Document:

EX-4.16

 EXHIBIT 4.16 
  

			
	RIGHTS CERTIFICATE #:	  	NUMBER OF RIGHTS:                        

 THE TERMS AND CONDITIONS OF THE RIGHTS OFFERING ARE SET FORTH IN THE COMPANY’S PROSPECTUS DATED MARCH [•], 2019 (THE
“PROSPECTUS”) AND ARE INCORPORATED HEREIN BY REFERENCE.COPIES OF THE PROSPECTUS ARE AVAILABLE UPON REQUEST FROM BROADRIDGE CORPORATE ISSUER SOLUTIONS, INC., THE INFORMATION AGENT FOR THE RIGHTS OFFERING. 

Galectin Therapeutics Inc. 

Incorporated under the laws of the State of Nevada 

NON-TRANSFERABLE SUBSCRIPTION RIGHTS CERTIFICATE 

Evidencing Non-Transferable Subscription Rights to Purchase Units of Galectin Therapeutics Inc. Subscription Price: to
be determined as set forth below 
 THE SUBSCRIPTION RIGHTS WILL EXPIRE IF NOT EXERCISED BEFORE 5:00 P.M., EASTERN TIME, ON [•], 2019, UNLESS EXTENDED
BY THE COMPANY 
 THIS CERTIFIES THAT 
 the registered owner
whose name is inscribed hereon is the owner of the number of non-transferable subscription rights set forth above (the “Rights”). Each Right gives the holder thereof the right to purchase from
Galectin Therapeutics Inc. a unit (the “Unit”) consisting of 0.3 shares of its common stock and a warrant to purchase 0.075 shares of its common stock (representing 25% warrant coverage) (the “Basic Subscription
Right”), at a subscription price (the “Subscription Price”) for each share of common stock in the offering and the related warrant equal to the lesser of (i) [•] (the “Initial Price”) and (ii) [•]
([•]% of the volume weighted average of our common stock for the five trading day period through and including the expiration date of the Rights as established by the Company (the “Alternate Price”). In addition, a Rights
holder that timely and fully exercises its Basic Subscription Rights will be eligible to subscribe (the “Over-Subscription Right”), at the Subscription Price, for any Units not purchased by other Rights holders through the exercise
of their Basic Subscription Right (the “Unsubscribed Units”). If the over-subscription requests exceed the available Unsubscribed Units, we will allocate the Unsubscribed Units as described in the Prospectus. The Rights represented
by this Certificate may be exercised by completing Form 1 and any other appropriate forms on the reverse side hereof and by returning payment of the full Subscription Price for each Unit in accordance with the Instructions for Use of Subscription
Rights Certificates that accompany this Certificate. 
 This Subscription Rights Certificate is not valid unless countersigned by the subscription agent and
registered by the registrar. Witness the seal of Galectin Therapeutics Inc. and the signatures of its duly authorized officers. 
  

							
	COUNTERSIGNED AND REGISTERED:	  		  	
			
	  
 Harold H. Shlevin,
President and CEO
	  		  	  
 Jack W. Callicutt, Chief Financial
Officer

				
	By:	 	  
	  		  	
		 	Continental Stock Transfer & Trust Company	  		  	

 DELIVERY OPTIONS FOR SUBSCRIPTION RIGHTS CERTIFICATE 

Delivery other than to the address listed below will not constitute valid delivery. 

Continental Stock Transfer & Trust Company, 1 State Street Plaza - 30th Floor, New York, NY 10004, Attn: Reorganization Department 

PLEASE PRINT ALL INFORMATION CLEARLY AND LEGIBLY 

FORM 1 – EXERCISE OF SUBSCRIPTION RIGHTS 
 To
subscribe for Units pursuant to your Basic Subscription Right, please complete lines (a) and (c) and sign under Form 2 below. To subscribe for Units pursuant to your Over-Subscription Right, please also complete line (b) and sign under
Form 2 below. To the extent you subscribe for more Units than you are entitled under either the Basic Subscription Right or the Over-Subscription Right, you will be deemed to have elected to purchase the maximum number of Units for which you are
entitled to subscribe under the Basic Subscription Right or the Over-Subscription Right, as applicable. 
 (a) EXERCISE OF BASIC SUBSCRIPTION RIGHT

  

															
	 I exercise
	  		  	x	  	1	  	=	  		  		  	
		  	  
	  		  	  
	  		  	  
