event of Default, as defined below, or, if the Debenture is not fully paid or converted after the Maturity Date), the Holder of this Debenture is entitled, at its option, subject to
the following provisions of this Section 4, to convert this Debenture at any time into shares of Common Stock, $0.001 par value (“Common Stock”), of the Company at the Conversion Price (as defined below). Any such conversion is
referred to as a “Voluntary Conversion.” 
  

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 (ii) On the Maturity Date the Company shall pay the principal and accrued interest (through the actual
date of payment) of any portion of this Debenture which is then outstanding. 
 (iii) For purposes of this Debenture, the following terms
shall have the meanings indicated below: 
 “Conversion Price” means the Fixed Conversion Price or the Interest Conversion Price, as
the case may be. 
 “Fixed Conversion Price” means $0.50 (which amount is subject to adjustment as provided herein) 
 “Interest Conversion Price” means (i) the VWAP for the ten (10) Regular Trading Days ending on the Trading Day immediately before the
relevant Conversion Date, multiplied by (ii) ninety percent (90%). 
 “Regular Trading Day,” “Reporting Service,”
“Trading Day,” and “VWAP” have the meanings ascribed to them in the Securities Purchase Agreement. 
 “Conversion
Date” means the date on which the Holder faxes or otherwise delivers a Notice of Conversion to the Company so that it is received by the Company on or before such specified date. 
 “Conversion Shares” has the meaning ascribed to in Section 4(H) hereof. 
 B. A Voluntary Conversion shall be effectuated by the Holder by faxing a notice of conversion (“Notice of Conversion”) to the Company as
provided in this paragraph. The Notice of Conversion shall be executed by the Holder of this Debenture and shall evidence such Holder’s intention to convert this Debenture or a specified portion hereof in the form annexed hereto as Exhibit A.
Delivery of the Notice of Conversion shall be accepted by the Company by hand, mail or courier delivery at the address specified in said Exhibit A or at the facsimile number specified in said Exhibit A (each of such address or facsimile number may
be changed by notice given to the Holder in the manner provided in the Securities Purchase Agreement). 
  

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 C. Notwithstanding any other provision hereof, in no event (except (i) as specifically provided
herein as an exception to this provision, or (ii) while there is outstanding a tender offer for any or all of the shares of the Company’s Common Stock) shall the Holder be entitled to convert any portion of this Debenture, or shall the
Company have the obligation to convert such Debenture (and the Company shall not have the right to pay interest hereon in shares of Common Stock) to the extent that, after such conversion or issuance of stock in payment of interest, the sum of
(1) the number of shares of Common Stock beneficially owned by the Holder and its affiliates (other than shares of Common Stock which may be deemed beneficially owned through the ownership of the unconverted portion of the Debentures or other
convertible securities or of the unexercised portion of warrants or other rights to purchase Common Stock), and (2) the number of shares of Common Stock issuable upon the conversion of the Debentures with respect to which the determination of this
proviso is being made, would result in beneficial ownership by the Holder and its affiliates of more than 4.99% of the outstanding shares of Common Stock (after taking into account the shares to be issued to the Holder upon such conversion). For
purposes of the proviso to the immediately preceding sentence, beneficial ownership shall be determined in accordance with Section 13(d) of the Securities Exchange Act of 1934, as amended, except as otherwise provided in clause (1) of such
sentence. Nothing herein shall preclude the Holder from disposing of a sufficient number of other shares of Common Stock beneficially owned by the Holder so as to thereafter permit the continued conversion of this Debenture. 
 D. (i) Subject to the terms of Section 4(C) and to the other terms of this Section 4(D), interest on the principal amount of this Debenture
payable on an Interest Payment Date shall be due and payable, at the option of the Holder, in cash or in shares of Common Stock on the Interest Payment Date. 
 (ii) If the interest payable hereunder is to be paid in cash, the Company shall make such payment within three (3) Trading Days after the Interest Payment Date. 
 (iii) If interest is to be paid in Common Stock, the number of shares of Common Stock to be received shall be determined by dividing the dollar amount
of the interest by the Interest Conversion Price in effect on the relevant Interest Payment Date. 
  

