Document:

Exhibit 4.28

 

 

ASSIGNMENT AND ASSUMPTION AGREEMENT

This Agreement made and entered effective as of the 11th day of August, 2014, by and among TCA Global Credit Master Fund, LP, with an address at 19950 W. Country Club Dr., First Floor, Aventura, FL 33180 ("Assignor") and GEL Properties, LLC with an address at 16192 Coastal Highway, Lewes, DE 19958 ("Assignee"), and Hangover Joe's Holding Corp., a Colorado corporation ("Borrower").

WHEREAS, Assignor owns all right, title and interest in and to a Convertible Note issued by the Borrower in the original principal amount of $425,000 and issued to Assignor on December 31, 2012, but made effective as of January 10, 2013 (such note, as same has been amended, modified, replaced, or renewed from time to time, the "Note"), which Note was issued in connection with that certain Credit Agreement by and between Assignor and Borrower dated as of December 31, 2013, but made effective as of January 10, 2014 (the "Credit Agreement," and together with all other documents executed by Borrower in connection therewith, the "Transaction Documents," and all obligations of the Borrower to Assignor under the Transaction Documents, hereinafter collectively referred to as the "Obligations"); and

WHEREAS, Assignor wishes to assign and Assignee wishes to purchase Assignor's right, title and interest in and to Two Hundred Thirty Thousand Dollars ($230,000.00) of the Obligations in a series of tranches as set forth below, and upon each of such assignments, Borrower shall cancel that portion of the Note acquired in each tranche and issue new Convertible Promissory Notes to the Assignee in the amount of the principal and interest acquired in the relative tranche in the form attached hereto as Exhibit A (each a "New Note").

NOW THEREFORE, in consideration of transfer of the respective tranches (each referred to as the "Purchase Price" of the appurtenant closing) and the covenants set forth herein, the parties hereto agree as follows:

1. Assignment. Assignor agrees to assign, transfer and convey unto Assignee up to $230,000.00 of the Obligations due under the Note and the Transaction Documents, together with all accrued and unpaid interest thereon, all in accordance with the terms hereof.

1.1.The assignment and transfer shall take place in a series of closings for the amounts (the respective "Purchase Price") and on the dates set forth on Schedule 1 attached hereto. 

1.2.At each closing, Assignor shall: (i) deliver to Assignee an assignment instrument in form and substance reasonably acceptable to Assignor and Assignee, transferring and assigning the portion of the Obligations assigned at such closing; and (ii) file a UCC-3 amendment, providing for the assignment of the portion of the Obligations so assigned to Assignee at such closing. In addition, prior to the first closing hereunder, Assignor shall deliver to Assignee copies of the wire transfer confirmations for the original funding of the Note. At each closing, Assignee shall pay to Assignor, the amount of the Purchase Price applicable to such closing, by wire transfer of immediately available U.S. funds to an account designated by Assignor. Upon payment of the applicable Purchase Price to Assignor, and delivery of Assignee's assignment instrument, it shall be Assignee's obligation to obtain the New Note from Assignee, and obtaining such New Note shall not be a condition to payment of the applicable portion of the Purchase Price at each closing. Notwithstanding the foregoing, the Assignee shall have no obligation to purchase a tranche if: (A) the aggregate trading volume of the Borrower's common stock on its principal trading market is $25,000 or less in any 5 day trading period; or (B) after Assignee converts any New Note, or any portion thereof, into shares of the Borrower's common stock, or Assignee settles any portion of the New Note in exchange for shares of the Borrower's common stock, and such common stock received by Assignee does not clear into Assignee's brokerage account within five (5) trading days after the applicable conversion or settlement, such that Assignee could sell such stock in the public markets thereafter.

2. Representations of Assignor. Assignor represents to the Assignee, that:

2.1.Assignor is the lawful owner of the Note, free and clear of all liens, encumbrances, restrictions and claims of every kind; and Assignor has full legal right, power and authority to enter into this Agreement and to sell, assign, transfer and convey the portion of the Note so owned pursuant to this Agreement.

2.2.Assignor is not an "affiliate" of the Borrower as defined in the rules adopted by the Securities and Exchange Commission under the Securities Act of 1933, as amended. 