	  		  	
		  	(no. of Rights)	  		  	(ratio)	  		  	(no. of Units)	  		  	
								
	 Therefore, I apply for
	  		  	x	  	$[•]	  	x	  	0.3	  	=	  	$
		  	  
	  		  	  
	  		  	  
	  		  	  

		  	(no. of Units)	  		  	(initial price)	  		  	(ratio)	  		  	(amount enclosed)

 (b) EXERCISE OF OVER-SUBSCRIPTION RIGHT 

If you have exercised your Basic Subscription Right in full, you may subscribe for additional Units in the Rights Offering pursuant to your Over-Subscription
Right: 
  

															
	 I apply for
	  		  	x	  	$[•]	  	x	  	0.3	  	=	  	$
		  	  
	  		  	  
	  		  	  
	  		  	  

		  	(no. of Units)	  		  	(initial price)	  		  	(ratio)	  		  	(additional amount enclosed)

 (c) Total Amount of Payment Enclosed (sum of amounts listed under lines (a) and (b)):
$                    . 
 METHOD OF PAYMENT
(CHECK ONE) 
  

	☐	 Cashier’s or certified check or bank draft drawn on a U.S. bank payable to “Continental Stock
Transfer & Trust Company, as Subscription Agent for Galectin Therapeutics Inc.”; 

  

	☐	 U.S. postal, telegraphic or express money order; or 

 

	☐	 wire transfer of immediately available funds directly to the account maintained by “Continental Stock
Transfer & Trust Company as agent for Galectin Therapeutics Inc.”; at Bank Name: JP Morgan Chase; ABA #: 021000021; Account #:
                    , with reference to the rights holder’s name and the account number listed on the Subscription Rights Certificate or
Notice of Guaranteed Delivery. 

 FORM 2 – SIGNATURE 

TO SUBSCRIBE: 
 I acknowledge that I have received the Prospectus
for this Rights Offering and I hereby irrevocably subscribe for the number of Units indicated above on the terms and conditions specified in the Prospectus. 
  

					
		 	  
 Signature of Owner
	 	
			
		 	  
 Signature of Joint Owner(s)
	 	

 If you wish for the Units issuable to you to be delivered to an address different than that shown on the face of this
Certificate, please enter the alternate address below and have your signature guaranteed as set forth below. 

                          
                                         
                                         
                         

IMPORTANT: The signature(s) must correspond with the name(s) as printed on the reverse of this Certificate in every particular, without alteration or
enlargement, or any other change whatsoever. When signing as attorney, executor, administrator, or other fiduciary, please give full title as such. Joint owners must each sign personally. 

SIGNATURE GUARANTEE 
  

					
		 	 Signature of Owner
	 	
			
		 	 Signature of Joint Owner(s)
	 	

 IMPORTANT: The signature(s) should be guaranteed by an eligible guarantor institution (bank, stock broker, savings &
loan association or credit union) with membership in an approved signature guarantee medallion program (STAMP, MSP, OR SEMP) pursuant to Securities and Exchange Commission Rule 17Ad-15. 

FOR INSTRUCTIONS ON THE USE OF GALECTIN THERAPEUTICS INC. SUBSCRIPTION RIGHTS CERTIFICATES, CONSULT BROADRIDGE CORPORATE ISSUER SOLUTIONS, INC., THE
INFORMATION AGENT FOR THE RIGHTS OFFERING, BY EMAIL AT SHAREHOLDER@BROADRIDGE.COM OR BY TELEPHONE AT 1-888-789-8409.EX-4.17

 EXHIBIT 4.17 

NEITHER THIS WARRANT CERTIFICATE NOR THE WARRANTS REPRESENTED HEREBY NOR ANY SHARES OF COMMON STOCK ISSUABLE UPON THE EXERCISE OF SUCH WARRANTS, NOR ANY
INTEREST IN OR RIGHTS UNDER SAME, HAVE BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933 OR THE LAWS OF ANY STATE, AND NEITHER THIS WARRANT CERTIFICATE NOR THE WARRANTS REPRESENTED HEREBY NOR ANY SHARES OF COMMON STOCK ISSUABLE UPON THE EXERCISE OF
SUCH WARRANTS, NOR ANY INTEREST IN OR RIGHTS UNDER SAME, MAY BE SOLD OR OTHERWISE TRANSFERRED UNLESS REGISTERED UNDER SUCH ACT AND APPLICABLE STATE SECURITIES LAWS OR AN EXEMPTION FROM REGISTRATION IS AVAILABLE. 

