Document:

exv10w2

 

Exhibit 10.2

FORM OF CONVERTIBLE NOTE

THE SECURITIES EVIDENCED BY THIS NOTE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF
1933, AS AMENDED, OR QUALIFIED FOR SALE UNDER ANY STATE SECURITIES LAWS (COLLECTIVELY, “SECURITIES
LAWS”) AND MAY NOT BE OFFERED, SOLD OR OTHERWISE TRANSFERRED UNLESS REGISTERED OR QUALIFIED FOR
SALE UNDER ALL APPLICABLE SECURITIES LAWS OR UNLESS, IN THE OPINION OF COUNSEL SATISFACTORY TO THE
ISSUER, IN FORM AND SUBSTANCE SATISFACTORY TO THE ISSUER, ANY SUCH OFFER, SALE OR OTHER TRANSFER IS
EXEMPT FROM THE REGISTRATION OR QUALIFICATION REQUIREMENTS OF SUCH SECURITIES LAWS.

				
	 	 	 
	$612,500.00	 	 	“Issuance Date”

     FOR VALUE RECEIVED, SAVE THE WORLD AIR, INC., a corporation organized under the laws of the
state of Nevada (the “Company”), promises to pay to the order of “Investor”, as that term is
defined on the Acknowledgement and Acceptance page of this Note (hereafter, together with any
subsequent holder hereof, called “Holder”), at “Investor’s Address”, as that term is set forth on
such page or at such other place as Holder may direct, the “Subscription Amount”, noted above (the
“Loan”), payable in full on the first anniversary of the date hereof (the “Maturity Date”).

     The Company agrees to make payments to the order of the Holder in an amount equal to $3,750
per month on the 1st day of each calendar month hereunder commencing on the
1st day of January, 2007 and continuing on the first day of each calendar month
thereafter until the Maturity Date, at which time all sums outstanding and unpaid hereunder shall
be due and payable in full. If this Note is not paid in full on or prior to the Maturity Date the
remaining balance shall be increased by 10% as an initial penalty, and the Company shall pay 2.5%
per month, compounded daily and prorated for partial months, for each month until all sums due
hereunder are paid in full.

     Payments of both principal and interest will be made in immediately available funds in lawful
money of the United States of America to the Holder at the Investor’s Address.

     The Note is subject to the following additional provisions:

     1. The Company shall be entitled to withhold from all payments of principal and/or interest of
this Note any amounts required to be withheld under the applicable provisions of the U.S. Internal
Revenue Code of 1986, as amended, or other applicable laws at the time of such payments.

 

 

     2. This Note has been issued subject to representations, warranties and covenants of the
original Holder hereof and may be transferred or exchanged only in compliance with the Securities
Act of 1933, as amended, and applicable state and other securities laws.. Prior to the due
presentment for such transfer of this Note, the Company and any agent of the Company may treat the
person in whose name this Note is duly registered on the Company’s Note register as the owner
hereof for the purpose of receiving payment as herein provided and all other purposes, whether or
not this Note is overdue, and neither the Company nor any such agent shall be affected by notice to
the contrary. The transferee shall be bound, as the original Holder by the same representations and
terms described herein and under the Agreement.

     3. The Holder or Company may, at such Holder’s option, at any time on or after the
90th day prior to the Maturity Date convert the principal amount of this Note or any
portion thereof, and any interest accrued and unpaid thereon (the “Conversion Amount”), into a
number shares of fully paid and nonassessable Common Stock of the Company (the “Conversion Shares”)
pursuant to the following formula: the Conversion Amount divided by                      (as the same may
be adjusted from time to time pursuant to the provisions of this Note, the “Conversion Price”).
The Holder may exercise the right to convert all or any portion of the Conversion Amount by
delivering to the Company (i) an executed and completed notice of conversion in the form attached
to this Note (the “Notice of Conversion”) to the Company and (ii) this Note. The business day on
which a Notice of Conversion and this Note are delivered to the Company in accordance with the
provisions hereof shall be deemed a “Conversion Date”. The Company will transmit the certificates
representing Conversion Shares issuable upon such conversion of this Note (together with the
certificates representing the amount of this Note not so converted) to the Holder via express
courier within ten Business Days after the Conversion Date. No fractional shares shall be issued
upon conversion of this Note. The amount of any of the Conversion Amount which is less than a
whole share of Common Stock shall be paid to the Holder in cash. The conversion of this Note may
require that the Company amend its charter to increase the number of common shares authorized and
therefore, the conversion may not take place prior to the Company’s completion of that process. Any
delay due to such circumstance shall not be an event of default under this Note. Company shall
promptly take action to affect such amendments to its charter.