2.3.Assignor shall provide an affidavit of lost securities in the event it is unable to locate the original Note and acknowledges that payment in full of the Purchase Price is evidence of the lawful assignment and assumption of the portion of the Note so assigned to Assignee. Assignor shall not be required to provide the original Note unless and until all Obligations are paid in full.

2.4. Except for the foregoing representations and warranties in Sections 2.1 and 2.2, this Assignment (ad each assignment made at each closing) is made by Assignor without recourse, representation or warranty of any nature or kind, express or implied, and Assignor specifically disclaims any warranty, guaranty or representation, oral or written, past, present or future with respect to the Note, the Obligations, or any other Transaction Documents, including, without limitation: (i) the validity, effectiveness or enforceability of the Note, the Obligations, or any of the other Transaction Documents; (ii) the validity, existence, or priority of any lien or security interest securing the Obligations; (iii) the existence of, or basis for, any claim, counterclaim, defense or offset relating to the Note, other Obligations, or any of the other Transaction Documents; (iv) the financial condition

of the Borrower, or any other guarantor or obligor liable under the Note, the Obligations, or any of the other Transaction Documents, or the ability of any such parties to pay or perform their respective obligations under the Note or any of the other Transaction Documents; (v) the compliance of the Note or any of the other Transaction Documents with any laws, ordinances or regulations of any governmental agency or other body; (vi) the value or condition of any collateral securing the Obligations; and (vii) the future performance of the Borrower, or any other guarantor or obligor liable under the Note, the Obligations, or any of the other Transaction Documents. Assignee acknowledges and represents to Assignor that Assignee has been given the opportunity to undertake its own investigations of the Borrower, the Note, the Obligations, and all other Transaction Documents, and having undertaken and performed all such investigations as Assignee deemed necessary or desirable, Assignee represents, warrants and agrees that it is relying solely on its own investigation of the Borrower, the Note, the Obligations, and all other Transaction Documents, and not any information whatsoever provided or to be provided by Assignor, or any representation or warranty of Assignor. The assignment of the Note as provided for herein is made on an "AS IS," "WHERE IS" basis, with all faults, and Assignee, by acceptance of this Assignment, shall be deemed to have agreed and acknowledged that Assignor has fully performed, discharged and complied with all of Assignor's obligations, representations, warranties, covenants and agreements hereunder, that Assignor is discharged therefrom, and that Assignor shall have no further liability with respect thereto, except only for those express warranties contained in this Assignment, and Assignee, by such acceptance, expressly acknowledges that

ASSIGNOR MAKES NO WARRANTY OR REPRESENTATIONS, EXPRESS OR IMPLIED, OR ARISING BY OPERATION OF LAW, RELATING TO THE NOTE, THE OBLIGATIONS, OR ANY OF THE OTHER TRANSACTION DOCUMENTS, EXCEPT AS SPECIFICALLY SET FORTH HEREIN.

3. Representations of the Assignee. Assignee represents and warrants to the Assignor that it has made an independent investigation of the Borrower and is not relying on any representations of the Borrower or Assignor except as set forth in the Company's filings under the Securities Exchange Act of 1934 and in this Agreement; it is an accredited investor as defined in Rule 501(a) of Regulation D under the Securities Act of 1933 and is acquiring the Note for investment purposes. It understands that the Note and the securities issuable upon the conversion of the Note will bear a customary legend restricting re-sales of the securities represented thereby unless such securities are registered under the Securities Act of 1933 or an exemption is available therefrom.

4. Representations of Borrower. For purposes of this Agreement only, Borrower represents and warrants to the Assignee that the Note is valid and enforceable against it by Assignee in the amounts purchased by the Assignee. Borrower retains and expressly does not waive any defenses it has asserted or could have asserted against enforcement of the Note by Assignor or any other party other than Assignee.

5. Further Assurances. Each of Assignor and Assignee agrees to execute and deliver at the request of the other, all papers, instruments, and assignments, and to perform any other reasonable acts as may be requested or required by the other in order to give effect to the transactions contemplated by this Assignment in accordance with the terms hereof.

6. Governing Law. This Agreement and any disputes arising hereunder shall be construed and interpreted in accordance with the laws of Nevada.

