Document:

Exhibit 10.1

 

FORM OF

 

AGREEMENT REGARDING

CHANGE IN CONTROL

 

THIS AGREEMENT
(“Agreement”) is made and entered into as of ___________ ____, 202
___ (the “Effective Date”), by and between AbbVie Inc. (the
 “Company”)
and _____________ (the
 “Executive”).

 

WITNESSETH THAT:

 

WHEREAS, the Company considers it essential to
the best interests of its shareholders to foster the continuous employment of key management personnel, and the Board of Directors of
the Company (the “Board”) recognizes that, as is the case with many publicly held corporations, a change in control might
occur and that such possibility, and the uncertainty and questions which it may raise among management, may result in the departure or
distraction of management personnel to the detriment of the Company and its shareholders; and

 

WHEREAS, the Board has determined that appropriate
steps should be taken to reinforce and encourage the continued attention and dedication of members of the Company’s management,
including the Executive, to their assigned duties without distraction in the face of potentially disturbing circumstances arising from
the possibility of a change in control of the Company;

 

NOW, THEREFORE, to induce the Executive to remain
in the employ of the Company and in consideration of the premises and mutual covenants set forth herein, IT IS HEREBY AGREED by and
between the parties as follows:

 

1.            AGREEMENT
TERM. The initial “Agreement Term” shall begin on the Effective Date and continue through December 31, 2027 (the initial
 “Expiration Date”). The Agreement Term may be extended beyond the Expiration Date. If notification of extension is provided
before an Expiration Date, the Agreement Term shall continue through the fifth anniversary of the applicable Expiration Date. If notification
of non-extension is provided before an Expiration Date, the Agreement Term shall expire on the first anniversary of the date of such notification
(but in no event prior to such Expiration Date). If no notification regarding Agreement Term extension or non-extension is provided prior
to an Expiration Date, the Agreement Term shall expire on the first anniversary of such Expiration Date. Each time the Agreement Term
is extended, the procedure described in the foregoing sentences shall repeat. Notwithstanding the foregoing, if a Change in Control (as
defined in Section 7 below) occurs during the Agreement Term, the Agreement Term shall continue through and terminate on the second
anniversary of the date on which the Change in Control occurs.

 

2.            ENTITLEMENT
TO CHANGE IN CONTROL BENEFITS. The Executive shall be entitled to the change in control benefits described in Section 3 hereof if
the Executive’s employment by the Company is terminated during the Agreement Term but after a Change in Control (i) by the
Company for any reason other than Permanent Disability or Cause or (ii) by the Executive for Good Reason. For purposes of this Agreement:

 

     

     

    

 

(a)            A
termination of the Executive’s employment shall be treated as a termination by reason of “Permanent Disability” only
if, by reason of any medically determinable physical or mental impairment that can be expected to result in death or can be expected to
last for a continuous period of not less than twelve months, the Executive is unable to engage in any substantial gainful activity or
is receiving income replacement benefits under an accident and health plan provided by the Company for a period of not less than three
months.

 

(b)            The
term “Cause” shall mean the willful engaging by the Executive in illegal conduct or gross misconduct which is demonstrably
and materially injurious to the Company. For purposes of this Agreement, no act, or failure to act, on the Executive’s part shall
be deemed “willful” unless done, or omitted to be done, by the Executive not in good faith and without reasonable belief that
the Executive’s action or omission was in the best interest of the Company. Notwithstanding the foregoing, the Executive shall not
be deemed to have been terminated for Cause unless and until the Company delivers to the Executive a copy of a resolution duly adopted
by the affirmative vote of not less than three-quarters of the entire membership of the Board at a meeting of the Board called and held
for such purpose (after reasonable notice to the Executive and an opportunity for the Executive, together with counsel, to be heard before
the Board) finding that, in the good faith opinion of the Board, the Executive was guilty of conduct set forth above and specifying the
particulars thereof in detail.

 

(c)            The
term “Good Reason” shall mean the occurrence of any of the following circumstances without the Executive’s express written
consent:

 

(i)            a
significant adverse change in the nature, scope, or status of the Executive’s position, authorities, or duties from those in effect
immediately prior to the Change in Control, including, without limitation, if the Executive was, immediately prior to the Change in Control,
an executive officer of a public company, the Executive ceasing to be an executive officer of a public company;

 

(ii)            the
failure by the Company to pay the Executive any portion of the Executive’s current compensation, or to pay the Executive any portion
of any installment of deferred compensation under any deferred compensation program of the Company, within seven (7) days of the
date such compensation is due;

 

(iii)            a
reduction in the Executive’s annual base salary (or a material change in the frequency of payment) as in effect immediately prior
to the Change in Control as the same may be increased from time to time;

 

(iv)            the
failure by the Company to award the Executive an annual bonus in any year which is at least equal to the annual bonus, awarded to the
Executive under the annual bonus plan of the Company for the year immediately preceding the year of the Change in Control;

 

(v)            the
failure by the Company to award the Executive equity-based incentive compensation (such as stock options, shares of restricted stock,
restricted stock units, or other equity-based compensation) on a periodic basis consistent with the Company’s practices with respect
to timing, value, and terms prior to the Change in Control;

 

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(vi)            the
failure by the Company to continue to provide the Executive with the welfare benefits, fringe benefits, and perquisites enjoyed by the
Executive immediately prior to the Change in Control under any of the Company’s plans or policies, including, but not limited to,
those plans and policies providing pension, life insurance, medical, health and accident, disability, vacation, executive automobile,
executive tax or financial advice benefits or club dues;

 

(vii)            the
relocation of the Company’s principal executive offices to a location more than thirty-five miles from the location of such offices
immediately prior to the Change in Control or the Company requiring the Executive to be based anywhere other than the location where the
Executive primarily performs services for the Company immediately prior to the Change in Control except for required travel for the Company’s
business to an extent substantially consistent with the Executive’s business travel obligations immediately prior to the Change
in Control; or

 

(viii)            the
failure of the Company to obtain a satisfactory agreement from any successor to the Company to assume and agree to perform this Agreement
as contemplated by Section 17.

 

For purposes of any determination regarding the existence
of Good Reason, any good faith determination by the Executive that Good Reason exists shall be conclusive.

 

3.            CHANGE
IN CONTROL BENEFITS. In the event of a termination of employment entitling the Executive to benefits in accordance with Section 2,
the Executive shall receive the following:

 

(a)            The
Executive shall be entitled to receive the following employee welfare benefits, provided that such benefits were provided to the Executive
immediately prior to the Change in Control: medical, accident, dental, prescription, and life insurance
coverage for the Executive (and, where applicable under the Company’s welfare benefit plans, the Executive’s family) through
the second anniversary of the Executive’s date of termination of employment, or, if earlier, the date on which the Executive becomes
employed by another employer. The benefits provided by the Company shall be no less favorable in terms of coverage and cost to the Executive
than those provided under the Company’s welfare benefit plans applicable to the Executive (and, where applicable, the Executive’s
family) prior to the Change in Control, determined as if the Executive remained in the employ of the Company through such second anniversary.
For purposes of determining eligibility of the Executive for retiree welfare benefits, the Executive shall be considered to have remained
in the employ of the Company through such second anniversary.

 

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(b)            If
the Executive’s date of termination occurs after the end of a performance period applicable to an annual incentive (bonus) award,
and prior to the payment of the award for the period, the Executive shall be entitled to a lump sum payment in cash no later than twenty
(20) business days after the date of termination equal to the greatest of (i) the Executive’s annual incentive (bonus) award
for that period, as determined under the terms of that incentive award arrangement; (ii) the Executive’s annual incentive
(bonus) award for that period, with the determination of the amount of such award based on an assumption that the target level of performance
had been achieved; or (iii) the Executive’s average annual incentive (bonus) award for the three annual performance periods
preceding that period (provided that if the Executive was not a participant in the incentive award arrangement for any of those three
prior years, the averaging period shall be reduced from three years to the number of years during the three year period in which the
Executive was a participant; and further provided that if the Executive’s award for any such year was reduced because the Executive
was not a participant for the full year, such amount shall be annualized for purposes of the computation in this clause (iii)).

