Document:

Exhibit 10.3

 

THE REGISTERED HOLDER OF THIS
PURCHASE WARRANT BY ITS ACCEPTANCE HEREOF, AGREES THAT IT WILL NOT SELL, TRANSFER OR ASSIGN THIS PURCHASE WARRANT EXCEPT AS HEREIN PROVIDED
AND THE REGISTERED HOLDER OF THIS PURCHASE WARRANT AGREES THAT IT WILL NOT SELL, TRANSFER, ASSIGN, PLEDGE OR HYPOTHECATE THIS PURCHASE
WARRANT FOR A PERIOD OF ONE HUNDRED EIGHTY DAYS FOLLOWING AUGUST 26, 2021 (THE “EFFECTIVE DATE”) TO ANYONE OTHER THAN
(I) DAWSON JAMES SECURITIES, INC. OR A PLACEMENT AGENT OR A SELECTED DEALER IN CONNECTION WITH THE OFFERING FOR WHICH THIS WARRANT WAS
ISSUED TO THE PLACEMENT AGENT AS CONSIDERATION (“OFFERING”), OR (II) A BONA FIDE OFFICER OR PARTNER OF DAWSON JAMES
SECURITIES, INC. OR OF ANY SUCH PLACEMENT AGENT OR SELECTED DEALER.

 

THIS PURCHASE WARRANT IS NOT
EXERCISABLE PRIOR TO MARCH 2, 2022. VOID AFTER 5:00 P.M., EASTERN TIME, AUGUST 26, 2026.

 

COMMON STOCK PURCHASE WARRANT

 

For the Purchase of [____] Shares of Common
Stock

of

ADITXT, INC.

 

1. Purchase
Warrant. THIS CERTIFIES THAT, in consideration of funds duly paid by or on behalf of [______] (“Holder”),
as registered owner of this Purchase Warrant, to Aditxt, Inc., a Delaware corporation (the “Company”), Holder is entitled,
at any time or from time to time from March 2, 2022 (the “Commencement Date”), and at or before 5:00 p.m., Eastern
time, August 26 2026 (the “Expiration Date”), but not thereafter, to subscribe for, purchase and receive,
in whole or in part, up to [_____] shares of common stock of the Company, par value $0.001 per share (the “Shares”),
subject to adjustment as provided in Section 6 hereof. If the Expiration Date is a day on which banking institutions are authorized by
law to close, then this Purchase Warrant may be exercised on the next succeeding day which is not such a day in accordance with the terms
herein. During the period ending on the Expiration Date, the Company agrees not to take any action that would terminate this Purchase
Warrant. This Purchase Warrant is initially exercisable at $[_____] per Share; provided, however, that upon the occurrence
of any of the events specified in Section 6 hereof, the rights granted by this Purchase Warrant, including the exercise price per Share
and the number of Shares to be received upon such exercise, shall be adjusted as therein specified. The term “Exercise Price”
shall mean the initial exercise price or the adjusted exercise price, depending on the context.

 

2. Exercise.

 

2.1 Exercise
Form. In order to exercise this Purchase Warrant, the exercise form attached hereto must be duly executed and completed and delivered
to the Company, together with this Purchase Warrant and payment of the Exercise Price for the Shares being purchased payable in cash by
wire transfer of immediately available funds to an account designated by the Company or by certified check or official bank check. If
the subscription rights represented hereby shall not be exercised at or before 5:00 p.m., Eastern time, on the Expiration Date, this Purchase
Warrant shall become and be void without further force or effect, and all rights represented hereby shall cease and expire.

 

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2.2 Cashless
Exercise. In lieu of exercising this Purchase Warrant by payment of cash or check payable to the order of the Company pursuant
to Section 2.1 above, Holder may elect to receive the number of Shares equal to the value of this Purchase Warrant (or the portion thereof
being exercised), by surrender of this Purchase Warrant to the Company, together with the exercise form attached hereto, in which event
the Company will issue to Holder Shares in accordance with the following formula:

 

	X = 	Y(A-B)
	    A

 

Where,

 

X
= The number of Shares to be issued to Holder;

Y = The number of Shares for which the Purchase Warrant is being exercised;

A = The fair market value of one Share; and

B = The Exercise Price.

