Document:

EXECUTIVE EMPLOYMENT AGREEMENT

THIS EXECUTIVE EMPLOYMENT AGREEMENT (this “Agreement”), dated as of July 23, 2018 (“Effective Date”) is entered into by and among MorphoSys US Inc., a Delaware corporation (the "Company"), and Jennifer Herron ("Employee").

WHEREAS, the Company is a subsidiary of MorphoSys AG, a German corporation (the “Parent Company”);

WHEREAS, the Company wishes to offer the Employee employment according to the following terms and conditions;

WHEREAS, Employee wishes to accept employment with the Company on such terms; and

WHEREAS, Employee and the Company (collectively hereafter, the “Parties”) intend that this Agreement shall be and is the sole agreement between them concerning the employment of Employee, and the terms and conditions of such employment.

NOW, THEREFORE, in consideration of the premises and the mutual agreements set forth herein, the Company and Employee agree as follows:

	1.	
Employment, Duties and Acceptance.

1.1          Title/Position.  The Company hereby employs Employee to render full-time services to the Company, responsible for global commercial operations and all United States operations, and to perform such other duties as the Company shall reasonably direct Employee to perform.  Employee shall be President of the Company and shall have the title Executive Vice President, Global Commercial.  As President of the Company, Employee shall have full power and authority to manage and conduct the business of the Company in accordance with the Company’s Bylaws, subject to the review and direction of the Company’s Board of Directors (the “Board”) or its designee.  Unless otherwise notified in writing by the Company, Employee shall report to the Chairman of the Board or its designee.  As Executive Vice President, Global Commercial, Employee shall be principally responsible for all global commercial business activities of both the Company and Parent Company.

1.2          Duties of Employee.  Employee shall devote substantially all of Employee’s full business time and attention to the performance of Employee’s duties hereunder.  Employee shall faithfully and to the best of Employee’s abilities and experience perform all duties that may be reasonably required of Employee by this Agreement, in accordance with the standards and ethics of the business in which Company is engaged, and in compliance with any applicable laws and regulations.

1.3          Principal Place of Employment.  Unless otherwise mutually agreed in writing by the Parties, Employee’s principal place of employment shall be situated at a location in the State of New Jersey as reasonably determined by the Employee with the informed consent of the Board, which shall not be unreasonably withheld.  Employee acknowledges that, from time to time, as may be reasonably required, Employee shall provide services for the Company outside of the State of New Jersey.  

1.4          Permitted Activities.  Notwithstanding anything to the contrary herein, it is understood and agreed that Employee may, upon prior written approval by the Board which shall not be unreasonably withheld, engage in certain outside business activities, such as (a) having an academic appointment, or (b)

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participating in professional activities, e.g. speaking engagements or corporate directorship (collectively, “Permitted Activities”); provided, however, that such Permitted Activities shall not interfere with Employee’s obligations under this Agreement or present a conflict of interest with Employee’s duties to the Company.

1.5          No Contractual Restrictions.  Employee represents and affirms that, as of the Effective Date, Employee does not have any contractual obligations to any other Person that would prohibit or impede Employee’s ability to perform Employee’s obligations under this Agreement, or that would conflict with the terms of this Agreement, except for any duty against disclosing another Person’s confidential information without authorization.  Employee further acknowledges and understands that the Company has instructed Employee not to bring to the Company or use or disclose in the course of Employee’s employment with the Company, any confidential information belonging to another Person or entity without that Person’s express written authorization.

1.6          Appointment to Company Board of Directors.  During the term of Employee’s employment with the Company as its President, and for so long as Employee is President of the Company, Employee shall be a member of the Company’s Board, unless otherwise reasonably determined by the Company’s stockholder(s) in accordance with its Bylaws.

	2.	
Term of Employment.

2.1          The initial term of Employee’s employment shall commence on the Effective Date and end on the second (2nd) anniversary thereafter (the “Initial Term”), provided, however, that this Agreement shall automatically be renewed for successive one (1) year terms (each, together with the Initial Term, a “Term”) unless, in each case, sooner terminated pursuant to Section 6.  The date on which the Employee’s employment ends, regardless of the reason for the termination, shall be called the “Termination Date.”

	3.	
Compensation.

3.1          Base Salary.  As compensation for the services to be rendered by Employee under this Agreement, Company shall pay Employee an annualized base salary at the initial rate of Four Hundred Fifty Thousand Dollars and Zero Cents ($450,000.00) per annum (“Base Salary”), payable in equal installments in accordance with the Company’s customary payroll practices in the ordinary course of Company’s business, with all applicable and necessary payroll withholdings, deductions and taxes deducted as may be required by law or applicable regulation.

3.2          Increase in Salary.  Depending on the Company’s financial condition, Employee may be eligible to receive increases in Employee’s Base Salary each calendar year, by an amount that accounts for change in cost of living and inflation, if any, and Employee may be eligible to receive annual merit increases warranted by Employee’s performance as determined by the Board in its sole, but reasonable, discretion.  The Company, in determining any merit increases in Employee’s Base Salary, shall consider factors including but not limited to: (i) Employee’s attainment of one or more performance objectives or benchmarks; (ii) the Company’s attainment of one or more performance objectives or benchmarks; or (iii) the application of performance factors for the Company and for individual performance. The specific criteria for determining any such merit increases in Employee’s Base Salary shall be mutually determined by and between Employee and the Board or its Chairman by no later than January 31st of the applicable year.  Nothing contained herein shall be deemed to grant Employee any right to future salary increases, except as expressly set forth herein, and a salary increase in one year shall not automatically entitle Employee to salary increases in subsequent years.

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3.3          Minimum Annual Base Salary. In no event shall Employee’s annual Base Salary be reduced below the initial Base Salary of Four Hundred Fifty Thousand Dollars and Zero Cents ($450,000.00), unless pursuant to an across-the-board salary reduction affecting other similarly situated senior executive-level employees of Company.

3.4          Annual Bonus.  Employee shall be eligible to receive an annual cash bonus ("Annual Bonus"), in accordance with an annual incentive program applicable generally to executive officers of the Company or any similar bonus plan adopted by the Board.  The target for the Annual Bonus shall be  sixty percent (60%) of Employee’s Base Salary for 100% achievement of performance objectives (or such higher amount for any calendar year as may be determined by the Board, from time to time, but in no event shall the Base Salary used to calculate any bonus payment include the grossed-up salary payment that may be paid in accordance with the Temporary COBRA Reimbursement described in Section 4.2), and shall be payable in full to Employee upon Employee’s attainment of one or more performance objectives or benchmarks determined as set forth below.  In the event Employee does not achieve 100% of Employee’s benchmarks, Employee shall be entitled to receive a prorated amount of the Annual Bonus in relation to the objectives and benchmarks substantially achieved by Employee.  Company, in its sole and unilateral discretion, may elect to pay a greater bonus in any year, based on its assessment of Employee’s individual performance and the Company’s annual financial and operating performance and any other factors the Company may deem appropriate.  Employee’s benchmarks for each calendar year shall be mutually determined by and between Employee and the Company, acting through its Board or its Chairman, by no later than January 31st of the applicable year; provided, however, that for the balance of the year ending December 31, 2018, Employee’s benchmarks for the 2018 calendar year shall be determined by Employee and the Board or its Chairman by no later than Friday, August 24, 2018.  The Annual Bonus, if any, payable to Employee under this Section 3.4 shall be paid on or before March 15th of the year following the calendar year as to which such Annual Bonus relates; provided, however, that it is not required that Employee be employed by the Company on March 15th of the following year to receive payment of the Annual Bonus due to Employee under this Section.  Rather, Employee shall earn and become fully vested in the Annual Bonus, or any prorated portion thereof, based upon the performance objectives or benchmarks achieved by Employee in any calendar year, unless Employee’s employment is terminated by the Company for Cause as defined in Section 6.7 (below); provided that for any partial year(s) of employment, Employee shall only be eligible to receive a prorated Annual Bonus subject to the terms and provisions of this Section 3.4.

