Document:

Exhibit 10.4

 

NOTE EXCHANGE AGREEMENT

 

This NOTE EXCHANGE AGREEMENT,
dated as of _________ ___, 201__ (this “Agreement”), is by and between Intellinetics, Inc. (the “Company”)
and each of the noteholders who executed the signature page affixed hereto (each, a “Noteholder” and, collectively,
the “Noteholders”).

 

WHEREAS, the Company has
previously issued Convertible Notes (the “Notes”), one or more of which were purchased by each Noteholder;

 

WHEREAS, the outstanding
principal amount of the Notes, plus accrued and unpaid interest, are convertible into shares (“Shares”) of common stock
in the Company, with a par value of $0.001 (“Common Stock”), at a conversion price that is set forth in such Notes;

 

WHEREAS, the Company has
offered to exchange all or a portion of the Notes for (i) an amount of Shares equal to the outstanding principal amount elected
by each Noteholder for conversion, plus accrued and unpaid interest (the “Conversion Amount”), divided by the conversion
price set forth in such Notes, and (ii) an amount of Warrants equal to the product of (a) the Conversion Amount, divided by 0.6,
multiplied by (b) 0.5, with each warrant constituting a five (5)-year right to purchase one share of Common Stock at an exercise
price of $0.65 per Share (the “Warrants”); and the Noteholders desire to exchange the amount of Notes set forth on
the signature pages in accordance with the terms and conditions set forth herein (the “Note Exchange”);

 

WHEREAS, the Notes will
be exchanged for the Shares and the Warrant in an exchange made in reliance upon the exemption from registration provided by Section 3(a)(9)
of the Securities Act;

 

WHEREAS, in connection with
the issuance of the Shares, Warrants, and the Common Stock issuable upon exercise of the Warrants (the “Warrant Shares,”
together with the Shares and Warrants, the “Securities”), the Noteholders will be subject to certain restrictions on
the transfer of the Shares and Warrants, all as more fully set forth in this Agreement.

 

NOW, THEREFORE, in consideration
of the mutual terms, conditions and other agreements set forth herein and for other good and valuable consideration, the receipt
and sufficiency of which are hereby acknowledged, and intending to be legally bound hereby, the parties hereto hereby agree to
the Note Exchange as set forth herein.

 

1. Definitions.

 

For purposes of this Agreement,
the terms set forth below shall have the corresponding meanings provided below.

 

“Affiliate” shall
mean, with respect to any specified Person (as defined below), (i) if such Person is an individual, the spouse, heirs, executors,
or legal representatives of such individual, or any trusts for the benefit of such individual or such individual’s spouse
and/or lineal descendants, or (ii) otherwise, another Person that directly, or indirectly through one or more intermediaries, controls,
is controlled by, or is under common control with, the Person specified. As used in this definition, “control” shall
mean the possession, directly or indirectly, of the sole and unilateral power to cause the direction of the management and policies
of a Person, whether through the ownership of voting securities or by contract or other written instrument.

 

“Blue Sky Application”
as defined in Section 5.3(a) hereof.

 

“Business Day”
shall mean any day on which banks located in New York City are not required or authorized by law to remain closed.

 

“Common Stock”
as defined in the recitals above.

 

“Company Financial Statements”
as defined in Section 4.5(a) hereof.

 

“Company’s Knowledge”
means the actual knowledge of any executive officer (as defined in Rule 405 under the Securities Act) or director of the Company,
or the knowledge of any fact or matter which any person would reasonably be expected to become aware of in the course of performing
the duties and responsibilities as an executive officer or director of the Company.

 

    	 	1	 

     

    

 

Exhibit 10.4

 

“Exchange Act”
means the Securities Exchange Act of 1934, as amended.

 

“Liens” means
any mortgage, lien, title claim, assignment, encumbrance, security interest, adverse claim, contract of sale, restriction on use
or transfer or other defect of title of any kind.

 

“Material Adverse Effect”
means a material adverse effect on (i) the assets, liabilities, results of operations, condition (financial or otherwise), business,
or prospects of the Company and its Subsidiaries taken as a whole, (ii) the transactions contemplated hereby or in any of the Transaction
Documents or (iii) the ability of the Company to perform its obligations under the Transaction Documents (as defined below).

 

“Note” as defined
in the recitals above.

 

“Note Exchange”
as defined in the recitals above.

 

“Noteholders”
as defined in the recitals above.

 

“Offering” as
defined in Section 4.4 below.

 

“PA Warrant Shares”
shall mean any shares issuable upon exercise of warrants issued to the Placement Agent as compensation in connection with the transactions
contemplated hereby.

 

“Person” shall
mean an individual, entity, corporation, partnership, association, limited liability company, limited liability partnership, joint-stock
company, trust or unincorporated organization.

 

“Piggyback Registration”
as defined in Section 5.1 hereof.

 

“Placement Agency Agreement”
means that certain agreement, dated December 11, 2015, by and between the Placement Agent and the Company.

 

“Placement Agent”
means Taglich Brothers, Inc.