     4. The principal amount of this Note, and any accrued interest thereon, shall be reduced as
per that principal amount indicated on the Notice of Conversion upon the proper receipt by the
Holder of such Conversion Shares due upon such Notice of Conversion.

     5. The number of Conversion Shares shall be adjusted as follows:

          a. If the Company shall at any time after the Issuance Date subdivide its outstanding shares
of Common Stock into a greater number of shares of Common Stock, the number of Conversion Shares in
effect immediately prior to such subdivision shall be proportionately increased, and conversely, in
case the outstanding shares of Common Stock shall be combined into a smaller number of shares of
Common Stock, the

 

 

Conversion Price in effect immediately prior to such combination shall be proportionately
reduced.

          b. If the Company shall at any time or from time to time after the Issuance Date makes, or
fixes a record date for the determination of holders of Common Stock entitled to receive, a
dividend or other distribution payable in additional shares of Common Stock, then and in each such
event the number of Conversion Shares issuable upon conversion of this Note shall be
proportionately increased; provided, however, that if such record date is fixed and such dividend
is not fully paid, or if such distribution is not fully made on the date fixed therefor, the number
of Conversion Shares shall be recomputed to reflect that such dividend was not fully paid or that
such distribution was not fully made.

          c. If Company at any time or from time to time after the Issuance Date makes, or fixes a
record date for the determination of holders of Common Stock entitled to receive, a dividend or
other distribution payable in securities of Company other than shares of Common Stock, then and in
each such event provision shall be made so that Holder shall receive upon exercise of the
conversion right of this Note, in addition to the number of shares of Common Stock receivable
thereupon, the amount of securities of Company which Holder would have received had the Conversion
Amount of this Note been exercised on the date of such event and had it thereafter, during the
period from the date of such event to and including the date of conversion or purchase, retained
such securities receivable during such period.

          d If the Common Stock issuable upon the conversion of this Note or option to purchase is
changed into the same or a different number of shares of any class or classes of stock, whether by
recapitalization, reclassification or otherwise (other than a transaction described elsewhere in
Section 5 of this Note), then, and in any such event, each Holder shall have the right thereafter,
upon conversion of this Note or purchase pursuant to option to receive the kind and amount of stock
and other securities and property receivable upon such reorganization or other change, in an amount
equal to the amount that Holder would have been entitled to had it immediately prior to such
reorganization, reclassification or change converted this Note, but only to the extent this Note is
actually converted, all subject to further adjustment as provided herein.

     6. No provision of this Note shall alter or impair the obligation of the Company, which is
absolute and unconditional, upon an Event of Default (as defined below), to pay the principal of,
and interest on this Note at the place, time, and rate, and in the coin or currency herein
prescribed.

     7. Events of Default. Each of the following occurrences is hereby defined as an “Event of
Default”:

Nonpayment. The Company shall fail to make any payment of principal,
interest, or other amounts payable hereunder when and as due; or

 

 

Dissolutions, etc. The Company or any subsidiary shall fail to comply with
any provision concerning its existence or any prohibition against dissolution,
liquidation, merger, consolidation or sale of assets; or

Noncompliance with this Agreement. The Company shall fail to comply in any
material respect with any provision hereof, which failure does not otherwise
constitute an Event of Default; or

Insolvency. The institution of bankruptcy, insolvency, reorganization or
liquidation proceedings or other proceedings for relief under any bankruptcy
law or any law for the relief of debtors shall be instituted by or against
Company, which proceedings shall not have been vacated by appropriate court
order within sixty (60) days of such institution.