3.5          Initial Equity Grant to Employee.  On or as soon as practicable following the Effective Date but no later than [thirty (30)] business days thereafter, including following registration under the Securities Act of 1933 (the “Grant Date”), the Parent Company shall grant to Employee equity in the form of Parent Company (“MOR”) American Depository Shares (“ADS”) in accordance with the terms and conditions set forth herein.  Parent Company shall make such equity grant to Employee with an overall value of One Million, Three Hundred Thousand Dollars and Zero Cents ($1,300,000.00) (the “Initial Equity Grant”), with the number of ADSs to be granted determined by dividing $1,300,000 by the average closing price of MOR ADSs as quoted by the NASDAQ Stock Market LLC on the thirty (30) trading days prior to the Effective Date and rounding down to the nearest whole ADS.  The Initial Equity Grant will be subject to a four (4) year vesting schedule, with 12.5% of the ADSs fully vesting every six (6 months) as of the Effective Date provided that Employee is still employed with the Company on the respective vesting dates.  The Initial Equity Grant and each vesting of such grant shall be subject in all respects to (i) applicable U.S. securities laws and (ii) acceptance by the Bank of New York Mellon, as depositary for the ADSs, of Parent Company ordinary shares underlying such ADSs. For purposes of clarity and subject to the terms set forth in Section 6 below, Employee shall have no claim or right to shares that have not vested as of the date of Employee’s termination from employment.

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3.6          Long-Term Incentive Compensation.  Employee shall be eligible to participate in a long-term incentive compensation (“LTIC”) program with an annual grant value of at least Five Hundred Seventy-Five Thousand Dollars and Zero Cents ($575,000.00) (the “LTIC Award”).  Employee shall become eligible to participate in the LTIC program for the first time upon the Parent Company’s regular grant cycle in the calendar year of 2019.  Company, in its sole and unilateral discretion, may elect to pay greater LTIC in any year, based on its assessment of Employee’s individual performance and the Company’s annual, financial and operating performance and any other factors as the Company may deem appropriate.  The annual grants awarded to Employee, which shall be in a form selected by the Board in its discretion, shall vest over four (4) years, and shall only be exercisable after such four (4) year vesting period, and shares underlying the grants (if any) may not be sold or otherwise transferred prior to the vesting date.  Employee’s LTIC Award otherwise shall be subject to (i) applicable U.S. securities laws, and (ii) the terms and conditions of the applicable LTIC program and the applicable award agreement thereunder.

	4.	
Benefits.

4.1          Benefits Available to Employee. Employee and Employee’s dependents (where applicable) shall be eligible to participate in any additional incentive plans, stock-based compensation plans, bonus plans, deferred or extra compensation plans, pensions, 401(k) or similar retirement plans, insurance plans, group insurance plans, including but not limited to health/medical, dental, life, and short-term and long-term disability, paid time off, wellness, and any other so-called “fringe” benefits, which the Company customarily provides for its senior executives from time to time.  The terms of any such additional or “fringe” benefits shall be governed and controlled by the applicable plan documents and Company policies and procedures in effect from time to time.  To the extent a conflict exists between the terms of this Agreement and any such plan, the plan document shall control.

4.2          Temporary COBRA Reimbursement.  Until the Company establishes its own health insurance plan, to ensure Employee may continue to receive Employee’s current health insurance benefits through COBRA as provided by Employee’s prior employer, the Company shall either: (i) enter into a qualified reimbursement plan for small employers or, in the alternative, shall make suitable arrangements, as mutually agreed by the Parties, to reimburse Employee for an amount equal to the amount of premium currently paid by Employee, on a month-to-month basis, to continue Employee’s health insurance coverage through COBRA; or (ii) appropriately gross-up Employee’s Base Salary to fully reimburse Employee for the amount of premium currently paid by Employee, on a month-to-month basis, to continue Employee’s health insurance coverage through COBRA.  Regardless of whether Employee’s COBRA premium is reimbursed by Company as provided by 4.2(i) or by 4.2(ii), such amount shall be adjusted to account for any income or other taxes Employee may be required to pay on the additional reimbursement income received by Employee.  The COBRA reimbursement benefit made available by way of this Section 4.2 shall commence on the Effective Date of this Agreement and shall remain in full force and effect until the Company has established and implemented its own health/medical insurance plan, at which point this COBRA reimbursement benefit shall cease.

4.3          Business/Travel Expense Reimbursement.  Employee shall be entitled to reimbursement for all reasonable and necessary out-of-pocket business, entertainment, and travel expenses incurred by Employee in connection with the performance of the Employee’s duties hereunder in accordance with the Company's expense reimbursement policies and procedures in effect from time to time.

4.4          Paid Time Off.  In addition to the Company’s observation of United States Federal Holidays, Employee shall be entitled to take up to thirty (30) days of paid time off (“PTO”) pursuant to Company’s

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written policies and procedures that may be in effect from time to time.  Additionally, Employee shall be entitled to take a reasonable number of sick days each year as may be required under applicable law.  Except as otherwise provided by applicable law or regulation, under no circumstances shall Employee be entitled to receive a cash payment for any accrued, but unused vacation, personal or sick time, including upon termination of employment.

5.          Conflicting Activities.   During the Term, Employee shall not engage in any activity that (i) conflicts with, appears to conflict with, is detrimental to, or appears to be detrimental to, Company’s best interests, (ii) conflicts with the conduct of Company’s business, or (iii) conflicts with the performance by Employee of Employee’s duties hereunder.

	6.	
Termination.

6.1          Termination by Consent.  This Agreement may be terminated at any time by mutual agreement of the Parties, expressed in a writing signed by the Parties, with the Company’s only obligation being the payment of (i) any Compensation and Annual Bonus (or prorated amount thereof) due to Employee as of the Termination Date and(ii) the reimbursement of any travel, business or other expenses due to Employee as of the Termination Date.  All incentive compensation and benefits vested as of the Termination Date can be exercised pursuant to the terms and conditions of the underlying benefit plans and programs (with the compensation and benefits identified herein in Section 6.1(i) and (ii) hereafter referred to collectively as the “Earned Compensation”).

6.2          Termination by Death.  Upon the death of Employee, this Agreement shall immediately terminate, and, except as otherwise mutually agreed by the Parties, and except as otherwise required by applicable law or regulations, any and all rights of Employee and Employee’s heirs, executors, administrators, successors and assigns, shall immediately cease, with the Company’s only obligation being the payment to Employee of any Earned Compensation. All incentive compensation and benefits can be exercised by Employee’s heirs pursuant to the terms and conditions of the underlying benefit plans and programs.

6.3          Termination by Disability.  This Agreement shall terminate, consistent with applicable laws and regulations, upon the Disability (as defined herein) of Employee. Should Employee’s employment be terminated pursuant to this Section 6.3, Company’s only obligation shall be: (i) the payment to Employee of any Earned Compensation; and (ii) the payment of any amounts due as a result of Employee’s disability under any other agreement between the Company and Employee.  For purposes of this Section 6.3, “Disability” shall mean that Employee, due to physical or mental illness or other condition (whether total or partial), becomes substantially unable to perform the essential functions of Employee’s position, with or without reasonable accommodation, for (x) a period of one-hundred eighty (180) consecutive days, or (y) for shorter periods aggregating one-hundred eighty (180) days during any twelve (12) month period.

