Document:

Document

Exhibit 4.6

. ZQ|CERT#|COY|CLS|RGSTRY|ACCT#|TRANSTYPE|RUN#|TRANS# CLASS B COMMON STOCK CLASS B COMMON STOCK PO BOX 505006, Louisville, KY 40233-5006 ADD 4 ADD 3 ADD 2 ADD 1 DESIGNATION (IF ANY) MR ASAMPLE PAR VALUE $0.0001 Certificate Shares Number **000000****************** ***000000***************** ZQ00000000 ****000000**************** SNOWFLAKE INC. *****000000*************** ******000000************** INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE ** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample SEE REVERSE FOR CERTAIN DEFINITIONS **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David THIS CERTIFIES THAT Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David SampleMR. **** Mr. Alexander SAMPLE David Sample **** Mr. Alexander & David MRS. Sample **** Mr. Alexander SAMPLE David Sample **** Mr. Alexander & David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. AlexanderMR. David SampleSAMPLE **** Mr. Alexander David Sample& MRS.**** Mr. Alexander DavidSAMPLE Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Sample **** Mr. Sample **000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares*** is the owner of *000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares**** 000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****0 THIS CERTIFICATE IS TRANSFERABLE IN 00000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****00 0000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000***ZERO HUNDRED THOUSAND000**Shares****000 CITIES DESIGNATED BY THE TRANSFER 000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****0000 00**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****00000 AGENT, AVAILABLE ONLINE AT 0**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000ZERO HUNDRED AND ZERO*****Shares****000000 www.computershare.com **Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000* *Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000** Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**S FULLY-PAID AND NON-ASSESSABLE SHARES OF CLASS B COMMON STOCK OF Snowflake Inc. (hereinafter called the “Company”) DTC Number of Shares Insurance Value Holder ID CUSIP/IDENTIFIER , transferable on the books of the Company in person or Total Transaction 1234567890/1234567890 1234567890/1234567890 1234567890/1234567890 1234567890/1234567890 1234567890/1234567890 1234567890/1234567890 Certificate Numbers by duly authorized attorney, upon surrender of this Certificate properly endorsed. This Certificate and the shares represented hereby, are issued and shall be held subject to all of the provisions of the Certificate of Incorporation, as amended, and the Bylaws, as amended, of the Company (copies of which are on file with the Company and with the Transfer Agent), to all of which each holder, by acceptance hereof, assents. This Certificate is not valid unless countersigned and registered by the Transfer Agent and Registrar. Witness the facsimile seal of the Company and the facsimile signatures of its duly authorized officers. 12345678 123456789012345 Num/No. DATED DD-MMM-YYYY 6 5 4 3 2 1 LAK WF E COUNTERSIGNED AND REGISTERED: O IN RPORA C N O TE COMPUTERSHARE TRUST COMPANY, N.A. S C . Denom. Chief Financial Officer TRANSFER AGENT AND REGISTRAR, XXXXXXXXXX XXXXXX XX X 1,000,000.00 6 5 4 3 2 1 July 23, 2012 123456 Total D E E L AWA R 7 6 5 4 3 2 1 By General Counsel and Secretary AUTHORIZED SIGNATURE