Warrant No. ____ 
 GALECTIN
THERAPEUTICS, INC. 
 COMMON STOCK PURCHASE WARRANT 

Galectin Therapeutics, Inc., a Nevada corporation (the “Company”), for value received and subject to the terms set forth below
hereby grants to                     , or its registered successors and assigns (the “Holder”), the right to purchase from the Company at
any time or from time to time until the date and time permitted under Section 2.1 below, [•] ([•]) fully paid and nonassessable shares of the Company’s Common Stock, par value $0.001 per share, at the
purchase price of [•] ($[•]) per share (the “Exercise Price”). The Exercise Price and the number and character of such shares of Common Stock purchasable pursuant to the rights granted under this
Warrant are subject to adjustment as provided herein. 
 1. Definitions. Capitalized terms used and not otherwise defined herein shall have the meanings set
forth in that certain Subscription Agreement. As used herein the following terms, unless the context otherwise requires, have the following respective meanings: 

“Common Stock” means the Company’s common stock, par value $0.001 per share, and stock of any other class
of securities into which such securities may hereafter have been reclassified or changed into, including any stock (other than Common Stock) and other securities of the Company or any other Person (corporate or other) which the Holder of this
Warrant at any time shall be entitled to receive, or shall have received, upon the exercise of this Warrant, in lieu of or in addition to Common Stock, or which at any time shall be issuable or shall have been issued in exchange for or in
replacement of Common Stock pursuant to Section 3.2 hereof or otherwise.. 
 “Common Stock Equivalents”
means any securities of the Company or its subsidiaries which would entitle the holder thereof to acquire at any time Common Stock, including, without limitation, any debt, preferred stock, right, option, warrant or other instrument that is at any
time convertible into or exercisable or exchangeable for, or otherwise entitles the holder thereof to receive, Common Stock. 

“Issue Date” means
                                , 201    . 

“Market Value” 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 (other than the OTC Bulletin Board), 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 Financial L.P. (based on a Trading Day from 9:30 a.m. Eastern Time to 4:00 p.m. Eastern Time); (b) if the Common Stock is then listed or quoted on the OTC Bulletin Board, the average
of the high and low price of the Common Stock for such date (or the nearest preceding date) on the OTC Bulletin Board; or (c) if the Common Stock is not then listed or quoted on a Trading Market and if prices for the Common Stock are then
reported in the “Pink Sheets” published by the Pink Sheets, LLC (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. 

  
 1 

 “Subscription Agreement” means the Non-Transferable Subscription Rights Certificate pursuant to which the original Holder exercised its right to purchase units consisting of 0.3 shares of Common Stock and a warrant to purchase 0.075 shares of Common
Stock under a Stockholder Rights Offering of the Company. 
 “This Warrant” means, collectively, this
Warrant and all other stock purchase warrants issued in exchange therefor or replacement thereof. 
 “Trading
Day” means a day on which the common Stock is traded on a Trading Market. 
 “Trading Market” means
any of the following markets or exchanges on which the common Stock is listed or quoted for trading on the date in question: the Nasdaq SmallCap Market, the NYSE Alternext US, the New York Stock Exchange, the Nasdaq National Market, the OTC Bulletin
Board or the “Pink Sheets”. 
 2. Exercise. 

2.1 Exercise Period. The Holder may exercise this Warrant at any time six months after the Issue Date and before 5:00 P.M. New York City Time
on the [•] anniversary of the Issue Date (the “Exercise Period”), unless earlier terminated pursuant to Section 3.2 herein. 

2.2 Exercise Procedure. 
 (a) This
Warrant will be deemed to have been exercised at such time as the Company has received all of the following items (the “Exercise Date”): 

(i) a completed Exercise Notice as described in Section 2.4 hereof, executed by the Person exercising all or part of the
purchase rights represented by this Warrant (the “Purchaser”); 
 (ii) this Warrant; 

(iii) if this Warrant is not registered in the name of the Purchaser, an Assignment or Assignments in the form set forth in
Exhibit B hereto, evidencing the assignment of this Warrant to the Purchaser together with any documentation required pursuant to Section 7 hereof; and 