6.4          Termination by Employee (Resignation).  Employee may terminate this Agreement upon giving sixty (60) days’ prior written notice (“Termination Notice”) to the Company, with the Company’s only obligation being the payment to Employee of any Earned Compensation and any other amounts due to Employee pursuant to any other agreement between the Parties.  Notwithstanding the foregoing, upon the Company’s receipt of the Termination Notice, the Company, in its sole discretion, may elect to pay Employee the amounts specified above, except to the extent any such payment would violate applicable requirements of Section 409A of the Internal Revenue Code of 1986, as amended (“Section 409A”), and upon such payment, Employee shall immediately cease to be employed by the Company.

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6.5          Termination by Company Without Cause.  The Company may, in its discretion, terminate this Agreement at any time, without Cause (defined below), upon sixty (60) days prior notice to Employee.

6.5.1          Separation Benefits for Termination Without Cause by the Company.  If the Company terminates this Agreement without Cause pursuant to Section 6.5 above, subject to and in accordance with the terms and conditions of this Section 6.5, the Company shall pay Employee: (a) any Earned Compensation due to Employee as of the Termination Date; (b) as severance, (i) the equivalent of one (1) year of Employee’s then-current Base Salary plus (ii) an amount equal to the Employee’s target Annual Bonus.  All equity awards outstanding, vested and unvested shall immediately vest in full and be deemed earned as of the Termination Date and can be exercised pursuant to the terms and conditions of the underlying programs.; In order to receive the severance pay or other separation benefits, Employee must execute a separation agreement containing a full waiver and general release in favor of the Company and its Affiliates (the “Separation Agreement”).

6.5.2          Payment of Separation Benefits.  Except as otherwise required by law, or unless otherwise mutually agreed by the Parties, the severance pay referenced in Section 6.5.1(b) shall be paid by the Company to Employee as follows: (a) the amount set forth in 6.5.1(b)(i) shall be paid in equal installments over the course of the severance period in accordance with the Company’s standard payroll practices, and subject to any applicable taxes, withholdings and payroll deductions, beginning on the first regular payroll date following the effective date of the Separation Agreement; (b) the amount set forth in Section 6.5.1(b)(ii) shall be paid when the Annual Bonus payment would have been due for the year in which the termination became effective. Any equity awards can only be exercised pursuant to the terms and payment schedule of the underlying plans and programs.

6.5.3          COBRA Benefits.  In addition to the severance pay pursuant to Section 6.5.1, the Company shall continue to pay its share of the costs for Employee’s coverage under the Company’s group health insurance plan for the duration of the severance period, provided Employee makes an effective COBRA election regarding Employee’s continuation of such group health insurance. If Employee obtains alternate group health insurance benefits during the applicable severance period, Employee shall immediately notify the Company in writing and the Company shall no longer be obligated to pay its share of the costs for continuing Employee’s coverage under the Company’s group health insurance plan.

6.5.4          Accord and Satisfaction for Employee Compensation.  If the Company terminates this Agreement without Cause pursuant to this Section 6.5, pays Employee all Earned Compensation as of the Termination Date, and offers to Employee all applicable severance pay and benefits as required by Sections 6.5.1 through 6.5.3, in the amount and on the terms specified hereinabove (as the case may be) or as may be otherwise agreed upon in writing by the Parties, the Company’s act of doing so shall be in complete accord and satisfaction of any claim that Employee has, or may have, for compensation due from the Company under this Agreement (including, without limitation, bonus(es), if any, due under Section 3.4).

6.5.5          Garden Leave.  Unless otherwise prohibited by law, should the Company terminate Employee’s employment without Cause, the Company may relieve Employee of Employee’s duties effective immediately upon providing notice of termination; provided, however, that Company shall still be obligated to pay Employee’s Base Salary and provide to Employee all benefits Employee was receiving prior to termination, which shall continue for the duration of the sixty (60)-day notice period.

6.6          Termination by Employee for Good Reason.  Employee may terminate Employee’s employment under this Agreement for “Good Reason” if, without the prior consent of Employee, any one or more of the following conditions arise or events occur: (i) the Company requires that Employee relocate to a worksite that would increase Employee’s one-way commuting distance by more than twenty-five (25) miles;

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(ii) the Company materially breaches its obligations under this Agreement and has not cured such breach within thirty (30) days after receipt of written notice thereof by Employee; or (iii) the material reduction or diminution of Employee’s roles, responsibilities or scope of authority, provided Employee gives written notice to the Company of such material diminution or reduction in role(s), responsibilities or scope of authority, and same is not cured by the Company within thirty (30) days receipt of such notice.

6.6.1          Separation Benefits for Termination for Good Reason.  For purposes of this Agreement, any termination of this Agreement by Employee for Good Reason in accordance with the terms of this Section 6.6 shall constitute a termination of this Agreement by the Company without Cause, for which Employee shall be entitled to all separation benefits and compensation provided by Section 6.5.  For the avoidance of doubt, if Employee terminates this Agreement for Good Reason, then Employee shall be entitled to receive the severance pay and separation benefits set forth in Section 6.5.1 and Section 6.5.3; provided that in order to receive any such severance pay or other separation benefits Employee must execute a Separation Agreement as set forth in Section 6.5.1.

6.6.2          Material Breach Defined.  For purposes of this Agreement, a material breach by the Company of its obligations under this Agreement shall include, without limitation, the Company’s the failure to pay or provide Employee’s Base Salary, Annual Bonus insofar as earned, incentive compensation, equity grants, benefits or any other form of compensation or benefits referenced in Sections 3 and 4 of this Agreement, which are not corrected or cured by the Company within thirty (30) days after receiving written notice from Employee of such breach; provided, however, that across-the-board salary reductions in compensation or benefits affecting similarly situated senior executive-level employees shall not constitute a material breach of this Agreement or Good Reason.

6.6.3          Material Reduction or Diminution upon Change in Control.  The material reduction or diminution of Employee’s role(s), responsibilities or scope of authority resulting from a Change in Control shall not constitute Good Reason so long as the Change in Control results in Employee working for a subsidiary or operating division of a larger organization, and provided that Employee’s role(s), responsibilities and scope of authority within that subsidiary or operating division are consistent with Employee’s role(s), responsibilities and scope of authority with the Company prior to the Change in Control.

6.7          Termination by the Company for Cause.  The Company may terminate this Agreement for Cause effective immediately, with the Company’s only obligation being the payment of the Earned Compensation (which in the event of a “for Cause” termination shall exclude any bonus pay and/or incentive compensation and benefits as may be required pursuant to the underlying benefit plans and programs).  An event of “Cause” shall occur if Employee: (i) materially violates any term of this Agreement or the Confidentiality, Inventions and Restrictive Covenant Agreement; (ii) repeatedly fails to follow reasonable instructions of the Company, is chronically absent from work, fails to perform any reasonably assigned duties after receiving written notice of same from the Company, or willfully violates any written policy of Company provided to Employee; (iii) engages in unprofessional conduct that results in, or reasonably could result in, unfavorable publicity for the Company, or engages in unprofessional conduct inconsistent with Employee’s position with the Company; or (iv) engages in any of the following forms of willful misconduct: (a) conviction of the commission of any felony, or any criminal act involving moral turpitude, or any misdemeanor where imprisonment is imposed; (b) misappropriation, theft or destruction of the Company property; (c) securing or attempting to secure any personal profit in connection with any transaction entered into by or on behalf of the Company; (d) causing substantial material harm to the Company as a result of Employee’s malfeasance, gross negligence or reckless disregard of Employee’s duties and responsibilities under this Agreement; (e)

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falsification of any business record of the Company; (f) any material act of fraud or dishonesty within the scope of, or relating to, Employee’s employment by Company; (g) commission of any crime relating to Employee’s employment with the Company; (f) violation of any applicable law or regulation related to the business of the Company.

6.7.1          Material Harm Defined.  For the purposes of this Section 6.7, the term “Material Harm” shall mean any material injury to the economic well-being, ethical welfare or goodwill of the Company or its Affiliates.