 

For purposes of this Section
2.2, the fair market value of a Share is defined as follows:

 

		(i)	if the Company’s common stock is traded on a national
securities exchange, the OTCQB or OTCQX, the value shall be deemed to be the closing price on such exchange, the OTCQB or OTCQX, as the
case may be, prior to the exercise form being submitted in connection with the exercise of the Purchase Warrant; or

 

		(ii)	if the Company’s common stock is not then traded on a securities exchange, the OTCQB or OTCQX and
if prices for the Company’s common stock are then reported on the “Pink Sheets” published by OTC Markets Group, Inc.,
the value shall be deemed to be the closing bid prior to the exercise form being submitted in connection with the exercise of the Purchase
Warrant so reported; provided, however, if there is no active public market, the value shall be the fair market value thereof, as determined
in good faith by the Company’s Board of Directors.

 

2.3  Legend.
Each certificate for the securities purchased under this Purchase Warrant shall bear a legend as follows unless such securities have been
registered under the Securities Act of 1933, as amended (the “Act”):

 

“The securities represented
by this certificate have not been registered under the Securities Act of 1933, as amended (the “Act”), or applicable
state law. Neither the securities nor any interest therein may be offered for sale, sold or otherwise transferred except pursuant to an
effective registration statement under the Act, or pursuant to an exemption from registration under the Act and applicable state law which,
in the opinion of counsel to the Company, is available.”

 

2.4 Resale
of Shares. Holder and the Company acknowledge that as of the date hereof the Staff of the Division of Corporation Finance of the SEC
has published Compliance & Disclosure Interpretation 528.04 in the Securities Act Rules section thereof, stating that the holder of
securities issued in connection with a public offering may not rely upon Rule 144 promulgated under the Act to establish an exemption
from registration requirements under Section 4(a)(1) under the Act, but may nonetheless apply Rule 144 constructively for the resale of
such shares in the following manner: (a) provided that six months has elapsed since the last sale under the registration statement, an
underwriter or finder may resell the securities in accordance with the provisions of Rule 144(c), (e), and (f), except for the notice
requirement; (b) a purchaser of the shares from an underwriter receives restricted securities unless the sale is made with an appropriate,
current prospectus, or unless the sale is made pursuant to the conditions contained in (a) above; (c) a purchaser of the shares from an
underwriter who receives restricted securities may include the underwriter’s holding period, provided that the underwriter or finder
is not an affiliate of the issuer; and (d) if an underwriter transfers the shares to its employees, the employees may tack the firm’s
holding period for purposes of Rule 144(d), but they must aggregate sales of the distributed shares with those of other employees, as
well as those of the underwriter or finder, for a six-month period from the date of the transfer to the employees. Holder and the Company
also acknowledge that the Staff of the Division of Corporation Finance of the SEC has advised in various no-action letters that the holding
period associated with securities issued without registration to a service provider commences upon the completion of the services, which
the Company agrees and acknowledges shall be the closing of the Offering, and that Rule 144(d)(3)(ii) provides that securities acquired
from the issuer solely in exchange for other securities of the same issuer shall be deemed to have been acquired at the same time as the
securities surrendered for conversion (which the Company agrees is the date of the initial issuance of this Purchase Warrant). In the
event that following a request by Holder to transfer the Shares in accordance with Compliance & Disclosure Interpretation 528.04 counsel
for the Company reasonably concludes that Compliance & Disclosure Interpretation 528.04 no longer may be relied upon as a result of
changes in applicable laws, regulations, or interpretations of the SEC Division of Corporation Finance, or as a result of judicial interpretations
not known by the Company or its counsel on the date hereof (either, a “Registration Trigger Event”), then the Company shall
promptly, and in any event within five (5) business days following the request, provide written notice to Holder of such determination.
As a condition to giving such notice, the Company shall offer Holder a single demand registration right pursuant to an agreement in form
acceptable to the Holder; provided that notwithstanding anything to the contrary, the obligations of the Company pursuant to this Section
2 shall terminate on the fifth anniversary of the Effective Date. In the absence of such conclusion by counsel for the Company, the Company
shall, upon request of Holder given no earlier than six months after the final closing of the Offering, instruct its transfer agent to
permit the transfer of such shares in accordance with Compliance & Disclosure Interpretation 528.04, provided that Holder has provided
such documentation as shall be reasonably be requested by the Company to establish compliance with the conditions of Compliance &
Disclosure Interpretation 528.04.