(iv) a check payable to the order of the Company in an amount equal to the product of the Exercise Price multiplied by the
number of shares of Common Stock being purchased upon such exercise. 
 (b) As soon as practicable after the exercise of this Warrant in full
or in part, and in any event within ten (10) days after the Exercise Date, the Company at its expense will cause to be issued in the name of and delivered to the Purchaser, or as the Purchaser (upon payment by the Purchaser of any applicable
transfer taxes) may direct, a certificate or certificates for the number of fully paid and non-assessable shares of Common Stock to which the Purchaser shall be entitled upon such exercise, together with any
other stock or other securities and property (including cash, where applicable) to which the Purchaser is entitled upon exercise. 
 (c)
Unless this Warrant has expired or all of the purchase rights represented hereby have been exercised, the Company at its expense will, within ten (10) days after the Exercise Date, issue and deliver to or upon the order of the Purchaser a new
Warrant or Warrants of like tenor, in the name of the Purchaser or as the Purchaser (upon payment by the Purchaser of any applicable transfer taxes) may request, calling in the aggregate on the face or faces thereof for the number of shares of
Common Stock remaining issuable under this Warrant. 
 (d) The Common Stock issuable upon the exercise of this Warrant will be deemed to have
been issued to the Purchaser on the Exercise Date, and the Purchaser will be deemed for all purposes to have become the record holder of such Common Stock on the Exercise Date. 

  
 2 

 (e) The issuance of certificates for shares of Common Stock upon exercise of this Warrant
will be made without charge to the Holder or the Purchaser for any issuance tax in respect thereof or any other cost incurred by the Company in connection with such exercise and the related issuance of shares of Common Stock. 

(f) The holder represents and warrants that at the time of any exercise of this warrant the holder is an “accredited investor,” as
such term is defined in Rule 501 promulgated under the Securities Act and acknowledges and agrees that the Company may, in its sole discretion, (i) require, as a condition to the exercise of this Warrant, that the holder provide such written
evidence that such holder is an accredited investor as the time of exercise, and (ii) decline to issue the shares of Common Stock issuable upon such exercise if the Company is not satisfied that this warrant may be exercised by the holder
pursuant to a valid registration exemption from the Securities Act and any applicable state securities law. 
 2.3 Acknowledgement of
Continuing Obligations. The Company will, at the time of the exercise of this Warrant, upon the request of the Purchaser, acknowledge in writing its continuing obligation to afford to the Purchaser any rights to which the Purchaser shall continue to
be entitled after such exercise in accordance with the provisions of this Warrant, provided that if the Purchaser shall fail to make any such request, such failure shall not affect the continuing obligation of the Company to afford to the Purchaser
any such rights. 
 2.4 Exercise Notice. The Exercise Notice will be substantially in the form set forth in Exhibit A hereto,
except that if the shares of Common Stock issuable upon exercise of this Warrant are not to be issued in the name of the Purchaser, the Exercise Notice will also state the name of the Person to whom the certificates for the shares of Common Stock
are to be issued, and if the number of shares of Common Stock to be issued does not include all the shares of Common Stock issuable hereunder, it will also state the name of the Person to whom a new Warrant for the unexercised portion of the rights
hereunder is to be delivered. 
 2.5 Fractional Shares. If a fractional share of Common Stock would, but for the provisions of
Section 2.1 hereof, be issuable upon exercise of the rights represented by this Warrant, the Company will, within ten (10) days after the Exercise Date, deliver to the Purchaser a check payable to the Purchaser in lieu of such fractional
share, in an amount equal to the Market Value of such fractional share as of the close of business on the Exercise Date. 
 3. Adjustments. 

3.1 Adjustments for Stock Splits, Etc. If the Company shall at any time after the Issue Date subdivide its outstanding Common Stock, by split-up or otherwise, or combine its outstanding Common Stock, or issue additional shares of its capital stock in payment of a stock dividend in respect of its Common Stock, the number of shares issuable on the
exercise of the unexercised portion of this Warrant shall forthwith be proportionately increased in the case of a subdivision or stock dividend, or proportionately decreased in the case of a combination, and the Exercise Price then applicable to
shares covered by the unexercised portion of this Warrant shall forthwith be proportionately decreased in the case of a subdivision or stock dividend, or proportionately increased in the case of combination. 

