Document:

Exhibit 4.3

 

REPRESENTATIVE’S PURCHASE WARRANT

 

ACLARION,
INC.

 

	Warrant Shares: _________1	Initial Exercise Date: _____, 20222
	 	 
	 	Issue Date: _______, 2022

 

This REPRESENTATIVE’S
PURCHASE WARRANT (the “Warrant”) certifies that, for value received, ___________________ or its assigns (the “Holder”)
is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter set forth, at any time on or after
the date referred to above as the Initial Exercise Date (the “Initial Exercise Date”) and on or prior to 5:00 p.m.
(New York City time) on ____, 20273 (the “Termination
Date”) but not thereafter, to subscribe for and purchase from Aclarion, Inc., a Delaware corporation (the “Company”),
up to _______ shares (as subject to adjustment hereunder, the “Warrant Shares”) of Common Stock. The purchase price
of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b).

 

Section 1.              Definitions.
Capitalized terms used and not otherwise defined herein shall have the meanings set forth in that certain Underwriting Agreement (the
“Underwriting Agreement”), dated _____, 2022, between the Company and Maxim Group LLC, as representative of the several
Underwriters named in Schedule A thereto.

 

Section 2.               Exercise.

 

a)            
Exercise of Warrant. Exercise of the purchase rights represented by this Warrant may be made, in whole or in part, at any
time or times on or after the Initial Exercise Date and on or before the Termination Date by delivery to the Company of a duly executed
facsimile copy or PDF copy submitted by email (or e-mail attachment) of the Notice of Exercise in the form annexed hereto (the “Notice
of Exercise”). Within the earlier of (i) two (2) Trading Days and (ii) the number of Trading Days comprising the Standard Settlement
Period (as defined in Section 2(d)(i) herein) following the date of exercise as aforesaid, the Holder shall deliver the aggregate Exercise
Price for the shares specified in the applicable Notice of Exercise by wire transfer or cashier’s check drawn on a United States
bank unless the cashless exercise procedure specified in Section 2(c) below is specified in the applicable Notice of Exercise. No ink-original
Notice of Exercise shall be required, nor shall any medallion guarantee (or other type of guarantee or notarization) of any Notice of
Exercise be required. Notwithstanding anything herein to the contrary, the Holder shall not be required to physically surrender this Warrant
to the Company until the Holder has purchased all of the Warrant Shares available hereunder and the Warrant has been exercised in full,
in which case, the Holder shall surrender this Warrant to the Company for cancellation within three (3) Trading Days of the date on which
the final Notice of Exercise is delivered to the Company. Partial exercises of this Warrant resulting in purchases of a portion of the
total number of Warrant Shares available hereunder shall have the effect of lowering the outstanding number of Warrant Shares purchasable
hereunder in an amount equal to the applicable number of Warrant Shares purchased. The Holder and the Company shall maintain records showing
the number of Warrant Shares purchased and the date of such purchases. The Company shall deliver any objection to any Notice of Exercise
within one (1) Business Day of receipt of such notice. The Holder and any assignee, by acceptance of this Warrant, acknowledge and
agree that, by reason of the provisions of this paragraph, following the purchase of a portion of the Warrant Shares hereunder, the number
of Warrant Shares available for purchase hereunder at any given time may be less than the amount stated on the face hereof.

 

b)            
Exercise Price. The exercise price per share of Common Stock under this Warrant shall be $____4,
subject to adjustment hereunder (the “Exercise Price”).

 

 

 

 

__________________

 

1
Insert 8% of the total shares sold in the Offering.

2
Insert the six month anniversary of the effective date of the registration statement.

3
Insert the five year anniversary of the effective date of the registration statement.

4
Insert 125% of the public offering price of the shares.

 

 

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c)             
Cashless Exercise. If at the time of exercise hereof there is no effective registration statement registering, or the prospectus
contained therein is not available for the issuance of the Warrant Shares to the Holder, then this Warrant may also be exercised, in whole
or in part, at such time by means of a “cashless exercise” in which the Holder shall be entitled to receive a number of Warrant
Shares equal to the quotient obtained by dividing [(A-B) (X)] by (A), where:

 

(A) = as applicable:
(i) the VWAP on the Trading Day immediately preceding the date of the applicable Notice of Exercise if such Notice of Exercise is (1)
both executed and delivered pursuant to Section 2(a) hereof on a day that is not a Trading Day or (2) both executed and delivered pursuant
to Section 2(a) hereof on a Trading Day prior to the opening of “regular trading hours” (as defined in Rule 600(b)(68) of
Regulation NMS promulgated under the federal securities laws) on such Trading Day, (ii) at the option of the Holder, either (y) the VWAP
on the Trading Day immediately preceding the date of the applicable Notice of Exercise or (z) the Bid Price of the Common Stock on the
principal Trading Market as reported by Bloomberg L.P. as of the time of the Holder’s execution of the applicable Notice of Exercise
if such Notice of Exercise is executed during “regular trading hours” on a Trading Day and is delivered within two (2) hours
thereafter (including until two (2) hours after the close of “regular trading hours” on a Trading Day) pursuant to Section
2(a) hereof or (iii) the VWAP on the date of the applicable Notice of Exercise if the date of such Notice of Exercise is a Trading Day
and such Notice of Exercise is both executed and delivered pursuant to Section 2(a) hereof after the close of “regular trading hours”
on such Trading Day;

 

(B) = the Exercise
Price of this Warrant, as adjusted hereunder; and

 

(X) = the number
of Warrant Shares that would be issuable upon exercise of this Warrant in accordance with the terms of this Warrant if such exercise were
by means of a cash exercise rather than a cashless exercise.

 

“VWAP” means, for
any date, the price determined by the first of the following clauses that applies: (a) if the Common Stock are then listed or quoted on
The New York Stock Exchange, the NYSE American or any tier of The Nasdaq Stock Market (each, a “Trading Market”), the
daily volume weighted average price of the Common Stock for such date (or the nearest preceding date) on the Trading Market on which the
Common Stock are then listed or quoted as reported by Bloomberg L.P. (“Bloomberg”) (based on a trading day from 9:30
a.m. (New York City time) to 4:02 p.m. (New York City time)), (b) if the Common Stock are listed or quoted on the OTCQB or OTCQX (each
as operated by OTC Markets Group, Inc., or any successor market), the volume weighted average price of the Common Stock for such date
(or the nearest preceding date) on OTCQB or OTCQX as applicable, (c) if the Common Stock are not then listed or quoted for trading on
the OTCQB or OTCQX Markets and if prices for the Common Stock are then reported in the OTC Pink Market published by OTC Markets Group
Inc. (or a similar organization or agency succeeding to its functions of reporting prices), the most recent bid price per share of the
Common Stock so reported, or (d) in all other cases, the fair market value of a Common Stock as determined by an independent appraiser
selected in good faith by the Board of Directors of the Company and reasonably acceptable to the Holder, the fees and expenses of which
shall be paid by the Company.

 

If Warrant Shares
are issued in such a cashless exercise, the parties acknowledge and agree that in accordance with Section 3(a)(9) of the Securities Act,
the Warrant Shares shall take on the registered characteristics of the Warrants being exercised, and the holding period of the Warrants
being exercised may be tacked onto the holding period of the Warrant Shares. The Company agrees not to take any position contrary to this
Section 2(c).

 

Notwithstanding
anything herein to the contrary, on the Termination Date, this Warrant shall be automatically exercised via cashless exercise pursuant
to this Section 2(c).

 

 

 

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d)            
Mechanics of Exercise.

 

		i.	Delivery of Warrant Shares Upon Exercise. The Company shall cause the Warrant Shares purchased
hereunder to be transmitted by the Transfer Agent to the Holder by crediting the account of the Holder’s or its designee’s
balance account with The Depository Trust Company through its Deposit or Withdrawal at Custodian system (“DWAC”) if
the Company is then a participant in such system and either (A) there is an effective registration statement permitting the issuance of
the Warrant Shares to or resale of the Warrant Shares by Holder or (B) this Warrant is being exercised via cashless exercise, and otherwise
by physical delivery of a certificate, registered in the Company’s share register in the name of the Holder or its designee, for
the number of Warrant Shares to which the Holder is entitled pursuant to such exercise to the address specified by the Holder in the Notice
of Exercise by the date that is the earliest of (i) two (2) Trading Days after the delivery to the Company by the Holder of the Notice
of Exercise, (ii) one (1) Trading Day after delivery of the aggregate Exercise Price to the Company and (iii) the number of Trading Days
comprising the Standard Settlement Period after the delivery to the Company of the Notice of Exercise (such date, the “Warrant
Share Delivery Date”). Upon delivery of the Notice of Exercise, the Holder shall be deemed for all corporate purposes to have
become the holder of record of the Warrant Shares with respect to which this Warrant has been exercised, irrespective of the date of delivery
of the Warrant Shares, provided that payment of the aggregate Exercise Price (other than in the case of a cashless exercise) is received
within the earlier of (i) two (2) Trading Days and (ii) the number of Trading Days comprising the Standard Settlement Period following
delivery of the Notice of Exercise. If the Company fails for any reason to deliver to the Holder the Warrant Shares subject to a Notice
of Exercise by the Warrant Share Delivery Date, the Company shall pay to the Holder, in cash, as liquidated damages and not as a penalty,
for each $1,000 of Warrant Shares subject to such exercise (based on the VWAP of the Common Stock on the date of the applicable Notice
of Exercise), $10 per Trading Day (increasing to $20 per Trading Day on the fifth Trading Day after the Warrant Share Delivery Date) for
each Trading Day after such Warrant Share Delivery Date until such Warrant Shares are delivered or Holder rescinds such exercise. The
Company agrees to maintain a transfer agent that is a participant in the FAST program so long as this Warrant remains outstanding and
exercisable. As used herein, “Standard Settlement Period” means the standard settlement period, expressed in a number
of Trading Days, on the Company’s primary Trading Market with respect to the Common Stock as in effect on the date of delivery of
the Notice of Exercise.

 

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

 

iii.           
Rescission Rights. If the Company fails to cause the Transfer Agent to transmit to the Holder the Warrant Shares pursuant
to Section 2(d)(i) by the Warrant Share Delivery Date, then the Holder will have the right to rescind such exercise; provided, however,
that the Holder shall be required to return any Warrant Shares or Common Stock subject to any such rescinded exercise notice concurrently
with the return to the Holder of the aggregate Exercise Price paid to the Company for such Warrant Shares and the restoration of the Holder’s
right to acquire such Warrant Shares pursuant to this Warrant (including, issuance of a replacement warrant certificate evidencing such
restored right).