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 E. Anything in the other provisions of this Debenture to the contrary notwithstanding, the Company shall
not have the right to prepay any or all of the outstanding principal of this Debenture, without the prior written consent of the Holder in each instance (which consent may be withheld for any reason or no reason, in the sole discretion of the
Holder). 
 F. (i) The following provisions apply to the issuances of Common Stock in payment of the amounts due under this Debenture,
whether as principal or interest, as provided in the preceding provisions of this Section 4. 
 (ii) No fractional shares of Common
Stock or scrip representing fractions of shares will be issued on conversion, but the number of shares issuable shall be rounded to the nearest whole share. 
 (iii) All shares issuable with respect to a Conversion Date or an Interest Payment Date shall be deemed “Conversion Shares” for all purposes of this Debenture. Certificates representing the relevant
Conversion Shares (“Conversion Certificates”) will be delivered to the Holder at the address specified in the relevant Notice of Conversion. which address the Holder may change from time to time, via express courier, by electronic transfer
or otherwise, within three (3) Trading Days (such third Trading Day, the “Delivery Date”) after the relevant Conversion Date. The Holder shall be deemed to be the holder of the shares issuable to it in accordance with the relevant
provisions of this Debenture on the Conversion Date or Interest Payment Date, as the case may be. 
 G. Except as may specified in a specific
provision of this Debenture, any payments under this Debenture shall be applied in the following order of priority: (i) first to amounts due to the Holder for accrued but unpaid interest on this Debenture; and (ii) then, to principal of this
Debenture in the inverse order of maturity. 
 5. No provision of this Debenture shall alter or impair the obligation of the Company, which
is absolute and unconditional, to pay the principal of, and interest on, this Debenture at the time, place, and rate, and in the coin or currency or where contemplated 

  

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herein in shares of its Common Stock, as applicable, as herein prescribed. This Debenture and all other Debentures now or hereafter issued of similar terms
are direct obligations of the Company. 
 6. No recourse shall be had for the payment of the principal of, or the interest on, this
Debenture, or for any claim based hereon, or otherwise in respect hereof against any incorporator, shareholder, officer or director, as such, past, present or future, of the Company or any successor corporation, whether by virtue of any
constitution, statute or rule of law, or by the enforcement of any assessment or penalty or otherwise, all such liability being, by the acceptance hereof and as part of the consideration for the issue hereof, expressly waived and released.

 7. All payments contemplated hereby to be made “in cash” shall be made in immediately available good funds of United States of
America currency by wire transfer to an account designated in writing by the Holder to the Company (which account may be changed by notice similarly given). All payments of cash and each delivery of shares of Common Stock issuable to the Holder as
contemplated hereby shall be made to the Holder at the address last appearing on the Debenture Register of the Company as designated in writing by the Holder from time to time; except that the Holder can designate, by notice to the Company, a
different delivery address for any one or more specific payments or deliveries. 
 8. If, for as long as this Debenture remains outstanding,
the Company enters into a merger (other than where the Company is the surviving entity) or consolidation with another corporation or other entity or a sale or transfer of all or substantially all of the assets of the Company to another person
(collectively, a “Sale”), the Company will require, in the agreements reflecting such transaction, that the surviving entity expressly assume the obligations of the Company hereunder. Notwithstanding the foregoing, if the Company enters
into a Sale and the holders of the Common Stock are entitled to receive stock, securities or property in respect of or in exchange for Common Stock, then as a condition of such Sale, the Company and any such successor, purchaser or transferee will
agree that the Debenture may thereafter be converted on the terms and subject to the conditions set forth above into the kind and 

  

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amount of stock, securities or property receivable upon such merger, consolidation, sale or transfer by a holder of the number of shares of Common Stock into
which this Debenture might have been converted immediately before such merger, consolidation, sale or transfer, subject to adjustments which shall be as nearly equivalent as may be practicable. In the event of any such proposed Sale, (i) the Holder
hereof shall have the right to convert by delivering a Notice of Conversion to the Company within fifteen (15) days of receipt of notice of such Sale from the Company, except that Section 4(C) shall not apply to such conversion.

 9. If, at any time while any portion of this Debenture remains outstanding, the Company spins off or otherwise divests itself of a part of
its business or operations or disposes of all or of a part of its assets in a transaction (the “Spin Off”) in which the Company, in addition to or in lieu of any other compensation received and retained by the Company for such business,
operations or assets, causes securities of another entity (the “Spin Off Securities”) to be issued to security holders of the Company, the Company shall cause (i) to be reserved Spin Off Securities equal to the number thereof which
would have been issued to the Holder had all of the Holder’s Debentures outstanding on the record date (the “Record Date”) for determining the amount and number of Spin Off Securities to be issued to security holders of the Company
(the “Outstanding Debentures”) been converted as of the close of business on the Trading Day immediately before the Record Date (the “Reserved Spin Off Shares”), and (ii) to be issued to the Holder on the conversion of all
or any of the Outstanding Debentures, such amount of the Reserved Spin Off Shares equal to (x) the Reserved Spin Off Shares multiplied by (y) a fraction, of which (I) the numerator is the principal amount of the Outstanding Debentures
then being converted, and (II) the denominator is the principal amount of the Outstanding Debentures. 
 10. If, at any time while any
portion of this Debenture remains outstanding, the Company effectuates a stock split or reverse stock split of its Common Stock or issues a dividend on its Common Stock consisting of shares of Common Stock, the prices used in determining the
Conversion Price from dates prior to such action or and any other fixed amounts calculated as contemplated hereby or by any of the other Transaction Agreements shall be equitably adjusted to reflect such action. 
  