 

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3. Transfer.

 

3.1 General
Restrictions. The registered Holder of this Purchase Warrant agrees by his, her or its acceptance hereof, that such Holder will not:
(a) sell, transfer, assign, pledge or hypothecate this Purchase Warrant for a period of one hundred eighty (180) days following the Effective
Date to anyone other than: (i) Dawson James Securities, Inc. (“Dawson”) or a placement agent, underwriter or a selected
dealer participating in the Offering, or (ii) a bona fide officer or partner of Dawson or of any such placement agent or selected dealer,
in each case in accordance with FINRA Rule 5110(e)(1), or (b) cause this Purchase Warrant or the securities issuable hereunder to be the
subject of any hedging, short sale, derivative, put or call transaction that would result in the effective economic disposition of this
Purchase Warrant or the securities hereunder, except as provided for in FINRA Rule 5110(e)(2). After 180 days after the Effective Date,
transfers to others may be made subject to compliance with or exemptions from applicable securitiee laws. In order to make any permitted
assignment, the Holder must deliver to the Company the assignment form attached hereto duly executed and completed, together with the
Purchase Warrant and payment of all transfer taxes, if any, payable in connection therewith. The Company shall within five (5) Business
Days transfer this Purchase Warrant on the books of the Company and shall execute and deliver a new Purchase Warrant or Purchase Warrants
of like tenor to the appropriate assignee(s) expressly evidencing the right to purchase the aggregate number of Shares purchasable hereunder
or such portion of such number as shall be contemplated by any such assignment.

 

3.2  Restrictions
Imposed by the Act. The securities evidenced by this Purchase Warrant shall not be transferred unless and until: (i) if required by
applicable law, the Company has received the opinion of counsel for the Company that the securities may be transferred pursuant to an
exemption from registration under the Act and applicable state securities laws (the Company hereby agrees that the opinion of Schiff Hardin
LLP shall also be accepted in lieu of an opinion from Company counsel), or (ii) a registration statement or a post-effective amendment
to the Registration Statement relating to the offer and sale of such securities has been filed by the Company and declared effective by
the U.S. Securities and Exchange Commission (the “Commission”) and compliance with applicable state securities
law has been established.

 

4. Reserved.

 

5. New
Purchase Warrants to be Issued.

 

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

 

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

 

6. Adjustments.

 

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

 

6.1.1 Share
Dividends; Split Ups. If, after the date hereof, and subject to the provisions of Section 6.3 below, the number of outstanding Shares
is increased by a stock dividend payable in Shares or by a split up of Shares or other similar event, then, on the effective day thereof,
the number of Shares purchasable hereunder shall be increased in proportion to such increase in outstanding Shares, and the Exercise Price
shall be proportionately decreased.

 

6.1.2  Aggregation
of Shares. If, after the date hereof, and subject to the provisions of Section 6.3 below, the number of outstanding Shares is decreased
by a consolidation, combination or reclassification of Shares or other similar event, then, on the effective date thereof, the number
of Shares purchasable hereunder shall be decreased in proportion to such decrease in outstanding Shares, and the Exercise Price shall
be proportionately increased.