 

“Registrable Securities”
shall mean the (i) Shares, (ii) the Warrant Shares, and (iii) PA Warrant Shares; provided, that a security shall cease to be a
Registrable Security upon (A) sale pursuant to a Registration Statement or Rule 144 under the Securities Act, or (B) such security
becoming eligible for sale by the Noteholders without any restriction pursuant to Rule 144 (including, without limitation, volume
restrictions) and without the need for current public information required by Rule 144(c)(1) (or Rule 144(i)(2), if applicable).

 

“Registration Statement”
shall mean any registration statement of the Company filed under the Securities Act that covers the resale of any of the Registrable
Securities pursuant to the provisions of this Agreement, amendments and supplements to such Registration Statement, including post-effective
amendments, all exhibits and all material incorporated by reference in such Registration Statement.

 

“Regulation D”
as defined in Section 3.7 hereof.

 

“Regulation S”
as defined in Section 6.1(i)(E) hereof.

 

“Rule 144” as
defined in Section 6.1(i)(C) hereof.

 

“SEC” means the
U.S. Securities and Exchange Commission.

 

“SEC Documents”
as defined in Section 4.5 hereof.

 

“Securities”
as defined in the recitals above.

 

“Securities Act”
means the Securities Act of 1933, as amended.

 

“Shares” as defined
in the recitals above.

 

    	 	2	 

     

    

 

Exhibit 10.4

 

“Subsidiaries”
shall mean any corporation or other entity or organization, whether incorporated or unincorporated, in which the Company owns,
directly or indirectly, any equity or other ownership interest or otherwise controls through contract or otherwise.

 

“Transaction Documents”
shall mean this Agreement and the Warrants.

 

“Transfer” shall
mean any sale, transfer, assignment, conveyance, charge, pledge, mortgage, encumbrance, hypothecation, security interest or other
disposition, or to make or effect any of the above.

 

“Underwriter”
shall mean any entity engaged by the Company to serve as an underwriter in connection with a registration or offering of securities
referred to in Section 5.

 

“Warrants” as
defined in the recitals above.

 

“Warrant Shares”
shall mean the shares of Common Stock issuable upon exercise of the Warrants.

 

2. Note Exchange. Subject
to the terms and conditions of this Agreement, upon the execution of this Agreement, the parties shall, pursuant to Section 3(a)(9)
of the Securities Act, effectuate the Note Exchange in the following manner: (a) each of the Noteholders shall severally, and not
jointly, deliver to the Company the Notes elected for exchange, and (b) the Company shall issue and deliver to the Noteholders,
duly issued certificates representing the Shares and Warrants, in the respective amounts set forth on the signature pages attached
hereto. The parties acknowledge and agree that the Shares and the Warrant shall be issued to the Noteholder in exchange for the
Note without the payment of any additional consideration.

 

3. Representations and Warranties
of the Noteholders. Each Noteholder hereby, severally and not jointly, represents and warrants to the Company as of the date
hereof as follows:

 

3.1           Authorization.
The execution, delivery and performance by such Noteholder of the Transaction Documents to which such Noteholder is a party have
been duly authorized and will each constitute the valid and legally binding obligation of such Noteholder, enforceable against
such Noteholder in accordance with their respective terms, subject to bankruptcy, insolvency, fraudulent transfer, reorganization,
moratorium and similar laws of general applicability, relating to or affecting creditors’ rights generally.

 

3.2           Ownership
of the Notes. Each Noteholder is, and at all times since the effective date thereof has been, the beneficial owner of all of
the Notes exchanged by such Noteholder hereunder, free and clear of any adverse claim, mortgage, pledge, lien, encumbrance, option,
charge or other security interest that would prevent such Noteholder’s compliance with its obligations hereunder. Such Noteholder
has the sole right and power to vote and dispose of the Notes, and none of such Notes is subject to any voting trust or other agreement,
arrangement or restriction with respect to the voting or transfer of any of the Notes, except for this Agreement.

 

3.3           Investment
Entirely for Own Account. The Shares, Warrants, and Warrant Shares to be received by such Noteholder hereunder will be acquired
for such Noteholder’s own account, not as nominee or agent, and not with a view to the resale or distribution of any part
thereof in violation of the Securities Act, and such Noteholder has no present intention of selling, granting any participation
in, or otherwise distributing the same in violation of the Securities Act, without prejudice, however, to such Noteholder’s
right at all times to sell or otherwise dispose of all or any part of such Securities in compliance with applicable federal and
state securities laws. Nothing contained herein shall be deemed a representation or warranty by such Noteholder to hold the Securities
for any period of time. Such Noteholder is not a broker-dealer registered with the SEC under the Exchange Act or an entity engaged
in a business that would require it to be so registered.

 

3.4           Investment
Experience. Such Noteholder acknowledges that the Securities are a highly speculative investment and that it can bear the economic
risk and complete loss of its investment in the Securities and has such knowledge and experience in financial or business matters
such that it is capable of evaluating the merits and risks of the investment contemplated hereby.