  

(c)            For
any annual incentive (bonus) plan or arrangement in which the Executive participates for the performance period in which the Executive’s
termination of employment occurs, the Executive shall be entitled to a lump sum payment in cash no later than twenty (20) business days
after the date of termination equal to the greater of (i) the Executive’s annual incentive (bonus) award for the performance
period that includes the date of termination, with the determination of the amount of such award based on an assumption that the target
level of performance has been achieved, or (ii) the Executive’s average annual incentive (bonus) award for the three annual
performance periods preceding the performance period that includes the date of termination (provided that if the Executive was not a participant
in the incentive award arrangement for any of those three prior years, the averaging period shall be reduced from three years to the number
of years during the three year period in which the Executive was a participant; and further provided that if the Executive’s award
for any such year was reduced because the Executive was not a participant for the full year, such amount shall be annualized for purposes
of the computation in this clause (ii)); provided that such payment shall be subject to a pro-rata reduction to reflect the number of
days in the performance period following the date of termination. The amount payable under this Section 3(c) shall be in lieu
of any amounts that may otherwise be due to the Executive with respect to any annual incentive (bonus) plan or arrangement in which the
Executive participates for the performance period in which the Executive’s date of termination occurs.

 

(d)            The
Executive shall be entitled to a lump sum payment in cash no later than twenty (20) business days after the Executive’s date of
termination equal to the sum of:

 

(i)            an
amount equal to 2.99 times the Executive’s annual salary rate in effect on the date of the Change in Control or, if greater, as
in effect immediately prior to the date of termination; plus

 

(ii)            an
amount equal to 2.99 times the greater of (x) the Executive’s annual incentive (bonus) award for the performance period that
includes the date of the Executive’s termination of employment, with the determination of the amount of such award based on an assumption
that the target level of performance has been achieved or (y) the Executive’s average annual incentive (bonus) award for the
three annual performance periods preceding the performance period that includes the date of termination (provided that if the Executive
was not a participant in the incentive award arrangement for any of those three prior years, the averaging period shall be reduced from
three years to the number of years during the three year period in which the Executive was a participant; and further provided that if
the Executive’s award for any such year was reduced because the Executive was not a participant for the full year, such amount shall
be annualized for purposes of the computation in this subsection (ii)); plus

 

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		(iii)	(A) or (B) or (C) below, as applicable:

 

(A)            if
the Executive is a participant in the AbbVie Supplemental Pension Plan (the “Supplemental Plan”), the lump sum present value
of the difference between the Enhanced Supplemental Plan Benefits (as defined below) and the total benefit to which the Executive is
then entitled under the Supplemental Plan. The Enhanced Supplemental Plan Benefits shall mean the benefits under the Supplemental Plan
determined as if the Executive had been credited for benefit accrual purposes with three additional years of service and three additional
years of eligible earnings at the higher of the Executive’s eligible earnings on the date of termination and the Executive’s
eligible earnings on the date of the Change in Control and, for purposes of determining the Executive’s eligibility for subsidized
early retirement benefits, determined as if the Executive were three years older than the Executive’s actual age on the date of
termination. For purposes of the determination of the Enhanced Supplemental Plan Benefits, “eligible earnings” shall include
salary, annual incentive (bonus) awards, and all other forms of compensation used to calculate benefits under the Supplemental Plan.
The amounts of the annual incentive (bonus) awards shall be calculated, to the extent applicable, in accordance with Sections 3(b) and
3(c) above. The Enhanced Supplemental Plan Benefits shall be determined without regard to any termination or amendment (including
any amendment affecting actuarial factors) of such plan or of any other plan, which is adopted on or after a Change in Control or in
contemplation of a Change in Control and shall be paid in accordance with the terms of that plan and the Executive’s elections
under that plan;

 

(B)            if
the Executive is not a participant in the Supplemental Plan but is a participant in a similar supplemental pension arrangement outside
the United States, the lump sum present value of the difference between the Enhanced Pension Plan Benefits (as defined below) and the
benefit to which the Executive is then entitled under the Pension Plan (as defined below). The Enhanced Pension Plan Benefits shall mean
the benefits under the Pension Plan determined as if the Executive had been credited for benefit accrual purposes with three (3) additional
years of service and three (3) additional years of eligible earnings at the higher of the Executive’s eligible earnings on
the date of termination and the Executive’s eligible earnings on the date of the Change in Control and, for purposes of determining
the Executive’s eligibility for any employer-subsidized early retirement benefits, determined as if the Executive were three years
older than the Executive’s actual age on the date of termination. For purposes of the determination of the Enhanced Pension Plan
Benefits, “eligible earnings” shall include salary, annual incentive (bonus) awards, and all other forms of compensation used
to calculate benefits under the Pension Plan. The amounts of the annual incentive (bonus) awards shall be calculated, to the extent applicable,
in accordance with Sections 3(b) and 3(c) above. The Enhanced Pension Plan Benefits shall be determined without regard to any
termination or amendment (including any amendment affecting actuarial factors) of such plan or of any other plan, which is adopted on
or after a Change in Control or in contemplation of a Change in Control and shall be paid in accordance with the terms of that plan and
the Executive’s elections under that plan. “Pension Plan” shall mean the pension or retirement plan or scheme of the
Company (or its applicable subsidiary) in which the Executive participates on the date of termination or the date of the Change in Control,
as applicable; or

 

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(C)            if
the Executive is neither an active participant in the Supplemental Plan nor an active participant in a similar supplemental pension arrangement
outside the United States but is a participant in the AbbVie Excess Plan Plus (the “Excess Plan”), then the Executive shall
receive an Enhanced Excess Plan Benefit (as defined below). The Enhanced Excess Plan Benefit shall equal the sum of:

 

(i) to the extent not previously credited to the Executive’s
account in the Excess Plan, the employer contributions under the Excess Plan calculated through the date of the Executive’s termination
of employment; plus

 

(ii) for each of the three years following the date of the Executive’s
termination, a contribution equal to 6% of the Executive’s eligible compensation (as defined in the AbbVie Savings Plan Plus (“ASP+”)
component of the AbbVie Savings Plan), assuming that the Executive received the same eligible compensation that the Executive received
during the most recent plan year and that there was no Internal Revenue Code limit on the amount of compensation that could be so recognized
(such assumed compensation referred to herein as “Enhanced Excess Plan Compensation”) and assuming, further, that the 415
Limit (as defined in the Excess Plan) did not apply; plus

 

(ii) the annual company contributions the Executive would have
received under ASP+ for the three years following the Executive’s termination of employment based on the Executive’s age during
the applicable year, based on the Executive’s Enhanced Excess Plan Compensation (as described above), and assuming the 415 Limit
did not apply.

 

The Executive shall receive the contributions specified above
without regard to any service requirements, last day of the year requirement, or other requirements. The Enhanced Excess Plan Benefit
shall be determined without regard to any termination or amendment of the Excess Plan or of any other plan that is adopted on or after
a Change in Control or in contemplation of a Change in Control and shall be paid in a lump sum cash payment no later than twenty (20)
business days after the Executive’s date of termination. The Executive shall be fully vested in his entire Excess Plan Benefit.

 

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The
amounts payable under Sections 3(d)(i), 3(d)(ii), and 3(d)(iii) shall include the amounts, if any, to which the Executive would
otherwise be entitled as severance or notice pay under any severance pay plan or applicable law,
provided that if the amount to which the Executive is entitled as severance or notice pay under applicable law exceeds the amounts payable
under Sections 3(d)(i), 3(d)(ii), and 3(d)(iii), the Executive shall be entitled to such excess in accordance with the provisions of
applicable law. The amounts payable under Sections 3(d)(i), 3(d)(ii), and 3(d)(iii) shall be in addition to (and not inclusive
of) any amount payable under any written agreement(s) directly between the Executive and the Company or any of its subsidiaries.

 

(e)            If
the Executive has previously made a timely election with respect to bonuses payable under the AbbVie 2013 Management Incentive Plan, the
AbbVie Performance Incentive Plan, or any successor plans thereto, all or any portion of the amounts payable under Sections 3(b) and
3(c) (less applicable tax withholding) shall be paid directly to a grantor trust established by the Executive to the same extent
as and pursuant to such election no later than twenty (20) business days after the Executive’s date of termination.

 

(f)            The
Company shall provide the Executive with outplacement services and tax and financial counseling suitable to the Executive’s position
through the second anniversary of the date of the Executive’s termination of employment, or, if earlier, the date on which the Executive
becomes employed by another employer.

 

If the Executive is a participant in the AbbVie
Performance Incentive Plan or any successor thereto, the Executive’s annual incentive (bonus) award for the performance period which
includes the date of termination under Sections 3(c) and 3(d)(ii) above and, if applicable, for the period preceding the date
of termination under Section 3(b) shall be determined under the bonus levels communicated in writing to the Executive by the
Company for such year and shall not be the Executive’s individual base award allocation as defined in the AbbVie Performance Incentive
Plan (or any corresponding provision of any successor plan).