7. Binding Effect. This Assignment Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their respective successors and assigns, including but not limited to any person who acquires substantially all of the assets of any party. Assignee may not assign its rights hereunder, unless it first obtains Assignor's prior written approval.

8. Legal Advice. Each party has received independent legal advice from its attorneys with respect to the advisability of executing, and with respect to the execution of, this Agreement. Additionally, the Borrower acknowledges that its legal counsel has advised the Borrower that the New Note qualifies for tacking of the holding period for purposes of Rule 144 of the Securities Act of 1933, as amended, to the original issue date of the Note which is January10, 2013.

 

  

Signature Page Follows

IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the day, month

and year first above written.

ASSIGNOR : TCA GLOBAL CREDIT MASTER FUND, LP

 

By: TCA Global Credit Fund GP, Ltd.

Its: General Partner

 

By: /s/ Robert Press

Name: Robert Press

Title: Director

ASSIGNEE: GEL PROPERTIES, LLC

 

By: /s/ Sam Eisenberg

Name: Sam Eisenberg

Title: Manager

ACKNOWLEDGED AND AGREED TO THIS DAY OF August 11, 2014

 

Hangover Joe's Holding Corp.

 

By: /s/ Matthew Veal

Name: Matthew Veal

Title: CEO

 

  

  

EXHIBIT A

PURCHASE SCHEDULE TRANCHES

DATES PURCHASED AMOUNTS

August 1, 2014 $57,500

September 1, 2014 $57,500

October 1, 2014 $57,500

November 1, 2014 $57,500

Assignee may elect to increase the amount purchased in any month.Exhibit 4.29

 

 

THIS NOTE AND THE COMMON STOCK ISSUABLE UPON CONVERSION OF THIS NOTE HAVE NOT BEEN AND WILL NOT BE REGISTERED WITH THE UNITED STATES SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES COMMISSION OF ANY STATE PURSUANT TO AN EXEMPTION FROM REGISTRATION PROVIDED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND THE RULES AND REGULATIONS PROMULGATED THEREUNDER (THE "1933 ACT")

  US $57,500.00

REPLACEMENT NOTE – ORIGINALLY ISSUED DECEMBER 31, 2012 IN THE AMOUNT OF $425,000.00

HANGOVER JOES HOLDING CORPORATION

8% CONVERTIBLE REDEEMABLE NOTE

DUE AUGUST 11, 2015

FOR VALUE RECEIVED, Hangover Joes Holding Corporation (the "Company") promises to pay to the order of UNION CAPITAL, LLC and its authorized successors and permitted assigns ("Holder"), the aggregate principal face amount of Fifty Seven Thousand Five Hundred Dollars exactly (U.S. $57,500.00) on August 11, 2015 ("Maturity Date") and to pay interest on the principal amount outstanding hereunder at the rate of 8% per annum commencing on August 11, 2014. The interest will be paid to the Holder in whose name this Note is registered on the records of the Company regarding registration and transfers of this Note.  The principal of, and interest on, this Note are payable at 338 Crown Street, Brooklyn, NY 11225  initially, and if changed, last appearing on the records of the Company as designated in writing by the Holder hereof from time to time.  The Company will pay each interest payment and the outstanding principal due upon this Note before or on the Maturity Date, less any amounts required by law to be deducted or withheld, to the Holder of this Note by check or wire transfer addressed to such Holder at the last address appearing on the records of the Company.  The forwarding of such check or wire transfer shall constitute a payment of outstanding principal hereunder and shall satisfy and discharge the liability for principal on this Note to the extent of the sum represented by such check or wire transfer.  Interest shall be payable in Common Stock (as defined below) pursuant to paragraph 4(b) herein.

This Note is subject to the following additional provisions:

1.            This Note is exchangeable for an equal aggregate principal amount of Notes of different authorized denominations, as requested by the Holder surrendering the same.  No service charge will be made for such registration or transfer or exchange, except that Holder shall pay any tax or other governmental charges payable in connection therewith.

2.            The Company shall be entitled to withhold from all payments any amounts required to be withheld under applicable laws.