     If one or more “Events of Default” shall occur, then, or at any time thereafter, and
in each and every such case, unless such Event of Default shall have been waived in writing
by the Holder (which waiver shall not be deemed to be a waiver of any subsequent default)
or cured as provided herein, at the option of the Holder, and in the Holder’s sole
discretion, the Holder may elect to consider this Note (and all interest through such date)
immediately due and payable. In order to so elect, the Holder must deliver written notice
of the election and the amount due to the Company via certified mail, return receipt
requested, at the Company’s address as set forth herein (or any other address provided to
the Holder), and thereafter the Company shall have ten (10) business days upon receipt to
cure the Event of Default or pay this Note, or convert the amount due on the Note pursuant
to the conversion formula set forth above.

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

     9. This Note does not entitle the Holder hereof to any voting rights or other rights as a
shareholder of the Issuer prior to the conversion into Common Stock thereof, except as provided by
applicable law. If, however, at the time of the surrender of this Note and conversion the Holder
hereof shall be entitled to convert this Note, the Conversion Shares so issued shall be and be
deemed to be issued to such holder as the record owner of such shares as of the close of business
on the Conversion Date.

     10. The Holder shall pay all issue and transfer taxes and other incidental expenses in respect
of the issuance of certificates for Conversion Shares upon the conversion of this Note, and such
certificates shall be issued in the name of the Holder of this Note.

 

 

     11. This Note does not entitle the Holder to any voting rights or other rights as a
stockholder of the Company prior to the exercise hereof.

     12. Upon receipt by the Company of evidence reasonably satisfactory to it of the loss, theft,
destruction or mutilation of this Note, and in case of loss, theft or destruction of this Note,
upon delivery of an indemnity agreement or security reasonably satisfactory in form and amount to
the Company or, in the case of any such mutilation, upon surrender and cancellation of such Note,
and upon reimbursement to the Company of all reasonable expenses incidental thereto, the Company
will make and deliver to the Holder, in lieu thereof, a new Note in substantially identical form
and dated as of such cancellation.

     13. If the last or appointed day for the taking of any action or the expiration of any right
required or granted herein shall be a Saturday or a Sunday or shall be a legal holiday in the
United States or the State of California, then such action may be taken or such right may be
exercised on the next succeeding business day.

     14. (a) This Note shall be governed by and construed in accordance with the laws of the State
of California applicable to contracts made and to be performed wholly within such state.

          (b) Except as otherwise provided herein, any notice or demand which, by the provisions hereof,
is required or which may be given to or served upon the parties hereto shall be in writing and, if
by telegram, telecopy or telex, shall be deemed to have been validly served, given or delivered
when sent, if by personal delivery, shall be deemed to have been validly served, given or delivered
upon actual delivery and, if mailed, shall be deemed to have been validly served, given or
delivered three (3) business days after deposit in the United States mails, as registered or
certified mail, with proper postage prepaid and addressed to the party or parties to be notified.

          (c) The Holder acknowledges that the Conversion Shares acquired upon the exercise of this Note
may have restrictions upon its resale imposed by state and federal securities laws.

          (d) With regard to any power, remedy or right provided herein or otherwise available to any
party hereunder (i) no waiver or extension of time shall be effective unless expressly contained in
a writing signed by the waiving party; and (ii) no alteration, modification or impairment shall be
implied by reason of any previous waiver, extension of time, delay or omission in exercise, or
other indulgence.

[remainder of page intentionally left blank]

 

 

          (e) This Note constitutes the Company’s and Holder’s entire agreement with respect to the
subject matter hereof and supersedes all agreements, representations, warranties, statements,
promises and understandings, whether oral or written, with respect to the subject matter hereof.
This Note may not be amended, altered or modified except by a writing signed by the Company and the
Holder.

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

	 	 	 	 	 	 	 
	SAVE THE WORLD AIR, INC.	 	 
	 
	By
	 	 	 	 	 	 
	 	 	 	 	 
	 

	 	Name:	 	 	 	 
	 

	 	Title:	 	 	 	 

	 	 	 	 	 
	ACKNOWLEDGED AND ACCEPTED:
	 
	 	 	 	 
	MORALE ORCHARDS, LLC
	Investor Address:

	 	17048 SE River Road, Portland, Oregon 97267	 	 
	 
	 	 	 	 
	Investor Signature:
	 	 	 	 
	 

	 	 	 	 

 

 

NOTICE OF EXERCISE OF CONVERSION RIGHT 

TO: SAVE THE WORLD AIR, INC.