 

4.            MITIGATION.
The Executive shall not be required to mitigate the amount of any payment provided for in this Agreement by seeking other employment or
otherwise. Except as set forth in Section 3(a) with respect to benefits, the Company shall not be entitled to set off against
the amounts payable to the Executive under this Agreement any amounts owed to the Company by the Executive, any amounts earned by the
Executive in other employment after the Executive’s termination of employment with the Company, or any amounts which might have
been earned by the Executive in other employment had the Executive sought such other employment.

 

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5.            CODE
SECTION 280G.

 

(a)            Anything
in this Agreement to the contrary notwithstanding, in the event that the Accounting Firm (as defined below) determines that receipt of
all Payments (as defined below) would subject the Executive to the tax under Section 4999 of the Internal Revenue Code of 1986, as
amended (the “Code”), the Accounting Firm shall determine whether to reduce any of the Agreement Payments (as defined below)
to the Executive so that the Parachute Value (as defined below) of all Payments to the Executive, in the aggregate, equals the applicable
Safe Harbor Amount (as defined below). Agreement Payments shall be so reduced only if the Accounting Firm determines that the Executive
would have a greater Net After-Tax Receipt (as defined below) of aggregate Payments if the Agreement Payments were so reduced. If the
Accounting Firm determines that the Executive would not have a greater Net After-Tax Receipt of aggregate Payments if the Agreement Payments
were so reduced, the Executive shall receive all Agreement Payments to which the Executive is entitled hereunder.

  

(b)            If
the Accounting Firm determines that the aggregate Agreement Payments to the Executive should be reduced so that the Parachute Value of
all Payments to the Executive, in the aggregate, equals the applicable Safe Harbor Amount, the Company shall promptly give the Executive
notice to that effect and a copy of the detailed calculation thereof. All determinations made by the Accounting Firm under this Section 5
shall be binding upon the Company and the Executive and shall be made as soon as reasonably practicable and in no event later than fifteen
(15) days following the date of the Executive’s termination of employment. For purposes of reducing the Agreement Payments to the
Executive so that the Parachute Value of all Payments to the Executive, in the aggregate, equals the applicable Safe Harbor Amount, only
Agreement Payments (and no other Payments) shall be reduced. The reduction contemplated by this Section 5, if applicable, shall
be made by reducing payments and benefits (to the extent such amounts are considered Payments) under the following sections in the following
order: (i) any Payments under Section 3(e); (ii) any Payments under Section 3(d); and (iii) any other cash Agreement
Payments that would be made upon a termination of the Executive’s employment, beginning with payments that would be made last in
time.

 

(c)            As
a result of the uncertainty in the application of Code Section 4999 at the time of the initial determination by the Accounting Firm
hereunder, it is possible that amounts will have been paid or distributed by the Company to or for the benefit of the Executive pursuant
to this Agreement that should not have been so paid or distributed (each an “Overpayment”) or that additional amounts which
will have not been paid or distributed by the Company to or for the benefit of the Executive pursuant to this Agreement could have been
so paid or distributed (each an “Underpayment”), in each case consistent with the calculation of the applicable Safe Harbor
Amount hereunder. In the event that the Accounting Firm, based on the assertion of a deficiency by the Internal Revenue Service against
the Company or the Executive which the Accounting Firm believes has a high probability of success, determines that an Overpayment has
been made, any such Overpayment paid or distributed by the Company to or for the benefit of the Executive shall be repaid by the Executive
to the Company, together with interest at the applicable federal rate provided for in Code Section 7872(f)(2); provided, however,
that no such repayment shall be required if and to the extent such deemed repayment would not either reduce the amount on which the Executive
is subject to tax under Code Sections 1 and 4999 or generate a refund of such taxes. In the event that the Accounting Firm, based
on controlling precedent or substantial authority, determines that an Underpayment has occurred, any such Underpayment shall be promptly
paid by the Company to or for the benefit of the Executive, together with interest at the applicable federal rate provided for in Code
Section 7872(f)(2).

 

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(d)            In
connection with making determinations under this Section 5, the Accounting Firm shall take into account the value of any reasonable
compensation for services to be rendered by the Executive before or after the Change in Control, including any noncompetition provisions
that may apply to the Executive, and the Company shall cooperate in the valuation of any such services, including any noncompetition provisions.

 

(e)            All
fees and expenses of the Accounting Firm in implementing the provisions of this Section 5 shall be borne by the Company.

 

(f)            Definitions.
The following terms shall have the following meanings for purposes of this Section 5.

 

(i)            “Accounting
Firm” shall mean a nationally recognized certified public accounting firm that is selected by the Company for purposes of making
the applicable determinations hereunder, which firm shall not, without the Executive’s consent, be a firm serving as accountant
or auditor for the individual, entity, or group effecting the Change in Control.

 

(ii)            “Agreement
Payment” shall mean a Payment paid or payable pursuant to this Agreement.

 

(iii)            “Net
After-Tax Receipt” shall mean the Present Value of a Payment net of all taxes imposed on the Executive with respect thereto under
Code Sections 1 and 4999 and under applicable state, local, and foreign laws, determined by applying the highest marginal rate under Code
Section 1 and under state, local, and foreign laws that applied to the Executive’s taxable income for the immediately preceding
taxable year, or such other rate as the Executive shall certify, in the Executive’s sole discretion, as likely to apply to the Executive
in the relevant tax year.

 

(iv)            “Parachute
Value” of a Payment shall mean the present value as of the date of the Change in Control for purposes of Code Section 280G
of the portion of such Payment that constitutes a “parachute payment” under Code Section 280G(b)(2), as determined by
the Accounting Firm for purposes of determining whether and to what extent the excise tax under Code Section 4999 will apply to such
Payment.

 

(v)            “Payment”
shall mean any payment or distribution in the nature of compensation (within the meaning of Code Section 280G(b)(2)) to or for the
benefit of the Executive, whether paid or payable pursuant to this Agreement or otherwise.

 

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(vi)            “Present
Value” of a Payment shall mean the economic present value of a Payment as of the date of the Change in Control for purposes of Code
Section 280G, as determined by the Accounting Firm using the discount rate required by Code Section 280G(d)(4).

  

(vii)            “Safe
Harbor Amount” means (x) 3.0 times the Executive’s “base amount,” within the meaning of Code Section 280G(b)(3),
minus (y) $1.00.

 

6.            TERMINATION
DURING POTENTIAL CHANGE IN CONTROL. If a Potential Change in Control (as defined in Section 8) occurs during the Agreement Term,
and the Company terminates the Executive’s employment for reasons other than Permanent Disability or Cause during such Potential
Change in Control, the Executive shall be entitled to receive the benefits that the Executive would have received under Section 3,
such benefits to be calculated based on the Executive’s compensation prior to the actual termination of employment and such benefits
to be paid within twenty (20) business days of the date of such termination; provided, however, that if the Executive is then a “covered
employee” as defined under Code Section 162(m), with respect to (a) any annual incentive (bonus) award under Section 3(b) and
(b) any annual incentive (bonus) award under Section 3(c), (i) the Executive shall be entitled to receive such annual incentive
(bonus) awards only based on achievement of the applicable performance goals, as determined by the terms of the applicable incentive award
arrangement, and (ii) upon the occurrence of a Change in Control that (A) qualifies as a “change in control event”
(within the meaning of Treasury Regulation Section 1.409A-3(i)(5)) and (B) results from the consummation of the Potential Change
in Control in connection with which the Executive was terminated, the Executive shall also be entitled to receive the excess of (x) the
annual incentive (bonus) awards that the Executive would have received under Sections 3(b) and 3(c) over (y) the amount
paid to the Executive under clause 6(b)(i) above, which awards shall be paid to the Executive within twenty (20) business days
of the date of the occurrence of such Change in Control.