3.2 Adjustment for Reclassification, Reorganization, Etc. In case of any reclassification, capital reorganization, or change of the outstanding
Common Stock (other than as a result of a subdivision, combination or stock dividend), or in the case of any consolidation of the Company with, or merger of the Company into, another Person (other than a consolidation or merger in which the Company
is the continuing corporation and which does not result in any reclassification or change of the outstanding Common Stock of the Company), or in case of any sale or conveyance to one or more Persons of the property of the Company as an entirety or
substantially as an entirety at any time prior to the expiration of this Warrant, then, as a condition of such reclassification, reorganization, change, consolidation, merger, sale or conveyance, lawful provision shall be made, and duly executed
documents evidencing the same from the Company or its successor shall be delivered to the Holder of this Warrant, so that the Holder of this Warrant shall have the right at any time prior to the expiration of this Warrant to purchase, at a total
price not to exceed that payable upon the exercise of the unexercised portion of this Warrant, the kind and amount of shares of stock and other securities and property receivable upon such reclassification, reorganization, change, consolidation,
merger, sale or conveyance by a holder of the number of shares of Common Stock of the Company as to which this Warrant was exercisable immediately prior to such reclassification, reorganization, change, consolidation, merger, sale or conveyance, and
in any such case appropriate provision shall be made with respect to the rights and interests of the Holder of this Warrant to the end that the provisions hereof (including, without limitation, provisions for the adjustment of the Exercise Price and
of the number of shares 

  
 3 

 
purchasable upon exercise of this Warrant) shall thereafter be applicable in relation to any shares of stock, and other securities and property, thereafter deliverable upon exercise hereof. If,
as a consequence of any such transaction, solely cash, and no securities or other property of any kind, is deliverable upon exercise of this Warrant, then, in such event, the Company may terminate this Warrant by giving the Holder hereof written
notice thereof. Such notice shall specify the date (at least thirty (30) days subsequent to the date on which notice is given) on which, at 3:00 P.M., Norcross, Georgia time, this Warrant shall terminate. Notwithstanding any such notice, this
Warrant shall remain exercisable, and otherwise in full force and effect, until such time of termination. 
 3.3 Certificate of Adjustment.
Whenever the Exercise Price or the number of shares issuable hereunder is adjusted, as herein provided, the Company shall promptly deliver to the registered Holder of this Warrant a certificate of the Treasurer of the Company, which certificate
shall state (i) the Exercise Price and the number of shares of Common Stock issuable hereunder after such adjustment, (ii) the facts requiring such adjustment, and (iii) the method of calculation for such adjustment and increase or
decrease. 
 3.4 Small Adjustments. No adjustment in the Exercise Price shall be required unless such adjustment would require an
increase or decrease in the Exercise Price of at least one percent; provided, however, that any adjustments which by reason of this Section 3.4 are not required to be made immediately shall be carried forward and taken into account at the time
of exercise of this Warrant or any subsequent adjustment in the Exercise Price which, singly or in combination with any adjustment carried forward, is required to be made under Sections 3.1 or 3.2.  

4. Reservation of Stock, etc., Issuable on Exercise of Warrant. The Company will at all times reserve and keep available, solely for issuance and
delivery upon the exercise of this Warrant, all shares of Common Stock from time to time issuable upon the exercise of this Warrant. 
 5. Disposition of
This Warrant, Common Stock, Etc. The Holder of this Warrant and any transferee hereof or of the Common Stock with respect to which this Warrant may be exercisable, by their acceptance hereof, hereby understand and agree that this Warrant has not
been registered under the Securities Act, and may not be sold, pledged, hypothecated, donated, or otherwise transferred (whether or not for consideration) without an effective registration statement under the Act or an opinion of counsel
satisfactory to the Company and/or submission to the Company of such other evidence as may be satisfactory to counsel to the Company, in each such case, to the effect that any such transfer shall not be in violation of the Act. It shall be a
condition to the transfer of this Warrant that any transferee thereof deliver to the Company its written agreement to accept and be bound by all of the terms and conditions of this Warrant. The foregoing notwithstanding, the Company acknowledges
that the shares of Common Stock to be issued upon the exercise of this Warrant have been registered under the Securities Act. 
 6. Rights and Obligations of
Warrant Holder. The Holder of this Warrant shall not, by virtue hereof, be entitled to any voting rights or other rights as a stockholder of the Company. No provision of this Warrant, in the absence of affirmative actions by the Holder to
purchase Common Stock of the Company by exercising this Warrant, and no enumeration in this Warrant of the rights or privileges of the Holder, will give rise to any liability of such Holder for the Exercise Price of Common Stock acquirable by
exercise hereof or as a stockholder of the Company. 
 7. Transfer of Warrants. Subject to compliance with the restrictions on transfer applicable to
this Warrant referred to in Section 5 hereof, this Warrant and all rights hereunder are transferable, in whole or in part, without charge to the registered Holder, upon surrender of this Warrant with a properly executed Assignment (in
substantially the form attached hereto as Exhibit B), to the Company, and the Company at its expense will issue and deliver to or upon the order of the Holder hereof a new Warrant or Warrants in such denomination or denominations as
may be requested, but otherwise of like tenor, in the name of the Holder or as the Holder (upon payment of any applicable transfer taxes) may direct. 
 8.
Replacement of Warrants. Upon receipt of evidence reasonably satisfactory to the Company of the loss, theft, destruction or mutilation of any Warrant and, in the case of any such loss, theft or destruction, upon delivery of an indemnity
agreement reasonably satisfactory in form and amount to the Company or, in the case of any such mutilation, upon surrender and cancellation of such Warrant, the Company at its expense will execute and deliver, in lieu thereof, a new Warrant of like
tenor. 
 9. Company Records. Until this Warrant is transferred on the books of the Company, the Company may treat the registered Holder hereof as the
absolute owner hereof for all purposes, notwithstanding any notice to the contrary. 