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 11. The Holder of the Debenture, by acceptance hereof, agrees that this Debenture is being acquired for
investment and that such Holder will not offer, sell or otherwise dispose of this Debenture or the shares of Common Stock issuable upon conversion thereof except under circumstances which will not result in a violation of the Act or any applicable
state Blue Sky or foreign laws or similar laws relating to the sale of securities. 
 12. This Debenture shall be governed by and construed
in accordance with the laws of the State of Florida for contracts to be wholly performed in such state and without giving effect to the principles thereof regarding the conflict of laws. Each of the parties consents to the exclusive jurisdiction of
the federal courts whose districts encompass any part of the County of Broward or the state courts of the State of Florida sitting in the County of Broward in connection with any dispute arising under this Debenture and hereby waives, to the maximum
extent permitted by law, any objection, including any objection based on forum non coveniens, to the bringing of any such proceeding in such jurisdictions. To the extent determined by such court, the Company shall reimburse the Holder for any
reasonable legal fees and disbursements incurred by the Holder in enforcement of or protection of any of its rights under any of this Debenture. 
 13. JURY TRIAL WAIVER. The Company and the Holder hereby waive a trial by jury in any action, proceeding or counterclaim brought by either of the Parties hereto against the other in respect of any matter arising out of or in
connection with this Debenture. 
 14. A. The term “Change in Control” means the transaction or series of transactions occurring
after the Issue Date which result in one or more third parties (collectively, the “Acquiror”) acquires more than fifty percent (50%) of either (i) the voting rights of stockholders of the Company or (ii) the fair market
value of the assets of the Company (and for such purposes the assets of Subsidiaries shall be considered assets of the Company). 
  

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 B. If, at any time while this Debenture is outstanding, there is a Change in Control, the Holder will
have the right at any time thereafter, by written notice to the Company (the “Change in Control Demand Notice”), to demand payment in full of the outstanding principal of this Debenture together with all accrued but unpaid interest
thereon. The Company will be obligated to pay such amount (with interest calculated through the actual date of payment; such total, the “Change in Control Redemption Amount” ) by the date (the “Change in Control Redemption Due
Date”) which is five (5) Trading Days after the Company’s receipt of the Change in Control Demand Notice. 
 C. (i) The Change
in Control Redemption Amount shall be payable in cash, except as provided in clause (ii) of this subparagraph 14(C). 
 (ii) If, but
only if, no later than the Change in Control Redemption Due Date, the Company can deliver to the Holder registered shares of Common Stock which the Holder can resell without restriction, the Company may elect to pay the Control Redemption Amount in
such shares. The number of shares to be so delivered shall be equal to the sum of (x) the number of shares equal to the outstanding principal of the Debenture divided by the Fixed Conversion Price in effect on the Change in Control Redemption
Date (or earlier payment date), plus (y) the number of shared equal to the accrued but unpaid interest being paid divided by the Interest Conversion in effect on the Change in Control Redemption Date (or earlier payment date); provided,
however, that the provisions of Section 4(C) hereof shall apply to the number of shares issuable to the Holder. 
 15. The term
“Event of Default” means the occurrence of any one or more of the following events: 
  

	 	a.	The Company shall default in the payment of principal or interest on this Debenture or any other amount due hereunder (including payment of a Change in Control Redemption Amount or
a Redemption Amount, as defined below) when due and such default, except with respect to a Change in Control Redemption Amount or a Redemption Amount, shall continue for a period of five (5) Trading Days; or 

  

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	 	b.	Any of the representations or warranties made by the Company herein, or in any certificate or financial or other written statements heretofore or hereafter furnished by the Company
in connection with the execution and delivery of this Debenture or the Securities Purchase Agreement shall be false or misleading in any material respect at the time made; or 

  

	 	c.	The Company fails to authorize or to cause its Transfer Agent to issue shares of Common Stock upon exercise by the Holder of the conversion rights of the Holder in accordance with
the terms of this Debenture (provided, however, that for purposes of this provision, such failure to cause the Transfer Agent to issue such shares shall not be deemed to occur until two (2) Trading Days after the Delivery Date), fails to
transfer or to cause its Transfer Agent to transfer any certificate for shares of Common Stock issued to the Holder upon conversion of this Debenture and when required by this Debenture, and such transfer is otherwise lawful, or fails to remove any
restrictive legend on any certificate or fails to cause its Transfer Agent to remove such restricted legend, in each case where such removal is lawful, as and when required by this Debenture, and any such failure shall continue uncured for ten
(10) Trading Days; or 