 

6.1.3  Replacement
of Securities upon Reorganization, etc. In case of any reclassification or reorganization of the outstanding Shares other than a change
covered by Section 6.1.1 or 6.1.2 hereof or that solely affects the par value of such Shares, or in the case of any share reconstruction
or amalgamation or consolidation or merger of the Company with or into another corporation (other than a consolidation or share reconstruction
or amalgamation or merger in which the Company is the continuing corporation and that does not result in any reclassification or reorganization
of the outstanding Shares), or in the case of any sale or conveyance to another corporation or entity of the property of the Company as
an entirety or substantially as an entirety in connection with which the Company is dissolved, the Holder of this Purchase Warrant shall
have the right thereafter (until the expiration of the right of exercise of this Purchase Warrant) to receive upon the exercise hereof,
for the same aggregate Exercise Price payable hereunder immediately prior to such event, the kind and amount of shares of stock or other
securities or property (including cash) receivable upon such reclassification, reorganization, share reconstruction or amalgamation, or
consolidation, or upon a dissolution following any such sale or transfer, by a Holder of the number of Shares of the Company obtainable
upon exercise of this Purchase Warrant immediately prior to such event; and if any reclassification also results in a change in Shares
covered by Section 6.1.1 or 6.1.2, then such adjustment shall be made pursuant to Sections 6.1.1, 6.1.2 and this Section 6.1.3. The provisions
of this Section 6.1.3 shall similarly apply to successive reclassifications, reorganizations, share reconstructions or amalgamations,
or consolidations, sales or other transfers.

 

6.1.4  Changes
in Form of Purchase Warrant. This form of Purchase Warrant need not be changed because of any change pursuant to this Section 6.1,
and Purchase Warrants issued after such change may state the same Exercise Price and the same number of Shares as are stated in the Purchase
Warrants initially issued pursuant to this Agreement. The acceptance by any Holder of the issuance of new Purchase Warrants reflecting
a required or permissive change shall not be deemed to waive any rights to an adjustment occurring after the Commencement Date or the
computation thereof.

 

6.2  Substitute
Purchase Warrant. In case of any consolidation of the Company with, or share reconstruction or amalgamation or merger of the Company
with or into, another corporation (other than a consolidation or share reconstruction or amalgamation or merger which does not result
in any reclassification or change of the outstanding Shares), the corporation formed by such consolidation or share reconstruction or
amalgamation shall execute and deliver to the Holder a supplemental Purchase Warrant providing that the holder of each Purchase Warrant
then outstanding or to be outstanding shall have the right thereafter (until the stated expiration of such Purchase Warrant) to receive,
upon exercise of such Purchase Warrant, the kind and amount of shares of stock and other securities and property receivable upon such
consolidation or share reconstruction or amalgamation, by a holder of the number of Shares of the Company for which such Purchase Warrant
might have been exercised immediately prior to such consolidation, share reconstruction or amalgamation or merger, sale or transfer. Such
supplemental Purchase Warrant shall provide for adjustments which shall be identical to the adjustments provided for in this Section 6.
The above provision of this Section shall similarly apply to successive consolidations or share reconstructions or amalgamations or mergers.

 

    -4-

     

    

 

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

 

7.  Reservation
and Listing. The Company shall at all times reserve and keep available out of its authorized Shares, solely for the purpose of issuance
upon exercise of the Purchase Warrants, such number of Shares or other securities, properties or rights as shall be issuable upon the
exercise thereof. The Company covenants and agrees that, upon exercise of the Purchase Warrants and payment of the Exercise Price therefor
(unless exercise via cashless exercise as provided herein), in accordance with the terms hereby, all Shares and other securities issuable
upon such exercise shall be duly and validly issued, fully paid and non-assessable and not subject to preemptive rights of any shareholder.
As long as the Purchase Warrants shall be outstanding, the Company shall use its commercially reasonable efforts to cause all Shares issuable
upon exercise of the Purchase Warrants to be listed (subject to official notice of issuance) on all national securities exchanges (or,
if applicable, quoted on the OTC Bulletin Board or any successor trading market) on which the Shares issued to the public in the Offering
may then be listed and/or quoted.