 

7.            CHANGE
IN CONTROL. For purposes of this Agreement, a “Change in Control” shall be deemed to have occurred on the earliest of the
following dates:

 

(a)            the
date any Person is or becomes the Beneficial Owner, directly or indirectly, of securities of the Company (not including, in the securities
beneficially owned by such Person, any securities acquired directly from the Company or its Affiliates) representing 20% or more of the
combined voting power of the Company’s then outstanding securities, excluding any Person who becomes such a Beneficial Owner in
connection with a transaction described in clause (i) of Section 7(c) below; or

 

(b)            the
date on which the following individuals cease for any reason to constitute a majority of the number of directors then serving on the Board:
individuals who, on the date hereof, constitute the Board and any new director (other than a director whose initial assumption of office
is in connection with an actual or threatened election contest, including, but not limited to, a consent solicitation, relating to the
election of directors of the Company) whose appointment or election by the Board or nomination for election by the Company’s shareholders
was approved or recommended by a vote of at least two-thirds (2/3) of the directors then still in office either who were directors on
the date hereof or whose appointment, election, or nomination for election was previously so approved or recommended; or

 

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(c)            the
date on which there is consummated a merger or consolidation of the Company or any direct or indirect subsidiary of the Company with any
other corporation or other entity, other than (i) a merger or consolidation (A) immediately following which the individuals
who comprise the Board immediately prior thereto constitute at least a majority of the board of directors of the Company, the entity surviving
such merger or consolidation, or, if the Company or the entity surviving such merger or consolidation is then a subsidiary, the ultimate
parent thereof and (B) which results in the voting securities of the Company outstanding immediately prior to such merger or consolidation
continuing to represent (either by remaining outstanding or by being converted into voting securities of the surviving entity or any parent
thereof), in combination with the ownership of any trustee or other fiduciary holding securities under an employee benefit plan of the
Company or any subsidiary of the Company, at least 50% of the combined voting power of the securities of the Company or such surviving
entity or any parent thereof outstanding immediately after such merger or consolidation; or (ii) a merger or consolidation effected
to implement a recapitalization of the Company (or similar transaction) in which no Person is or becomes the Beneficial Owner, directly
or indirectly, of securities of the Company (not including, in the securities Beneficially Owned by such Person, any securities acquired
directly from the Company or its Affiliates) representing 20% or more of the combined voting power of the Company’s then outstanding
securities; or

 

(d)            the
date on which the shareholders of the Company approve a plan of complete liquidation or dissolution of the Company or there is consummated
an agreement for the sale or disposition by the Company of all or substantially all of the Company’s assets, other than a sale
or disposition by the Company of all or substantially all of the Company’s assets to an entity, at least 50% of the combined voting
power of the voting securities of which are owned by shareholders of the Company, in combination with the ownership of any trustee or
other fiduciary holding securities under an employee benefit plan of the Company or any subsidiary of the Company, in substantially the
same proportions as their ownership of the Company immediately prior to such sale.

 

Notwithstanding the foregoing, a “Change
in Control” shall not be deemed to have occurred by virtue of the consummation of any transaction or series of integrated transactions
immediately following which the record holders of the common stock of the Company immediately prior to such transaction or series of transactions
continue to have substantially the same proportionate ownership in an entity which owns all or substantially all of the assets of the
Company immediately following such transaction or series of transactions.

 

For purposes of this Agreement, “Affiliate”
shall have the meaning set forth in Rule 12b-2 promulgated under Section 12 of the Exchange Act; “Beneficial Owner”
shall have the meaning set forth in Rule 13d-3 under the Exchange Act; “Exchange Act” shall mean the Securities Exchange
Act of 1934, as amended from time to time; and “Person” shall have the meaning given in Section 3(a)(9) of the Exchange
Act, as modified and used in Sections 13(d) and 14(d) thereof, except that such term shall not include (i) the Company
or any of its subsidiaries, (ii) a trustee or other fiduciary holding securities under an employee benefit plan of the Company or
any of its Affiliates, (iii) an underwriter temporarily holding securities pursuant to an offering of such securities, or (iv) a
corporation owned, directly or indirectly, by the shareholders of the Company in substantially the same proportions as their ownership
of stock of the Company.

 

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8.            POTENTIAL
CHANGE IN CONTROL. A “Potential Change in Control” shall exist during any period in which the circumstances described in Section (a),
(b), (c), or (d), below, exist (provided, however, that a Potential Change in Control shall cease to exist not later than the occurrence
of a Change in Control):

 

(a)            The
Company enters into an agreement, the consummation of which would result in the occurrence of a Change in Control, provided that a Potential
Change in Control described in this Section 8(a) shall cease to exist upon the expiration or other termination of all such agreements.

 

(b)            Any
Person (without regard to the exclusions set forth in subsections (i) through (iv) of such definition) publicly announces
an intention to take or to consider taking actions the consummation of which would constitute a Change in Control; provided that a Potential
Change in Control described in this Section 8(b) shall cease to exist upon the withdrawal of such intention, or upon a determination
by the Board that there is no reasonable chance that such actions would be consummated.

 

(c)            Any
Person becomes the Beneficial Owner, directly or indirectly, of securities of the Company representing 10% or more of either the then
outstanding shares of common stock of the Company or the combined voting power of the Company’s then outstanding securities (not
including, in the securities beneficially owned by such Person, any securities acquired directly from the Company or its Affiliates).

 

(d)            The
Board adopts a resolution to the effect that, for purposes of this Agreement, a Potential Change in Control exists; provided that a Potential
Change in Control described in this Section 8(d) shall cease to exist upon a determination by the Board that the reasons that
gave rise to the resolution providing for the existence of a Potential Change in Control have expired or no longer exist.

 

9.            EQUITY
AWARDS. With respect to any award granted to the Executive under the Company’s 2013 Amended and Restated Incentive Stock Program
(the “Program”) or any successor program, the following shall apply:

 

(a)            if
the award (other than an incentive stock option granted pursuant to Code Section 422 (an “Incentive Stock Option”)) includes
a provision substantially similar to the applicable provision in Appendix A, then after a Change in Control, no forfeiture shall be effected
pursuant to such provision with respect to the Executive unless the Executive has been terminated for “Cause” within the meaning
of Section 2(b) above; and

 

(b)            if
the Executive becomes entitled to severance benefits under Section 2(b) above, then in determining the Executive’s rights
with respect to that award, other than Incentive Stock Options, the Executive shall be treated as having incurred a termination of employment
due to retirement.

 

    12

     

    

10.            WITHHOLDING.
All payments to the Executive under this Agreement will be subject to withholding of applicable taxes. The Company shall withhold the
applicable taxes in an amount calculated at the minimum statutory rate and shall pay the amount so withheld to the appropriate tax authority.

  

11.            CODE
SECTION 409A. To the extent applicable, it is intended that the Agreement be in accordance with the provisions of Code Section 409A.
The Agreement will be administered and interpreted in a manner consistent with this intent, and any provision that would cause the Agreement
to fail to satisfy Code Section 409A will have no force and effect until amended to comply therewith (which amendment may be retroactive
to the extent permitted by Code Section 409A). To the extent Code Section 409A applies, and notwithstanding anything contained
herein to the contrary, for all purposes of this Agreement, the Executive shall not be deemed to have had a termination of employment
unless the Executive has incurred a separation from service as defined in Treasury Regulation §1.409A-1(h), and, to the extent required
to avoid accelerated taxation and/or tax penalties under Code Section 409A and applicable guidance issued thereunder, payment of
the amounts payable under the Agreement that would otherwise be payable during the six-month period after the date of termination shall
instead be paid on the first business day after the expiration of such six-month period. In addition, for purposes of the Agreement, each
amount to be paid and each installment payment shall be construed as a separate, identified payment for purposes of Code Section 409A.
With respect to expenses eligible for reimbursement under the terms of this Agreement, (i) the amount of such expenses eligible for
reimbursement in any taxable year shall not affect the expenses eligible for reimbursement in another taxable year and (ii) any reimbursements
of such expenses shall be made no later than the end of the calendar year following the calendar year in which the related expenses were
incurred, except, in each case, to the extent that the right to reimbursement does not provide for a “deferral of compensation”
within the meaning of Code Section 409A.

 

12.            NONALIENATION.
The interests of the Executive under this Agreement are not subject in any manner to anticipation, alienation, sale, transfer, assignment,
pledge, encumbrance, attachment, or garnishment by creditors of the Executive or the Executive’s beneficiary.

 

13.            AMENDMENT.
This Agreement may be amended or canceled only by mutual agreement of the parties in writing without the consent of any other person.
So long as the Executive lives, no person, other than the parties hereto, shall have any rights under or interest in this Agreement or
the subject matter hereof.

 

14.            APPLICABLE
LAW. The provisions of this Agreement shall be construed in accordance with the laws of the State of Illinois, without regard to the conflict
of law provisions of any state.

 

15.            SEVERABILITY.
The invalidity or unenforceability of any provision of this Agreement will not affect the validity or enforceability of any other provision
of this Agreement, and this Agreement will be construed as if such invalid or unenforceable provision were omitted (but only to the extent
that such provision cannot be appropriately reformed or modified).

 

16.            WAIVER
OF BREACH. No waiver by any party hereto of a breach of any provision of this Agreement by any other party, or of compliance with any
condition or provision of this Agreement to be performed by such other party, will operate or be construed as a waiver of any subsequent
breach by such other party of any similar or dissimilar provisions and conditions at the same or any prior or subsequent time. The failure
of any party hereto to take any action by reason of such breach will not deprive such party of the right to take action at any time while
such breach continues.