 

 

 

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iv.           
Compensation for Buy-In on Failure to Timely Deliver Warrant Shares Upon Exercise. In addition to any other rights available
to the Holder, if the Company fails to cause the Transfer Agent to transmit to the Holder the Warrant Shares in accordance with the provisions
of Section 2(d)(i) above pursuant to an exercise on or before the Warrant Share Delivery Date, and if after such date the Holder is required
by its broker to purchase (in an open market transaction or otherwise) or the Holder’s brokerage firm otherwise purchases, shares
of Common Stock to deliver in satisfaction of a sale by the Holder of the Warrant Shares which the Holder anticipated receiving upon such
exercise (a “Buy-In”), then the Company shall (A) pay in cash to the Holder the amount, if any, by which (x) the Holder’s
total purchase price (including brokerage commissions, if any) for the shares of Common Stock so purchased exceeds (y) the amount obtained
by multiplying (1) the number of Warrant Shares that the Company was required to deliver to the Holder in connection with the exercise
at issue times (2) the price at which the sell order giving rise to such purchase obligation was executed, and (B) at the option of the
Holder, either reinstate the portion of the Warrant and equivalent number of Warrant Shares for which such exercise was not honored (in
which case such exercise shall be deemed rescinded) or deliver to the Holder the number of shares of Common Stock that would have been
issued had the Company timely complied with its exercise and delivery obligations hereunder. For example, if the Holder purchases Common
Stock having a total purchase price of $11,000 to cover a Buy-In with respect to an attempted exercise of shares of Common Stock with
an aggregate sale price giving rise to such purchase obligation of $10,000, under clause (A) of the immediately preceding sentence the
Company shall be required to pay the Holder $1,000. The Holder shall provide the Company written notice indicating the amounts payable
to the Holder in respect of the Buy-In and, upon request of the Company, evidence of the amount of such loss. Nothing herein shall limit
a Holder’s right to pursue any other remedies available to it hereunder, at law or in equity including, without limitation, a decree
of specific performance and/or injunctive relief with respect to the Company’s failure to timely deliver shares of Common Stock
upon exercise of the Warrant as required pursuant to the terms hereof.

 

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

 

vi.           
Charges, Taxes and Expenses. Issuance of Warrant Shares shall be made without charge to the Holder for any issue or transfer
tax or other incidental expense in respect of the issuance of such Warrant Shares, all of which taxes and expenses shall be paid by the
Company, and such Warrant Shares shall be issued in the name of the Holder or in such name or names as may be directed by the Holder;
provided, however, that in the event that Warrant Shares are to be issued in a name other than the name of the Holder, this
Warrant when surrendered for exercise shall be accompanied by the Assignment Form attached hereto duly executed by the Holder and the
Company may require, as a condition thereto, the payment of a sum sufficient to reimburse it for any transfer tax incidental thereto.
The Company shall pay all Transfer Agent fees required for same-day processing of any Notice of Exercise and all fees to the Depository
Trust Company (or another established clearing corporation performing similar functions) required for same-day electronic delivery of
the Warrant Shares.

 

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

 

 

 

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e)                  
Holder’s Exercise Limitations. The Company shall not effect any exercise of this Warrant, and a Holder shall not
have the right to exercise any portion of this Warrant, pursuant to Section 2 or otherwise, to the extent that after giving effect to
such issuance after exercise as set forth on the applicable Notice of Exercise, the Holder (together with the Holder’s Affiliates,
and any other Persons acting as a group together with the Holder or any of the Holder’s Affiliates (such Persons, “Attribution
Parties”)), would beneficially own in excess of the Beneficial Ownership Limitation (as defined below).  For purposes of the
foregoing sentence, the number of shares of Common Stock beneficially owned by the Holder and its Affiliates and Attribution Parties
shall include the number of shares of Common Stock issuable upon exercise of this Warrant with respect to which such determination is
being made, but shall exclude the number of shares of Common Stock which would be issuable upon (i) exercise of the remaining, nonexercised
portion of this Warrant beneficially owned by the Holder or any of its Affiliates or Attribution Parties and (ii) exercise or conversion
of the unexercised or nonconverted portion of any other securities of the Company (including, without limitation, any other Common Stock
Equivalents) subject to a limitation on conversion or exercise analogous to the limitation contained herein beneficially owned by the
Holder or any of its Affiliates or Attribution Parties.  Except as set forth in the preceding sentence, for purposes of this Section
2(e), beneficial ownership shall be calculated in accordance with Section 13(d) of the Exchange Act and the rules and regulations promulgated
thereunder, it being acknowledged by the Holder that the Company is not representing to the Holder that such calculation is in compliance
with Section 13(d) of the Exchange Act and the Holder is solely responsible for any schedules required to be filed in accordance therewith.
To the extent that the limitation contained in this Section 2(e) applies, the determination of whether this Warrant is exercisable (in
relation to other securities owned by the Holder together with any Affiliates and Attribution Parties) and of which portion of this Warrant
is exercisable shall be in the sole discretion of the Holder, and the submission of a Notice of Exercise shall be deemed to be the Holder’s
determination of whether this Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates
and Attribution Parties) and of which portion of this Warrant is exercisable, in each case subject to the Beneficial Ownership Limitation,
and the Company shall have no obligation to verify or confirm the accuracy of such determination. In addition, a determination as to
any group status as contemplated above shall be determined in accordance with Section 13(d) of the Exchange Act and the rules and regulations
promulgated thereunder. For purposes of this Section 2(e), in determining the number of outstanding shares of Common Stock, a Holder
may rely on the number of outstanding shares of Common Stock as reflected in (A) the Company’s most recent periodic or annual report
filed with the Commission, as the case may be, (B) a more recent public announcement by the Company or (C) a more recent written notice
by the Company or the Transfer Agent setting forth the number of shares of Common Stock outstanding.  Upon the written or oral request
of a Holder, the Company shall within one Trading Day confirm orally and in writing to the Holder the number of shares of Common Stock
then outstanding.  In any case, the number of outstanding shares of Common Stock shall be determined after giving effect to the
conversion or exercise of securities of the Company, including this Warrant, by the Holder or its Affiliates or Attribution Parties since
the date as of which such number of outstanding shares of Common Stock was reported. The “Beneficial Ownership Limitation”
shall be 4.99% (or, upon election by a Holder prior to the issuance of any Warrants, 9.99%) of the number of shares of Common Stock outstanding
immediately after giving effect to the issuance of shares of Common Stock issuable upon exercise of this Warrant. The Holder, upon notice
to the Company, may increase or decrease the Beneficial Ownership Limitation provisions of this Section 2(e), provided that the Beneficial
Ownership Limitation in no event exceeds 9.99% of the number of shares of Common Stock outstanding immediately after giving effect to
the issuance of shares of Common Stock upon exercise of this Warrant held by the Holder and the provisions of this Section 2(e) shall
continue to apply. Any increase in the Beneficial Ownership Limitation will not be effective until the 61st day after such
notice is delivered to the Company. The provisions of this paragraph shall be construed and implemented in a manner otherwise than in
strict conformity with the terms of this Section 2(e) to correct this paragraph (or any portion hereof) which may be defective or inconsistent
with the intended Beneficial Ownership Limitation herein contained or to make changes or supplements necessary or desirable to properly
give effect to such limitation. The limitations contained in this paragraph shall apply to a successor holder of this Warrant.

 

 

 

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Section 3.               Certain
Adjustments.

 

a)            
Stock Dividends and Splits. If the Company, at any time while this Warrant is outstanding: (i) pays a stock dividend or
otherwise makes a distribution or distributions on shares of its Common Stock or any other equity or equity equivalent securities payable
in shares of Common Stock (which, for avoidance of doubt, shall not include any shares of Common Stock issued by the Company upon exercise
of this Warrant), (ii) subdivides outstanding shares of Common Stock into a larger number of shares, (iii) combines (including by way
of reverse stock split) outstanding shares of Common Stock into a smaller number of shares, or (iv) issues by reclassification of shares
of Common Stock any shares of capital stock of the Company, then in each case the Exercise Price shall be multiplied by a fraction of
which the numerator shall be the number of shares of Common Stock (excluding treasury shares, if any) outstanding immediately before such
event and of which the denominator shall be the number of shares of Common Stock outstanding immediately after such event, and the number
of shares issuable upon exercise of this Warrant shall be proportionately adjusted such that the aggregate Exercise Price of this Warrant
shall remain unchanged. Any adjustment made pursuant to this Section 3(a) shall become effective immediately after the record date for
the determination of stockholders entitled to receive such dividend or distribution and shall become effective immediately after the effective
date in the case of a subdivision, combination or re-classification. For the purposes of clarification, the Exercise Price of this Warrant
will not be adjusted in the event that the Company or any subsidiary thereof, as applicable, sells or grants any option to purchase, or
sell or any grant any right to reprice, or otherwise dispose of or issue (or announce any offer, sale, grant or any option to purchase
or other disposition) any Common Stock or Common Stock Equivalents, at an effective price per share less than the Exercise Price then
in effect.

 

b)            
Subsequent Rights Offerings. In addition to any adjustments pursuant to Section 3(a) above, if at any time the Company grants,
issues or sells any Common Stock Equivalents or rights to purchase stock, warrants, securities or other property pro rata to the record
holders of any class of shares of Common Stock (the “Purchase Rights”), then the Holder will be entitled to acquire,
upon the terms applicable to such Purchase Rights, the aggregate Purchase Rights which the Holder could have acquired if the Holder had
held the number of shares of Common Stock acquirable upon complete exercise of this Warrant (without regard to any limitations on exercise
hereof, including without limitation, the Beneficial Ownership Limitation) immediately before the date on which a record is taken for
the grant, issuance or sale of such Purchase Rights, or, if no such record is taken, the date as of which the record holders of shares
of Common Stock are to be determined for the grant, issue or sale of such Purchase Rights (provided, however, to the extent that the Holder’s
right to participate in any such Purchase Right would result in the Holder exceeding the Beneficial Ownership Limitation, then the Holder
shall not be entitled to participate in such Purchase Right to such extent (or beneficial ownership of such shares of Common Stock as
a result of such Purchase Right to such extent) and such Purchase Right to such extent shall be held in abeyance for the Holder until
such time, if ever, as its right thereto would not result in the Holder exceeding the Beneficial Ownership Limitation).

 

c)             
Pro Rata Distribution. During such time as this Warrant is outstanding, if the Company shall declare or make any dividend
or other distribution of its assets (or rights to acquire its assets) to holders of shares of Common Stock, by way of return of capital
or otherwise (including, without limitation, any distribution (other than cash) of stock or other securities, property or options by way
of a dividend, spin off, reclassification, corporate rearrangement, scheme of arrangement or other similar transaction) (a “Distribution”),
at any time after the issuance of this Warrant, then, in each such case, the Holder shall be entitled to participate in such Distribution
to the same extent that the Holder would have participated therein if the Holder had held the number of shares of Common Stock acquirable
upon complete exercise of this Warrant (without regard to any limitations on exercise hereof, including without limitation, the Beneficial
Ownership Limitation) immediately before the date of which a record is taken for such Distribution, or, if no such record is taken, the
date as of which the record holders of shares of Common Stock are to be determined for the participation in such Distribution (provided,
however, that, to the extent that the Holder's right to participate in any such Distribution would result in the Holder exceeding
the Beneficial Ownership Limitation, then the Holder shall not be entitled to participate in such Distribution to such extent (or in the
beneficial ownership of any shares of Common Stock as a result of such Distribution to such extent) and the portion of such Distribution
shall be held in abeyance for the benefit of the Holder until such time, if ever, as its right thereto would not result in the Holder
exceeding the Beneficial Ownership Limitation). To the extent that this Warrant has not been partially or completely exercised at the
time of such Distribution, such portion of the Distribution shall be held in abeyance for the benefit of the Holder until the Holder has
exercised this Warrant.