 

8. Certain
Notice Requirements.

 

8.1 Holder’s
Right to Receive Notice. Nothing herein shall be construed as conferring upon the Holders the right to vote or consent or to receive
notice as a shareholder for the election of directors or any other matter, or as having any rights whatsoever as a shareholder of the
Company. If, however, at any time prior to the expiration of the Purchase Warrants and their exercise, any of the events described in
Section 8.2 shall occur, then, in one or more of said events, the Company shall give written notice of such event at least ten (10) days
prior to the date fixed as a record date or the date of closing the transfer books for the determination of the shareholders entitled
to such dividend, distribution, conversion or exchange of securities or subscription rights, or entitled to vote on such proposed dissolution,
liquidation, winding up or sale. Such notice shall specify such record date or the date of the closing of the transfer books, as the case
may be. Notwithstanding the foregoing, the Company shall deliver to each Holder a copy of each notice given to the other shareholders
of the Company at the same time and in the same manner that such notice is given to the shareholders.

 

8.2  Events
Requiring Notice. The Company shall be required to give the notice described in this Section 8 upon one or more of the following events:
(i) if the Company shall take a record of the holders of its Shares for the purpose of entitling them to receive a dividend or distribution
payable otherwise than in cash, or a cash dividend or distribution payable otherwise than out of retained earnings, as indicated by the
accounting treatment of such dividend or distribution on the books of the Company, (ii) the Company shall offer to all the holders of
its Shares any additional shares of capital stock of the Company or securities convertible into or exchangeable for shares of capital
stock of the Company, or any option, right or warrant to subscribe therefor, or (iii) a dissolution, liquidation or winding up of the
Company (other than in connection with a consolidation or share reconstruction or amalgamation) or a sale of all or substantially all
of its property, assets and business shall be proposed.

 

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

 

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

 

If to the Holder:

 

Dawson James Securities, Inc.

1 North Federal Highway – 5th Floor

Boca Raton, FL 33432

Attention: Chief Executive Officer

 

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

Schiff Hardin LLP

901 K Street, NW, Suite 700

Washington, DC 20001

Attn: Ralph V. De Martino, Esq.

Fax No.:  (202) 778-6460

 

If to the Company:

 

__________

 

9. Miscellaneous.

 

9.1 Amendments.
The Company and Dawson may from time to time supplement or amend this Purchase Warrant without the approval of any of the Holders in order
to cure any ambiguity, to correct or supplement any provision contained herein that may be defective or inconsistent with any other provisions
herein, or to make any other provisions in regard to matters or questions arising hereunder that the Company and Dawson may deem necessary
or desirable and that the Company and Dawson deem shall not adversely affect the interest of the Holders. All other modifications or amendments
shall require the written consent of and be signed by (i) the Company and (ii) the Holder(s) of Purchase Warrants then-exercisable for
at least a majority of the Shares then-exercisable pursuant to all then-outstanding Purchase Warrants.

 

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

 

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

 

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

 

    -6-

     

    

 

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

 

9.6  Waiver,
etc. The failure of the Company or the Holder to at any time enforce any of the provisions of this Purchase Warrant shall not be deemed
or construed to be a waiver of any such provision, nor to in any way affect the validity of this Purchase Warrant or any provision hereof
or the right of the Company or any Holder to thereafter enforce each and every provision of this Purchase Warrant. No waiver of any breach,
non-compliance or non-fulfillment of any of the provisions of this Purchase Warrant shall be effective unless set forth in a written instrument
executed by the party or parties against whom or which enforcement of such waiver is sought; and no waiver of any such breach, non-compliance
or non-fulfillment shall be construed or deemed to be a waiver of any other or subsequent breach, non-compliance or non-fulfillment.

 

9.7  Exchange
Agreement. As a condition of the Holder’s receipt and acceptance of this Purchase Warrant, Holder agrees that, at any time prior
to the complete exercise of this Purchase Warrant by Holder, if the Company and Dawson enter into an agreement (“Exchange Agreement”)
pursuant to which they agree that all outstanding Purchase Warrants will be exchanged for securities or cash or a combination of both,
then Holder shall agree to such exchange and become a party to the Exchange Agreement.