6.7.2          Employee Opportunity to Cure.  If the conduct constituting Cause arises under Section 6.7(ii), the Company shall provide to Employee written notice and opportunity to cure and Employee shall have thirty (30) days to cure or remedy such failure or breach, in which event Employee’s employment shall not be terminated.  If the conduct constituting Cause arises under Section 6.7(i) or (iii), and such conduct is susceptible to correction or cure, then, prior to terminating this Agreement, the Company shall provide to Employee written notice and opportunity to cure and Employee shall have thirty (30) days to cure or remedy such failure or breach, in which event Employee’s employment shall not be terminated.  If, however, the conduct constituting Cause under Section 6.7(i) or (iii) is not susceptible to correction or cure as reasonably determined by the Company in its sole discretion, Employee’s employment shall terminate immediately upon such written notice by the Company.

6.8          Termination in the Event of a Change in Control.  In the event of a consummation of a Change in Control of the Company, and if, upon such occurrence, or within the period of six (6) months following such occurrence, or within three (3) months prior to and in anticipation of such occurrence, (i) the Company terminates Employee’s employment without Cause or Employee resigns for Good Reason, and (ii) Employee executes a Separation Agreement consistent with Section 6.5.1, then, subject to compliance with this Agreement and the Separation Agreement, the following shall occur: (a) the Company shall pay to Employee an amount equal to any earned and accrued but unpaid bonus(es) and incentive compensation for the fiscal year for which same has not been paid, plus  two (2) times Employee’s then-current Base Salary, plus an amount equal to the target Annual Bonus paid to Employee; and (b) all equity grants and performance shares under any long-term incentive program granted as compensation then held by the Employee as of the Termination Date shall become fully vested irrespective of the applicable vesting periods of the governing participation plan and/or will be allocated in accordance with the respective provisions of such participation plan.  Company shall continue to pay its share of the costs for Employee’s coverage under the Company’s group health insurance plan for a period of twenty-four (24) months (the “Change in Control Severance Period”), provided Employee makes an effective COBRA election regarding group health insurance.  All monetary payments required to be paid by Company as referenced in this Section 6.8 shall be paid to Employee by way of one lump sum payment on the first regularly scheduled payroll following the effective date of the Separation Agreement. If Employee obtains alternate group health insurance benefits during the Change in Control Severance Period, Employee shall immediately notify Company in writing and Company shall no longer be obligated to pay its share of the costs for continuing Employee’s coverage under the Company’s group health insurance plan.

7.            Confidentiality.   Employee acknowledges and agrees that Employee must abide by the terms of the Confidentiality, Inventions and Restrictive Covenants Agreement annexed hereto as Exhibit “A.”

	8.	
Indemnification.

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8.1          Indemnification of Employee by MorphoSys Group.  The Company, Parent Company and their Affiliates (hereinafter, the “MorphoSys Group”) shall indemnify Employee and hold Employee harmless, to the maximum extent permitted by applicable law, from and against any and all claims, costs, losses, liabilities, charges, damages and expenses (including but not limited to attorneys’ fees and costs of suit) that Employee incurs, or may incur, in connection with or as a result of any act performed by Employee within the scope of Employee’s employment or in furtherance of Employee’s duties and obligations under this Agreement, with respect to any MorphoSys Group matters, except for any claims or losses arising from any willful misconduct or fraud of Employee, or Employee’s willful breach of this Agreement.

8.1.1          Company shall provide at its expense, subject to its availability upon reasonable terms, directors and officers liability insurance for Employee, for which Employee shall be named as an “additional insured,” either specifically or in Employee’s capacity as President and member of the Board.  The Company, in its sole discretion, shall determine (i) the availability of insurance upon reasonable terms, and (ii) the amount of such insurance coverage.

8.1.2          Employee shall not, by virtue of Employee’s status as President of Company or appointment to the Company’s Board, or otherwise, be liable for any debts, obligations or liabilities of Company, nor shall Employee be liable, responsible or accountable in damages or otherwise to Company for any act performed by Employee within the scope of the authority and responsibilities conferred on Employee by this Agreement.

8.1.3          The rights of indemnification set forth in this Agreement are in addition to all rights to which the Employee may be entitled to receive as a matter of law and shall survive the termination of this Agreement (even if Employee has ceased being an employee of Company or a member of its Board) and shall insure to the benefit of Employee and any heirs, personal representatives, successors and assigns of Employee.

8.2          Indemnification of MorphoSys Indemnified Parties by Employee.  In the event that the MorphoSys Group (in addition to any of its officers, directors, members, owners, employees and/or agents) (collectively, the “MorphoSys Indemnified Parties”) becomes a party to any legal proceeding, action or claim, or incurs costs or suffers damages as a result of Employee’s fraud, willful misconduct or breach of this Agreement, Employee hereby acknowledges and agrees to indemnify and hold harmless the MorphoSys Indemnified Parties from and against any and all obligations, liabilities, judgments, claims, actions and proceedings, settlements, awards, attorneys’ fees, expenses and costs, to the extent same exceed or are not covered by any applicable liability insurance (or other form of insurance policy or other insurance coverage, including but not limited to general liability insurance or errors and omissions insurance coverage) maintained by Company.

9.            Notices. All notices, requests, consents, demands, and other communications required or permitted to be given hereunder shall be in writing and shall be deemed to have been duly given if sent by facsimile (delivery confirmed by such service), private overnight mail service (delivery confirmed by such service), registered or certified mail (return receipt requested), electronic mail (upon confirmation of receipt) or delivered personally, as follows (or to such other address as either party shall designate by notice in writing to the other in accordance herewith):

If to the Company:

E-mail: simon.moroney@morphosys.com

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Fax: +49 89 899275311

Attn:  Chairman of the Board of Directors

with a copy to:

MorphoSys AG

Semmelweisstr. 7

82152 Planegg, Germany

E-mail: charlotte.lohmann@morphosys.com

Fax: +49 89 8992753720

Attn:  General Counsel

If to the Employee:

The mailing and e-mail address on record as delivered by Employee to and acknowledged by the General Counsel of MorphoSys AG.

	10.	
Taxation; Section 409A.

10.1          Notwithstanding any other provision to the contrary, the Parties agree that amounts payable under the Agreement shall be interpreted to comply with or be exempt from Section 409A of the Internal Revenue Code of 1986, as amended, and the final regulations and any guidance promulgated thereunder ("Section 409A") consistent with the intentions set forth in this Section 10.

10.2          Salary continuation payments that may become payable under Section 3 or Section 6 are intended to be exempt from Section 409A to the maximum extent permitted under (a) the “short-term deferral” rule set forth in Section I .409A-l (b)(4) of the Treasury Regulations (to the extent of such payments made from the Termination Date, as the case may be, through March 14th of the calendar year following such separation) and (b) the “separation pay due to involuntary separation from service” rule set forth in Section 1.409A--l (b)(9)(iii) of the Treasury Regulations (to the extent that such payments made after said March 14th). For purposes of the Agreement, each payable and benefit payable hereunder is intended to constitute a separate payment for purposes of Section I .409A-2(b)(2) of the Treasury Regulations.

10.3          Continued Company-paid COBRA benefits described in Section 6 are intended to be exempt from Section 409A under either the welfare benefits exception set forth in Section I.409A-l(a)(5) of the Treasury Regulations (if COBRA premium payments are not taxable to the Employee) or the limited payments exception set forth in Section I.409A-l (b)(9)(v)(D) of the Treasury Regulations (if COBRA premium payments are taxable to the Employee).

10.4          All expenses or other reimbursements as provided under the Agreement shall be payable in accordance with the Company’s policies in effect from time to time, but in any event shall be made on or prior to the last day of the taxable year following the taxable year in which such expenses were incurred by the Employee.  No reimbursement or expenses eligible for reimbursement in any taxable year shall in any way

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affect the expenses eligible for reimbursement in any other taxable year and the right to reimbursement or in-kind benefits shall not be subject to liquidation or exchanged for another benefit.