 

 

 

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d)            
Fundamental Transaction. If, at any time while this Warrant is outstanding, (i) the Company, directly or indirectly, in
one or more related transactions effects any merger or consolidation of the Company with or into another Person, (ii) the Company (and
all of its Subsidiaries, taken as a whole), directly or indirectly, effects any sale, lease, license, assignment, transfer, conveyance
or other disposition of all or substantially all of its assets in one or a series of related transactions, (iii) any, direct or indirect,
purchase offer, tender offer or exchange offer (whether by the Company or another Person) is completed pursuant to which holders of Common
Stock are permitted to sell, tender or exchange their shares for other securities, cash or property and has been accepted by the holders
of 50% or more of the outstanding Common Stock, (iv) the Company, directly or indirectly, in one or more related transactions effects
any reclassification, reorganization or recapitalization of the Common Stock or any compulsory share exchange pursuant to which the Common
Stock is effectively converted into or exchanged for other securities, cash or property, or (v) the Company, directly or indirectly,
in one or more related transactions consummates a stock or share purchase agreement or other business combination (including, without
limitation, a reorganization, recapitalization, spin-off, merger or scheme of arrangement) with another Person or group of Persons whereby
such other Person or group acquires more than 50% of the outstanding shares of Common Stock (not including any shares of Common Stock
held by the other Person or other Persons making or party to, or associated or affiliated with the other Persons making or party to,
such stock or share purchase agreement or other business combination) (each a “Fundamental Transaction”), then, upon
any subsequent exercise of this Warrant, the Holder shall have the right to receive, for each Warrant Share that would have been issuable
upon such exercise immediately prior to the occurrence of such Fundamental Transaction, at the option of the Holder (without regard to
any limitation in Section 2(e) on the exercise of this Warrant), the number of shares of Common Stock of the successor or acquiring corporation
or of the Company, if it is the surviving corporation, and any additional consideration (the “Alternate Consideration”)
receivable as a result of such Fundamental Transaction by a holder of the number of shares of Common Stock for which this Warrant is
exercisable immediately prior to such Fundamental Transaction (without regard to any limitation in Section 2(e) on the exercise of this
Warrant). For purposes of any such exercise, the determination of the Exercise Price shall be appropriately adjusted to apply to such
Alternate Consideration based on the amount of Alternate Consideration issuable in respect of one share of Common Stock in such Fundamental
Transaction, and the Company shall apportion the Exercise Price among the Alternate Consideration in a reasonable manner reflecting the
relative value of any different components of the Alternate Consideration. If holders of Common Stock are given any choice as to the
securities, cash or property to be received in a Fundamental Transaction, then the Holder shall be given the same choice as to the Alternate
Consideration it receives upon any exercise of this Warrant following such Fundamental Transaction. Notwithstanding anything to the contrary,
in the event of a Fundamental Transaction, the Company or any Successor Entity (as defined below) shall, at the Holder’s option,
exercisable at any time concurrently with, or within 30 days after, the consummation of the Fundamental Transaction (or, if later, the
date of the public announcement of the applicable Fundamental Transaction), purchase this Warrant from the Holder by paying to the Holder
an amount of cash equal to the Black Scholes Value (as defined below) of the remaining unexercised portion of this Warrant on the date
of the consummation of such Fundamental Transaction; provided, however, that, if the Fundamental Transaction is not within
the Company's control, including not approved by the Company's Board of Directors, Holder shall only be entitled to receive from the
Company or any Successor Entity, as of the date of consummation of such Fundamental Transaction, the same type or form of consideration
(and in the same proportion), at the Black Scholes Value of the unexercised portion of this Warrant, that is being offered and paid to
the holders of Common Stock of the Company in connection with the Fundamental Transaction, whether that consideration be in the form
of cash, stock or any combination thereof, or whether the holders of Common Stock are given the choice to receive from among alternative
forms of consideration in connection with the Fundamental Transaction. “Black Scholes Value” means the value of this
Warrant based on the Black-Scholes Option Pricing Model obtained from the “OV” function on Bloomberg, L.P. (“Bloomberg”)
determined as of the day of consummation of the applicable Fundamental Transaction for pricing purposes and reflecting (A) a risk-free
interest rate corresponding to the U.S. Treasury rate for a period equal to the time between the date of the public announcement of the
applicable Fundamental Transaction and the Termination Date, (B) an expected volatility equal to the greater of 100% and the 100 day
volatility obtained from the HVT function on Bloomberg (determined utilizing a 365 day annualization factor) as of the Trading Day immediately
following the public announcement of the applicable Fundamental Transaction, (C) the underlying price per share used in such calculation
shall be the greater of (i) the sum of the price per share being offered in cash, if any, plus the value of any non-cash consideration,
if any, being offered in such Fundamental Transaction and (ii) the greater of (x) the last VWAP immediately prior to the public announcement
of such Fundamental Transaction and (y) the last VWAP immediately prior to the consummation of such Fundamental Transaction and (D) a
remaining option time equal to the time between the date of the public announcement of the applicable Fundamental Transaction and the
Termination Date. The payment of the Black Scholes Value will be made by wire transfer of immediately available funds within five Business
Days of the Holder’s election (or, if later, on the effective date of the Fundamental Transaction). The Company shall cause any
successor entity in a Fundamental Transaction in which the Company is not the survivor (the “Successor Entity”) to
assume in writing all of the obligations of the Company under this Warrant in accordance with the provisions of this Section 3(e) pursuant
to written agreements in form and substance reasonably satisfactory to the Holder and approved by the Holder (without unreasonable delay)
prior to such Fundamental Transaction and shall, at the option of the Holder, deliver to the Holder in exchange for this Warrant a security
of the Successor Entity evidenced by a written instrument substantially similar in form and substance to this Warrant which is exercisable
for a corresponding number of shares of capital stock of such Successor Entity (or its parent entity) equivalent to the shares of Common
Stock acquirable and receivable upon exercise of this Warrant (without regard to any limitations on the exercise of this Warrant) prior
to such Fundamental Transaction, and with an exercise price which applies the exercise price hereunder to such shares of capital stock
(but taking into account the relative value of the shares of Common Stock pursuant to such Fundamental Transaction and the value of such
shares of capital stock, such number of shares of capital stock and such exercise price being for the purpose of protecting the economic
value of this Warrant immediately prior to the consummation of such Fundamental Transaction), and which is reasonably satisfactory in
form and substance to the Holder. Upon the occurrence of any such Fundamental Transaction, the Successor Entity shall succeed to, and
be substituted for (so that from and after the date of such Fundamental Transaction, the provisions of this Warrant referring to the
“Company” shall refer instead to the Successor Entity), and may exercise every right and power of the Company and shall assume
all of the obligations of the Company under this Warrant with the same effect as if such Successor Entity had been named as the Company
herein.

    	 	7	 

     

    

 

e)            
Calculations. All calculations under this Section 3 shall be made to the nearest cent or the nearest 1/100th of a share,
as the case may be. For purposes of this Section 3, the number of shares of Common Stock deemed to be issued and outstanding as of a given
date shall be the sum of the number of shares of Common Stock (excluding treasury shares, if any) issued and outstanding.

 

f)                  
Notice to Holder.

 

i.           
Adjustment to Exercise Price. Whenever the Exercise Price is adjusted pursuant to any provision of this Section 3, the Company
shall promptly deliver to the Holder by facsimile or email a notice setting forth the Exercise Price after such adjustment and any resulting
adjustment to the number of Warrant Shares and setting forth a brief statement of the facts requiring such adjustment.

 

ii.           
Notice to Allow Exercise by Holder. If (A) the Company shall declare a dividend (or any other distribution in whatever form)
on the Common Stock, (B) the Company shall declare a special nonrecurring cash dividend on or a redemption of the Common Stock, (C) the
Company shall authorize the granting to all holders of the Common Stock rights or warrants to subscribe for or purchase any shares of
capital stock of any class or of any rights, (D) the approval of any stockholders of the Company shall be required in connection with
any reclassification of the Common Stock, any consolidation or merger to which the Company (and all of its Subsidiaries, taken as a whole)
is a party, any sale or transfer of all or substantially all of the assets of the Company, or any compulsory share exchange whereby the
Common Stock is converted into other securities, cash or property, or (E) the Company shall authorize the voluntary or involuntary dissolution,
liquidation or winding up of the affairs of the Company, then, in each case, the Company shall cause to be delivered by facsimile or email
to the Holder at its last facsimile number or email address as it shall appear upon the Warrant Register of the Company, at least 20 calendar
days prior to the applicable record or effective date hereinafter specified, a notice stating (x) the date on which a record is to be
taken for the purpose of such dividend, distribution, redemption, rights or warrants, or if a record is not to be taken, the date as of
which the holders of the Common Stock of record to be entitled to such dividend, distributions, redemption, rights or warrants are to
be determined or (y) the date on which such reclassification, consolidation, merger, sale, transfer or share exchange is expected to become
effective or close, and the date as of which it is expected that holders of the Common Stock of record shall be entitled to exchange their
shares of Common Stock for securities, cash or other property deliverable upon such reclassification, consolidation, merger, sale, transfer
or share exchange; provided that the failure to deliver such notice or any defect therein or in the delivery thereof shall not affect
the validity of the corporate action required to be specified in such notice. To the extent that any notice provided in this Warrant constitutes,
or contains, material, non-public information regarding the Company or any of the Subsidiaries, the Company shall simultaneously file
such notice with the Commission pursuant to a Current Report on Form 8-K. The Holder shall remain entitled to exercise this Warrant during
the period commencing on the date of such notice to the effective date of the event triggering such notice except as may otherwise be
expressly set forth herein.

 

Section 4.               Transfer
of Warrant.