. SNOWFLAKE INC. THE COMPANY WILL FURNISH WITHOUT CHARGE TO EACH SHAREHOLDER WHO SO REQUESTS, A SUMMARY OF THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OF THE COMPANY AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND RIGHTS, AND THE VARIATIONS IN RIGHTS, PREFERENCES AND LIMITATIONS DETERMINED FOR EACH SERIES, WHICH ARE FIXED BY THE CERTIFICATE OF INCORPORATION OF THE COMPANY, AS AMENDED, AND THE RESOLUTIONS OF THE BOARD OF DIRECTORS OF THE COMPANY, AND THE AUTHORITY OF THE BOARD OF DIRECTORS TO DETERMINE VARIATIONS FOR FUTURE SERIES. SUCH REQUEST MAY BE MADE TO THE OFFICE OF THE SECRETARY OF THE COMPANY OR TO THE TRANSFER AGENT. THE BOARD OF DIRECTORS MAY REQUIRE THE OWNER OF A LOST OR DESTROYED STOCK CERTIFICATE, OR HIS LEGAL REPRESENTATIVES, TO GIVE THE COMPANY A BOND TO INDEMNIFY IT AND ITS TRANSFER AGENTS AND REGISTRARS AGAINST ANY CLAIM THAT MAY BE MADE AGAINST THEM ON ACCOUNT OF THE ALLEGED LOSS OR DESTRUCTION OF ANY SUCH CERTIFICATE. The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws or regulations: TEN COM - as tenants in common UNIF GIFT MIN ACT -............................................Custodian ................................................ (Cust) (Minor) TEN ENT - as tenants by the entireties under Uniform Gifts to Minors Act ........................................................ (State) JT TEN - as joint tenants with right of survivorship UNIF TRF MIN ACT -............................................Custodian (until age ................................) and not as tenants in common (Cust) .............................under Uniform Transfers to Minors Act ................... (Minor) (State) Additional abbreviations may also be used though not in the above list. PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE For value received, ____________________________hereby sell, assign and transfer unto ________________________________________________________________________________________________________________________________ (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE) ________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________ Shares of the common stock represented by the within Certificate, and do hereby irrevocably constitute and appoint _______________________________________________________________________________________________________________________ Attorney to transfer the said stock on the books of the within-named Company with full power of substitution in the premises. Dated: __________________________________________20__________________ Signature(s) Guaranteed: Medallion Guarantee Stamp THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (Banks, Stockbrokers, Savings and Loan Associations and Credit Unions) WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM, PURSUANT TO S.E.C. RULE 17Ad-15. Signature: ____________________________________________________________ Signature: ____________________________________________________________ Notice: The signature to this assignment must correspond with the name as written upon the face of the certificate, in every particular, without alteration or enlargement, or any change whatever. The IRS requires that the named transfer agent (“we”) report the cost basis of certain shares or units acquired after January 1, 2011. If your shares or units are covered by the legislation, and you requested to sell or transfer the shares or units using a specific cost basis calculation method, then we have processed as you requested. If you did not specify a cost basis calculation method, then we have defaulted to the first in, first out (FIFO) method. Please consult your tax advisor if you need additional information about cost basis. If you do not keep in contact with the issuer or do not have any activity in your account for the time period specified by state law, your property may become subject to state unclaimed property laws and transferred to the appropriate state.Exhibit
10.1

 

Form
of Exchange Agreement

 

     

     

    

 

MICT,
INC. 

 

SERIES
B CONVERTIBLE PREFERRED STOCK EXCHANGE AGREEMENT 

 

This
Series B Convertible Preferred Stock Exchange Agreement (this “Agreement”) is made as of September [__], 2020
(“Effective Date”), by and between MICT, Inc., a Delaware corporation (the “Company”), and [__________]
(the “Holder”).

 

RECITALS

 

WHEREAS,
the Holder currently holds 1,818,181 shares (the “Initial Shares”) of Series B Convertible Preferred Stock,
with a par value of $0.001 per share and a stated value of $1.10 per share (the “Series B Preferred”), which
are convertible into shares of the Company’s common stock, par value of $0.001 per share (“Common Stock”);
and

 

WHEREAS,
subject to the terms and conditions set forth herein, the Company and the Holder desire to cancel and retire the Initial Shares
in exchange (the “Exchange”) for a number of shares of Common Stock (the “Exchange Shares”)
determined by a ratio of one (1) share of Common Stock for every one (1) share of Series B Preferred, in reliance on the exemption
from registration provided by Section 3(a)(9) of the Securities Act of 1933, as amended (the “Securities Act”).

 

In
consideration of the mutual covenants contained in this Agreement, and for other good and valuable consideration, the receipt
of which is hereby acknowledged, the Company and the Holder hereby agree as follows:

 

SECTION
1. EXCHANGE AND TERMINATION. 

 

a)
In consideration of and in express reliance upon the representations, warranties, covenants, terms and conditions of this Agreement,
the Holder hereby agrees that the Initial Shares shall be cancelled (and that all rights previously granted to the Holder in connection
therewith shall be terminated) in exchange for the Exchange Shares, and the Company agrees to issue and deliver the Exchange Shares
to the Holder.

 

b)
The closing under this Agreement (the “Closing”) shall take place upon the satisfaction of each of the conditions
set forth in Sections 4 and 5 hereof, and in any event within 2 Trading Days of the date hereof (the “Closing Date”).
At the Closing, (i) the Company shall cause the transfer agent for the Common Stock to issue and deliver the Exchange Shares
to the Holder and (ii) the Holder shall take all necessary action, including instructing the transfer agent for the Initial
Shares, to cancel the Initial Shares, which cancellation shall occur no later than simultaneously with delivery of the Exchange
Shares to the Holder.