10.5          If Employee is considered by the Company to be a “specified employee” (within the meaning of Section 409A) upon separation from service and any payment or the provision of any benefit under the Agreement or otherwise that is payable upon separation from service is determined to be nonqualified deferred compensation subject to Section 409A after giving full effect to the intentions set forth in this Section 10, then any such payment or benefit shall not commence until the earlier of (i) the first payroll period commencing during the seventh month immediately following the date of such separation from service, and (ii) the date of Employee’s death (the "Delay Period").  Upon the expiration of the Delay Period, all payments and benefits delayed hereunder (whether they would have otherwise been payable in a single sum or in installments in the absence of such delay) shall be paid or reimbursed to Employee in a lump sum, and any remaining payments and benefits due under the Agreement shall be paid or provided in accordance with the normal payment dates specified for them herein.

10.6          All payments and benefits that are payable upon the termination of the Employee’s employment hereunder shall be paid or provided only upon the Employee’s “separation from service” from the Company within the meaning of Section 409A (determined after applying the presumptions set forth in Section 1.409A1 of the Treasury Regulations).

	11.	
Section 280G. 3

11.1          Employee shall bear all expense of, and be solely responsible for, all federal, state, local or foreign taxes due with respect to any payment received under the Agreement, including, without limitation, any excise tax imposed by Section 4999 of the Code (the “Excise Tax”); provided, however, that any payment or benefit received or to be received by the Employee in connection with a Change in Control or the termination of employment (whether payable under the terms of the Agreement or any other plan, arrangement or agreement with the Company or an Affiliate (collectively, the “Payments”) that would constitute a “parachute payment” within the meaning of Section 280G of the Code, shall be reduced to the extent necessary so that no portion thereof shall be subject to the Excise Tax but only if, by reason of such reduction, the net after-tax benefit received by the Employee shall exceed the net after-tax benefit that would be received by the Employee if no such reduction was made. For purposes of this Section 11:

(i)          The “net after-tax benefit” shall mean (i) the Payments which the Employee receives or is then entitled to receive from the Company or its Affiliates that would constitute “parachute payments” within the meaning of Section 280G of the Code, less (ii) the amount of all federal, state and local income and employment taxes payable by the Employee with respect to the foregoing calculated at the highest marginal income tax rate for each year in which the foregoing shall be paid to the Employee (based on the rate in effect for such year as set forth in the Code as in effect at the time of the first payment of the foregoing), less (iii) the amount of Excise Tax imposed with respect to the payments and benefits described in (i) above.

(ii)          All determinations under this Section 11 will be made by an accounting firm or law firm that is selected for this purpose by the Company prior to the Change in Control (the “280G Firm”).  All fees and expenses of the 280G Firm shall be borne by the Company.  Company will direct the 280G Firm to submit any determination it

Page 11 of 16

makes under this Section 11 and detailed supporting calculations to both the Employee and the Company as soon as reasonably practicable.

(iii)          If the 280G Firm determines that one or more reductions are required under Section 11, the 280G Firm shall also determine which Payments shall be reduced (first from cash payments and then from non-cash benefits) to the extent necessary so that no portion thereof shall be subject to the excise tax imposed by Section 4999 of the Code, and the Company shall pay such reduced amount to the Employee. The 280G Firm shall make reductions required under this Section 11 in a manner that maximizes the net after-tax amount payable to the Employee.

(iv)          As a result of the uncertainty in the application of Section 280G at the time that the 280G Firm makes its determinations under this Section 11, it is possible that amounts will have been paid or distributed to the Employee that should not have been paid or distributed (collectively, the "Overpayments"), or that additional amounts should be paid or distributed to the Employee (collectively, the "Underpayments"). If the 280G Firm determines, based on either the assertion of a deficiency by the Internal Revenue Service against the Company or the Employee, which assertion the 280G Firm believes has a high probability of success or controlling precedent or substantial authority, that an Overpayment has been made, the Employee must repay to the Company, without interest; provided, however, that no loan will be deemed to have been made and no amount will be payable by the Employee to the Company unless, and then only to the extent that, the deemed loan and payment would either reduce the amount on which the Employee is subject to tax under Section 4999 of the Code or generate a refund of tax imposed under Section 4999 of the Code. If the 280G determines, based upon controlling precedent or substantial authority, that an Underpayment has occurred, the 280G Firm will notify the Employee and the Company of that determination, and the Company will promptly pay the amount of that Underpayment to the Employee.

(v)          The Parties will provide the 280G Firm access to and copies of any books, records, and documents in their possession as reasonably requested by the 280G Firm, and otherwise reasonably cooperate with the 280G Firm in connection with the preparation and issuance of the determinations and calculations contemplated by this Section 11.

	12.	
Definitions.

12.1          As used herein, the following terms have the following meaning:

(i)          "Affiliate" means and includes any person controlling, controlled by, or under shared or common control with the Person in question.

(ii)          "Change in Control" means the occurrence of any of the following events: (i) if any Person becomes the "Beneficial Owner" (as defined in Rule 13d-3 under said Act), directly or indirectly, of securities of Company representing 50% or more of the total voting power represented by the Company’s then outstanding voting securities (excluding for this purpose the Parent Company or its Affiliates or any employee benefit plan of the Parent Company or its Affiliates); (ii) a merger or consolidation of the Company, whether or not approved by the Company's Board, other than a merger or consolidation which would result in the voting securities of the Company outstanding immediately prior thereto continuing to

Page 12 of 16

represent (either by remaining outstanding or by being converted into voting securities of the surviving entity or the parent of such corporation) more than fifty percent (50%) of the total voting power represented by the voting securities of the Company or such surviving entity or parent of such corporation outstanding immediately after such merger or consolidation; or (iii) the sale or disposition by the Company of all or substantially all of the Company’s assets in a transaction requiring stockholder approval.

(iii)          "Person" means any natural person, corporation, partnership, firm, joint venture, association, joint stock company, trust, unincorporated organization, governmental body or other entity.

(iv)          “Subsidiary" means any corporation or other business entity directly or indirectly owned or controlled by the corporation in question.

	13.	
General.

13.1          Work Authorization.  Employee shall provide to the Company necessary documents required by Form I-9 to confirm Employee is authorized to work in the United States so that, within three (3) business days of the Effective Date of this Agreement, the Company can have a completed Form I-9 for Employee.

13.2          Background Check.  Given the nature of the Company’s business, Employee’s offer of employment and continued employment with the Company may be contingent upon the results of a background check, which may include Employee’s education, prior employment, criminal record, and any other background facts that the Company may deem relevant, in the Company’s sole but reasonable discretion.

13.3          Governing Law; Venue.  This Agreement shall be governed by the laws of the State of New Jersey without giving effect to the principles of conflict of laws thereof.  All disputes arising out of or in connection with this Agreement shall be submitted and subject to the exclusive jurisdiction of the federal or state courts of competent jurisdiction located in the State of New Jersey.  The Parties to this Agreement hereby irrevocably waive any objection to jurisdiction and venue of any action instituted hereunder, and shall not assert any defense based on lack of jurisdiction, venue or based upon forum non conveniens.  EACH PARTY IRREVOCABLY AND UNCONDITIONALLY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN ANY LEGAL ACTION, PROCEEDING, CAUSE OF ACTION OR COUNTERCLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY.