 

a)            
Transferability. Pursuant to FINRA Rule 5110(e)(1), neither this Warrant nor any Warrant Shares
issued upon exercise of this Warrant shall be sold, transferred, assigned, pledged or hypothecated, or be the subject of any hedging,
short sale, derivative, put or call transaction that would result in the effective economic disposition of the securities by any person
for a period of 180 days immediately following the commencement of sales of the offering pursuant to which this Warrant is being issued,
except as permitted under FINRA Rule 5110(e)(2). Subject to the foregoing restriction, this Warrant and all rights hereunder are transferable,
in whole or in part, upon surrender of this Warrant at the principal office of the Company or its designated agent, together with a written
assignment of this Warrant substantially in the form attached hereto duly executed by the Holder or its agent or attorney and funds sufficient
to pay any transfer taxes payable upon the making of such transfer. Upon such surrender and, if required, such payment, the Company shall
execute and deliver a new Warrant or Warrants in the name of the assignee or assignees, as applicable, and in the denomination or denominations
specified in such instrument of assignment, and shall issue to the assignor a new Warrant evidencing the portion of this Warrant not so
assigned, and this Warrant shall promptly be cancelled. Notwithstanding anything herein to the contrary, the Holder shall not be required
to physically surrender this Warrant to the Company unless the Holder has assigned this Warrant in full, in which case, the Holder shall
surrender this Warrant to the Company within three (3) Trading Days of the date on which the Holder delivers an assignment form to the
Company assigning this Warrant in full. This Warrant, if properly assigned in accordance herewith, may be exercised by a new holder for
the purchase of Warrant Shares without having a new Warrant issued.

 

 

 

 

    	 	8	 

     

    

 

b)            
New Warrants. This Warrant may be divided or combined with other Warrants upon presentation
hereof at the aforesaid office of the Company, together with a written notice specifying the names and denominations in which new Warrants
are to be issued, signed by the Holder or its agent or attorney. Subject to compliance with Section 4(a), as to any transfer which may
be involved in such division or combination, the Company shall execute and deliver a new Warrant or Warrants in exchange for the Warrant
or Warrants to be divided or combined in accordance with such notice. All Warrants issued on transfers or exchanges shall be dated the
initial issuance date of this Warrant and shall be identical with this Warrant except as to the number of Warrant Shares issuable pursuant
thereto. 

 

c)            
Warrant Register. The Company shall register this Warrant, upon records to be maintained by
or on behalf of the Company for that purpose (the “Warrant Register”), in the name of the record Holder hereof from
time to time. The Company may deem and treat the registered Holder of this Warrant as the absolute owner hereof for the purpose of any
exercise hereof or any distribution to the Holder, and for all other purposes, absent actual notice to the contrary.

 

d)            
Representation by Holder. The Holder, by the acceptance hereof, represents and warrants that
it is acquiring this Warrant and, upon any exercise hereof, will acquire the Warrant Shares issuable upon such exercise, for its own account
and not with a view to or for distributing or reselling such Warrant Shares or any part thereof in violation of the Securities Act or
any applicable state securities law, except pursuant to sales registered or exempted under the Securities Act.

 

Section 5.               Registration
Rights.

 

a)            
To the extent the Company does not maintain an effective registration statement for the Warrant Shares and in the further event
that the Company files a registration statement with the Securities and Exchange Commission covering the sale of its shares of Common
Stock (other than a registration statement on Form S-4 or S-8, or on another form, or in another context, in which such “piggyback”
registration would be inappropriate), then, for a period of five (5) years from the commencement of sales of the Offering, the Company
shall give written notice of such proposed filing to the Holder as soon as practicable but in no event less than ten (10) days before
the anticipated filing date, which notice shall describe the amount and type of securities to be included in such offering, the intended
method(s) of distribution, and the name of the proposed managing underwriter or underwriters, if any, of the offering, and offer to the
Holder in such notice the opportunity to register the sale of such number of shares of Warrant Shares as such Holder may request in writing
within five (5) days following receipt of such notice (a “Piggyback Registration”). The Company shall cause such Warrant
Shares to be included in such registration and shall use its commercially reasonable efforts to cause the managing underwriter or underwriters
of a proposed underwritten offering to permit the Warrant Shares requested to be included in a Piggyback Registration on the same terms
and conditions as any similar securities of the Company and to permit the sale or other disposition of such Warrant Shares in accordance
with the intended method(s) of distribution thereof. All Holders proposing to distribute their securities through a Piggyback Registration
that involves an underwriter or underwriters shall enter into an underwriting agreement in customary form with the underwriter or underwriters
selected for such Piggyback Registration. Furthermore, each Holder must provide such information as reasonably requested by the Company
(which information shall be limited to that which is required for disclosure under the Securities Act and the forms, rules and regulations
promulgated thereunder) to be included in the registration statement timely or the Company may elect to exclude such Holder from the registration
statement.

 

b)           
In addition, to the extent the Company does not maintain an effective registration statement for the Warrant Shares, for a period
of five (5) years from the commencement of sales of the Offering, the Holder, or if the Warrants are held by more than one Holder, a majority
of the Holders, shall be entitled to one (1) demand right for the registration of the Warrant Shares at the Company’s expense (other
than any underwriting discounts, selling commissions, share transfer taxes applicable to the sale of the Warrant Shares, and fees and
disbursements of counsel for the Holder) (the “Demand Registration”). In the event of a Demand Registration, the Company
shall use its commercially reasonable efforts to register the applicable Warrant Shares within sixty (60) days after receiving the Demand
Registration. All Holders of Warrant Shares proposing to distribute their securities through a Demand Registration that involves an underwriter
or underwriters shall enter into an underwriting agreement in customary form with the underwriter or underwriters selected for such Demand
Registration. Furthermore, each Holder must provide such information as reasonably requested by the Company (which information shall be
limited to that which is required for disclosure under the Securities Act and the forms, rules and regulations promulgated thereunder)
to be included in the registration statement timely or the Company may elect to exclude such Holder from the registration statement.

 

 

 

    	 	9	 

     

    

 

c)            
Notwithstanding the foregoing, the registration rights described in this Section 5 shall be subject to limitations imposed by the
Commission’s rules or comments of the Commission staff in connection with its review of the registration statement for any such
resale registration. Moreover, notwithstanding the foregoing registration obligations of the Company, if the Company furnishes to the
Holders requesting a Demand Registration a certificate signed by the Company’s chief executive officer stating that in the good
faith judgment of the Company’s Board of Directors it would be materially detrimental to the Company and its stockholders for a
registration statement to either become effective or remain effective for as long as such registration statement otherwise would be required
to remain effective, because such action would (i) materially interfere with a significant acquisition, corporate reorganization, or other
similar transaction involving the Company; (ii) require premature disclosure of material information that the Company has a bona fide
business purpose for preserving as confidential; or (iii) render the Company unable to comply with requirements under the Securities Act
or Exchange Act, then the Company shall have the right to defer taking action with respect to such Demand Registration or withdraw a related
registration statement for a period of not more than forty-five (45) calendar days; provided, however, that the Company may not invoke
this right more than twice in any twelve (12) month period or during the twelve (12) month period prior to the Termination Date.

 

Section 6.               Miscellaneous.

 

a)            
No Rights as Stockholder Until Exercise; No Settlement in Cash. This Warrant does not entitle the Holder to any voting rights,
dividends or other rights as a stockholder of the Company prior to the exercise hereof as set forth in Section 2(d)(i), except as expressly
set forth in Section 3. Without limiting any rights of a Holder to receive Warrant Shares on a “cashless exercise” pursuant
to Section 2(c) or to receive cash payments pursuant to Section 2(d)(i) and Section 2(d)(iv) herein, in no event shall the Company be
required to net cash settle an exercise of this Warrant.

 

b)            
Loss, Theft, Destruction or Mutilation of Warrant. The Company covenants that upon receipt by the Company of evidence reasonably
satisfactory to it of the loss, theft, destruction or mutilation of this Warrant or any stock certificate relating to the Warrant Shares,
and in case of loss, theft or destruction, of indemnity or security reasonably satisfactory to it (which, in the case of the Warrant,
shall not include the posting of any bond), and upon surrender and cancellation of such Warrant or stock certificate, if mutilated, the
Company will make and deliver a new Warrant or stock certificate of like tenor and dated as of such cancellation, in lieu of such Warrant
or stock certificate.

 

c)             
Saturdays, Sundays, Holidays, etc. If the last or appointed day for the taking of any action or the expiration of any right
required or granted herein shall not be a Business Day, then, such action may be taken or such right may be exercised on the next succeeding
Business Day.

 

d)            
Authorized Shares.

 

i.              
The Company covenants that, during the period the Warrant is outstanding, it will reserve from its authorized and unissued Common
Stock a sufficient number of shares to provide for the issuance of the Warrant Shares upon the exercise of any purchase rights under this
Warrant. The Company further covenants that its issuance of this Warrant shall constitute full authority to its officers who are charged
with the duty of issuing the necessary Warrant Shares upon the exercise of the purchase rights under this Warrant. The Company will take
all such reasonable action as may be necessary to assure that such Warrant Shares may be issued as provided herein without violation of
any applicable law or regulation, or of any requirements of the Trading Market upon which the Common Stock may be listed. The Company
covenants that all Warrant Shares which may be issued upon the exercise of the purchase rights represented by this Warrant will, upon
exercise of the purchase rights represented by this Warrant and payment for such Warrant Shares in accordance herewith, be duly authorized,
validly issued, fully paid and nonassessable and free from all taxes, liens and charges created by the Company in respect of the issue
thereof (other than taxes in respect of any transfer occurring contemporaneously with such issue).

 

 

 

    	 	10	 

     

    

 

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

 

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

 

e)            
Governing Law; Venue. This Warrant shall be deemed to have been executed and delivered in New York and both this Warrant
and the transactions contemplated hereby shall be governed as to validity, interpretation, construction, effect, and in all other respects
by the laws of the State of New York applicable to agreements wholly performed within the borders of such state and without regard to
the conflicts of laws principals thereof (other than Section 5-1401 of The New York General Obligations Law). Each of the Holder and the
Company: (a) agrees that any legal suit, action or proceeding arising out of or relating to this Warrant and/or the transactions contemplated
hereby shall be instituted exclusively in the Supreme Court of the State of New York, New York County, or in the United States District
Court for the Southern District of New York, (b) waives any objection which it may have or hereafter to the venue of any such suit, action
or proceeding, and (c) irrevocably consents to the jurisdiction of Supreme Court of the State of New York, New York County, or in the
United States District Court for the Southern District of New York in any such suit, action or proceeding. Each of the Holder and the
Company further agrees to accept and acknowledge service of any and all process which may be served in any such suit, action or proceeding
in the Supreme Court of the State of New York, New York County, or in the United States District Court for the Southern District of New
York and agrees that service of process upon the Company mailed by certified mail to the Company’s address or delivered by Federal
Express via overnight delivery shall be deemed in every respect effective service of process upon the Company, in any such suit, action
or proceeding, and service of process upon the Holder mailed by certified mail to the Holder’s address or delivered by Federal Express
via overnight delivery shall be deemed in every respect effective service process upon the Holder, in any such suit, action or proceeding.
THE HOLDER (ON BEHALF OF ITSELF, ITS SUBSIDIARIES AND, TO THE FULLEST EXTENT PERMITTED BY LAW, ON BEHALF OF ITS RESPECTIVE EQUITY HOLDERS
AND CREDITORS) HEREBY WAIVES ANY RIGHT HOLDER MAY HAVE TO A TRIAL BY JURY IN RESPECT OF ANY CLAIM BASED UPON, ARISING OUT OF OR IN CONNECTION
WITH THIS WARRANT AND THE TRANSACTIONS CONTEMPLATED BY THIS WARRANT.