 

[Signature Page Follows]

 

    -7-

     

    

 

IN WITNESS WHEREOF, the Company has caused this
Purchase Warrant to be signed by its duly authorized officer as of the 30th day of August, 2021.

 

	Aditxt, Inc.	 
	 	 	 
	By: 	 	 
	 	Name: 	 	 
	 	Title:	 	 

 

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[Form to be used to exercise Purchase Warrant]

 

Date: __________, 20___

 

The undersigned hereby elects
irrevocably to exercise the Purchase Warrant for ______ shares of common stock, par value $0.001 per share (the “Shares”),
of Aditxt, Inc., a Delaware corporation (the “Company”), and hereby makes payment of $____ (at the rate of $____ per
Share) in payment of the Exercise Price pursuant thereto. Please issue the Shares as to which this Purchase Warrant is exercised in accordance
with the instructions given below and, if applicable, a new Purchase Warrant representing the number of Shares for which this Purchase
Warrant has not been exercised.

 

or

 

The undersigned
hereby elects irrevocably to convert its right to purchase ___ Shares of the Company under the Purchase Warrant for ______ Shares, as
determined in accordance with the following formula:

 

	X = 	Y(A-B)
	    A

 

Where,

 

X = The number of Shares to be issued to Holder;

Y = The number of Shares for which the Purchase Warrant is being exercised;

A = The fair market value of one Share which is equal to $_____; and

B = The Exercise Price which is equal to $______ per share

 

The undersigned
agrees and acknowledges that the calculation set forth above is subject to confirmation by the Company and any disagreement with respect
to the calculation shall be resolved by the Company in its sole discretion.

 

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

 

Signature                                                                                                  

 

Signature Guaranteed                                                                            

 

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INSTRUCTIONS FOR REGISTRATION OF SECURITIES

 

	Name:	 	 
	(Print in Block Letters) 	 
	 	 
	Address:	 	 
	 	 
	 	 	 
	 	 
	 	 	 

 

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

 

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[Form to be used to assign Purchase Warrant]

 

ASSIGNMENT

 

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

 

FOR VALUE RECEIVED, __________________
does hereby sell, assign and transfer unto the right to purchase shares of Common Stock, par value $0.001 per share, of Aditxt, Inc.,
a Delaware corporation (the “Company”), evidenced by the Purchase Warrant and does hereby authorize the Company to
transfer such right on the books of the Company.

 

Dated: __________, 20__

 

Signature                                                                                            

 

Signature Guaranteed                                                                     

 

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

 

 

-11-Exhibit 10.4

 

DEFEASANCE AND WAIVER AGREEMENT

 

This Defeasance and Waiver
Agreement (this “Agreement”), dated as of August 30, 2021, is by and between Aditxt, Inc., a Delaware corporation (the
“Company”) and CVI Investments, Inc. (the “Investor”). Capitalized terms not defined herein shall
have the meanings assigned to them in the January SPA (as defined herein).

 

WITNESSETH:

 

WHEREAS, on January
25, 2021, the Company entered into a securities purchase agreement (the “January SPA”) with the Investor whereby the
Company issued the investor, among other things, a convertible secured promissory note in the principal amount of $6,000,000 (the “January
2021 Note”) and a warrant to purchase shares of common stock of the Company (the “January 2021 Warrant”);
and

 

WHEREAS, on August
25, 2021, the Company entered into a securities purchase agreement (as in effect as of the date hereof, the “Purchase Agreement”)
with certain institutional investors, pursuant to which the Company agreed to sell to such investors an aggregate of 4,583,334 shares
of common stock of the Company (the “Shares” or “Common Stock”) at a purchase price of $2.40 per
share (the “August 2021 Financing”). The Shares were offered by the Company pursuant to its shelf registration statement
on Form S-3 (File No. 333-257645), which was declared effective by the Securities and Exchange Commission on July 13, 2021; and

 