13.4          Construction.  Headings in this Agreement are for convenience only and shall not control the meaning of this Agreement.  The words “this Agreement,” “hereby,” “hereof,” “herein,” “hereunder,” and comparable words refer to all of this Agreement, and not to any particular Section, subsection, preamble, recital, or other subdivision of this Agreement.  Whenever applicable, masculine and neutral pronouns shall apply equally to the feminine genders; the singular shall include the plural and the plural shall include the singular.  The Parties have reviewed and understand this Agreement, and each has had a full opportunity to negotiate the Agreement’s terms and to consult with counsel of their own choosing.  Therefore, the Parties expressly waive all applicable common law and statutory rules of construction that any provision of this Agreement should be construed against the Agreement’s drafter, and hereby agree that this Agreement shall be construed as a whole, according to the fair meaning of the language used.

Page 13 of 16

13.5          Entire Agreement.  This Agreement, along with any attached exhibits, sets forth the entire understanding and agreement of the Parties relating to the subject matter hereof, and supersedes all prior negotiations, agreements, arrangements and understandings, written or oral, relating to the subject matter hereof.  Neither party has made any representation, promise or inducement that is not embodied in this Agreement, and neither party shall be bound by or liable for any alleged representation, promise or inducement not so set forth.

13.6          Successors and Assigns.  The provisions hereof shall inure to the benefit of, and be binding upon and assignable to, successors of the Company by way of merger, consolidation or sale.  Employee may not assign or delegate to any third person Employee’s obligations under this Agreement.  The rights and benefits of the Employee under this Agreement are personal to the Employee and, except as otherwise provided specifically herein, no such right or benefit shall be subject to voluntary or involuntary alienation, assignment or transfer.  Company shall require any successor to all or substantially all of the business and/or assets of the Company (whether direct or indirect, by purchase, merger, consolidation or otherwise) to assume and agree to perform this Agreement in the same manner and to the same extent that the Company would have been required to perform it if no such succession had taken place.  As used in this Agreement, the term “Company” shall mean both the Company as defined above and any such successor that assumes and agrees to perform this Agreement, by operation of law or otherwise.

13.7          Modification; Waiver.  No provision of this Agreement may be amended or modified unless such amendment or modification is agreed to in writing and signed by the Employee and by a duly authorized officer of the Company (other than the Employee). No waiver by either of the Parties of any breach by the other party hereto of any condition or provision of this Agreement to be performed by the other party hereto shall be deemed a waiver of any similar or dissimilar provision or condition at the same or any prior or subsequent time, nor shall the failure of or delay by either of the Parties in exercising any right, power or privilege hereunder operate as a waiver thereof to preclude any other or further exercise thereof or the exercise of any other such right, power or privilege

13.8          Severability.  Should any provision of this Agreement be held by a court of competent jurisdiction to be enforceable only if modified, or if any portion of this Agreement shall be held as unenforceable and thus stricken, such holding shall not affect the validity of the remainder of this Agreement, the balance of which shall continue to be binding upon the Parties with any such modification to become a part hereof and treated as though originally set forth in this Agreement. The Parties further agree that any such court is expressly authorized to modify any such unenforceable provision of this Agreement in lieu of severing such unenforceable provision from this Agreement in its entirety, whether by rewriting the offending provision, deleting any or all of the offending provision, adding additional language to this Agreement or by making such other modifications as it deems warranted to carry out the intent and agreement of the Parties as embodied herein to the maximum extent permitted by law. The Parties expressly agree that this Agreement as so modified by the court shall be binding upon and enforceable against each of them. In any event, should one or more of the provisions of this Agreement be held to be invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provisions hereof, and if such provision or provisions are not modified as provided above, this Agreement shall be construed as if such invalid, illegal or unenforceable provisions had not been set forth herein.

13.9          Counterparts.  This Agreement may be executed in counterparts, each of which shall be deemed an original, but all of which taken together shall constitute one and the same instrument. [Delivery of an executed counterpart, by facsimile, electronic mail in portable document format (.pdf), or by any other

Page 14 of 16

electronic means intended to preserve the original graphic and pictorial appearance of a document, has the same effect as delivery of an executed original of this Agreement.

13.10          Authority/Execution.  Each signatory to this Agreement represents and warrants that he or she possesses the necessary authority and capacity to act for, sign and bind the respective person, party or entity on whose behalf he or she is signing.

13.11          Reimbursement for Legal Expenses.  Company hereby agrees to reimburse Employee’s reasonable legal expenses incurred in conjunction with the preparation, drafting and finalization of this Agreement up to an amount of Ten Thousand Dollars and Zero Cents ($10,000.00), which reimbursement shall be provided by Company to Employee within thirty (30) days receipt by the Company of Employee’s request for reimbursement.

13.12          Legal Compliance.  Employee authorizes the MorphoSys Group to disclose, at its determination, this Agreement and any other agreement Employee may enter into with any member of the MorphoSys Group for purposes of compliance with U.S. laws and regulations to which the MorphoSys Group may be subject, including without limitation, the Securities Exchange Act of 1934 and the Federal Food, Drug, and Cosmetic Act, and the rules and regulations respectively promulgated thereunder.

[Signature Page Follows]

Page 15 of 16

IN WITNESS WHEREOF, the Parties have executed this Agreement as of the date first above written.

EMPLOYEE

	
/s/ Jennifer Lyn Herron

	 
	
Jennifer Lyn Herron

	 

COMPANY

	
/s/ Simon Moroney

	 
	
MorphoSys US Inc.

	 
	
Simon Moroney

	 
	
Chairman, Board of Directors

	 

	
/s/ Jens Holstein

	 
	
MorphoSys US Inc.

	 
	
Jens Holstein

	 
	
Member, Board of Directors

	 

Page 16 of 16Exhibit 4.1

 

NEITHER THIS SECURITY NOR
THE SECURITIES FOR WHICH THIS SECURITY IS EXERCISABLE HAVE BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES
COMMISSION OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES
ACT”), AND, ACCORDINGLY, MAY NOT BE OFFERED OR SOLD EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES
ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE SECURITIES
ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS. THIS SECURITY AND THE SECURITIES ISSUABLE UPON EXERCISE OF THIS SECURITY
MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT OR OTHER LOAN SECURED BY SUCH SECURITIES.

 

[SERIES A/SERIES B] COMMON STOCK PURCHASE
WARRANT

 

AMERI
HOLDINGS, INC.

	[Warrant Shares: _______]1	Initial Exercise Date: July 27, 2018

 

 