 

SECTION
2. REPRESENTATIONS, WARRANTIES AND COVENANTS OF THE COMPANY. 

 

The
Company hereby represents and warrants as of the date hereof to, and covenants with, the Holder as follows:

 

(a)
Organization and Standing. The Company has been duly incorporated and is validly existing as a corporation in good standing
under the laws of Delaware, has full corporate power and authority to own or lease its properties and conduct its business as
presently conducted, and is duly qualified as a foreign corporation and in good standing in each jurisdiction in which the character
of the property owned or leased or the nature of the business transacted by it makes qualification necessary, except where the
failure to be so qualified would not have a material adverse effect on the business, properties, financial condition or results
or operations of the Company (a “Material Adverse Effect”).

 

     

     

    

 

(b)
Authorization; Corporate Power. This Agreement has been duly authorized, validly executed and delivered on behalf of the
Company and is a valid and binding obligation of the Company enforceable against the Company in accordance with its terms (except
as limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or similar laws relating to or affecting
the enforcement of creditors’ rights generally, and (ii) equitable principles generally, including any specific performance),
and the Company has the requisite corporate power and authority to execute and deliver this Agreement and the other agreements
and documents contemplated hereby and to perform its obligations hereunder and thereunder.

 

(c)
Issuance and Delivery of the Exchange Shares. The Exchange Shares have been duly authorized and, will be validly issued,
fully paid and nonassessable.

 

(d)
Governmental Consents. Other than any Form 8-K that the Company shall file in connection with this Agreement, no consent,
approval or authorization of or designation, declaration or filing with any governmental authority on the part of the Company
is required in connection with the valid execution and delivery of this Agreement or the offer, sale or issuance of the Exchange
Shares or the consummation of any other transaction contemplated by this Agreement.

 

(e)
No Default or Violation. The execution and delivery of the Agreement and the consummation of the transactions contemplated
by this Agreement by the Company do not and will not result in a breach of or a default under any of the terms or provisions of
the Company’s certificate of incorporation or by-laws.

 

SECTION
3. REPRESENTATIONS, WARRANTIES AND COVENANTS OF THE HOLDER. 

 

The
Holder hereby represents and warrants as of the date hereof to, and covenants with, the Company as follows:

 

(a)
Valid Existence; Good Standing. To the extent the Holder is a corporation, limited liability company or other type of entity,
the Holder is validly existing and in good standing under the laws of the jurisdiction of its organization.

 

(b)
Authority; Authorization. The Holder has full right, power, authority and capacity to enter into this Agreement and the
other agreements and documents contemplated hereby and to perform its obligations hereunder and thereunder and has taken all necessary
action to authorize the execution, delivery and performance of this Agreement. Upon the execution and delivery of this Agreement
by the Holder, this Agreement shall constitute a valid and binding obligation of the Holder, enforceable in accordance with its
terms (except (i) as limited by applicable bankruptcy, insolvency, reorganization, moratorium or similar laws relating to
or affecting the enforcement of creditors’ rights generally, and (ii) as limited by equitable principles generally,
including any specific performance).

 

(c)
Title. The Holder owns and holds the entire right, title and interest in and to, and is the record and beneficial owner
of, the Initial Shares and the Holder owns the Initial Shares free and clear of all Encumbrances (as defined below). The Holder
has the full power and authority to vote, transfer and dispose of the Initial Shares free and clear of any right or Encumbrances.
There is no restriction affecting the ability of the Holder to transfer the legal and beneficial title and ownership of the Initial
Shares to the Company and, at the Closing, the Company will acquire legal and valid title to the Initial Shares, free and clear
of all Encumbrances. Other than the transactions contemplated by this Agreement, there is no outstanding vote, plan, pending proposal,
or other right of any person to acquire all or any of the Initial Shares. “Encumbrances” shall mean any security
or other property interest or right, claim, lien, pledge, option, charge, security interest, contingent or conditional sale, or
other title claim or retention agreement, interest or other right or claim of third parties, whether perfected or not perfected,
voluntarily incurred or arising by operation of law, and including any agreement (other than this Agreement) to grant or submit
to any of the foregoing in the future.