3.            This Note may be transferred or exchanged only in compliance with the Securities Act of 1933, as amended ("Act") and applicable state securities laws.  Any attempted transfer to a non-qualifying party shall be treated by the Company as void.  Prior to due presentment for transfer of this Note, the Company and any agent of the Company may treat the person in whose name this Note is duly registered on the Company's records as the owner hereof for all other purposes, whether or not this Note be overdue, and neither the Company nor any such agent shall be affected or bound by notice to the contrary.  Any Holder of this Note electing to exercise the right of conversion set forth in Section 4(a) hereof, in addition to the requirements set forth in Section 4(a), and any prospective transferee of this Note, also is required to give the Company written confirmation that this Note is being converted ("Notice of Conversion") in the form annexed hereto as Exhibit A. The date of receipt (including receipt by telecopy) of such Notice of Conversion shall be the Conversion Date.

4.            (a)            The Holder of this Note is entitled, at its option, at any time after 180 days, to convert all or any amount of the principal face amount of this Note then outstanding into shares of the Company's common stock (the "Common Stock") without restrictive legend of any nature, at a price ("Conversion Price") for each share of Common Stock equal to 55% of the lowest closing bid of the Common Stock as reported on the National Quotations Bureau OTCQB exchange which the Company's shares are traded or any exchange upon which the Common Stock may be traded in the future ("Exchange"), for the twenty prior trading days including the day upon which a Notice of Conversion is received by the Company (provided such Notice of Conversion is delivered by fax or other electronic method of communication to the Company after 4 P.M. Eastern Standard or Daylight Savings Time if the Holder wishes to include the same day closing price). If the shares have not been delivered within 3 business days, the Notice of Conversion may be rescinded. Such conversion shall be effectuated by the Company delivering the shares of Common Stock to the Holder within 3 business days of receipt by the Company of the Notice of Conversion.  Once the Holder has received such shares of Common Stock, the Holder shall surrender this Note to the Company, executed by the Holder evidencing such Holder's intention to convert this Note or a specified portion hereof, and accompanied by proper assignment hereof in blank.  Accrued, but unpaid interest shall be subject to conversion.  No fractional shares 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.  In the event the Company experiences a DTC "Chill" on its shares, the conversion price shall be decreased to 45% instead of 55% while that "Chill" is in effect.

(b)            Interest on any unpaid principal balance of this Note shall be paid at the rate of 8% per annum.  Interest shall be paid by the Company in cash only.

(c)            This Note may not be prepaid.

(d)            Upon (i) a transfer of all or substantially all of the assets of the Company to any person in a single transaction or series of related transactions, (ii) a reclassification, capital reorganization or other change or exchange of outstanding shares of the Common Stock, other than a forward or reverse stock split or stock dividend, or (iii) any consolidation or merger of the Company with or into another person or entity in which the Company is not the surviving entity (other than a merger which is effected solely to change the jurisdiction of incorporation of the Company and results in a reclassification, conversion or exchange of outstanding shares of Common Stock solely into shares of Common Stock) (each of items (i), (ii) and (iii) being referred to as a "Sale Event"), then, in each case, the Company shall, upon request of the Holder, redeem this Note in cash for 140% of the principal amount, plus accrued but unpaid interest through the date of redemption, or at the election of the Holder, such Holder may convert the unpaid principal amount of this Note (together with the amount of accrued but unpaid interest) into shares of Common Stock immediately prior to such Sale Event at the Conversion Price.

(e)            In case of any Sale Event (not to include a sale of all or substantially all of the Company's assets) in connection with which this Note is not redeemed or converted, the Company shall cause effective provision to be made so that the Holder of this Note shall have the right thereafter, by converting this Note, to purchase or convert this Note into the kind and number of shares of stock or other securities or property (including cash) receivable upon such reclassification, capital reorganization or other change, consolidation or merger by a holder of the number of shares of Common Stock that could have been purchased upon exercise of the Note and at the same Conversion Price, as defined in this Note, immediately prior to such Sale Event. The foregoing provisions shall similarly apply to successive Sale Events. If the consideration received by the holders of Common Stock is other than cash, the value shall be as determined by the Board of Directors of the Company or successor person or entity acting in good faith.

5.            No provision of this Note shall alter or impair the obligation of the Company, which is absolute and unconditional, to pay the principal of, and interest on, this Note at the time, place, and rate, and in the form, herein prescribed.