WHEREAS, Concurrently
with the sale of the Shares, pursuant to the Purchase Agreement the Company also sold warrants to purchase 4,583,334 shares of common
stock (the “Warrants”) to such investors in a concurrent private placement; and

 

WHEREAS, on August
25, 2021, the Company entered into a letter of intent to acquire a biopharmaceutical company commercializing
a COVID-19 antiviral oral therapy (as in effect as of the date hereof, the “LOI”); and

 

WHEREAS, the August
2021 Financing and/or the execution of the LOI would result in an adjustment of the Conversion Price of the January 2021 Note, based upon
the provisions therein set forth (the “Contractual Adjustment”);
and

 

WHEREAS, in exchange
for (a) a cash payment by the Company to the Investor of $1.2 million (the “Cash Payment”), (b) a waiver, in part,
of the Contractual Adjustment such that the Note shall be convertible into 4,802,497 shares of Common Stock (without giving effect to
the conversion notices received by the Company from the Investor prior to the date hereof totaling 1,005,748 shares) (the “Adjustment
Waiver”) and (c) in accordance with Section 2(d) of the January 2021 Warrant, a voluntary and permanent reduction by the Company
of the exercise price of the January 2021 Warrant to $2.53 per share (the “Voluntary Warrant Reduction”), effective
as of the Effective Time (as defined below), the Company desires that the Investor waive all of the Investor’s rights pursuant to
Sections 2, 3(e), 4, 5(b), 7(a), 7(c), 7(d), 8, 9(a), 12, and 14 of the January 2021 Note (the “Defeasance”).

 

     

     

    

 

NOW, THEREFORE, in
consideration of and for the mutual promises and covenants contained herein, and for other good and valuable consideration, the receipt
of which is hereby acknowledged, the parties agree as follows:

 

1. Adjustment
Waiver and Voluntary Warrant Reduction. Effective as of the date hereof, the Investor and the Company hereby consent to and agree
that the Adjustment Waiver and the Voluntary Warrant Reduction shall have occurred and, solely with respect to the transactions contemplated
by the LOI, the Investor hereby waives its right to effect a redemption under the January 2021 Warrant.

 

2. Defeasance.
From the date hereof through October 15, 2021, the Investor shall forbear from exercising any of its rights under Sections 2, 3(e), 4
(other than with respect to Section 4(a)(iv), 4(a)(v), 4(a)(vii) or any Bankruptcy Event of Default (as defined in the January 2021 Note)),
5(b), 7(a), 7(c), 7(d), 8, 9(a), 12, and 14 of the January 2021 Note. Effective as of the time of the Company’s wire, in U.S. dollars
and immediately available funds, of the Cash Payment to the Investor in accordance with the wire instructions delivered by the Investor
to the Company (the “Effective Time”), the Defeasance shall occur and the Investor hereby (a) authorizes the Company
or any agent or other designee of the Company to file UCC-3 financing statement terminations with respect to each financing statement
filed against the Company for the benefit of the Investor, and (b) agrees, that at any time and from time to time, it will promptly execute
and deliver such other termination statements or other agreements and instruments in form and substance reasonably satisfactory to the
Company and take such other actions as the Company or its counsel may reasonably request to evidence, effect or reflect on public record
the release of the security interests, pledges, liens and other encumbrances granted to the Investor pursuant to the January 2021 Note,
each at the Company’s expense.

 

3. Restrictions
on Subsequent Placements and Amendments. The Company agrees that for the period commencing on the date hereof through, and including,
September 30, 2021 (the “Restricted Period’), neither the Company nor any of its Subsidiaries shall directly or indirectly
issue, offer, sell, grant any option or right to purchase, or otherwise dispose of (or announce any issuance, offer, sale, grant of any
option or right to purchase or other disposition of) any equity security or any equity-linked or related security (including, without
limitation, any “equity security” (as that term is defined under Rule 405 promulgated under the 1933 Act), any Convertible
Securities (as defined in the Securities Purchase Agreement), any debt, any preferred stock or any purchase rights) (any such issuance,
offer, sale, grant, disposition or announcement (other than Excluded Securities or such issuances required pursuant to the terms of the
LOI, the Warrant and/or the Purchase Agreement, as applicable). The Company further agrees that during the Restricted Period, neither
the Company nor any of its Subsidiaries shall, directly or indirectly, amend, modify or waive any Convertible Security or agreement to
lower the exercise price, conversion price, exchange price (or increase the aggregate number of shares of Common Stock issued or issuable
thereunder or in exchange therewith) or other similar term or condition of any such Convertible Security or agreement.