     (1) The undersigned hereby elects to convert $                     of the attached Note into                      shares of
Common Stock (the “Shares”) of Save the World Air, Inc. pursuant to the
terms of the attached Note.

     (2) Please issue a certificate or certificates representing the Shares in the name of the
undersigned or in such other name as is specified below:

	 	 	 	 	 
	 	 	 
	 	  	 	 
	 	 	(Print Name) 	 
	 
	 	 	Address: 	 
	 	  	 	 
	 	  	 	 
	 	  	 	 

     (3) The undersigned confirms that the Shares are being acquired for the account of the
undersigned for investment only and not with a view to, or for resale in connection with, the
distribution thereof and that the undersigned has no present intention of distributing or selling
the Shares.

     (4) The undersigned accepts such shares subject to the restrictions on transfer set forth in
the attached Note.

	 	 	 	 	 
	 	 	 
	 	 	 	 
	(Date) 	 	(Signature) 	 
	 
	 	 	 	 
	 	 	(Print Name)exv10w3

 

Exhibit 10.3

FORM OF STOCK PURCHASE WARRANT

THIS WARRANT AND ANY SHARES ISSUED UPON ITS EXERCISE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933, AS AMENDED (THE “ACT”), AND HAVE BEEN ACQUIRED FOR INVESTMENT AND NOT WITH VIEW TO, OR
IN CONNECTION WITH, THE SALE OR DISTRIBUTION THEREOF. NO SUCH SALE OR DISPOSITION OF ANY SHARES
ISSUED UPON EXERCISE HEREOF MAY BE AFFECTED WITHOUT AN EFFECTIVE REGISTRATION STATEMENT RELATED
THERETO OR AN OPINION OF COUNSEL SATISFACTORY IN FORM AND SUBSTANCE TO THE COMPANY THAT SUCH
REGISTRATION IS NOT REQUIRED UNDER THE ACT THE TRANSFER OF THIS WARRANT IS RESTRICTED AS SET FORTH
HEREIN.

			
	 
	No.                     
	 	                    , 2006

SAVE
THE WORLD AIR, INC.

WARRANT
TO PURCHASE COMMON STOCK

VOID AFTER 5:00 P.M. P.S.T. ON                     , 2011

     THIS CERTIFIES that, for the value received, MORALE ORCHARDS, LLC (the “Holder”) is entitled,
upon the terms and subject to the conditions hereinafter set forth, at any time on or after 180
days following the date of this Warrant and on or prior to 5:00 p.m. P.S.T. on the fifth
anniversary of the date of this Warrant (the “Expiration Time”), but not thereafter, to subscribe
for and purchase, from SAVE THE WORLD AIR, INC., a Nevada corporation (the “Company”), up to
                         (                 ) shares of the Company’s Common Stock (the “Shares”) at a purchase price per
share equal to $                     (the “Exercise Price”).

     1. Exercise of Warrant.

          (a) The purchase rights represented by this Warrant are exercisable by the Holder, in whole or
in part, at any time after the date hereof and before the Expiration Time by the surrender of this
Warrant and the Notice of Exercise annexed hereto duly executed at the office of the Company, in
North Hollywood, California (or such other office or agency of the Company as it may designate by
notice in writing to the Holder at the address of the Holder appearing on the books of the
Company), and upon payment of an amount equal to the aggregate Exercise Price for the number of
Shares thereby purchased (by cash or by check or certified bank check payable to the order of the
Company in an amount equal to the purchase price of the shares thereby purchased); whereupon the
Holder shall be entitled to receive a stock certificate representing the number of Shares so
purchased. The Company agrees that if at the time of the surrender

 

 

of this Warrant and purchase of
the Shares, the Holder shall be entitled to exercise this
Warrant, the Shares so purchased shall be and be deemed to be issued to such holder as the
record owner of such Shares as of the close of business on the date on which this Warrant shall
have been exercised as aforesaid.

          Upon partial exercise of this Warrant, the Holder shall be entitled to receive from the
Company a new Warrant in substantially identical form for the purchase of that number of Shares as
to which this Warrant shall not have been exercised. Certificates for Shares purchased hereunder
shall be delivered to the Holder within a reasonable time after the date on which this Warrant
shall have been exercised as aforesaid.