 

f)             
Restrictions. The Holder acknowledges that the Warrant Shares acquired upon the exercise of this Warrant, if not registered,
and the Holder does not utilize cashless exercise, will have restrictions upon resale imposed by state and federal securities laws.

 

g)            
Nonwaiver and Expenses. No course of dealing or any delay or failure to exercise any right hereunder on the part of Holder
shall operate as a waiver of such right or otherwise prejudice the Holder’s rights, powers or remedies. Without limiting any other
provision of this Warrant, if the Company willfully and knowingly fails to comply with any provision of this Warrant, which results in
any material damages to the Holder, the Company shall pay to the Holder such amounts as shall be sufficient to cover any costs and expenses
including, but not limited to, reasonable attorneys’ fees, including those of appellate proceedings, incurred by the Holder in collecting
any amounts due pursuant hereto or in otherwise enforcing any of its rights, powers or remedies hereunder.

 

 

 

    	 	11	 

     

    

 

h)           
Notices. Any and all notices or other communications or deliveries to be provided hereunder shall be made in accordance
with Section 7.3 of the Underwriting Agreement.

 

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

 

j)            
Remedies. The Holder, in addition to being entitled to exercise all rights granted by law, including recovery of damages,
will be entitled to specific performance of its rights under this Warrant. The Company agrees that monetary damages would not be adequate
compensation for any loss incurred by reason of a breach by it of the provisions of this Warrant and hereby agrees to waive and not to
assert the defense in any action for specific performance that a remedy at law would be adequate.

 

k)            
Successors and Assigns. Subject to applicable securities laws, this Warrant and the rights and obligations evidenced hereby
shall inure to the benefit of and be binding upon the successors and permitted assigns of the Company and the successors and permitted
assigns of Holder. The provisions of this Warrant are intended to be for the benefit of any Holder from time to time of this Warrant and
shall be enforceable by the Holder or holder of Warrant Shares.

 

l)             
Amendment. This Warrant may be modified or amended or the provisions hereof waived with the written consent of the Company,
on the one hand, and the Holder of this Warrant, on the other hand.

 

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

 

n)            
Headings. The headings used in this Warrant are for the convenience of reference only and shall not, for any purpose, be
deemed a part of this Warrant.

 

********************

 

(Signature Page Follows)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

    	 	12	 

     

    

 

IN WITNESS WHEREOF, the Company
has caused this Warrant to be executed by its officer thereunto duly authorized as of the date first above indicated.

 

	 	
    ACLARION, INC.

     

     

     

	 	
    By:__________________________________________

    Name:

    Title:

     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

    	 	13	 

     

    

 

NOTICE OF EXERCISE

 

To:          ACLARION,
INC.

 

(1)  
The undersigned hereby elects to purchase ________ Warrant Shares of the Company pursuant to the
terms of the attached Warrant (only if exercised in full), and tenders herewith payment of the exercise price in full, together with all
applicable transfer taxes, if any.

 

(2)  
Payment shall take the form of (check applicable box):

 

[_] in lawful money
of the United States; or

 

[_] if permitted the
cancellation of such number of Warrant Shares as is necessary, in accordance with the formula set forth in subsection 2(c), to exercise
this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless exercise procedure set forth in
subsection 2(c).

 

(3)  
Please issue said Warrant Shares in the name of the undersigned or in such other name as is specified
below:

_______________________________

 

 

The Warrant Shares shall be delivered to the following
DWAC Account Number:

 

_______________________________

 

_______________________________

 

_______________________________

 

 

[SIGNATURE
OF HOLDER]

 

Name of Investing Entity: ___________________________________________________

 

________________________________________________________________________

Signature of Authorized Signatory of Investing
Entity:

 

_________________________________________________

Name of Authorized Signatory:

 

___________________________________________________________________

Title of Authorized Signatory:

 

Date: ___________________________________________________________________

 

 

 

 

    	 	14	 

     

    

 

ASSIGNMENT FORM

 

(To assign the foregoing
Warrant, execute this form and supply required information. Do not use this form to purchase shares.)

 

FOR VALUE RECEIVED, the foregoing
Warrant and all rights evidenced thereby are hereby assigned to

 

	Name:	 
	 	(Please Print)
	 	 
	Address:	 
	
     

     

    Phone Number:

     

    Email Address:
	
    (Please Print)

     

    ______________________________________

     

    ______________________________________

	 	 
	Dated: _______________ __, ______	 
	 	 
	Holder’s Signature:
    ________________________	 
	 	 
	Holder’s Address: _________________________	 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

    	 	15Exhibit 10.5

 

THIS NOTE
AND THE SECURITIES ISSUABLE UPON THE CONVERSION HEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "ACT"),
OR UNDER THE SECURITIES LAWS OF ANY STATES IN THE UNITED STATES. THESE SECURITIES ARE SUBJECT TO RESTRICTIONS ON TRANSFERABILITY
AND RESALE AND MAY NOT BE TRANSFERRED OR RESOLD EXCEPT AS PERMITTED UNDER THE ACT AND THE APPLICABLE STATE SECURITIES LAWS, PURSUANT TO
REGISTRATION OR EXEMPTION THEREFROM. THE ISSUER OF THESE SECURITIES MAY REQUIRE AN OPINION OF COUNSEL
IN FORM AND SUBSTANCE SATISFACTORY TO THE ISSUER TO THE EFFECT THAT ANY PROPOSED TRANSFER OR RESALE IS IN COMPLIANCE WITH THE ACT .AND
ANY APPLICABLE STATE SECURITIES LAWS.

 

 

SENIOR SECURED BRIDGE PROMISSORY NOTE

 

 

	 	

Note
Series:
	 	202lA

	 	 
	 	Date of Note:	 	June 16, 2021
	 	 
	 	Principal Amount of Note:	 	 $1,900,000

 

For value
received NOCIMED, INC., a Delaware corporation (the"Company"),
promises to pay to the undersigned holder or such party's assigns (the "Holder") the
principal amount set forth above with interest on the outstanding principal amount at the rate of 33% per annum, compounded annually.
Interest shall commence with the date hereof and shall continue on the outstanding principal amount until paid in full or converted. Interest
shall be computed on the basis of a year of 365 days for the actual number of days elapsed. All unpaid interest (to the extent provided
herein) and principal shall be due and payable upon request of the Majority Holders on or after the earliest of (i)
the closing date of a Qualified Financing (as defined below), (ii) the closing date of a Qualifying IPO (as defined below), (iii)
the closing date of a Change of Control (as defined below) or (iv) May 31, 2022 (or any later date as such date may be extended to in
accordance herewith) (collectively, the"Maturity Date").

 

		1.	BASIC TERMS.

 

(a)           
Series of Notes. This senior bridge promissory note (the "Note") is issued as part of a series of substantially
similar notes designated by the Note Series above (collectively, the "Notes"), and having an aggregate principal
amount not to exceed $2,000,000 and issued in a series of multiple closings to certain persons and entities (collectively, the "Holders").
The Company shall maintain a ledger of all Holders.

 

(b)           
Payments. All payments of interest and principal shall be in lawful money of the United States of America and shall be made
pro rata among all Holders. All payments shall be applied first to accrued interest, and thereafter to principal.

 

(c)           
Prepayment. Except as provided in this Section l(c), the Company may not prepay this Note prior to the Maturity Date without
the consent of the Holders of a majority of the outstanding principal amount of the Notes (the"Majority Holders").

 

(d)           
Renewal Option. If the Notes remain outstanding as of May 31, 2022, the Company shall have the option to extend the Notes
as provided in this paragraph l(d). To extend the Notes, the Company will issue to the Holders (as an extension fee) common stock warrants
as follows: (i) warrants for 150,000 common shares for each $2 million of Note principal extended, (ii) warrant exercise price of $0.01
per common share, (iii) five year warrant term, and (iv) customary net exercise provisions. Upon the issuance of the extension fee warrants
to the Holders, the May 31, 2022 date set forth above in the first full paragraph of this Note shall be automatically amended to read
"May 31, 2023." All other provisions of the Notes (as extended) would remain in full force and effect.

 

 

 

    	 	1	 

     

    

 

(e)           
Security Interest; Collateral. All obligations under this Note shall be secured by a lien and
security interest on substantially all of the Company's assets pursuant to a Security Agreement dated June 16, 2021 (the"Security
Agreement") between the Company and the Holders.

 

		2.	CONVERSION AND REPAYMENT.

 

(a)          
Qualified Financing Defined. The term "Qualified Financing" shall mean that the Company issues and
sells shares of its equity securities ("Equity Securities") to investors (the "Investors") on
or before the Maturity Date in an equity financing with total proceeds to the Company of not less than $5,000,000 (excluding the conversion
of the Notes or other convertible securities issued for capital raising purposes (e.g., Simple Agreements for Future Equity)).

 

(b)          
Optional Conversion at Qualified Financing. In the event the Company consummates, on or before the Maturity Date, a Qualified
Financing, then the Majority Holders shall have the option to convert any unpaid accrued interest into the Company's Equity Securities
issued in the Qualified Financing. Such unpaid accrued interest would convert into the Equity Securities sold in the Qualified Financing
at a conversion price equal to the cash price paid per share for Equity Securities by the Investors in the Qualified Financing multiplied
by 0.30. The issuance of Equity Securities pursuant to this paragraph 2(6) shall otherwise be upon and subject to the same terms and conditions
applicable to Equity Securities sold in the Qualified Financing. Notwithstanding this paragraph, if the conversion price as determined
pursuant to this paragraph (the "Optional Conversion Price") is less than the price per share at which Equity
Securities are issued in the Qualified Financing, the Company may, solely at its option, elect to convert this Note into shares of a newly
created series of preferred stock having the identical rights, privileges, preferences and restrictions as the Equity Securities issued
in the Qualified Financing, and otherwise on the same terms and conditions, other than with respect to (if applicable): (i) the per share
liquidation preference and the conversion price for purposes of price-based anti-dilution protection, which will equal the Optional Conversion
Price; and (ii) the per share dividend, which will be the same percentage of the Optional Conversion Price as applied to determine the
per share dividends of the Investors in the Qualified Financing relative to the purchase price paid by the Investors

 

(c)          
Payment of Principal and Automatic Conversion of Interest upon Initial Public Offering. In the event that Company issues and
sells securities in a Qualifying IPO (as defined below), then (i) the
outstanding principal balance of this Note shall be repaid as of the closing date of the Qualifying IPO, and (ii) any unpaid accrued
interest shall automatically convert (without any further action by the parties) into the Company securities offered to the public in
the Qualifying IPO. The conversion price shall be (i) the per common share or per unit (as applicable) initial public offering price
(before underwriting discounts and commissions) set forth in the final prospectus for the Qualifying IPO, multiplied by (ii) 0.30. "Qualifying
IPO" shall mean a registered initial public offering by the Company of its securities which (i)
results in gross proceeds to the Company of at least $5.0 million (before underwriting discounts and commissions), and (ii)
becomes effective on or before the Maturity Date. By· way of illustration, assume the Company's final prospectus for its
initial public offering provides for the offering of one unit (consisting of one common share and one common warrant) at a public offering
price of $10.00 per unit. In such circumstance, the conversion price would be $3.00 per unit. In the event of an automatic conversion
of interest on the Notes in connection with a Qualifying IPO, the Company shall have the option to pay up to a maximum of 15 days of
accrued interest on the Notes in cash (rather than having such accrued interest converted into Company securities.