 

(d)
Securities Act Exemption. Neither the Holder nor anyone acting on behalf of the Holder has received any commission or remuneration
directly or indirectly in connection with or in order to solicit or facilitate the Exchange. The Holder understands that the Exchange
contemplated hereby is intended to be exempt from registration by virtue of Section 3(a)(9) of the Securities Act. The Holder
understands that the Company is relying upon the truth and accuracy of the representations, warranties, agreements, acknowledgments
and understandings of the Holder set forth herein for purposes of qualifying for the exemption under Section 3(a)(9) of the
Securities Act as well as qualifying for exemptions under applicable state securities laws.

 

    2

     

    

 

(e)
Information. The Holder has, in connection with its decision to acquire the Exchange Shares, relied with respect to the
Company and its affairs solely upon the Company’s filings with the SEC and the representations and warranties of the Company
contained herein.

 

(f)
Advisors. The Holder understands that nothing in this Agreement or any other materials presented to the Holder in connection
with the exchange of the Initial Shares and issuance and acquisition of the Exchange Shares constitutes legal, tax or investment
advice. The Holder has consulted such legal, tax and investment advisors as it, in its sole discretion, has deemed necessary or
appropriate in connection with its acquisition of the Exchange Shares. With respect to such matters, the Holder relies solely
on such advisors and not on any statements or representations of the Company or any of its agents, written or oral. The Holder
understands that it (and not the Company) shall be responsible for its own tax liability that may arise as a result of this investment
or the transactions contemplated by this Agreement.

 

(g)
Investor Status. At the time the Holder was offered the Exchange Shares hereunder: (i) it was, and as of the date hereof
it is an “accredited investor” as defined in Rule 501 of Regulation D promulgated under the Securities Act, or (ii)
it was, and as of the date hereof it is a “qualified institutional buyer” as defined in Rule 144A under the Securities
Act. The Holder is not required to be registered as a broker-dealer under Section 15 of the Securities Exchange Act of 1934, as
amended.

 

SECTION
4. CONDITIONS TO COMPANY’S OBLIGATIONS AT THE CLOSING. 

 

The
Company’s obligation to complete the issuance of the Exchange Shares and deliver the Exchange Shares to the Holder at the
Closing shall be subject to the following conditions to the extent not waived by the Company:

 

(a)
Execution and Delivery. The Holder shall have executed and delivered this Agreement.

 

(b)
Covenants. The Holder shall have performed, satisfied and complied in all material respects with all covenants, agreements
and conditions required by this Agreement to be performed, satisfied or complied with by the Holder at or prior to the Closing
Date.

 

(c)
Surrender of Initial Shares. The Company shall have received in physical form or through book-entry transfer from the Holder
all certificates or book-entry notation representing the Initial Shares to be exchanged for the Exchange Shares.

 

(d)
Representations and Warranties. The representations and warranties of the Holder shall be true and correct in all material
respects as of the date when made and as of the Closing Date as though made at that time, except for representations and warranties
that are expressly made as of a particular date, which shall be true and correct in all material respects as of such date.

 

SECTION
5. CONDITIONS TO THE HOLDER’S OBLIGATIONS AT THE CLOSING. 

 

The
Holder’s obligation to deliver the Initial Shares and accept delivery of the Exchange Shares shall be subject to the following
conditions to the extent not waived by the Holder:

 

(a) Execution
and Delivery. The Company shall have executed and delivered this Agreement.

 

(b) Covenants.
The Company shall have performed, satisfied and complied in all material respects with all covenants, agreements and conditions
required by this Agreement to be performed, satisfied or complied with by the Company at or prior to the Closing Date.

 

(c)
Delivery of Exchange Shares. The Company shall have delivered the Exchange Shares in accordance with the terms hereof.

 

(d) Representations
and Warranties. Each of the representations and warranties of the Company shall be true and correct in all material respects
as of the date when made and as of the Closing Date as though made at that time, except for representations and warranties that
are expressly made as of a particular date, which shall be true and correct in all material respects as of such date.

 

    3

     

    

 

SECTION
6. NOTICES. 

 

All
notices, requests, consents and other communications hereunder shall be in writing, shall be sent by confirmed electronic mail,
or mailed by first-class registered or certified airmail, or nationally recognized overnight express courier, postage prepaid,
and shall be deemed given when so sent in the case of electronic mail transmission, or when so received in the case of mail or
courier, and addressed as follows:

 

(a)
if to the Company, to:

 

MICT,
Inc.