  

	 	d.	The Company shall fail to perform or observe, in any material respect, any other covenant, term, provision, condition, agreement or obligation of any Debenture (other than a failure
to pay money) and such failure shall continue uncured for a period of ten (10) days after the Company’s receipt written notice from the Holder of such failure; or 

  

	 	e.	 The Company shall fail to perform or observe, in any material respect, any covenant, term, provision, condition, agreement or obligation of the Company and such
failure, if capable of being cured, shall continue uncured for a 

  

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period of ten (10) days after the Holder gives the Company written notice thereof (but if not capable of being cured, such thirty day period shall be deemed
expired immediately upon the giving of such notice); or 

  

	 	f.	The Company shall (1) admit in writing its inability to pay its debts generally as they mature; (2) make an assignment for the benefit of creditors or commence proceedings for
its dissolution; or (3) apply for or consent to the appointment of a trustee, liquidator or receiver for its or for a substantial part of its property or business; or 

  

	 	g.	A trustee, liquidator or receiver shall be appointed for the Company or for a substantial part of its property or business without its consent and shall not be discharged within
sixty (60) days after such appointment; or 

  

	 	h.	Any governmental agency or any court of competent jurisdiction at the instance of any governmental agency shall assume custody or control of the whole or any substantial portion of
the properties or assets of the Company and shall not be dismissed within sixty (60) days thereafter; or 

  

	 	i.	Any money judgment, writ or warrant of attachment, or similar process in excess of Two Hundred Fifty Thousand ($250,000) Dollars in the aggregate shall be entered or filed against
the Company or any of its properties or other assets and shall remain unpaid, unvacated, unbonded or unstayed for a period of sixty (60) days or in any event later than five (5) days prior to the date of any proposed sale thereunder; or

  

	 	j.	 Bankruptcy, reorganization, insolvency or liquidation proceedings or other proceedings for relief under any bankruptcy law or any law for the relief of debtors
shall be instituted by or against the Company and, if instituted 

  

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against the Company, shall not be dismissed within sixty (60) days after such institution or the Company shall by any action or answer approve of, consent
to, or acquiesce in any such proceedings or admit the material allegations of, or default in answering a petition filed in any such proceeding; or 

  

	 	k.	The Company shall have its Common Stock suspended from trading on, or delisted from, the Principal Trading Market for in excess of ten (10) Trading Days.

 (ii) If an Event of Default shall have occurred and is continuing, then, 
 (x) unless and until such Event of Default shall have been cured or waived in writing by the Holder (which waiver shall not be deemed to be a waiver of
any subsequent default), at the option of the Holder and in the Holder’s sole discretion, but without further notice from the Holder, the unpaid amount of this Debenture, computed as of such date, will bear interest at the rate (the
“Default Rate”) equal to eighteen percent (18%) per annum or the highest rate allowed by law, whichever is lower, from the date of the Event of Default to until and including the date actually paid; and any partial payments shall be
applied as provided in Section 4(I) hereof; and 
 (y) at any time thereafter, and in each and every such case, unless such Event of
Default shall have been cured or waived in writing by the Holder (which waiver shall not be deemed to be a waiver of any subsequent default), at the option of the Holder and in the Holder’s sole discretion, the Holder may elect to redeem all or
part of the Unconverted Debenture (as defined below) on the terms provided in Section 16 hereof. 
 16. A. The Company acknowledges that
if there is an Event of Default, the Holder may require the Company to immediately redeem all or any part of the outstanding portion of this Debenture for an amount equal to the Redemption Amount (as defined 

  

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below). The Redemption Amount shall be paid in cash by the Company to the Holder. The Redemption Amount shall be applied in the priority provided in
Section 4(I) hereof. 
 B. For purposes of this Debenture, the following terms shall have the meanings indicated below: 
 “Unconverted Debenture” means the principal amount of this Debenture which has not been converted as of the relevant date. 
 “Redemption Payment Date” means the date on which the Company actually pays the Redemption Amount. 
 “Redemption Amount” means the amount equal to: 
  

					
	 M
	  	 V
	 	x
	  	 
	  	CP	 	

 where: 
 “V” means the principal of an Unconverted Debenture plus any accrued but unpaid interest thereon; 
 “CP” means the Conversion Price in effect on the date (the “Redemption Notice Date”) of the Redemption Notice (as
defined below); provided, however, if the Redemption Amount is not paid in full on or before the Redemption Due Date, “CP” means the lower of (x) the Conversion Price in effect on the Redemption Notice Date or (y) the lowest
Conversion Price in effect during the period commencing on the Redemption Due Date and ending on the Redemption Payment Date; and 
 “M” means the highest closing price per share of the Common Stock during the period beginning on the Redemption Notice Date and ending on the Redemption Payment Date. 
  