 

4. 8-K
Filing. The Company shall, on or before 9:30 a.m., New York City time, on the date of this Agreement, issue a Current Report on
Form 8-K disclosing all material terms of the transactions contemplated hereby and attaching this Agreement, as exhibits thereto (collectively
with all exhibits attached thereto, the “8-K Filing”). From and after the date of the 8-K Filing, the Investor shall
not be in possession of any material, nonpublic information received from the Company or any of its Subsidiaries or any of their respective
officers, directors, employees, affiliates or agents, that is not disclosed in the 8-K Filing. The Company shall not, and shall cause
its officers, directors, employees, affiliates and agents, not to, provide the Investor with any material, nonpublic information regarding
the Company from and after the 8-K Filing without the express written consent of the Investor. To the extent that the Company delivers
any material, non-public information to the Investor from and after the 8-K Filing without the Investor’s express prior written
consent, the Company hereby covenants and agrees that the Investor shall not have any duty of confidentiality to the Company, any of its
Subsidiaries or any of their respective officers, directors, employees, affiliates or agent with respect to, or a duty to the to the Company,
any of its Subsidiaries or any of their respective officers, directors, employees, affiliates or agent or not to trade on the basis of,
such material, non-public information. The Company shall not disclose the name of the Investor in any filing, announcement, release or
otherwise, unless such disclosure is required by law or regulation. In addition, effective upon and after the 8-K Filing, the Company
acknowledges and agrees that any and all confidentiality or similar obligations under any agreement, whether written or oral, between
the Company, any of its subsidiaries or any of their respective officers, directors, affiliates, employees or agents, on the one hand,
and the Investor or any of its affiliates, on the other hand, shall terminate and be of no further force or effect. The Company understands
and confirms that the Investor will rely on the foregoing representations in effecting transactions in securities of the Company.

 

    2

     

    

 

5. Fees.
The Company pay Kelley Drye & Warren, LLP (counsel to the Investor) a non-accountable amount of $15,000 in connection with preparing
and delivering this Agreement and the New Warrant.

 

6. Miscellaneous.

 

a. Except
as set forth above, the execution and delivery of this Agreement shall not be construed to waive any right of the Investor under the Transaction
Documents and the ancillary documents executed in connection therewith. This Agreement shall be binding upon and inure to the benefit
of the parties and their respective successors and assigns.

 

b. This
Agreement constitutes the entire agreement between the Company and the Investor with respect to the matters covered hereby and thereby
and supersedes all previous written, oral or implied understandings between them with respect to such matters. The terms set forth in
this Agreement may not be amended without the prior written consent of each of the Company and the Investor.

 

c. 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.

 

d. This
Agreement may be executed in two or more identical counterparts, all of which shall be considered one and the same agreement and shall
become effective when counterparts have been signed by each party and delivered to the other party. 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.

 

e. Section
9 of the Securities Purchase Agreement (as amended hereby) is hereby incorporated by reference herein, mutatis mutandis.

 

[Signature page follows]

 

    3

     

    

 

IN WITNESS WHEREOF, the parties
hereto have executed this Agreement as of the date first stated above.

 

	ADITXT, INC.	 
	 	 	 
	By:	 	 
	 	Name: 	Amro Albanna	 
	 	Title:	Chief Executive Officer	 

 

	CVI INVESTMENTS, INC.	 
	 	 	 
	By: 	 	 
	 	Name:	 
	 	Title:	 

 

 

4

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