     2. No Fractional Shares or Scrip. No fractional shares or scrip representing
fractional shares shall be issued upon the exercise of this Warrant. With respect to any fraction
of a share called for upon the exercise of this Warrant, an amount equal to such fraction
multiplied by the then current fair market value at which each Share may be purchased hereunder
shall be paid in cash to the Holder.

          (a) For purposes of this Section 2, the fair market value of the Shares shall mean the average
closing price of a share of the Company’s Common Stock on a national stock exchange on which the
Common Stock is listed at the time of exercise on the last business day prior to the date of
exercise of this Warrant pursuant to Section l or, if the Company’s Common Stock is not so listed,
the fair market value of the Common Stock (without regard to the restrictions on transfer or number
of Shares) as determined in good faith by the Company’s Board of Directors.

     3. Charges, Taxes and Expenses. The Holder shall pay all issue and transfer taxes and
other incidental expenses in respect of the issuance of certificates for Shares upon the exercise
of this Warrant, and such certificates shall be issued in the name of the Holder of this Warrant.

     4. No Rights as a Stockholder. This Warrant does not entitle the Holder to any voting
rights or other rights as a stockholder of the Company prior to the exercise hereof.

     5. Loss, Theft, Destruction or Mutilation of Warrant. Upon receipt by the Company of
evidence reasonably satisfactory to it of the loss, theft, destruction or mutilation of this
Warrant, and in case of loss, theft or destruction of this Warrant, upon delivery of an indemnity
agreement or security reasonably satisfactory in form and amount to the Company or, in the case of
any such mutilation, upon surrender and cancellation of such Warrant, and upon reimbursement to the
Company of all reasonable expenses incidental thereto, the Company will make and deliver to the
Holder, in lieu thereof, a new Warrant in substantially identical form and dated as of such
cancellation.

     6. 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 be a Saturday or a
Sunday or shall be a legal holiday in the United States or the State of California, then

 

 

such
action may be taken or such right may be exercised on the next succeeding business.

     7. Merger, Reclassification, etc.

          (a) Merger, etc. If at any time the Company proposes (A) the acquisition of the
Company by another entity by means of any transaction or series of related transactions (including,
without limitation, any reorganization, merger, consolidation or stock issuance) that results in
the transfer of fifty percent (50%) or more of the then outstanding voting power of the Company; or
(B) a sale of all or substantially all of the assets of the Company, then the Company shall give
the Holder ten (10) days notice of the proposed effective date of the transaction. If, in the case
of such acquisition of the Company, and the Warrant has not been exercised by the effective date of
the transaction, this Warrant shall be exercisable into the kind and number of shares of stock or
other securities or property of the Company or of the entity resulting from such merger or
acquisition to which such Holder would have been entitled if immediately prior to such acquisition
or merger, it had exercised this Warrant. The provisions of this Section 7(a) shall similarly apply
to successive consolidations, mergers, sales or conveyances.

          (b) Reclassification, etc. If the Company at any time shall, by subdivision,
combination or reclassification of securities or otherwise, change any of the securities to which
purchase rights under this Warrant exist into the same or a different number of securities of any
class or classes, this Warrant shall thereafter be to acquire such number and kind of securities as
would have been issuable as the result of such change with respect to the securities which were
subject to the purchase rights under this Warrant immediately prior to such subdivision,
combination, reclassification or other change. If the Shares are subdivided or combined into a
greater or smaller number of Shares, the Exercise Price under this Warrant shall be proportionately
reduced in case of subdivision of shares or proportionately increased in the case of combination of
shares, in both cases by the ratio which the total number of Shares to be outstanding immediately
after such event bears to the total number of Shares outstanding immediately prior to such event.

          (c) Cash Distributions. No adjustment on account of cash dividends or interest on the
Shares or other securities purchasable hereunder will be made to the Exercise Price under this
Warrant.