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 C. The Holder of an Unconverted Debenture may elect to redeem a portion of such Unconverted Debenture
without electing to redeem the balance of the Unconverted Debenture. The Holder’s option to redeem all or part of the Unconverted Debenture shall be exercised by the Holder giving written notice of the exercise of this provision by the Holder
(a “Redemption Notice”) at any time after a relevant Event of Default has occurred but before such Event of Default is cured. The Redemption Notice shall specify (a) the date (the “Redemption Due Date”) on which the
Redemption Amount shall be paid, which date shall be at least five (5) Trading Days after the date (a “Redemption Notice Date”) on which the Holder Redemption Notice is given, and (b) the wire instructions for the account to
which the Redemption Amount is to be paid; provided, however, that the Company shall have the right to accelerate the date of such payment. 
 D. If all of the Unconverted Debentures are being redeemed pursuant to this Section 16, then, upon payment in full of the Redemption Amount for all of the Unconverted Debentures in accordance with the provisions of this
Section 16, the Holder shall deliver the Debenture to the Company marked “paid in full”. 
 E. If the Redemption Amount is not
timely paid by the Company, the Redemption Amount shall accrue interest at the Default Rate and the Holder may declare the Redemption Amount, together with such interest, due under this Debenture immediately due and payable, without presentment,
demand, protest or notice of any kinds, all of which are hereby expressly waived, anything herein or in any note or other instruments contained to the contrary notwithstanding, and the Holder may immediately enforce any and all of the Holder’s
rights and remedies provided herein or any other rights or remedies afforded by law, including, but not necessarily limited to, the equitable remedy of specific performance and injunctive relief. 
 17. Nothing contained in this Debenture shall be construed as conferring upon the Holder the right to vote or to receive dividends or to consent or
receive notice as a shareholder in respect of any meeting of shareholders or any rights whatsoever as a shareholder of the Company, unless and to the extent converted in accordance with the terms hereof. 
  

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 19. In the event for any reason, any payment by or act of the Company or the Holder shall result in
payment of interest which would exceed the limit authorized by or be in violation of the law of the jurisdiction applicable to this Debenture, then ipso facto the obligation of the Company to pay interest or perform such act or requirement
shall be reduced to the limit authorized under such law, so that in no event shall the Company be obligated to pay any such interest, perform any such act or be bound by any requirement which would result in the payment of interest in excess of the
limit so authorized. In the event any payment by or act of the Company shall result in the extraction of a rate of interest in excess of a sum which is lawfully collectible as interest, then such amount (to the extent of such excess not returned to
the Company) shall, without further agreement or notice between or by the Company or the Holder, be deemed applied to the payment of principal, if any, hereunder immediately upon receipt of such excess funds by the Holder, with the same force and
effect as though the Company had specifically designated such sums to be so applied to principal and the Holder had agreed to accept such sums as an interest- free prepayment of this Debenture. If any part of such excess remains after the principal
has been paid in full, whether by the provisions of the preceding sentences of this Section or otherwise, such excess shall be deemed to be an interest-free loan from the Company to the Holder, which loan shall be payable immediately upon demand by
the Company. The provisions of this Section shall control every other provision of this Debenture. 
 IN WITNESS WHEREOF, the Company has
caused this instrument to be duly executed by an officer thereunto duly authorized. 
 Dated: August 29, 2008 
 OMNICOMM SYSTEMS, INC. 
  

			
	 By:
	 	  

		 	Ronald T. Linares
		 	(Print Name)
		
		 	Chief Financial Officer
		 	(Title)

  

 15Form of Warrant dated August 29, 2008

 EXHIBIT 4.9 
 THESE SECURITIES HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR THE SECURITIES LAWS OF ANY STATE AND MAY NOT BE SOLD OR OFFERED FOR SALE IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT
FOR THE SECURITIES OR AN OPINION OF COUNSEL OR OTHER EVIDENCE ACCEPTABLE TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED. 
 No. 08-03-xx