THIS [SERIES A/SERIES
B] COMMON STOCK 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 hereof (the “Initial Exercise Date”) and on or prior to 5:00 p.m.
(New York City time) on July 27, 2023 (the “Termination Date”) but not thereafter]2, to subscribe
for and purchase from AMERI Holdings, Inc., a Delaware corporation (the “Company”), [up to ______ shares of
Common Stock (as subject to adjustment hereunder, the “Warrant Shares”).]3 [a number of shares of
Common Stock (as subject to adjustment hereunder, the “Warrant Shares”) equal to the sum of (a) the number
of shares of Common Stock, if any, which were allocated by the Holder to this Warrant pursuant to Section 2.1 of the Purchase
Agreement, (b) on the 3rd Trading Day following the date that Shareholder Approval is obtained and deemed effective,
if 80% of the lowest VWAP during the 2 Trading Days immediately prior to such date (“Primary Shareholder Approval Price”)
is less than the Per Share Purchase Price, then a number of shares of Common Stock equal to such Holder’s Subscription Amount
at the Closing divided by the Primary Shareholder Approval Price less any shares of Common Stock (i) issued at the Closing, (ii)
issuable pursuant to clause (a) above, if any, and (iii) issued pursuant to clause (d) below, if any, (iv) and issued pursuant
to clause (e) below, if any, and (c) on the 6th Trading Day following the date that Shareholder Approval is obtained
and deemed effective, if 80% of the lowest VWAP during the 5 Trading Days immediately prior to such date (“Secondary
Shareholder Approval Price”) is less than the Per Share Purchase Price, then a number of shares of Common Stock equal
to such Holder’s Subscription Amount at the Closing divided by the Secondary Shareholder Approval Price less any shares
of Common Stock (i) issued at the Closing, (ii) issuable pursuant to clause (a) above, if any, (ii) issuable pursuant to clause
(b) above, if any, (iii) issued pursuant to clause (d) below, if any, and (iv) issued pursuant to clause (e) below, if any, and
(d) on the 3rd Trading Day following the Effective Date, if 80% of the lowest VWAP during the 2 Trading Days immediately
prior to such date (“Primary Effective Date Price”) is less than the Per Share Purchase Price, then a number
of shares of Common Stock equal to such Holder’s Subscription Amount at the Closing divided by the Primary Effective Date
Price less any shares of Common Stock (w) issued at the Closing, (x) issuable pursuant to clause (a) above, if any, (y) issued
pursuant to clause (b) above, if any and (z) issued pursuant to clause (c) above, if any, and (e) on the 6th Trading
Day following the Effective Date, if 80% of the lowest VWAP during the 5 Trading Days immediately prior to such date (“Secondary
Effective Date Price”) is less than the Per Share Purchase Price, then a number of shares of Common Stock equal to such
Holder’s Subscription Amount at the Closing divided by the Secondary Effective Date Price less any shares of Common Stock
(v) issued at the Closing, (w) issuable pursuant to clause (a) above, if any, (x) issued pursuant to clause (b) above, if any,
(y) issued pursuant to clause (c) above, if any, and (z) issued pursuant to clause (d) above, if any. Notwithstanding anything
herein to the contrary, (I) in the event that some, but not all, of the Registrable Securities (as defined in the Registration
Rights Agreement) are registered for resale on any Registration Statement, then for purposes of this provision "Effective
Date" shall mean (a) each date (such that the applicable reset may occur on multiple dates) on which each Registration Statement
is declared effective and (b) the date that all of the Registrable Securities may be resold pursuant to Rule 144 if any Registrable
Securities are not then registered on a Registration Statement and (II) in no event shall the Primary Shareholder Approval Price,
the Secondary Shareholder Approval Price, Primary Effective Date Price or the Secondary Effective Date Price be less than $0.29
(“Floor Price”), subject to adjustment for reverse and forward stock splits, stock dividends, stock combinations
and other similar transactions of the Common Stock that occur after the date of this Warrant, it being understood that if any
of the Primary Shareholder Approval Price, Secondary Shareholder Approval Price, Primary Effective Date Price or Secondary Effective
Date Price is less than the Floor Price, such Primary Shareholder Approval Price, Secondary Shareholder Approval Price, Primary
Effective Date Price or Secondary Effective Date Price, as the case may be, shall be the Floor Price and in no event shall the
amounts in clauses (b), (c), (d) or (e) be less than zero.]4 

1
Series A only.

2
Series A only.

3
Series A only.

4
Series B only if shares allocated to Series B at closing pursuant to Section 2.1.

     

     

    

 

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 Securities Purchase Agreement
(the “Purchase Agreement”), dated July 25, 2018, among the Company and the purchasers signatory 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]5by delivery to the Company of a duly executed facsimile copy or PDF copy submitted by e-mail (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 the Common Stock under this Warrant shall be $1.60, subject
to adjustment hereunder (the “Exercise Price”); provided, however, on each of (i) the 6th
Trading Day following the date the Shareholder Approval is approved and deemed effective, but only if such date is after the Effective
Date, and (ii) the 6th Trading Day following the Effective Date the Exercise Price shall be reduced, and only reduced,
to equal the lower of (1) the then Exercise Price and (2) 110% of the lowest VWAP during the 5 Trading Days immediately prior to
the applicable date (“Reset Price”); provided in no event shall such Exercise Price be less than $0.29 (the
 “Floor Price”), subject to adjustment for reverse and forward stock splits, stock dividends, stock combinations
and other similar transactions of the Common Stock that occur after the date of this Warrant and it being understood that if the
Reset Price is less than the Floor Price, the Reset Price shall equal to the Floor Price. Additionally, in the event of an adjustment
to the Exercise Price hereunder, the number of Warrant Shares issuable hereunder shall be increased (and only increased) such that
the aggregate Exercise Price payable hereunder, after taking into account the decrease in the Exercise Price to the Reset Price,
shall be equal to the aggregate Exercise Price prior to such adjustment (assuming for such purposes the per Warrant Share Exercise
Price that existed as of the Closing Date, subject to adjustment for reverse and forward stock splits, stock dividends, stock combinations
and other similar transactions of the Common Stock that occur after the date of this Warrant. Notwithstanding anything herein to
the contrary, the Exercise Price adjustments set forth in this Section 2(b) shall not trigger further adjustment under the anti-dilution
provisions provided for in Section 3(b).]6
[The aggregate exercise price of this Warrant, except for a nominal exercise price of $0.001 per Warrant Share, was pre-funded
to the Company on or prior to the Initial Exercise Date and, consequently, no additional consideration (other than the nominal
exercise price of $0.001 per Warrant Share) shall be required to be paid by the Holder to any Person to effect any exercise of
this Warrant. The Holder shall not be entitled to the return or refund of all, or any portion, of such pre-paid aggregate exercise
price under any circumstance or for any reason whatsoever, including in the event this Warrant shall not have been exercised. The
remaining unpaid exercise price per share of Common Stock under this Warrant shall be $0.001, subject to adjustment hereunder (the
 “Exercise Price”).]7

5
Series A only.

6
Series A only.

7
Series B only.

     

     

    

c)                 
Cashless Exercise. If at any time after the six-month anniversary of the Closing Date, there is no effective registration
statement registering, or no current prospectus available for, the resale of the Warrant Shares by 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)(64) 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.

 

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 characteristics of the Warrants being exercised, and the holding period
of the Warrant Shares being issued may be tacked on to the holding period of this Warrant.  The Company agrees not to
take any position contrary to this Section 2(c).

 

“Bid
Price” means, for any date, the price determined by the first of the following clauses that applies: (a) if the Common
Stock is then listed or quoted on a Trading Market, the bid price of the Common Stock for the time in question (or the nearest
preceding date) on the Trading Market on which the Common Stock is then listed or quoted as reported by Bloomberg L.P. (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 OTCQB or OTCQX is not a Trading
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 is not then listed or quoted for trading on OTCQB or OTCQX and if prices for the Common Stock
are then reported in the “Pink Sheets” 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 share of Common Stock as determined by an independent appraiser selected in good faith
by the Purchasers of a majority in interest of the Securities then outstanding and reasonably acceptable to the Company, the fees
and expenses of which shall be paid by the Company.

 

“VWAP”
means, for any date, the price determined by the first of the following clauses that applies: (a) if the Common Stock is then listed
or quoted on 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 is then listed or quoted as reported by Bloomberg L.P. (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 OTCQB or OTCQX is not a Trading 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 is not then listed or quoted for trading on OTCQB or OTCQX and if prices for the Common Stock are then
reported in the “Pink Sheets” 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 share of Common Stock as determined by an independent appraiser selected in good faith
by the Purchasers of a majority in interest of the Securities then outstanding and reasonably acceptable to the Company, the fees
and expenses of which shall be paid by the Company.

     

     

    

 

[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).]8

 

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 the Holder or (B) the Warrant Shares are eligible for resale by the Holder
without volume or manner-of-sale limitations pursuant to Rule 144 (assuming cashless exercise of the Warrants), 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 of the
Notice of Exercise and (ii) one (1) Trading Day after delivery of the aggregate Exercise Price to the Company (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), $5 per Trading Day (increasing to $10
per Trading Day on the tenth Trading Day after such liquidated damages begin to accrue) 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.

8
Series A only.

     

     

    

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.

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.