 

(d)           
Change of Control. If the Company consummates a Change of Control (as defined below)
while this Note remains outstanding, the Company shall repay the Holder in cash in an amount equal to the outstanding principal amount
of this Note plus any unpaid accrued interest on the original principal, provided, however, that the Majority Holders shall have the
option to convert any unpaid accrued interest on the Notes into shares of the Company's Common Stock at a conversion price equal to (x)
the price per share paid to Common Stock in the Change of Control transaction multiplied by (y)  
0.30. For purposes of this Note, a "Change of Control" means (i)
a consolidation or merger of the Company with or into any other corporation or other entity or person, or any other corporate
reorganization, other than any such consolidation, merger or reorganization in which the shares of capital stock of the Company immediately
prior to such consolidation, merger or reorganization continue to represent a majority of the voting power of the surviving entity immediately
after such consolidation, merger or reorganization; (ii) any transaction or series of related transactions to which the Company is a
party in which in excess of 50% of the Company's voting power is transferred; or (iii) the sale or transfer of all or substantially all
of the Company's assets, or the exclusive license of all or substantially all of the Company's material intellectual property; provided
that a Change of Control shall not include any transaction or series of transactions principally for bona fide equity financing purposes
in which cash is received by the Company or any successor, indebtedness of the Company is cancelled or converted or a combination thereof.
The Company shall give the Holder notice of a Change of Control not less than 10 days prior to the anticipated date of consummation of
the Change of Control. Any payments pursuant to this paragraph in connection with a Change of Control shall be subject to any required
tax withholdings, and may be made by the Company (or any party to such Change of Control or its agent) following the Change of Control
in connection with payment procedures established in connection with such Change of Control.

 

 

 

    	 	2	 

     

    

 

(e)           
SPAC Acquisition. In the event that the Company consummates a reverse acquisition transaction ("SPAC Acquisition")
with a special purpose acquisition company ("SPAC'), such SPAC Acquisition shall be treated hereunder, at the
election of the Majority Holders, as if such SPAC Acquisition was (i) a Qualified Financing, (ii) a Qualifying IPO, or (iii) a Change
of Control.

 

(f)           
Procedure for Conversion. In connection with any conversion of interest on this Note into capital stock, the Holder shall surrender
this Note to the Company and deliver to the Company any documentation reasonably required by the Company. The Company shall not be required
to issue or deliver the capital stock into which interest on this Note may convert until the Holder has surrendered this Note to the Company
and delivered to the Company any such documentation. Upon the conversion of interest on this Note into capital stock pursuant to the terms
hereof, in lieu of any fractional shares to which the Holder would otherwise be entitled, the Company shall pay the Holder cash equal
to such fraction multiplied by the price at which this Note converts.

 

(g)           
Interest Accrual. If a Change of Control or Qualified Financing is consummated, all interest on this Note shall be deemed to
have stopped accruing as of a date selected by the Company that is up to 5 days prior to the closing for the Change of Control or Qualified
Financing. If a Change of Control, Qualified Financing or Qualifying IPO is consummated prior to the six-month anniversary of the issue
date of this Note, the interest due on this Note as of such closing date shall be calculated to equal six months of interest accrual.

 

		3.	REPRESENTATIONS AND WARRANTIES.

 

(a)           
Representations and Warranties of the Company. The Company hereby represents and warrants to the Holder as of the date the
first Note was issued as follows:

 

(i)            
Organization, Good Standing and Qualification. The Company is a corporation duly organized,
validly existing and in good standing under the laws of the State of Delaware. The Company has the requisite corporate power to own and
operate its properties and assets and to carry on its business as now conducted and as proposed to be conducted. The Company is duly
qualified and is authorized to do business and is in good standing as a foreign corporation in all jurisdictions in which the nature
of its activities and of its properties (both owned and leased) makes such qualification necessary, except for those jurisdictions in
which failure to do so would not have a material adverse effect on the Company or its business (a "Material Adverse Effect").

 

(ii)          
Corporate Power. The Company has all requisite corporate power to issue this Note and to
carry out and perform its obligations under this Note. The Company's Board of Directors (the "Board") has approved
the issuance of this Note based upon a reasonable belief that the issuance of this Note is appropriate for the Company after reasonable
inquiry concerning the Company's financing objectives and financial situation.

 

(iii)         
Authorization. All corporate action on the part of the Company, the Board, the Company's
stockholders and the Company's debtholders necessary for the issuance and delivery of this Note has been taken. This Note constitutes
a valid and binding obligation of the Company enforceable in accordance with its terms, subject to laws of general application relating
to bankruptcy, insolvency, the relief of debtors and, with respect to rights to indemnity, subject to federal and state securities laws.
Any securities issued upon conversion of this Note (the "Conversion Securities"), when issued in compliance with
the provisions of this Note, will be validly issued, fully paid, nonassessable, free of any liens or encumbrances and issued in compliance
with all applicable federal and securities laws.

 

(iv)          
Governmental Consents. All consents, approvals, orders or authorizations of, or registrations, qualifications, designations,
declarations or filings with, any governmental authority required on the part of the Company in connection with issuance of this Note
has been obtained.

 

 

 

    	 	3	 

     

    

 

(v)           
Compliance with Laws. To its knowledge, the Company is not in violation of any applicable statute, rule, regulation, order
or restriction of any domestic or foreign government or any instrumentality or agency thereof in respect of the conduct of its business
or the ownership of its properties, which violation of which would have a Material Adverse Effect.

 

(vi)          
Compliance with Other Instruments. The Company is not in violation or default of any term of its charter or bylaws, or of
any provision of any mortgage, indenture or contract to which it is a party and by which it is bound or of any judgment, decree, order
or writ, other than such violation(s) that would not have a Material Adverse Effect or that is otherwise resolvable and shall be resolved
by making a payment as an intended use of the proceeds of the Notes. The execution, delivery and performance of this Note will not result
in any such violation or be in conflict with, or constitute, with or without the passage of time and giving of notice, either a default
under any such provision, instrument, judgment, decree, order or writ or an event that results in the creation of any lien, charge or
encumbrance upon any assets of the Company or the suspension, revocation, impairment, forfeiture, or nonrenewal of any material permit,
license, authorization or approval applicable to the Company, its business or operations or any of its assets or properties. Without
limiting the foregoing, the Company has obtained all waivers reasonably necessary with respect to any anti-dilution rights, preemptive
rights, rights of first refusal or similar rights, including any notice or offering periods provided for as part of any such rights,
in order for the Company to consummate the transactions contemplated hereunder without any third party obtaining any rights to cause
the Company to offer or issue any securities of the Company as a result of the consummation of the transactions contemplated hereunder.

 

(vii)         
No "Bad Actor" Disqualification. The Company has exercised reasonable care to determine whether any Company Covered
Person (as defined below) is subject to any of the "bad actor" disqualifications described in Rule 506(d)(l)(i) through (viii),
as modified by Rules 506(d)(2) and (d)(3), under the Act ("Disqualification Events"). To the Company's knowledge,
no Company Covered Person is subject to a Disqualification Event. The Company has complied, to the extent required, with any disclosure
obligations under Rule 506(e) under the Act. For purposes of this Note, "Company Covered Persons" are those persons
specified in Rule 506(d)(l) under the Act; provided, however, that Company Covered Persons do not include (a) any Holder, or (b) any person
or entity that is deemed to be an affiliated issuer of the Company solely as a result of the relationship between the Company and any
Holder.

 

(viii)        
Offering. Assuming the accuracy of the representations and warranties of the Holder contained in subsection (b) below, the
offer, issue, and sale of this Note and the Conversion Securities (collectively, the "Securities") are and will
be exempt from the registration and prospectus delivery requirements of the Act, and have been registered or qualified (or are exempt
from registration and qualification) under the registration, permit or qualification requirements of all applicable state securities
laws.

 

(ix)          
Use of Proceeds. The Company shall use the proceeds of this Note solely for the operations of its business, and not for
any personal, family or household purpose.

 

(x)           
Existing Indebtedness. The Company does not currently have any outstanding "Senior Indebtedness" (as such term is
defined in Section 6 of the Company's outstanding Subordinated Convertible Promissory Notes (the "Existing Bridge Notes"))
or any other outstanding indebtedness that would rank senior in right of payment to this Note. The Company and the holders of
the Existing Bridge Notes have (i) amended the Existing Bridge Notes to provide for an automatic conversion to equity if such Existing
Bridge Notes remain outstanding as of June 30, 2021, and (ii) agreed that the Existing Bridge Notes shall be subordinated to this Note
(which will be considered Senior Indebtedness under the Existing Bridge Notes) to the extent provided in Section 6 of the Company's Existing
Bridge Notes. Nothing in the Notes, however, shall restrict or prevent the Existing Bridge Notes from being converted into equity in accordance
with the terms thereof.

 

 

 

    	 	4	 

     

    

 

(b)           
Representations and Warranties of the Holder. The Holder hereby represents and warrants to the Company as of the date hereof
as follows:

 

(i)            
Purchase for Own Account. The Holder is acquiring the Securities solely for the Holder's own account and beneficial interest
for investment and not for sale or with a view to distribution of the Securities or any part thereof, has no present intention of selling
(in connection with a distribution or otherwise), granting any participation in, or otherwise distributing the same, and does not presently
have reason to anticipate a change in such intention.

 

(ii)          
Information and Sophistication. Without lessening or obviating the representations and warranties
of the Company set forth in subsection (a) above, the Holder hereby: (A) acknowledges that the Holder has received all the information
the Holder has requested from the Company and the Holder considers necessary or appropriate for deciding whether to acquire the Securities,
(B) represents that the Holder has had an opportunity to ask questions and receive answers from the Company regarding the terms and conditions
of the offering of the Securities and to obtain any additional information necessary to verify the accuracy of the information given
the Holder and (C) further represents that the Holder has such knowledge and experience in financial and business matters that the Holder
is capable of evaluating the merits and risk of this investment

 

(iii)         
Ability to Bear Economic Risk. The Holder acknowledges that investment in the Securities
involves a high degree of risk, and represents that the Holder is able, without materially impairing the Holder's financial condition,
to hold the Securities for an indefinite period of time and to suffer a complete loss of the Holder's investment.