 OMNICOMM SYSTEMS, INC. 
 COMMON STOCK PURCHASE WARRANT 
 CLASS 2008-3

 1. Issuance. In consideration of good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged by
OMNICOMM SYSTEMS, INC., a Delaware corporation (the “Company”), xxxxxxxxx or registered assigns (the “Holder”) is hereby granted the right to
purchase at any time, on or after the Issue Date (as defined below) until 5:00 P.M., New York City time, on the Expiration Date (as defined below), XXXXXXXX (xxx,xxx) fully paid and nonassessable shares of the Company’s Common Stock, $0.001 par
value per share (the “Common Stock”), at an initial exercise price per share (the “Exercise Price”) of $0.60 per share, subject to further adjustment as set forth herein. This Warrant is being issued pursuant to the terms of that
certain Securities Purchase Agreement, dated as of August 29, 2008 (the “Securities Purchase Agreement”), to which the Company and Holder (or Holder’s predecessor in interest) are parties. Capitalized terms not otherwise defined
herein shall have the meanings ascribed to them in the Securities Purchase Agreement. This Warrant was originally issued to the Holder or the Holder’s predecessor in interest on August 29, 2008 (the “Issue Date”). 
 2. Exercise of Warrants. 
 2.1
General. 
 (a) This Warrant is exercisable in whole or in part at any time and from time to time commencing on the Issue Date. Such
exercise shall be effectuated by submitting to the Company (either by delivery to the Company or by facsimile transmission as provided in Section 8 hereof) a completed and duly executed Notice of Exercise (substantially in the form attached to
this Warrant Certificate) as provided in the Notice of Exercise (or revised by notice given by the Company as contemplated by the Section headed “NOTICES” in the Securities Purchase Agreement). The date such Notice of Exercise is faxed to
the Company shall be the “Exercise Date,” provided that, if such exercise represents the full exercise of the outstanding balance of the Warrant, the Holder of this Warrant tenders this Warrant Certificate to the Company within five
(5) Trading Days thereafter. The Notice of Exercise shall be executed by the Holder of this Warrant and shall indicate (i) the number of shares then being purchased pursuant to such exercise and (ii) whether the exercise is a cashless
exercise. 
  

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 (b) If the Notice of Exercise form elects a “cashless” exercise, the Holder shall thereby be
entitled to receive a number of shares of Common Stock equal to (w) the excess of the Current Market Value (as defined below) over the total cash exercise price of the portion of the Warrant then being exercised, divided by (x) the Market
Price of the Common Stock. For the purposes of this Warrant, the terms (y) “Current Market Value” shall mean an amount equal to the Market Price of the Common Stock, multiplied by the number of shares of Common Stock specified in the
applicable Notice of Exercise, and (z) “Market Price of the Common Stock” shall mean the average Closing Price of the Common Stock for the three (3) Trading Days ending on the Trading Day immediately prior to the Exercise Date.

 (c) If the Holder provides on the Notice of Exercise form that the Holder has elected a “cash” exercise (or if the cashless
exercise referred to in the immediately preceding paragraph (b) is not available in accordance with its terms), the Exercise Price per share of Common Stock for the shares then being exercised shall be payable, at the election of the Holder, in
cash or by certified or official bank check or by wire transfer in accordance with instructions provided by the Company at the request of the Holder. 
 (d) Upon the appropriate payment, if any, of the Exercise Price for the shares of Common Stock purchased, together with the surrender of this Warrant Certificate (if required), the Holder shall be entitled to receive
a certificate or certificates for the shares of Common Stock so purchased. The Company shall deliver such certificates representing the Warrant Shares in accordance with the instructions of the Holder as provided in the Notice of Exercise (the
certificates delivered in such manner, the “Warrant Share Certificates”) within three (3) Trading Days (such third Trading Day, a “Delivery Date”) of (i) with respect to a “cashless exercise,” the Exercise
Date or the Automatic Exercise Date, as the case may be, or, (ii) with respect to a “cash” exercise, the later of the Exercise Date or the date the payment of the Exercise Price for the relevant Warrant Shares is received by the
Company. 
 (e) The Holder shall be deemed to be the holder of the shares issuable to it in accordance with the provisions of this
Section 2.1 on the Exercise Date. 
 2.2 Limitation on Exercise. Notwithstanding the provisions of this Warrant, the Securities
Purchase Agreement or of the other Transaction Agreements, in no event (except (i) as specifically provided in this Warrant as an exception to this provision, (ii) during the forty-five (45) day period prior to the Expiration Date, or
(iii) while there is outstanding a tender offer for any or all of the shares of the Company’s Common Stock) shall the Holder be entitled to exercise this Warrant, or shall the Company have the obligation to issue shares upon such exercise
of all or any portion of this Warrant to the extent that, after such exercise the sum of (1) the number of shares of Common Stock beneficially owned by the Holder and its affiliates (other than shares of Common Stock which may be deemed
beneficially owned through the ownership of the unexercised portion of the Warrants or other rights to purchase Common Stock or through the ownership of the unconverted portion of convertible securities), and (2) the number of shares 

  