  
 4 

 10. Miscellaneous. 

10.1 Notices. All notices and other communications from the Company to the Holder of this Warrant shall be mailed by first class mail, postage prepaid, to such
address as may have been furnished to the Company in writing by such Holder, or, until an address is so furnished, to and at the address of the last Holder of this Warrant who has so furnished an address to the Company. All communications from the
Holder of this Warrant to the Company shall be mailed by first class mail, postage prepaid, to Galectin Therapeutics, Inc., 4960 Peachtree Industrial Boulevard, Suite 240, Norcross, GA 30071, Attn: 

Chief Financial Officer, or such other address as may have been furnished to the Holder in writing by the Company. 

10.2 Amendment and Waiver. Except as otherwise provided herein, this Warrant and any term hereof may be amended, waived, discharged or terminated only by an
instrument in writing signed by the party against which enforcement of such amendment, waiver, discharge or termination is sought. 
 10.3 Governing Law;
Descriptive Headings. This Warrant shall be construed and enforced in accordance with and governed by the laws of the State of Delaware. The headings in this Warrant are for purposes of reference only, and shall not limit or otherwise affect any of
the terms hereof. 
 [SIGNATURE ON FOLLOWING PAGE] 

  
 5 

Dated:                        , 2019.

  

			
	GALECTIN THERAPEUTICS, INC.

 
			
		
	By:	 	  

 
			
	Name:	 	
	Title:	 	

  
 6 

 EXHIBIT A 

EXERCISE NOTICE 
 [To be signed
only upon exercise of Warrant] 
  

			
	To:	  	Date:

 The undersigned, the Holder of the within Warrant, pursuant to the provisions set forth in the within Warrant,
hereby irrevocably elects to exercise the purchase rights represented by such Warrant for, and agrees to subscribe for and purchase thereunder,                shares of
the Common Stock covered by such Warrant and herewith makes payment of $                therefor, and requests that the certificates for such shares be issued in the
name of, and delivered to,                , whose address is:                . If said
number of shares is less than all the shares covered by such Warrant, a new Warrant shall be registered in the name of the undersigned and delivered to the address stated below. 

 

			
	Signature	 	  

		
		 	(Signature must conform in all respects to name of Holder as specified on the face of the Warrant or on the form of Assignment attached as Exhibit B thereto.)
		
	Address	 	  

		
		 	  

	
	[Signature Guarantee]

  
 7 

 EXHIBIT B 

ASSIGNMENT 
 [To be signed only
upon transfer of Warrant] 
 For value received, the undersigned hereby sells, assigns and transfers all of the rights of the undersigned
under the within Warrant with respect to the number of shares of the Common Stock covered thereby set forth below, unto: 
  

					
	Name of Assignee	  	Address	  	No. of Shares

  

							
	Dated:	 	    	 	Signature	 	
				
		 		 		 	(Signature must conform in all respects to name of Holder as specified on the face of the Warrant.)
				
		 		 	Address	 	
			
		 		 	[Signature Guarantee]

  

  
 8

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00293-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00293-of-00352.parquet"}]]