 

(iv)          
Further Limitations on Disposition. Without in any way limiting the representations set forth
above, the Holder further agrees not to make any disposition
of all or any portion of the Securities
unless and until:

 

(1)          
There is then in effect a registration statement under the Act covering such proposed disposition
and such disposition is made in accordance with such registration statement; or

 

(2)           
The Holder shall have notified the Company of the proposed disposition and furnished the Company with a detailed statement of
the circumstances surrounding the proposed disposition, and if reasonably requested by the Company, the Holder shall have furnished the
Company with an opinion of counsel, reasonably satisfactory to the Company, that such disposition will not require registration under
the Act or any applicable state securities laws; provided that no such

opinion shall be required for dispositions
in compliance with Rule 144 under the Act, except in unusual circumstances.

 

(3)           
Notwithstanding the provisions of paragraphs (1) and (2) above, no such registration statement
or opinion of counsel shall be necessary for a transfer by the Holder to a partner (or retired partner) or member (or retired member)
of the Holder in accordance with partnership or limited liability company interests, or transfers by gift, will or intestate succession
to any spouse or lineal descendants or ancestors, if all transferees agree in writing to be subject to the terms hereof to the
same extent as if they were the Holders hereunder.

 

(v)            
Accredited Investor Status. The Holder is an "accredited investor" as such term is
defined in Rule 501 under the Act.

 

(vi)           
No "Bad Actor" Disqualification. The Holder represents and warrants that neither (A)
the Holder nor (B) any entity that controls the Holder or is under the control of, or under common control with, the Holder, is subject
to any Disqualification Event, except for Disqualification Events covered by Rule 506(d)(2)(ii) or (iii) or (d)(3) under the Act and
disclosed in writing in reasonable detail to the Company. The Holder represents that the Holder has exercised reasonable care to determine
the accuracy of the representation made by the Holder in this paragraph, and agrees to notify the Company if the Holder becomes aware
of any fact that makes the representation given by the Holder hereunder inaccurate.

 

 

 

    	 	5	 

     

    

 

(vii)         
Foreign Investors. If the Holder is not a United States person (as defined by Section 770l(a)(30)
of the Internal Revenue Code of 1986, as amended (the "Code")),
the Holder hereby represents that he, she or it has satisfied itself as to the full observance of the laws of the Holder's
jurisdiction in connection with any invitation to subscribe for the Securities or any use of this Note, including (A) the legal requirements
within the Holder's jurisdiction for the purchase of the Securities, (B) any foreign exchange restrictions applicable to such purchase,
(C) any governmental or other consents that may need to be obtained, and (D) the income tax and other tax consequences, if
any, that may be relevant to the purchase, holding, redemption, sale or transfer of the Securities.
The Holder's subscription, payment for and continued beneficial ownership of the Securities will not violate any applicable securities
or other laws of the Holder's jurisdiction.

 

(viii)        
Forward-Looking Statements. With respect to any forecasts, projections of results and other forward-looking
statements and information provided to the Holder, the Holder acknowledges that such statements were prepared based upon assumptions deemed
reasonable by the Company at the time of preparation. There is no assurance that such statements will prove accurate, and the Company
has no obligation to update such statements.

 

		4.	EVENTS OF DEFAULT.

 

(a)           
If there shall be any Event of Default (as defined below) hereunder, at the option and upon the declaration of the Majority
Holders and upon written notice to the Company (which election and notice shall not be required in the case of an Event of Default under
subsection (ix) or (x) below), this Note shall accelerate and all principal and unpaid accrued interest shall become due and payable.
The occurrence of any one or more of the following shall constitute an "Event of Default":

 

(i)             The
Company makes any repayment on the Existing Bridge Notes;

 

(ii)           
The Company amends any of the subordination provisions of the Existing Bridge Notes in any manner that is adverse to the Notes;

 

(iii)          The
Company incurs any indebtedness for money borrowed (unless such indebtedness is unsecured and expressly subordinated to these
Notes);

 

(iv)          
The Company enters into, creates, incurs, assumes or suffers to exist any liens of any kind,
on or with respect to any of its property or assets now owned or hereafter acquired or any interest therein or any income or profits therefrom;

 

(v)           
any representation or warranty made in the Notes, the Security Agreement, any other transaction
document related to the Notes, any written statement pursuant hereto or thereto, or any other report, financial statement or certificate
made or delivered to the Holder or any other Holder, shall be untrue or incorrect in any material respect as of the date when made or
deemed made, which failure is not cured, if possible to cure, within the earlier to occur of 10 business days after notice of such failure
is sent by the Holder or by any other Holder to the Company;

 

(vi)          
the Company shall materially fail to observe or perform any other covenant or agreement contained
in the Notes, the Security Agreement or any transaction document related thereto which failure is not cured, if possible to cure, within
the earlier to occur of (A) 10 business days after notice of such failure is sent by the Holder or by any other Holder to the Company
and (B) five business days after the Company has become aware of such failure;

 

(vii)        
the Company shall breach, or a default or event of default (subject to any grace or cure period
provided in the applicable agreement, document or instrument) shall occur under any other material agreement, lease, document or instrument
to which the Company is obligated which default or event of default if not cured, if possible to cure, within the earlier to occur of
(A) 10 business days after notice of such default sent by Holder or by any other holder to the Company and (B) ten business days after
the Company has become aware of such default;

 

 

 

    	 	6	 

     

    

 

(viii)       
The Company fails to pay timely any of the principal amount due under this Note on the date the
same becomes due and payable or any unpaid accrued interest or other amounts due under this Note on the date the same becomes due and
payable, and which failure is not cured within ten business days;

 

(ix)          
The Company files any petition or action for relief under any bankruptcy, reorganization, insolvency or moratorium law or any
other law for the relief of, or relating to, debtors, now or hereafter in effect, or makes any assignment for the benefit of creditors
or takes any corporate action in furtherance of any of the foregoing; or

 

(x)           
An involuntary petition is filed against the Company (unless
such petition is dismissed or discharged within 60 days under any bankruptcy
statute now or hereafter in effect, or a custodian, receiver, trustee
or assignee for the benefit of creditors (or other similar official) is appointed to take possession, custody or control of any property
of the Company).

 

(b)           
In the event of any Event of Default hereunder, the Company shall pay all reasonable attorneys' fees and court costs incurred
by the Holder in enforcing and collecting this Note.

 

		5.	MISCELLANEOUS PROVISIONS.

 

(a)            Waivers. The Company
hereby waives demand, notice, presentment, protest and notice of dishonor.

 

(b)            Further
Assurances. The Holder agrees and covenants that at any time and from time to time the Holder will promptly execute and deliver
to the Company Waivers.The Company hereby waives demand, notice, presentment, protest and such further instruments and
documents and take such further action as the Company may reasonably require in order to carry out the full intent and purpose of
this Note and to comply with state or federal securities laws or other regulatory approvals.

 

(c)           
Transfers of Notes. This Note may be transferred only upon its surrender to the Company for registration of transfer, duly
endorsed, or accompanied by a duly executed written instrument of transfer in form satisfactory to the Company. Thereupon, this Note shall
be reissued to, and registered in the name of, the transferee, or a new Note for like principal amount and interest shall be issued to,
and registered in the name of, the transferee. Interest and principal shall be paid solely to the registered holder of this Note (including
any registered transferee). Such payment shall constitute full discharge of the Company's obligation to pay such interest and principal.

 

(d)           
Market Standoff. To the extent requested by the Company or an underwriter of securities of the Company, the Holder and any
permitted transferee thereof shall not, without the prior written consent of the managing underwriters in the IPO (as hereafter defined),
offer, sell, make any short sale of, grant or sell any option for the purchase of, lend, pledge, otherwise transfer or dispose of (directly
or indirectly), enter into any swap or other arrangement that transfers to another, in whole or in part, any of the economic consequences
of ownership (whether any such transaction is described above or is to be settled by delivery of Securities or other securities, in cash,
or otherwise), any Securities or other shares of stock of the Company then owned by the Holder or any transferee thereof, or enter into
an agreement to do any of the foregoing, for up to 180 days following the effective date of the registration statement of the initial
public offering of the Company (the "IPO") filed under the Securities Act. For purposes of this paragraph, "Company"
includes (x) any wholly owned subsidiary of the Company into which the Company merges or consolidates or (y) any corporation
that the Company converts into. The Company may place restrictive legends on the certificates representing the shares subject to this
paragraph and may impose stop transfer instructions with respect to the Securities and such other shares of stock of the Holder and any
transferee thereof (and the shares or securities of every other person subject to the foregoing restriction) until the end of such period.
The Holder and any transferee thereof shall enter into any agreement reasonably required by the underwriters to the IPO to implement
the foregoing within any reasonable timeframe so requested. The underwriters for any IPO are intended third party beneficiaries of this
paragraph and shall have the right, power and authority to enforce the provisions of this paragraph as though they were parties hereto.

 

 

 

    	 	7	 

     

    

 

(e)            
Amendment and Waiver. Any term of this Note may be amended or waived with the written consent of the Company and the Holder.
In addition, any term of this Note may be amended or waived with the written consent of the Company and the Majority Holders if
such amendment or waiver applies to all Holders of the Notes in the same fashion. Upon the effectuation
of such waiver or amendment with the consent of the required parties in conformance with this paragraph, such amendment or waiver shall
be effective as to, and binding against the holders of, all of the Notes and the Company shall promptly give written notice thereof to
the Holder if the Holder has not previously consented to such amendment or waiver in writing; provided that the failure to give such notice
shall not affect the validity of such amendment or waiver.

 

(f)             Governing
Law. This Note shall be governed by and construed under the laws of the State of Delaware, as applied to agreements among
Delaware residents, made and to be performed entirely within the State of Delaware, without giving effect to conflicts of laws
principles.

 

(g)           
Binding Agreement. The terms and conditions of this Note shall inure to the benefit of and be binding upon the respective successors
and assigns of the parties. Nothing in this Note, expressed or implied, is intended to confer upon any third party any rights, remedies,
obligations or liabilities under or by reason of this Note, except as expressly provided in this Note.

 

(h)           
Counterparts; Manner of Delivery. This Note may be executed in two or more counterparts, each of which shall be deemed an original,
but all of which together shall constitute one and the same instrument. Counterparts may be delivered via facsimile, electronic mail (including
pdf or any electronic signature complying with the U.S. federal ESIGN Act of 2000, Uniform Electronic Transactions Act or other applicable
law) or other transmission method and any counterpart so delivered shall be deemed to have been duly and validly delivered and be valid
and effective for all purposes.

 

(i)            
Titles and Subtitles. The titles and subtitles used in this Note are used for convenience only and are not to be considered
in construing or interpreting this Note.

 

(j)            Notices. All
notices required or permitted hereunder shall be in writing and shall be deemed effectively given: (i) upon personal delivery to the
party to be notified, (ii) when sent by confirmed electronic mail or
facsimile if sent during normal business hours of the recipient, if not, then on the next business day, (iii)
five days after having been sent by registered or certified mail, return receipt requested, postage prepaid, or (iv) one day after
deposit with a nationally recognized overnight courier, specifying next day delivery, with written verification of receipt. All
communications to a party shall be sent to the party's address set forth on the signature page hereto or at such other address(es)
as such party may designate by 10 days' advance written notice to the other party hereto.