 

    13

     

    

 

17.            SUCCESSORS,
ASSUMPTION OF CONTRACT. This Agreement shall be binding upon and inure to the benefit of the Company and any successor of the Company.
The Company will require any successor (whether direct or indirect, by purchase, merger, consolidation, or otherwise) to all or substantially
all of the business and/or assets of the Company to expressly assume and agree to perform this Agreement in the same manner and to the
same extent that the Company would be required to perform it if no succession had taken place. This Agreement is personal to the Executive
and may not be assigned by the Executive without the written consent of the Company. However, to the extent that rights or benefits under
this Agreement otherwise survive the Executive’s death, the Executive’s heirs and estate shall succeed to such rights and
benefits pursuant to the Executive’s will or the laws of descent and distribution; provided that the Executive shall have the right
at any time and from time to time, by notice delivered to the Company, to designate or to change the beneficiary or beneficiaries with
respect to such benefits.

 

18.            NOTICES.
Notices and all other communications provided for in this Agreement shall be in writing and shall be delivered personally or sent by registered
or certified mail, return receipt requested, postage prepaid (provided that international mail shall be sent via overnight or two-day
delivery), or sent by facsimile or prepaid overnight courier to the parties at the addresses set forth below. Such notices, demands, claims,
and other communications shall be deemed given:

 

(a)            in
the case of delivery by overnight service with guaranteed next day delivery, the next day or the day designated for delivery;

 

(b)            in
the case of certified or registered U.S. mail, five (5) days after deposit in the U.S. mail; or

 

(c)            in
the case of facsimile, the date upon which the transmitting party received confirmation of receipt by facsimile, telephone, or otherwise;

 

provided, however, that in no event shall any such communications be
deemed to be given later than the date they are actually received. Communications that are to be delivered by the U.S. mail or by overnight
service or two-day delivery service are to be delivered to the addresses set forth below:

 

to the Company:

 

Executive
Vice President, Human Resources

AbbVie Inc. 

1 North Waukegan Road 

North Chicago, Illinois 60064

 

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

 

General
Counsel and Secretary

AbbVie Inc. 

1 North Waukegan Road 

North Chicago, Illinois 60064

 

or to the Executive:

 

Name

Address

City, State Zip

 

Each party, by written notice furnished to the other party, may modify
the applicable delivery address, except that notice of change of address shall be effective only upon receipt.

 

19.            RESOLUTION
OF ALL DISPUTES. Any controversy or claim arising out of or relating to this Agreement (or the breach thereof) (a “Dispute”)
shall be settled by alternative dispute resolution procedures in accordance with Appendix B hereto. During the pendency of any Dispute,
the Company shall continue to pay the Executive the full compensation in effect when the notice giving rise to the Dispute was given (including,
but not limited to, salary) and continue the Executive (and, where applicable, the Executive’s family) as a participant in all compensation,
benefit, and insurance plans in which the Executive was participating when the notice giving rise to the Dispute was given, until such
Dispute is resolved.

 

20.            LEGAL
AND ENFORCEMENT COSTS. The provisions of this Section 20 shall apply if it becomes necessary or desirable for the Executive to retain
legal counsel or incur other costs and expenses in connection with enforcing any and all rights under this Agreement or any other compensation
plan maintained by the Company, including, but not limited to, the AbbVie 2013 Amended and Restated Incentive Stock Program, the AbbVie
2013 Management Incentive Plan, the AbbVie Performance Incentive Plan, the AbbVie Deferred Compensation Plan, the AbbVie Supplemental
Pension Plan, the AbbVie Supplemental Savings Plan, or, in each case, any trust adopted pursuant thereto:

 

(a)            The
Executive shall be entitled to recover from the Company reasonable attorneys’ fees, costs, and expenses incurred in connection with
such enforcement or defense.

 

(b)            Payments
required under this Section 20 shall be made by the Company to the Executive (or directly to the Executive’s attorney), as
such attorney’s fees, costs, and expenses are incurred, upon the Executive’s prompt submission to the Company of appropriate
documentation evidencing the incurrence of such attorneys’ fees, costs, and expenses.

 

(c)            The
Executive shall be entitled to select legal counsel; provided, however, that such right of selection shall not affect the requirement
that any costs and expenses reimbursable under this Section 20 be reasonable.

 

(d)            The
Executive’s rights to payments under this Section 20 shall not be affected by the final outcome of any dispute with the Company.

    15

     

    

 

 

21.            SURVIVAL
OF AGREEMENT. Except as otherwise expressly provided in this Agreement, the rights and obligations of the parties to this Agreement shall
survive the termination of the Executive’s employment with the Company.

  

22.            ENTIRE
AGREEMENT. Except as otherwise provided herein, this Agreement constitutes the entire agreement between the parties concerning the subject
matter hereof and supersedes all prior or contemporaneous agreements between the parties relating to the subject matter hereof; provided,
however, that nothing in this Agreement shall be construed to limit any policy or agreement that is otherwise applicable relating to confidentiality,
rights to inventions, copyrightable material, business and/or technical information, trade secrets, solicitation of employees, interference
with relationships with other businesses, competition, and other similar policies or agreements for the protection of the business and
operations of the Company and the subsidiaries.

 

23.            DATE
OF TERMINATION. For purposes of this Agreement, the Executive’s termination of employment shall be effective as of the last day
the Executive performs services for or on behalf of the Company and its subsidiaries, and the Executive’s term of employment shall
not be deemed extended by any notice period mandated under local law. The Company shall have the exclusive discretion to determine the
date as of which the Executive’s employment has been terminated for purposes of this Agreement.

 

24.            NO
RIGHT TO CONTINUED EMPLOYMENT. This Agreement is not and shall not be interpreted to confer upon the Executive any right to continue
in the employ of the Company or any of its subsidiaries or interfere with the ability of the Company or its subsidiaries to terminate
the Executive’s employment at any time.

 

25.            NATURE
OF BENEFITS. References in this Agreement to other benefits or programs on which change in control benefits may be based do not guarantee
continued receipt of such benefits or participation in such benefit programs, and such references are not intended to create any contractual
or other right to receive future benefits.

 

26.            INTERPRETATION.
The Company (or its delegate) shall, subject to and not inconsistent with the express provisions of the Agreement, have the power and
authority to construe and interpret the terms of the Agreement and to make all other determinations deemed necessary or advisable for
the administration of the Agreement. The Company (or its delegate) may correct any defect or supply any omission or reconcile any inconsistency
in the Agreement in the manner and to the extent it shall deem necessary or advisable to carry the Agreement into effect and shall be
the sole and final judge of such necessity or advisability.

 

27.            COUNTERPARTS.
This Agreement may be executed in two or more counterparts, any one of which shall be deemed the original without reference to the others.

 

[SIGNATURE PAGE FOLLOWS]

 

    16

     

    

 

IN WITNESS THEREOF, the Executive has hereunto set his or her hand,
and the Company has caused these presents to be executed in its name and on its behalf, and its corporate seal to be hereunto affixed
on this ____ day of ___________, 202__, all as of the Effective Date.

  

	 	 
	 	EXECUTIVE
	 	 
	 	ABBVIE INC.
	 	 
	 	By	       
	 	 
	 	Its Chairman and Chief Executive Officer
	 	 
	ATTEST:	 
	 	 
	 	 

 

    17

     

    

 

APPENDIX A

 

AGREEMENT REGARDING CHANGE IN CONTROL

FORFEITURE PROVISION REFERENCED IN SECTION 9

 

Option

 

The Option shall be cancelled and forfeited immediately if, in the
sole opinion and discretion of the Committee or its delegate, the Employee:

 

(a)            commits
a material breach of the terms and conditions of the Employee’s employment, including, but not limited to:

 

(i)            material
breach by the Employee of the Code of Business Conduct;

 

(ii)            material
breach by the Employee of the Employee’s employee agreement or employment contract, if any;

 

(iii)            commission
by the Employee of an act of fraud, embezzlement, or theft in connection with the Employee’s duties or in the course of the Employee’s
employment;

 

(iv)            wrongful
disclosure by the Employee of secret processes or confidential information of the Company or any of its Subsidiaries; or

 

(v)            failure
by the Employee to substantially perform the duties of the Employee’s employment (other than any such failure resulting from the
Employee’s Disability); or

 

(b)            to
the extent permitted by applicable law, engagement by the Employee, directly or indirectly, for the benefit of the Employee or others,
in any activity, employment, or business which is competitive with the Company or any of its Subsidiaries.

 

Restricted Stock/Restricted Stock Units

 

Shares or units with respect to which Restrictions have not lapsed
shall be cancelled and forfeited immediately if, in the sole opinion and discretion of the Committee or its delegate, the Employee engages
in activity that constitutes Cause, whether or not the Employee experiences a Termination or remains employed with the Company or a Subsidiary.