6.            The Company hereby expressly waives demand and presentment for payment, notice of non-payment, protest, notice of protest, notice of dishonor, notice of acceleration or intent to accelerate, and diligence in taking any action to collect amounts called for hereunder and shall be directly and primarily liable for the payment of all sums owing and to be owing hereto.

7.            The Company agrees to pay all costs and expenses, including reasonable attorneys' fees and expenses, which may be incurred by the Holder in collecting any amount due under this Note.

8.            If one or more of the following described "Events of Default" shall occur:

(a)            The Company shall default in the payment of principal or interest on this Note or any other note issued to the Holder by the Company; or

(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 or on behalf of the Company in connection with the execution and delivery of this Note, or the Securities Purchase Agreement under which this note was issued shall be false or misleading in any respect; or

(c)            The Company shall fail to perform or observe, in any respect, any covenant, term, provision, condition, agreement or obligation of the Company under this Note or any other note issued to the Holder; or

(d)            The Company shall (1) become insolvent; (2) admit in writing its inability to pay its debts generally as they mature; (3) make an assignment for the benefit of creditors or commence proceedings for its dissolution; (4) 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; (5) file a petition for  bankruptcy relief, consent to the filing of such petition or have filed against it an involuntary petition for bankruptcy relief, all under federal or state laws as applicable; or

(e)            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

(f)            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; or

(g)            Unless previously disclosed in the Company's filings with the Securities and Exchange Commission, one or more money judgments, writs or warrants of attachment, or similar process, in excess of fifty thousand dollars ($50,000) 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 fifteen (15) days or in any event later than five (5) days prior to the date of any proposed sale thereunder.

(h)            The Company shall have defaulted on or breached any term of any other note of similar debt instrument into which the Company has entered and failed to cure such default within the appropriate grace period; or

(i)            The Company shall have its Common Stock delisted from an exchange (including the OTCBB exchange) or, if the Common Stock trades on an exchange, then trading in the Common Stock shall be suspended for more than 10 consecutive days;

(j)            If a majority of the members of the Board of Directors of the Company on the date hereof are no longer serving as members of the Board;

(k)            The Company shall not deliver to the Holder the Common Stock pursuant to paragraph 4 herein without restrictive legend within 3 business days of its receipt of a Notice of Conversion; or

(l)            The Company shall not replenish the reserve set forth in Section 12, within 3 business days of the request of the Holder; or

(m)            The Company shall not be "current" in its filings with the Securities and Exchange Commission; or

(n)            The Company shall lose the "bid" price for its stock in a market (including the OTCQB marketplace or other exchange).

Then, or at any time thereafter, unless cured, and in each and every such case, unless such Event of Default shall have been 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 consider this Note immediately due and payable, without presentment, demand, protest or (further) notice of any kind (other than notice of acceleration), 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, and without expiration of any period of grace, enforce any and all of the Holder's rights and remedies provided herein or any other rights or remedies afforded by law.  Upon an Event of Default, interest shall accrue at a default interest rate of 16% per annum or, if such rate is usurious or not permitted by current law, then at the highest rate of interest permitted by law.  In the event of a breach of Section 8(k) the penalty shall be $250 per day the shares are not issued beginning on the 4th day after the conversion notice was delivered to the Company.  This penalty shall increase to $500 per day beginning on the 10th day.  The penalty for a breach of Section 8(n) shall be an increase of the outstanding principal amounts by 20%.  In case of a breach of Section 8(i), the outstanding principal due under this Note shall increase by 50%.  If this Note is not paid at maturity, the outstanding principal due under this Note shall increase by 10%.

If the Holder shall commence an action or proceeding to enforce any provisions of this Note, including, without limitation, engaging an attorney, then if the Holder prevails in such action, the Holder shall be reimbursed by the Company for its attorneys' fees and other costs and expenses incurred in the investigation, preparation and prosecution of such action or proceeding.

9.            In case any provision of this Note is held by a court of competent jurisdiction to be excessive in scope or otherwise invalid or unenforceable, such provision shall be adjusted rather than voided, if possible, so that it is enforceable to the maximum extent possible, and the validity and enforceability of the remaining provisions of this Note will not in any way be affected or impaired thereby.