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of Common Stock issuable upon the exercise of the Warrants with respect to which the determination of this proviso is being made, would result in beneficial
ownership by the Holder and its affiliates of more than 4.99% of the outstanding shares of Common Stock (after taking into account the shares to be issued to the Holder upon such exercise). For purposes of the proviso to the immediately preceding
sentence, beneficial ownership shall be determined in accordance with Section 13(d) of the Securities Exchange Act of 1934, as amended (the “1934 Act”), except as otherwise provided in clause (1) of such sentence. Nothing herein
shall preclude the Holder from disposing of a sufficient number of other shares of Common Stock beneficially owned by the Holder so as to thereafter permit the continued exercise of this Warrant. 
 2.3 Automatic Exercise. If any portion of this Warrant remains unexercised as of the Expiration Date and the Market Price of the Common Stock as
of the Expiration Date is greater than the applicable Exercise Price as of the Expiration Date, then, without further action by the Holder, this Warrant shall be deemed to have been exercised automatically on the date (the “Automatic Exercise
Date”) which is the day immediately prior to the close of business on the Expiration Date (or, in the event that the Expiration Date is not a Business Day, the immediately preceding Business Day) as if the Holder had duly given a Notice of
Exercise for a “cashless” exercise as contemplated by Section 2.1(b) hereof, and the Holder (or such other person or persons as directed by the Holder) shall be treated for all purposes as the holder of record of such Warrant Shares
as of the close of business on such Automatic Exercise Date. This Warrant shall be deemed to be surrendered to the Company on the Automatic Exercise Date by virtue of this Section 2.3 without any action by the Holder. 
 2.4 Certain Definitions. As used herein, the term “Expiration Date” means the date which is the last calendar day of the month in which
the fourth anniversary of the Closing Date occurs. 
 3. Reservation of Shares. The Company hereby agrees that, at all times during
the term of this Warrant, there shall be reserved for issuance upon exercise of this Warrant, one hundred percent (100%) of the number of shares of its Common Stock as shall be required for issuance of the Warrant Shares for the then
unexercised portion of this Warrant. For the purposes of such calculations, the Company should assume that the outstanding portion of this Warrants was exercisable in full at any time, without regard to any restrictions which might limit the
Holder’s right to exercise all or any portion of this Warrant held by the Holder. 
 4. Mutilation or Loss of Warrant. Upon
receipt by the Company of evidence satisfactory to it of the loss, theft, destruction or mutilation of this Warrant, and (in the case of loss, theft or destruction) receipt of reasonably satisfactory indemnification, and (in the case of mutilation)
upon surrender and cancellation of this Warrant, the Company will execute and deliver a new Warrant of like tenor and date and any such lost, stolen, destroyed or mutilated Warrant shall thereupon become void. 
  

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 5. Rights of the Holder. The Holder shall not, by virtue hereof, be entitled to any rights of a
stockholder in the Company, either at law or equity, and the rights of the Holder are limited to those expressed in this Warrant and are not enforceable against the Company except to the extent set forth herein. 
 6. Protection Against Dilution and Other Adjustments. 
 6.1 Adjustment Mechanism. If an adjustment of the Exercise Price is required pursuant to this Section 6 (other than pursuant to Section 6.4), the Holder shall be entitled to purchase such number of
shares of Common Stock as will cause (i) (x) the total number of shares of Common Stock Holder is entitled to purchase pursuant to this Warrant following such adjustment, multiplied by (y) the adjusted Exercise Price per share, to
equal the result of (ii) (x) the dollar amount of the total number of shares of Common Stock Holder is entitled to purchase before adjustment, multiplied by (y) the total Exercise Price before adjustment. 
 6.2 Capital Adjustments. In case of any stock split or reverse stock split, stock dividend, reclassification of the Common Stock,
recapitalization, merger or consolidation (where the Company is not the surviving entity), the provisions of this Section 6 shall be applied as if such capital adjustment event had occurred immediately prior to the date of this Warrant and the
original Exercise Price had been fairly allocated to the stock resulting from such capital adjustment; and in other respects the provisions of this Section shall be applied in a fair, equitable and reasonable manner so as to give effect, as nearly
as may be, to the purposes hereof. A rights offering to stockholders shall be deemed a stock dividend to the extent of the bargain purchase element of the rights. The Company will not effect any consolidation or merger, unless prior to the
consummation thereof, the successor or acquiring entity (if other than the Company) and, if an entity different from the successor or acquiring entity, the entity whose capital stock or assets the holders of the Common Stock of the Company are
entitled to receive as a result of such consolidation or merger assumes by written instrument the obligations under this Warrant (including under this Section 6) and the obligations to deliver to the holder of this Warrant such shares of stock,
securities or assets as, in accordance with the foregoing provisions, the holder may be entitled to acquire. 
 6.3 Adjustment for Spin
Off. If, for any reason, prior to the exercise of this Warrant in full, the Company spins off or otherwise divests itself of a part of its business or operations or disposes all or of a part of its assets in a transaction (the “Spin
Off”) in which the Company does not receive compensation for such business, operations or assets, but causes securities of another entity (the “Spin Off Securities”) to be issued to security holders of the Company, then the Company
shall cause (i) to be reserved Spin Off Securities equal to the number thereof which would have been issued to the Holder had all of the Holder’s unexercised Warrants outstanding on the record date (the “Record Date”) for
determining the amount and number of Spin Off Securities to be issued to security holders of the Company (the “Outstanding Warrants”) been exercised as of the close of business on the Trading Day immediately before the Record Date (the
“Reserved Spin Off Shares”), and (ii) to be issued to the Holder on the exercise of all or 