 

Cause shall mean the following, as determined by the Company in its
sole discretion:

 

(a)            material
breach by the Employee of the terms and conditions of the Employee’s employment, including, but not limited to:

 

(i)            material
breach by the Employee of the Code of Business Conduct;

 

    1

     

    

 

(ii)            material
breach by the Employee of the Employee’s employee agreement or employment contract, if any;

 

(iii)            commission
by the Employee of an act of fraud, embezzlement, or theft in connection with the Employee’s duties or in the course of the Employee’s
employment;

 

(iv)            wrongful
disclosure by the Employee of secret processes or confidential information of the Company or any of its Subsidiaries; or

 

(v)            failure
by the Employee to substantially perform the duties of the Employee’s employment (other than any such failure resulting from the
Employee’s Disability); or

 

(b)            to
the extent permitted by applicable law, engagement by the Employee, directly or indirectly, for the benefit of the Employee or others,
in any activity, employment, or business which is competitive with the Company or any of its Subsidiaries.

 

UK Option

 

The Option shall be cancelled and forfeited immediately if, in the
sole opinion and discretion of the Committee or its delegate, acting fairly and reasonably, the Employee:

 

(a)            engages
in a material breach of the Code of Business Conduct;

 

(b)            commits
an act of fraud, embezzlement, or theft in connection with the Employee’s duties or in the course of the Employee’s employment;

 

(c)            wrongfully
discloses secret processes or confidential information of the Company or any of its Subsidiaries; or

 

(d)            to
the extent permitted by applicable law, engages, directly or indirectly, for the benefit of the Employee or others, in any activity, employment,
or business which is competitive with the Company or any of its Subsidiaries.

 

    2

     

    

  

APPENDIX B

 

AGREEMENT REGARDING CHANGE IN CONTROL

ALTERNATIVE DISPUTE RESOLUTION PROCEDURES

 

The parties to the Agreement Regarding Change in
Control (the “Agreement”) recognize that a bona fide dispute as to certain matters may arise from time to time during the
term of the Agreement which relates to either party’s rights and/or obligations. To have such a dispute resolved by this Alternative
Dispute Resolution (“ADR”) provision, a party first must send written notice of the dispute to the other party for attempted
resolution by good faith negotiations between the Executive and the Company within twenty-eight (28) days after such notice is received
(all references to “days” in the ADR provision are to calendar days).

 

If the matter has not been resolved within twenty-eight
(28) days of the notice of dispute, or if the parties fail to meet within such twenty-eight (28) days, either party may initiate an ADR
proceeding as provided herein. The parties shall have the right to be represented by counsel in such a proceeding.

 

1.            To
begin an ADR proceeding, a party shall provide written notice to the other party of the issues to be resolved by ADR. Within fourteen
(14) days after its receipt of such notice, the other party may, by written notice to the party initiating the ADR, add additional issues
to be resolved within the same ADR.

 

2.            Within
twenty-one (21) days following receipt of the original ADR notice, the parties shall select a mutually acceptable neutral to preside in
the resolution of any disputes in this ADR proceeding. If the parties are unable to agree on a mutually acceptable neutral within such
period, either party may request the President of the CPR Institute for Dispute Resolution (“CPR”), 366 Madison Avenue, 14th
Floor, New York, New York 10017, to select a neutral pursuant to the following procedures:

 

(a)            The
CPR shall submit to the parties a list of not less than five (5) candidates within fourteen (14) days after receipt of the request,
along with a Curriculum Vitae for each candidate. No candidate shall be an employee, director, or shareholder of either party or
any of their subsidiaries or affiliates.

 

(b)            Such
list shall include a statement of disclosure by each candidate of any circumstances likely to affect his or her impartiality.

 

(c)            Each
party shall number the candidates in order of preference (with the number one (1) signifying the greatest preference) and shall deliver
the list to the CPR within seven (7) days following receipt of the list of candidates. If a party believes a conflict of interest
exists regarding any of the candidates, that party shall provide a written explanation of the conflict to the CPR along with its list
showing its order of preference for the candidates. Any party failing to return a list of preferences on time shall be deemed to have
no order of preference.

 

(d)            If
the parties collectively have identified fewer than three (3) candidates deemed to have conflicts, the CPR immediately shall designate
as the neutral the candidate for whom the parties collectively have indicated the greatest preference. If a tie should result between
two candidates, the CPR may designate either candidate. If the parties collectively have identified three (3) or more candidates
deemed to have conflicts, the CPR shall review the explanations regarding conflicts and, in its sole discretion, may either (i) immediately
designate as the neutral the candidate for whom the parties collectively have indicated the greatest preference or (ii) issue a new
list of not less than five (5) candidates, in which case the procedures set forth in subsections 2(a)-2(d) shall be repeated.

 

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3.            No
earlier than twenty-eight (28) days or later than fifty-six (56) days after selection, the neutral shall hold a hearing to resolve each
of the issues identified by the parties. The ADR proceeding shall take place at a location agreed upon by the parties. If the parties
cannot agree, the neutral shall designate a location other than the principal place of business of either party or any of the subsidiaries
or affiliates.

 

4.            At
least seven (7) days prior to the hearing, each party shall submit the following to the other party and the neutral:

 

(a)            a
copy of all exhibits on which such party intends to rely in any oral or written presentation to the neutral;

 

(b)            a
list of any witnesses such party intends to call at the hearing, and a short summary of the anticipated testimony of each witness;

 

(c)            a
proposed ruling on each issue to be resolved, together with a request for a specific damage award or other remedy for each issue. The
proposed rulings and remedies shall not contain any recitation of the facts or any legal arguments and shall not exceed one (1) page per
issue.

 

(d)            a
brief in support of such party’s proposed rulings and remedies, provided that the brief shall not exceed twenty (20) pages. This
page limitation shall apply regardless of the number of issues raised in the ADR proceeding. Except as expressly set forth in subsections
4(a) - 4(d), no discovery shall be required or permitted by any means, including deposition, interrogatories, requests for admissions,
or production of documents.

 

5.            The
hearing shall be conducted on two (2) consecutive days and shall be governed by the following rules:

 

(a)            Each
party shall be entitled to five (5) hours of hearing time to present its case. The neutral shall determine whether each party has
had the five (5) hours to which it is entitled.

 

(b)            Each
party shall be entitled, but not required, to make an opening statement; to present regular or rebuttal testimony, documents, or other
evidence; to cross-examine witnesses; and to make a closing argument. Cross-examination of witnesses shall occur immediately after their
direct testimony, and cross-examination time shall be charged against the party conducting the cross-examination.

 

(c)            The
party initiating the ADR shall begin the hearing and, if it chooses to make an opening statement, shall address not only issues it raised
but also any issues raised by the responding party. The responding party, if it chooses to make an opening statement, also shall address
all issues raised in the ADR. Thereafter, the presentation of regular and rebuttal testimony and documents, other evidence, and closing
arguments shall proceed in the same sequence.

 

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(d)            Except
when testifying, witnesses shall be excluded from the hearing until closing arguments.

 

(e)            Settlement
negotiations, including any statements made therein, shall not be admissible under any circumstances. Affidavits prepared for purposes
of the ADR hearing also shall not be admissible. As to all other matters, the neutral shall have sole discretion regarding the admissibility
of any evidence.

 

6.            Within
seven (7) days following completion of the hearing, each party may submit to the other party and the neutral a post-hearing brief
in support of its proposed rulings and remedies, provided that such brief shall not contain or discuss any new evidence and shall not
exceed ten (10) pages. This page limitation shall apply regardless of the number of issues raised in the ADR proceeding.

 

7.            The
neutral shall rule on each disputed issue within fourteen (14) days following completion of the hearing. Such ruling shall adopt
in its entirety the proposed ruling and remedy of one of the parties on each disputed issue but may adopt one party’s proposed rulings
and remedies on some issues and the other party’s proposed rulings and remedies on other issues. The neutral shall not issue any
written opinion or otherwise explain the basis of the ruling.

 

8.            The
neutral shall be paid a reasonable fee plus expenses by the Company. The Company shall bear its own fees and expenses. The Executive’s
fees and expenses shall be paid or reimbursed by the Company to the extent provided by the Agreement.

 

9.            The
rulings of the neutral and the allocation of fees and expenses shall be binding, non-reviewable, and non-appealable and may be entered
as a final judgment in any court having jurisdiction.

 

10.            Except
as provided in Section 9 or as required by law, the existence of the dispute, any settlement negotiations, the ADR hearing, any submissions
(including exhibits, testimony, proposed rulings, and briefs), and the rulings shall be deemed confidential information. The neutral shall
have the authority to impose sanctions for unauthorized disclosure of confidential information.

 

    3sobr_ex104.htm

 
 EXHIBIT 10.4
  
  
 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.
  