28
West Grande Avenue, Suite 3

Montvale,
NJ 07645

Attention:
Darren Mercer

E-Mail:
darren@mict-inc.com

 

or
to such other person at such other place as the Company shall designate to the Holder in writing; and

 

(b)
if to the Holder, at the address as set forth at the end of this Agreement, or at such other address as may have been furnished
by the Holder to the Company in writing.

 

SECTION
7. MISCELLANEOUS. 

 

(a)
Headings. The headings of the various sections of this Agreement have been inserted for convenience of reference only and
shall not be deemed to be part of this Agreement.

 

(b)
Severability. In case any provision contained in this Agreement should be invalid, illegal or unenforceable in any respect,
the validity, legality and enforceability of the remaining provisions contained herein shall not in any way be affected or impaired
thereby.

 

(c)
Governing Law. This Agreement shall be governed by and construed under the laws of the State of New York without regard
to the choice of law principles thereof. Each party hereby irrevocably submits to the exclusive jurisdiction of the state and
federal courts sitting in the State of New York located in The City of New York, Borough of Manhattan for the adjudication of
any dispute hereunder or in connection herewith or with any transaction contemplated hereby or thereby, and hereby irrevocably
waives any objection that such suit, action or proceeding is brought in an inconvenient forum or that the venue of such suit,
action or proceeding is improper. Nothing contained herein shall be deemed to limit in any way any right to serve process in any
manner permitted by law. EACH PARTY HEREBY IRREVOCABLY WAIVES ANY RIGHT IT MAY HAVE, AND AGREES NOT TO REQUEST, A JURY TRIAL FOR
THE ADJUDICATION OF ANY DISPUTE HEREUNDER OR IN CONNECTION WITH OR ARISING OUT OF THIS AGREEMENT OR ANY TRANSACTION CONTEMPLATED
HEREBY.

 

(d)
Counterparts. This Agreement may be executed in two or more counterparts, each of which shall constitute an original, but
all of which, when taken together, shall constitute but one instrument, and shall become effective when one or more counterparts
have been signed by each party hereto and delivered to the other parties. In the event that any signature is delivered by facsimile
transmission or by an e-mail which contains an electronic file of an executed signature page, such signature page shall create
a valid and binding obligation of the party executing (or on whose behalf such signature is executed) with the same force and
effect as if such facsimile or electronic file signature page (as the case may be) were an original thereof.

 

(f)
Successors and Assigns. Except as otherwise expressly provided herein, the provisions hereof shall inure to the benefit
of, and be binding upon, the successors, permitted assigns, heirs, executors and administrators of the parties hereto.

 

(g)
Entire Agreement; Amendments. This Agreement and other documents delivered pursuant hereto constitute the full and entire
understanding and agreement between the parties with regard to the subjects hereof and thereof. This Agreement may be amended,
modified, superseded, cancelled, renewed or extended, and the terms and conditions hereof may be waived, only by a written instrument
signed by all parties, or, in the case of a waiver, by the party waiving compliance. Except as expressly stated herein, no delay
on the part of any party in exercising any right, power or privilege hereunder shall operate as a waiver thereof, nor shall any
waiver on the part of any party of any right, power or privilege hereunder preclude any other or future exercise of any other
right, power or privilege hereunder.

 

(h)
Survival. The representations, warranties, covenants and agreements made in this Agreement shall survive the closing of
the transactions contemplated hereby and the exchange and delivery of the Warrants and the Exchange Shares.

 

[signature
pages follow]

 

    4

     

    

 

IN
WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their duly authorized representatives as
of the day and year first above written.

 

	 	MICT, INC.
	 	 
		By: 	 
	 

        
	Name:  	Darren
    Mercer
	 

        
	Title: 	Chief
    Executive Officer

 

 

COMPANY
SIGNATURE PAGE TO

SERIES
B CONVERTIBLE PREFERRED STOCK EXCHANGE AGREEMENT

 

     

     

    

 

IN
WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their duly authorized representatives as
of the day and year first above written.

 

	 	HOLDER
	 	 	 
	 	By:	 
	 	 	 
	 	Holder:	 
	 	 	 
	 	Name:	 
	 	 	 
	 	Title:	 
	 	 	 
	 	Address:	 
	 	 	 
	 	Email:	 

  

 

HOLDER
SIGNATURE PAGE TO

SERIES
B CONVERTIBLE PREFERRED STOCK EXCHANGE AGREEMENT

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