10.            Neither this Note nor any term hereof may be amended, waived, discharged or terminated other than by a written instrument signed by the Company and the Holder.

11.            The Company represents that it is not a "shell" issuer and has never been a "shell" issuer or that if it previously has been a "shell" issuer that at least 12 months have passed since the Company has reported form 10 type information indicating it is no longer a "shell issuer.  Further. The Company will instruct its counsel to either (i) write a 144- 3(a) (9) opinion to allow for salability of the conversion shares or (ii) accept such opinion from Holder's counsel.

 

12.          The Company shall issue irrevocable transfer agent instructions reserving 15,000,000 shares of its Common Stock for conversions under this Note and another $25,000 note of even date herewith (the "Share Reserve"). The reserve shall be replenished as needed to allow for conversions of this Note. The Holder will initially submit a conversion notice/request for a tranche of shares to be issued with an agreed to conversion price equal to $1000 (an "Initial Tranche Request").  The shares that are the subject to the Initial Trance Request may be subsequently reconverted and repriced as follows: (i) the Holder shall immediately reduce the outstanding balance of the Note by $1,000 and simultaneously send to the Company a live" or "repriced" conversion notice for the $1,000 priced using the conversion formula set forth in Section 4(a) of this Note,  (ii) As the balance of the shares in the Initial Tranche Request are converted via the delivery of the "live" or "repriced" conversion notice,  the balance of the Note shall be reduced using the formula set forth in Section 4(a) of this Note, as if such shares had originally been converted as set forth in Section 4(a).  By way of example, if the Tranche Conversion Request was for 1,000,000 shares and the face amount of the Note was $25,000 the Holder would initially reduce $1,000 from the face amount leaving a balance of $24,000 and send the Company a repriced conversion notice deducting that number of shares from the Initial Tranche Request necessary to equal $1,000 using the formula set forth in Section 4(a).  Additionally, if, the following day, the Holder sent a "live" or "repriced" conversion notice to the Company for 25,000 shares and, using the formula set forth in Section 4(a) the true conversion price would have been $6,000, then the Holder shall make an additional reduction of $6,000 on the Note and shall indicate both the Note balance and the share reserve balance on the "live" conversion notice.  This process shall be repeated until there is no balance remaining outstanding on the Note.  Upon full conversion of this Note, the any shares remaining in the Share Reserve shall be cancelled.

13.            The Company will give the Holder direct notice of any corporate actions, including but not limited to name changes, stock splits, recapitalizations etc.  This notice shall be given to the Holder as soon as possible under law.

14.            This Note shall be governed by and construed in accordance with the laws of New York applicable to contracts made and wholly to be performed within the State of New York and shall be binding upon the successors and assigns of each party hereto.  The Holder and the Company hereby mutually waive trial by jury and consent to exclusive jurisdiction and venue in the courts of the State of New York.  This Agreement may be executed in counterparts, and the facsimile transmission of an executed counterpart to this Agreement shall be effective as an original.

 

IN WITNESS WHEREOF, the Company has caused this Note to be duly executed by an officer thereunto duly authorized.

Dated: August 11, 2014   

 

HANGOVER JOES HOLDING CORPORATION

 

By:  /s/ Matthew A. Veal

Title: CEO

 

EXHIBIT A

NOTICE OF CONVERSION

 (To be Executed by the Registered Holder in order to Convert the Note)

The undersigned hereby irrevocably elects to convert $___________ of the above Note into _________ Shares of Common Stock of Hangover Joes Holding Corporation  ("Shares") according to the conditions set forth in such Note, as of the date written below.

If Shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer and other taxes and charges payable with respect thereto.

Date of Conversion: _________________________________________________________________

Applicable Conversion Price: _________________________________________________________________

Signature: _________________________________________________________________

[Print Name of Holder and Title of Signer]

Address: _________________________________________________________________

 

_____________________________________________________  

SSN or EIN: _________________________________________________________________

Shares are to be registered in the following name: _________________________________________________________________

Name: _________________________________________________________________

Address: _________________________________________________________________

Tel: _________________________________________________________________

Fax: _________________________________________________________________

SSN or EIN: _________________________________________________________________

Shares are to be sent or delivered to the following account:

Account Name: _________________________________________________________________

Address: _________________________________________________________________

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