 COMMON STOCK PURCHASE WARRANT
  
 SOBR SAFE, INC. 
  
  	 Warrant Shares: _______
	 Issue Date: September 30, 2022

 
  
 THIS 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 Issue Date and on or prior to 5:00 p.m. (New York City time) on September 30, 2029 (the “Termination Date”) but not thereafter, to subscribe for and purchase from SOBR SAFE, INC, a Delaware company (the “Company”), up to ______ shares (as subject to adjustment hereunder, the “Warrant Shares”) of the Company’s Common Stock. The purchase price of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b).
  
 Section 1. Definitions. Capitalized terms used and not otherwise defined herein shall have the meanings set forth in that certain Securities Purchase Agreement (the “Purchase Agreement”), dated September 28, 2022, 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 Issue Date and on or before the Termination Date by delivery to the Company of a duly executed PDF copy submitted by e-mail (or e-mail attachment) of the Notice of Exercise substantially in the form annexed hereto as Exhibit A (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 Warrant 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) Trading 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.
  
  	 
	1
	

	 

 
  
 b) Exercise Price. The exercise price per share of Common Stock under this Warrant shall be $1.35, subject to adjustment hereunder (the “Exercise Price”).
  
 c) Cashless Exercise. If at any time after the six month anniversary of the Issue Date, there is no effective registration statement registering, or the prospectus contained therein is not 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) 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.

 
  
  	 
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 “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 on The Pink Open Market (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 Holders 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 on The Pink Open Market (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 Holders 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.
  
 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. Assuming (i) the Holder is not an Affiliate of the Company, and (ii) all of the applicable conditions of Rule 144 promulgated under the Securities Act with respect to Holder and the Warrant Shares are met in the case of such a cashless exercise, the Company agrees that the Company will cause the removal of the legend from such Warrant Shares (including by delivering an opinion of the Company’s counsel to the Company’s transfer agent at its own expense to ensure the foregoing), and the Company agrees that the Holder is under no obligation to sell the Warrant Shares issuable upon the exercise of the Warrant prior to removing the legend. The Company agrees not to take any position contrary to this Section 2(c). 
  
  	 
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 Notwithstanding anything herein to the contrary, in the event that, on the Termination Date, there is no effective registration statement registering, or no current prospectus available for the issuance of, the Warrant Shares to the Holder, this Warrant shall be automatically exercised via cashless exercise pursuant to this Section 2(c) on such Termination Date. 
  
 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, (ii) one (1) Trading Day after delivery of the aggregate Exercise Price to the Company and (iii) the number of Trading Days comprising the Standard Settlement Period after the delivery to the Company of the Notice of Exercise (such date, the “Warrant Share Delivery Date”). Upon delivery of the Notice of Exercise, the Holder shall be deemed for all corporate purposes to have become the holder of record of the Warrant Shares with respect to which this Warrant has been exercised, irrespective of the date of delivery of the Warrant Shares, provided that payment of the aggregate Exercise Price (other than in the case of a cashless exercise) is received by the Warrant Share Delivery Date. If the Company fails for any reason to deliver to the Holder the Warrant Shares subject to a Notice of Exercise by the Warrant Share Delivery Date, the Company shall pay to the Holder, in cash, as liquidated damages and not as a penalty, for each $1,000 of Warrant Shares subject to such exercise (based on the VWAP of the Common Stock on the date of the applicable Notice of Exercise), $10 per Trading Day (increasing to $20 per Trading Day on the fifth Trading Day after 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.
  
  	 
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 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. 
  
  	 
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 v. No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued upon the exercise of this Warrant. As to any fraction of a share which the Holder would otherwise be entitled to purchase upon such exercise, the Company shall, at its election, either pay a cash adjustment in respect of such final fraction in an amount equal to such fraction multiplied by the Exercise Price or round up to the next whole share.
  
 vi. Charges, Taxes and Expenses. Issuance of Warrant Shares shall be made without charge to the Holder for any issue or transfer tax or other incidental expense in respect of the issuance of such Warrant Shares, all of which taxes and expenses shall be paid by the Company, and such Warrant Shares shall be issued in the name of the Holder or in such name or names as may be directed by the Holder; provided, however, that in the event that Warrant Shares are to be issued in a name other than the name of the Holder, this Warrant when surrendered for exercise shall be accompanied by the Assignment Form attached hereto duly executed by the Holder and the Company may require, as a condition thereto, the payment of a sum sufficient to reimburse it for any transfer tax incidental thereto. The Company shall pay all Transfer Agent fees required for same-day processing of any Notice of Exercise and all fees to the Depository Trust Company (or another established clearing corporation performing similar functions) required for same-day electronic delivery of the Warrant Shares.
  
 vii. Closing of Books. The Company will not close its stockholder books or records in any manner which prevents the timely exercise of this Warrant, pursuant to the terms hereof.
  
  	 
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 e) Holder’s Exercise Limitations. The Company shall not effect any exercise of this Warrant, and a Holder shall not have the right to exercise any portion of this Warrant, pursuant to Section 2 or otherwise, to the extent that after giving effect to such issuance after exercise as set forth on the applicable Notice of Exercise, the Holder (together with the Holder’s Affiliates, and any other Persons acting as a group together with the Holder or any of the Holder’s Affiliates (such Persons, “Attribution Parties”)), would beneficially own in excess of the Beneficial Ownership Limitation (as defined below). For purposes of the foregoing sentence, the number of shares of Common Stock beneficially owned by the Holder and its Affiliates and Attribution Parties shall include the number of shares of Common Stock issuable upon exercise of this Warrant with respect to which such determination is being made, but shall exclude the number of shares of Common Stock which would be issuable upon (i) exercise of the remaining, unexercised 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 non-converted 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 (1) Trading Day confirm orally and in writing to the Holder the number of shares of Common Stock then outstanding. In any case, the number of outstanding shares of Common Stock shall be determined after giving effect to the conversion or exercise of securities of the Company, including this Warrant, by the Holder or its Affiliates or Attribution Parties since the date as of which such number of outstanding shares of Common Stock was reported. The “Beneficial Ownership Limitation” shall be 4.99% (or, at the election of the Holder prior to the issuance of this Warrant, 9.99%) 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.
  
  	 
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 Section 3. Certain Adjustments.
  
 a) Stock Dividends and Splits. If the Company, at any time while this Warrant is outstanding: (i) pays a stock dividend or otherwise makes a distribution or distributions on shares of its Common Stock or any other equity or equity equivalent securities payable in shares of Common Stock (which, for avoidance of doubt, shall not include any shares of Common Stock issued by the Company upon exercise of this Warrant), (ii) subdivides outstanding shares of Common Stock into a larger number of shares, (iii) combines (including by way of reverse stock split) outstanding shares of Common Stock into a smaller number of shares, or (iv) issues by reclassification of shares of 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. If the Company or any Subsidiary thereof, as applicable, at any time while this Warrant is outstanding, shall sell, enter into an agreement to sell, or grant any option to purchase, or sell, enter into an agreement to 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 shares of 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 shares of Common Stock or such other securities 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 greater of (x) the Base Share Price and (y) the Floor Price.  As used herein, the “Floor Price” shall mean (i) prior to the Shareholder Approval, $1.35 (subject to adjustment for reverse and forward stock splits, recapitalizations and similar transactions following the date of the Purchase Agreement) and (ii) following the Shareholder Approval, the par value of the Common Stock. In the event clause (i) of the Floor Price has been rendered inapplicable, as of the date of such Shareholder Approval, the Company will give immediate effect to any Dilutive Issuance effected prior to the Shareholder Approval pursuant to this Section. Notwithstanding the foregoing, (i) no adjustments shall be made, paid or issued under this Section 3(b) in respect of an Exempt Issuance, and (ii) an Exempt Issuance will not be deemed a Dilutive Issuance for purposes of this Section 3(b). The Company shall notify the Holder, in writing, no later than the Trading Day following the issuance or deemed issuance of any shares of 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, the Company shall be deemed to have issued shares of Common Stock or Common Stock Equivalents at the lowest possible price, conversion price or exercise price at which such securities may be issued, converted or exercised.
  
  	 
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 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).
  