     8. Restrictions on Transfer.

          (a) Restrictions on Transfer of Shares. In no event will the Holder make a disposition
of this Warrant or the Shares unless and until, if requested by the Company, it shall have
furnished the Company with an opinion of counsel satisfactory to the Company and its counsel to the
effect that appropriate action necessary for compliance with the Securities Act of 1933, as amended
(the “Act”) relating to sale of an unregistered security has been taken. Notwithstanding the
foregoing, the restrictions imposed upon the transferability of the Shares shall terminate as to
any particular Share when (i) such security shall have been sold without registration in compliance
with Rule 144 under the Act, or (ii) a letter shall have been issued to the Holder at its request
by the staff of the

 

 

Securities and Exchange Commission or a ruling shall have been issued to the
Holder at
its request by such Commission stating that no action shall be recommended by such staff or
taken by such Commission, as the case may be, if such security is transferred without registration
under the Act in accordance with the conditions set forth in such letter or ruling and such letter
or ruling specifies that no subsequent restrictions on transfer are required, or (iii) such
security shall have been registered under the Act and sold by the Holder thereof in accordance with
such registration.

          (b) Subject to the provisions of Section 8(a) hereof, this Warrant and all rights hereunder
are transferable, in whole or in part, upon surrender of the Warrant with a properly executed
assignment at the principal office of the Company.

          (c) Restrictive Legends. The stock certificates representing the Shares and any
securities of the Company issued with respect thereto shall be imprinted with legends restricting
transfer except in compliance with the terms hereof and with applicable federal and state
securities laws.

     9. Miscellaneous.

          (a) Governing Law. This Warrant shall be governed by and construed in accordance with
the laws of the State of California applicable to contracts made and to be performed wholly within
such state.

          (b) Restrictions. The Holder acknowledges that the Shares acquired upon the exercise
of this Warrant may have restrictions upon its resale imposed by state and federal securities laws.

          (c) Waivers Strictly Construed. With regard to any power, remedy or right provided
herein or otherwise available to any party hereunder (i) no waiver or extension of time shall be
effective unless expressly contained in a writing signed by the waiving party; and (ii) no
alteration, modification or impairment shall be implied by reason of any previous waiver, extension
of time, delay or omission in exercise, or other indulgence.

[remainder of page intentionally left blank]

 

 

          (d) Complete Agreement and Modifications. This Warrant constitutes the Company’s and
Holder’s entire agreement with respect to the subject matter hereof and supersedes all agreements,
representations, warranties, statements, promises and understandings, whether oral or written, with
respect to the subject matter hereof. This Warrant may not be amended, altered or modified except
by a writing signed by the Company and the Holder of this Warrant.

     IN WITNESS WHEREOF, SAVE THE WORLD AIR, INC. has caused this Warrant to be executed by its
duly authorized representative dated as of the date first set forth above.

	 	 	 	 	 
	 	SAVE THE WORLD AIR, INC.

5125 Lankershim Boulevard

North Hollywood, CA 91601

 	 
	 	By:  	 	 	 
	 	 	 	 
	 	 	 	 

 

 

NOTICE OF EXERCISE

TO: SAVE THE WORLD AIR, INC., a Nevada corporation

     (1) The undersigned hereby elects to purchase                      shares of Common Stock (the
“Shares”) of Save the World Air, Inc. pursuant to the terms of the attached Warrant, and tenders
herewith payment of the purchase price in full, together with all applicable transfer taxes, if
any.

     (2) Please issue a certificate or certificates representing the Shares in the name of the
undersigned or in such other name as is specified below:

	 	 	 	 	 
	 

	 	 	 	 
	 

	 	(Print Name)
	 	 
	 
	 	 	 	 
	 

	 	Address:	 	 
	 
	 	 	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	 

	 	 	 	 

     (3) The undersigned confirms that he is an “accredited investor” as defined by Rule 501(a)
under the Securities Act of 1933, as amended, at the time of execution of this Notice.

     (4) The undersigned confirms that the Shares are being acquired for the account of the
undersigned for investment only and not with a view to, or for resale in connection with, the
distribution thereof and that the undersigned has no present intention of distributing or selling
the Shares.

     (5) The undersigned accepts such Shares subject to the restrictions on transfer set forth in
the attached Warrant.

	 	 	 	 	 	 	 	 	 
	Date:
	 	 	 	 	 	 	 	 
	 

	 	 

	 	 	 

(Signature)
	 	 
	 
	 	 	 	 	 	 	 	 
	 
	 

	 	 	 	 	 

(Print Name)

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