     

     

    

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 [9.99/4.99%] of the number of shares of the 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 the 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.

     

     

    

f)              
Issuance Restrictions. If the Company has not obtained Shareholder Approval, then the Company may not issue upon
exercise of this Warrant a number of shares of Common Stock, which, when aggregated with any shares of Common Stock issued (i)
pursuant to the Purchase Agreement, (ii) upon prior exercise of this or any other Warrant issued pursuant to the Purchase Agreement
and (iii) pursuant to any warrants issued to any registered broker-dealer as a fee in connection with the issuance of Securities
pursuant to the Purchase Agreement, would exceed 3,810,783, subject to adjustment for reverse and forward stock splits, stock dividends,
stock combinations and other similar transactions of the Common Stock that occur after the date of the Purchase Agreement (such
number of shares, the “Issuable Maximum”). The Holder and the holders of the other Warrants issued pursuant
to the Purchase Agreement shall be entitled to a portion of the Issuable Maximum equal to the quotient obtained by dividing (x)
the Holder’s original Subscription Amount by (y) the aggregate original Subscription Amount of all holders pursuant to the
Purchase Agreement. In addition, the Holder may allocate its pro-rata portion of the Issuable Maximum among Warrants held by it
in its sole discretion. Such portion shall be adjusted upward ratably in the event a Purchaser no longer holds any Warrants and
the amount of shares issued to such Purchaser pursuant to its Warrants was less than such Purchaser’s pro-rata share of the
Issuable Maximum. For avoidance of doubt, unless and until any required Shareholder Approval is obtained and effective, warrants
issued to any registered broker-dealer as a fee in connection with the Securities issued pursuant to the Purchase Agreement as
described in clause (iii) above shall provide that such warrants shall not be allocated any portion of the Issuable Maximum and
shall be unexercisable unless and until such Shareholder Approval is obtained and effective.

Section 3.Certain
Adjustments.

a)                 
Stock Dividends and Splits. If the Company, at any time while this Warrant is outstanding: (i) other than the payment
of dividends on the Company’s Series A Preferred Stock in shares of Series A Preferred Stock, 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 the 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.

     

     

    

b)                 
Subsequent Equity Sales. Until the 2nd anniversary of the Effective Date, if the Company or any Subsidiary
thereof, as applicable, at any time while this Warrant is outstanding, shall sell or grant any option to purchase, or sell or 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 (such
lower price, the “Base Share Price” and such issuances collectively, a “Dilutive Issuance”)
(it being understood and agreed that if the holder of the Common Stock or Common Stock Equivalents so issued shall at any time,
whether by operation of purchase price adjustments, reset provisions, floating conversion, exercise or exchange prices or otherwise,
or due to warrants, options or rights per share which are issued in connection with such issuance, be entitled to receive shares
of Common Stock at an effective price per share that is less than the Exercise Price, such issuance shall be deemed to have occurred
for less than the Exercise Price on such date of the Dilutive Issuance at such effective price), then simultaneously with the consummation
(or, if earlier, the announcement) of each Dilutive Issuance the Exercise Price shall be reduced and only reduced to equal the
Base Share Price. Such adjustment shall be made whenever such Common Stock or Common Stock Equivalents are issued. Notwithstanding
the foregoing, no adjustments shall be made, paid or issued under this Section 3(b) in respect of an Exempt Issuance. The Company
shall notify the Holder, in writing, no later than the Trading Day following the issuance or deemed issuance of any Common Stock
or Common Stock Equivalents subject to this Section 3(b), indicating therein the applicable issuance price, or applicable reset
price, exchange price, conversion price and other pricing terms (such notice, the “Dilutive Issuance Notice”).
For purposes of clarification, whether or not the Company provides a Dilutive Issuance Notice pursuant to this Section 3(b), upon
the occurrence of any Dilutive Issuance, the Holder is entitled to receive a number of Warrant Shares based upon the Base Share
Price regardless of whether the Holder accurately refers to the Base Share Price in the Notice of Exercise. If the Company enters
into a Variable Rate Transaction, despite the prohibition thereon in the Purchase Agreement, the Company shall be deemed to have
issued Common Stock or Common Stock Equivalents at the lowest possible conversion or exercise price at which such securities may
be converted or exercised.

     

     

    

c)                 
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, that, 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).

d)                
Pro Rata Distributions. 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 of cash, 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).

     

     

    

e)                 
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,
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 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) or Section 2(f) 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) or Section 2(f) 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 of the remaining unexercised portion of this Warrant on the date of the consummation
of such Fundamental Transaction; provided, however, 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 (as defined below) 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 and 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 five year anniversary of
the Initial Issuance Date, (B) an expected volatility equal to the greater of 100% and the 100 day volatility obtained from the
HVT function on Bloomberg 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 five year anniversary of the Initial Issue
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 and the other Transaction Documents 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 and the other Transaction
Documents 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 and the other Transaction Documents
with the same effect as if such Successor Entity had been named as the Company herein.

     

     

    

f)                  
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.

g)                 
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 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 the 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. Subject to compliance with any applicable securities laws and the conditions set forth in Section
4(d) hereof and to the provisions of Section 4.1 of the Purchase Agreement, this Warrant and all rights hereunder (including, without
limitation, any registration rights) 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. The 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.

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 Exercise Date 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 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)                
Transfer Restrictions. If, at the time of the surrender of this Warrant in connection with any transfer of this Warrant,
the transfer of this Warrant shall not be either (i) registered pursuant to an effective registration statement under the Securities
Act and under applicable state securities or blue sky laws or (ii) eligible for resale without volume or manner-of-sale restrictions
or current public information requirements pursuant to Rule 144, the Company may require, as a condition of allowing such transfer,
that the Holder or transferee of this Warrant, as the case may be, comply with the provisions of Section 5.7 of the Purchase Agreement.

e)                 
Representation by the 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.Miscellaneous.

a)                 
No Rights as Stockholder Until Exercise. 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.

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.

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).

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.

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)                 
Jurisdiction. All questions concerning the construction, validity, enforcement and interpretation of this Warrant
shall be determined in accordance with the provisions of the Purchase Agreement.

     

     

    

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 or the Purchase Agreement, 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.

h)                 
Notices. Any notice, request or other document required or permitted to be given or delivered to the Holder by the
Company shall be delivered in accordance with the notice provisions of the Purchase 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 and the Holder.

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.

h)                 
Voluntary Adjustment By Company.  The Company may at any time during the term of this Warrant, with the prior
written consent of the Holder, reduce the then current Exercise Price to any amount and for any period of time deemed appropriate
by the Board of Directors of the Company unless such reduction would result in the Company violating any rules of its principal
trading market.

 

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

 

 

(Signature Page
Follows)

 

     

     

    

 

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.

	 	 	AMERI HOLDINGS, INC.
	 	 	 
	 	 	 
	 	 	 	By:	
   

	 	 	 	 	 	Name:	 
	 	 	 	 	 	Title:	 

 

 

     

     

    

 

NOTICE OF EXERCISE

 

To:AMERI
HOLDINGS, 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:

 

_______________________________

 

_______________________________

 

_______________________________

 

(4)  
Accredited Investor. The undersigned is an “accredited investor” as defined in Regulation D promulgated
under the Securities Act of 1933, as amended.

 

[SIGNATURE
OF HOLDER]

 

 

	Name of Investing Entity:	
   

	Signature of Authorized Signatory of Investing Entity:	
  

	Name of Authorized Signatory:	
  

	Title of Authorized Signatory:	
  

	Date:	
   

 

 

     

     

    

 

EXHIBIT B

 

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:	
   

	 	(Please Print)
	 	 
	Phone Number:	
   

	 	 
	Email Address:	
   

	 	 
	Dated:	
   

	 	 
	Holder’s Signature:	
   

	 	 
	Holder’s Address:

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