  	 
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 e) Fundamental Transaction.  If, at any time while the Warrants are 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 shares 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 Company’s shares of Common Stock or 50% or more of the total voting power of the Company’s shares of Common Stock; 
  

	  
	 (iv)
	 the Company, directly or indirectly, in one or more related transactions effects any reclassification, reorganization or recapitalization of shares of Common Stock or any compulsory share exchange pursuant to which the shares of Common Stock are 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 50% or more of the Company’s shares of Common Stock or 50% or more of the total voting power of the Company’s shares of Common Stock  (each a “Fundamental Transaction”),

 
  
  	 
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 then, upon any subsequent exercise of a Warrant, the Holder shall have the right to receive, for each share of Common Stock that would have been issuable upon such exercise immediately prior to the occurrence of such Fundamental Transaction, at the option of the Holder, the number of shares of capital stock of the successor or acquiring corporation or of the Company, if it is the surviving corporation, or depositary shares representing those shares, 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 limitations on exercise hereof, including without limitation, the Beneficial Ownership Limitation). For purposes of any such exercise, the determination of the Exercise Price shall be appropriately adjusted to apply to such Alternate Consideration based on the amount of Alternate Consideration issuable in respect of one share of Common Stock in such Fundamental Transaction and the Company shall apportion the Exercise Price among the Alternate Consideration in a reasonable manner reflecting the relative value of any different components of the Alternate Consideration. If holders of Common Stock are given any choice as to the securities, cash or property to be received in a Fundamental Transaction, then the Holder shall be given the same choice as to the Alternate Consideration it receives upon any exercise of this Warrant following such Fundamental Transaction.
  
 Notwithstanding anything to the contrary, in the event of a Fundamental Transaction, the Company or any Successor Entity (as defined below) shall, at the Holder’s option, exercisable at any time concurrently with, or within 30 days after, the consummation of the Fundamental Transaction (or, if later, the date of the public announcement of the applicable Fundamental Transaction), purchase this Warrant from the Holder by paying to the Holder an amount of cash equal to the Black Scholes Value (as defined below) of the remaining unexercised portion of this Warrant on the date of the consummation of such Fundamental Transaction; provided, however, that, if the Fundamental Transaction is not within the Company’s control, including not approved by the Company’s Board of Directors, Holder shall only be entitled to receive from the Company or any Successor Entity the same type or form of consideration (and in the same proportion), at the Black Scholes Value of the unexercised portion of this Warrant, that is being offered and paid to the holders of shares 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 shares of Common Stock are given the choice to receive from among alternative forms of consideration in connection with the Fundamental Transaction; provided, further, that if holders of shares of Common Stock of the Company are not offered or paid any consideration in such Fundamental Transaction, such holders will be deemed to have received common stock of the Successor Entity (which Entity may be the Company following such Fundamental Transaction) in such Fundamental Transaction.
  
  	 
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 “Black Scholes Value” means the value of this Warrant based on the Black-Scholes Option Pricing Model obtained from the “OV” function on Bloomberg determined as of the day of consummation of the applicable contemplated 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 contemplated Fundamental Transaction and the Termination Date, (B) an expected volatility equal to the greater of 100% and the 100 day volatility obtained from the HVT function on Bloomberg (determined utilizing a 365 day annualization factor) as of the Trading Day immediately following the public announcement of the applicable contemplated 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 highest VWAP during the period beginning on the Trading Day immediately preceding the public announcement of the applicable contemplated Fundamental Transaction (or the consummation of the applicable Fundamental Transaction, if earlier) and ending on the Trading Day of the Holder’s request pursuant to this Section 3(d) and (D) a remaining option time equal to the time between the date of the public announcement of the applicable contemplated Fundamental Transaction and the Termination Date and (E) a zero cost of borrow. The payment of the Black Scholes Value will be made by wire transfer of immediately available funds (or such other consideration) within the later of (i) five (5) Business Days of the Holder’s election and (ii) the date of consummation of the Fundamental Transaction.
  
 The Company shall cause any successor entity in a Fundamental Transaction in which the Company is not the survivor (the “Successor Entity”), to assume in writing all of the obligations of the Company under this Warrant in accordance with the provisions of this Section 3(d) pursuant to written agreements in form 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 such 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 that 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 prior 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 this Warrant had immediately prior to the consummation of such Fundamental Transaction). Upon the occurrence of any such Fundamental Transaction, the Successor Entity shall be added to the term “Company” under this Warrant (so that from and after the occurrence or consummation of such Fundamental Transaction, each and every provision of this Warrant and the other Transaction Documents referring to the “Company” shall refer instead to each of the Company and the Successor Entity or Successor Entities, jointly and severally), and the Successor Entity or Successor Entities, jointly and severally with the Company, may exercise every right and power of the Company prior thereto and the Successor Entity or Successor Entities shall assume all of the obligations of the Company prior thereto under this Warrant and the other Transaction Documents with the same effect as if the Company and such Successor Entity or Successor Entities, jointly and severally, had been named as the Company herein. For the avoidance of doubt, the Holder shall be entitled to the benefits of the provisions of this Section 3(e) regardless of whether the Company has sufficient authorized shares of Common Stock for the issuance of Warrant Shares. 
  
  	 
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 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 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 email to the Holder at its last 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.
  
  	 
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 h) Voluntary Adjustment by Company. Upon the Holder’s consent and subject to the rules and regulations of the Trading Market, the Company may at any time during the term of this Warrant, 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.
  
 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.
  
  	 
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 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 Issue Date of this Warrant and shall be identical with this Warrant except as to the number of Warrant Shares issuable pursuant thereto.
  
 c) Warrant Register. The Company shall register this Warrant, upon records to be maintained by 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; No Settlement in Cash. This Warrant does not entitle the Holder to any voting rights, dividends or other rights as a stockholder of the Company prior to the exercise hereof as set forth in Section 2(d)(i), except as expressly set forth in Section 3. Without limiting the rights of a Holder to receive Warrant Shares on a “cashless exercise,” and to receive the cash payments contemplated pursuant to Sections 2(d)(i) and 2(d)(iv), in no event will the Company be required to net cash settle an exercise of this Warrant.
  
 b) Loss, Theft, Destruction or Mutilation of Warrant. The Company covenants that upon receipt by the Company of evidence reasonably satisfactory to it of the loss, theft, destruction or mutilation of this Warrant or any stock certificate relating to the Warrant Shares, and in case of loss, theft or destruction, of indemnity or security reasonably satisfactory to it (which, in the case of the Warrant, shall not include the posting of any bond), and upon surrender and cancellation of such Warrant or stock certificate, if mutilated, the Company will make and deliver a new Warrant or stock certificate of like tenor and dated as of such cancellation, in lieu of such Warrant or stock certificate.
  
  	 
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 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 Trading Day, then, such action may be taken or such right may be exercised on the next succeeding Trading 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 (which means that no further sums are required to be paid by the holders thereof in connection with the issue thereof) 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.
  
  	 
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 Before taking any action that 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) Non-waiver 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, notwithstanding the fact that the right to exercise this Warrant terminates on the Termination Date. 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.
  
  	 
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 j) Remedies. The Holder, in addition to being entitled to exercise all rights granted by law, including recovery of damages, will be entitled to specific performance of its rights under this Warrant. The Company agrees that monetary damages would not be adequate compensation for any loss incurred by reason of a breach by it of the provisions of this Warrant and hereby agrees to waive and not to assert the defense in any action for specific performance that a remedy at law would be adequate.
  
 k) Successors and Assigns. Subject to applicable securities laws, this Warrant and the rights and obligations evidenced hereby shall inure to the benefit of and be binding upon the successors and permitted assigns of the Company and the successors and permitted assigns of Holder. The provisions of this Warrant are intended to be for the benefit of any Holder from time to time of this Warrant and shall be enforceable by the Holder or holder of Warrant Shares.
  
 l) Amendment. This Warrant may be modified or amended or the provisions hereof waived with the written consent of the Company, on the one hand, and the Holder of this Warrant, on the other hand.
  
 m) Severability. Wherever possible, each provision of this Warrant shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this Warrant shall be prohibited by or invalid under applicable law, such provision shall be ineffective to the extent of such prohibition or invalidity, without invalidating the remainder of such provisions or the remaining provisions of this Warrant.
  
 n) Headings. The headings used in this Warrant are for the convenience of reference only and shall not, for any purpose, be deemed a part of this Warrant.
  
 (Signature Page Follows)
  
  	 
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 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.
  
  	  
	 SOBR SAFE, INc.
	
	  
		  
	  

	  
	 By:
	  
	  

	  
	 Name:
	 David Gandini
	
	  
	 Title:
	 Chief Executive Officer
	

 
  
  	 
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 EXHIBIT A
  
 NOTICE OF EXERCISE
  
 TO: SOBR SAFE, inc.
  
 (1) The undersigned hereby elects to purchase ________ Warrant Shares of the Company pursuant to the terms of the attached Warrant dated September __, 2022 (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: 
	  

 
  
  	 
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 EXHIBIT B
  
 ASSIGNMENT FORM
  
 (To assign the foregoing Warrant, execute this form and supply required information. Do not use this form to exercise the Warrant 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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