 

(k)          
Expenses. The Company and the Holder shall each bear its respective expenses and legal fees incurred with respect to
the negotiation, execution and delivery of this Note and the transactions contemplated herein.

 

(l)              Delays
or Omissions. It is agreed that no delay or omission to exercise any right, power or remedy
accruing to the Holder, upon any breach or default of the Company under this Note shall impair any such right, power or remedy, nor
shall it be construed to be a waiver of any such breach or default, or any acquiescence therein, or of or in any similar breach or
default thereafter occurring; nor shall any waiver of any single breach or default be deemed a waiver of any other breach or default
theretofore or thereafter occurring. It is further agreed that any waiver, permit, consent or
approval of any kind or character by the Holder of any breach or default under this Note, or any waiver by the Holder of any
provisions or conditions of this Note, must be in writing and shall be effective only to the extent specifically set forth in
writing and that all remedies, either under this Note, or by law or otherwise afforded to the Holder, shall be cumulative and not
alternative. This Note shall be void and of no force or effect in the event that the Holder fails to remit the full principal amount
to the Company within five calendar days of the date of this Note.

 

 

 

    	 	8	 

     

    

 

(m)         
Entire Agreement. This Note constitutes the full and entire understanding and agreement between the parties with regard to
the subjects hereof, and no party shall be liable or bound to any other party in any manner by any representations, warranties, covenants
and agreements except as specifically set forth herein.

 

(n)           
Exculpation among Holders. The Holder acknowledges that the Holder is not relying on any person, firm or corporation, other
than the Company and its officers and Board members, in making its investment or decision to invest in the Company.

 

(o)           
Broker's Fees. Each party hereto represents and warrants that no agent, broker, investment banker, person or firm acting on
behalf of or under the authority of such party hereto is or will be entitled to any broker's or finder's fee or any other commission
directly or indirectly in connection with the transactions contemplated herein. Each party hereto further agrees to indemnify each other
party for any claims, losses or expenses incurred by such other party as a result of the representation in this subsection being untrue.

 

(p)           Severability. If
any provision of this Note is invalid, illegal or unenforceable, the balance of this Note shall remain in effect,
and if any provision is inapplicable to any person or circumstance, it shall nevertheless remain applicable to all other persons and
circumstances. If it shall be found that any interest or other amount deemed interest due hereunder violates the applicable law
governing usury, the applicable rate of interest due hereunder shall automatically be lowered to equal the maximum rate of interest
permitted under applicable law. The Company covenants (to the extent that .it may lawfully do so) that it shall not at any time
insist upon, plead, or in any manner whatsoever claim or take the benefit or advantage of, any stay, extension or usury law or other
law which would prohibit or forgive the Company from paying all or any portion of the principal of or interest on this Note as
contemplated herein, wherever enacted, now or at any time hereafter in force, or which may affect the covenants or the performance
of this Note, and the Company (to the extent it may lawfully do so) hereby expressly waives all benefits or advantage of any such
law, and covenants that it will not, by resort to any such law, hinder, delay or impede the execution of any power herein granted to
the Holder, but will suffer and permit the execution of every such as though no such law has been enacted.

 

(q)           
California Corporate Securities Law. THE SALE OF THE SECURITIES WHICH ARE THE SUBJECT OF THIS NOTE HAS NOT BEEN QUALIFIED WITH
THE COMMISSIONER OF CORPORATIONS OF THE STATE OF CALIFORNIA AND THE ISSUANCE OF SUCH SECURITIES OR THE PAYMENT OR RECEIPT OF ANY PART
OF THE CONSIDERATION THEREFOR PRIOR TO SUCH QUALIFICATION OR IN THE ABSENCE OF AN EXEMPTION FROM SUCH QUALIFICATION IS UNLAWFUL. PRIOR
TO ACCEPTANCE OF SUCH CONSIDERATION BY THE COMPANY, THE RIGHTS OF ALL PARTIES TO THIS NOTE ARE EXPRESSLY CONDITIONED UPON SUCH QUALIFICATION
BEING OBTAINED OR AN EXEMPTION FROM SUCH QUALIFICATION BEING AVAILABLE.

 

[Signature pages follow}

 

 

 

 

    	 	9	 

     

    

 

The parties have executed this
SENIOR SECURED BRIDGE PROMISSORY NOTE as of the date first noted above.

 

	 	COMPANY:
	 	 
	 	NOCIMED, INC.
	 	 
	 	 
	 	 
	 	 
	 	 
	 	By:	 
	 	 	 
	 	 	Name:
	 	 	Title:
	 	 	 
	 	E-mail:	 
	 	 	 
	 	Address:	 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature Page for Senior
Secured Bridge Promissory Note

 

 

 

 

    	 	10	 

     

    

 

The parties have executed this SENIOR BRIDGE PROMISSORY
NOTE as of the date first noted above.

 

 

	 	HOLDER (if an entity):

  

 

 

	Name of Holder:  	
	 	 
	 	 
	 	
    By:________________________________

     

    Name: __________________________

    Title: ___________________________

     

	 	 
	 	E-mail:	 
	 	 	 
	 	Address:	 
	 	 	 
	 	 	 
	 	 	 
	 	 
	 	 
	 	 
		
    HOLDER (if
an entity): 

     

     

	Name of Holder:   	Richard M. Minicozzi
	 	 
	 	 
	 	
    Signature:  /s/ Richard M.
    Minicozzi                                 

    

	 	 
	 	 
	 	 
	 	E-mail:	rickmm86@gmail.com
	 	 	 
	 	Address:	6008 Hood Hollow
	 	 	Austin, TX
	 	 	78731
	 	 	 

 

 

 

Signature Page for Senior Secured Bridge Promissory
Note

 

 

 

    	 	11	 

     

    

 

INVESTOR SUITABILITY QUESTIONNAIRE
SECURED CONVERTIBLE

PROMISSORY NOTE FINANCING OF

NOCIMED, INC.

 

This Questionnaire
is being distributed to certain individuals and entities which may be offered the opportunity to purchase secured convertible promissory
notes (the "Securities") of NOCIMED, INC., a Delaware corporation
(the "Company"). The purpose of this Questionnaire is to assure the Company that all such offers and purchases
will meet the standards imposed by the Securities Act of 1933, as amended (the "Act"),
and applicable state securities laws.

 

All
answers will be kept confidential. However, by signing this Questionnaire, the undersigned agrees that this information may be provided
by the Company to its legal and financial advisors, and the Company and such advisors may rely on the information set forth in this Questionnaire
for purposes of complying with all applicable securities laws and may present this Questionnaire to such parties as it reasonably deems
appropriate if called upon to establish its compliance with such securities laws. The undersigned represents
that the information contained herein is complete and accurate and will notify the Company of any material change in any of such information
prior to the undersigned's investment in the Company.

 

 

FOR INDIVIDUAL INVESTORS

 

 

 

Accredited
Investor Certification. The undersigned makes one of the following representations regarding its income or net worth and certain
related matters and has checked the applicable representation:

 

	[X]
	The undersigned's income1 during each of the last two years exceeded $200,000 or, if the
  undersigned is married, the joint income of the undersigned and the undersigned's spouse during each of the last two years exceed
  $300,000, and the undersigned reasonably expects the undersigned's income; from all sources during this year, will exceed $200,000
  or, if the undersigned is married, the joint income of undersigned and the undersigned's spouse from all sources during this year
  will exceed $300,000.
	 	 
	 	The undersigned's net worth, 2 including the net worth of the undersigned's spouse, is in excess of $1,000,000 (excluding
  the value of the undersigned's primary residence).
	 	 
	[_]	The
undersigned cannot make any of the representations set forth above.

 

 

 

    	 	12	 

     

    

 

 

FOR ENTITY INVESTORS

 

 

Accredited Investor Certification. The undersigned makes one of the following representations
regarding its net worth and certain related matters and has checked the applicable
representation:

	[_]	The undersigned is a trust with total assets in excess of $5,000,000 whose purchase is directed by a person with such knowledge and experience
in financial and business matters that such person is capable of evaluating the merits and risks of the prospective investment.
	 	 
	[_]	The undersigned is a bank, insurance company, investment company registered under the United States Investment Company Act of
1940, as amended (the "Companies Act"), a broker or dealer registered pursuant to Section 15 of the United States Securities
Exchange Act of 1934, as amended, a business development company, a Small Business Investment Company licensed by the United States Small
Business Administration, a plan with total assets in excess of $5,000,000 established and maintained by a state for the benefit of its
employees, or a private business development company as defined in Section 202(a)(22) of the United States Investment Advisers Act of
1940, as amended.
	 	 
	[_]	The undersigned is an employee benefit plan and either all investment decisions are
made by a bank, savings and loan association, insurance company, or registered investment advisor, or
the undersigned has total assets in excess of $5,000,000 or, if such plan is a
self-directed plan, investment decisions are made solely by persons who are accredited investors.
	 	 
	[_]	The undersigned is a corporation, partnership, business trust, not formed for the purpose of acquiring the Securities, or an organization
described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (the "Code"), in each case with total assets
in excess of $5,000,000.
	 	 
	[_]	The undersigned is an entity in which all of the equity
      owners (in the case of a revocable living trust, its grantor(s)) qualify under any of the above subparagraphs, or, if an individual,
      each such individual has a net worth,2 either individually or upon a joint basis with such individual's spouse, in excess of $1,000,000
      (within the meaning of such terms as used in the definition of "accredited investor"
      contained in Rule 501 under the Securities Act), or has had an individual
      income1 in excess of $200,000 for each of the two most recent years, or a joint income with such individual's spouse
      in excess of $300,000 in each of those years, and has a reasonable expectation of reaching the same income level in the current
      year.

	 	 
	 	The undersigned cannot make any of
the representations set forth above.

 

The undersigned has executed this Investor Suitability
Questionnaire as of the date written below.

 

___________________

 

1
For purposes of this Questionnaire, "Income" means adjusted gross income, as reported for federal income tax
purposes, increased by the following amounts: (a) the amount of any tax exempt interest income received, (b) the amount of losses claimed
as a limited partner in a limited partnership, (c) any deduction claimed for depletion, (d) amounts contributed to an IRA or Keogh retirement
plan, (e) alimony paid, and (f) any amounts by which income from long-term capital gains has been reduced in arriving at adjusted gross
income pursuant to the provisions of Section 1202 of the Internal Revenue
Code.

2 For purposes
of this Questionnaire,"Net worth" means the excess of total assets, excluding your primary residence, at fair
market value over total liabilities, including your mortgage or any other liability secured by your primary residence only if and to the
extent that it exceeds the value of your primary residence. Net worth should include the value of any other shares of stock or options
held by you and your spouse and any personal property owned by you or your spouse (e.g.
furniture, jewelry, other valuables, etc.).

 

 

 

 

 

 

    	 	13

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