  

 4 

 
any of the Outstanding Warrants, such amount of the Reserved Spin Off Shares equal to (x) the Reserved Spin Off Shares, multiplied by (y) a
fraction, of which (I) the numerator is the amount of the Outstanding Warrants then being exercised, and (II) the denominator is the amount of the Outstanding Warrants. 
 6.4 Adjustment for Certain Transactions. Reference is made to the provisions of Section 4(g) of the Securities Purchase Agreement, the terms
of which are incorporated herein by reference. The number of shares covered by this Warrant and the Exercise Price shall be adjusted as provided in the applicable provisions of said Section 4(g) of the Securities Purchase Agreement. 

7. Transfer to Comply with the Securities Act. This Warrant has not been registered under the Securities Act of 1933, as amended, (the
“1933 Act”) and has been issued to the Holder for investment and not with a view to the distribution of either the Warrant or the Warrant Shares. Neither this Warrant nor any of the Warrant Shares or any other security issued or issuable
upon exercise of this Warrant may be sold, transferred, pledged or hypothecated in the absence of an effective registration statement under the 1933 Act relating to such security or an opinion of counsel satisfactory to the Company that registration
is not required under the 1933 Act. Each certificate for the Warrant, the Warrant Shares and any other security issued or issuable upon exercise of this Warrant shall contain a legend on the face thereof, in form and substance satisfactory to
counsel for the Company, setting forth the restrictions on transfer contained in this Section. 
 8. Late Delivery of Warrant Shares.
Reference is made to Section 5(b) of the Securities Purchase Agreement, the terms of which are incorporated herein by reference. 
 9.
Notices. Any notice required or permitted hereunder shall be given in manner provided in the Section headed “NOTICES” in the Securities Purchase Agreement, the terms of which are incorporated herein by reference. 
 10. Supplements and Amendments; Whole Agreement. This Warrant may be amended or supplemented only by an instrument in writing signed by the
parties hereto. This Warrant contains the full understanding of the parties hereto with respect to the subject matter hereof and thereof and there are no representations, warranties, agreements or understandings other than expressly contained herein
and therein. 
  

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 11. Governing Law. This Warrant shall be deemed to be a contract made under the laws of the State
of New York for contracts to be wholly performed in such state and without giving effect to the principles thereof regarding the conflict of laws. Each of the parties consents to the jurisdiction of the federal courts whose districts encompass any
part of the County of New York or the state courts of the State of New York sitting in the County of New York in connection with any dispute arising under this Warrant and hereby waives, to the maximum extent permitted by law, any objection,
including any objection based on forum non conveniens, to the bringing of any such proceeding in such jurisdictions. To the extent determined by such court, the Company shall reimburse the Holder for any reasonable legal fees and
disbursements incurred by the Holder in enforcement of or protection of any of its rights under any of the Transaction Agreements. 
 12.
JURY TRIAL WAIVER. The Company and the Holder hereby waive a trial by jury in any action, proceeding or counterclaim brought by either of the Parties hereto against the other in respect of any matter arising out or in connection with
this Warrant. 
 13. Remedies. The Company stipulates that the remedies at law of the Holder of this Warrant in the event of any
default or threatened default by the Company in the performance of or compliance with any of the terms of this Warrant are not and will not be adequate and that, to the fullest extent permitted by law, such terms may be specifically enforced by a
decree for the specific performance of any agreement contained herein or by an injunction against a violation of any of the terms hereof or otherwise. 
 14. Counterparts. This Warrant may be executed in any number of counterparts and each of such counterparts shall for all purposes be deemed to be an original, and all such counterparts shall together constitute
but one and the same instrument. 
 [Balance of page intentionally left blank] 
  

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 15. Descriptive Headings. Descriptive headings of the several Sections of this Warrant are
inserted for convenience only and shall not control or affect the meaning or construction of any of the provisions hereof. 
 IN WITNESS
WHEREOF, the Company has caused this instrument to be duly executed by an officer thereunto duly authorized. 
 Dated: August 29, 2008

  

			
	OMNICOMM SYSTEMS, INC.
		
	By:	 	  

		
		 	 Ronald T. Linares

		 	(Print Name)
		
		 	 Chief Financial Officer

		 	(Title)

  

 7

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