 

    	 	3	 

     

    

 

Exhibit 10.4

 

3.5           Disclosure
of Information. Such Noteholder has had an opportunity to receive all information related to the Company and the Securities
requested by it and to ask questions of and receive answers from the Company regarding the Company, its business and the terms
and conditions of the Note Exchange. Neither such inquiries nor any other due diligence investigation conducted by such Noteholder
shall modify, amend or affect such Noteholder’s right to rely on the Company’s representations and warranties contained
in this Agreement. Such Noteholder acknowledges that it has reviewed, or has had the opportunity to review, with the assistance
of professional and legal advisors of its choosing, sufficient information (including all documents filed or furnished to the Securities
and Exchange Commission by the Company) and has had sufficient access to the Company necessary for such Noteholder to decide to
participate in the Note Exchange.

 

3.6             Restricted
Securities. Such Noteholder understands that the Securities, and the components thereof, are characterized as “restricted
securities” under the U.S. federal securities laws since they are being acquired from the Company in a transaction not involving
a public offering and that under such laws and applicable regulations such securities may be resold without registration under
the Securities Act only in certain limited circumstances.

 

3.7             Legends.
It is understood that, except as provided below, certificates evidencing the Shares or Warrant Shares may bear the following or
any similar legend:

 

(a)              “The
securities represented hereby may not be transferred unless (i) such securities have been registered for sale pursuant to the Securities
Act of 1933, as amended, (ii) such securities may be sold pursuant to an available exemption from, or in a transaction not subject
to, the registration requirements of the Securities Act, or (iii) the Company has received an opinion of counsel reasonably satisfactory
to it that such transfer may lawfully be made without registration under the Securities Act of 1933 or qualification under applicable
state securities laws.”

 

(b)             If
required by the authorities of any state in connection with the issuance of sale of the Shares, the legend required by such state
authority.

 

3.7             Accredited
Investor. Such Noteholder is an accredited investor as defined in Rule 501(a) of Regulation D, as amended, under the Securities
Act (“Regulation D”).

 

3.8             No
General Solicitation. Such Noteholder did not learn of the Note Exchange as a result of any public advertising or general solicitation.

 

3.9             Brokers
and Finders. No Noteholder will have, as a result of the transactions contemplated by the Transaction Documents, any valid
right, interest or claim against or upon the Company, any Subsidiary or any other Noteholder, for any commission, fee or other
compensation pursuant to any agreement, arrangement or understanding entered into by or on behalf of such Noteholder.

 

4.            Representations
and Warranties of the Company.

 

The Company represents, warrants
and covenants to the Noteholders that:

 

4.1.          Organization;
Execution, Delivery and Performance.

 

(a)          The
Company and each of its Subsidiaries, if any, is a corporation or other entity duly organized, validly existing and in good standing
under the laws of the jurisdiction in which it is incorporated or organized, with full power and authority (corporate and other)
to own, lease, use and operate its properties and to carry on its business as and where now owned, leased, used, operated and conducted.
The Company is duly qualified as a foreign corporation to do business and is in good standing in every jurisdiction in which its
ownership or use of property or the nature of the business conducted by it makes such qualification necessary except where the
failure to be so qualified or in good standing would not have a Material Adverse Effect.

 

    	 	4	 

     

    

 

Exhibit 10.4

 

(b)          (i)
The Company has all requisite corporate power and authority to enter into and perform the Transaction Documents and to consummate
the transactions contemplated hereby and thereby and to issue the Securities, in accordance with the terms hereof and thereof,
(ii) the execution and delivery of the Transaction Documents by the Company and the consummation by the Company of the transactions
contemplated hereby and thereby (including without limitation, the issuance of the Securities) have been duly authorized by the
Company’s Board of Directors and no further consent or authorization of the Company, its Board of Directors, or its stockholders,
is required, (iii) each of the Transaction Documents has been duly executed and delivered by the Company by its authorized representative,
and such authorized representative is a true and official representative with authority to sign each such document and the other
documents or certificates executed in connection herewith and bind the Company accordingly, and (iv) each of the Transaction Documents
constitutes, and upon execution and delivery thereof by the Company will constitute, a legal, valid and binding obligation of the
Company enforceable against the Company in accordance with its terms, except to the extent limited by applicable bankruptcy, insolvency,
reorganization, moratorium or other laws of general application affecting enforcement of creditors’ rights and general principles
of equity that restrict the availability of equitable or legal remedies.

 

4.2.            Securities
Duly Authorized. The Securities to be issued to each such Noteholder pursuant to this Agreement, when issued and delivered
in accordance with the terms of this Agreement, will be duly and validly issued and will be fully paid and nonassessable and free
from all taxes or Liens with respect to the issue thereof and shall not be subject to preemptive rights or other similar rights
of stockholders of the Company. Subject to the accuracy of the representations and warranties of the Noteholders to this Agreement,
the offer and issuance by the Company of the Securities is exempt from registration under the Securities Act.

 

4.3             No
Conflicts. The execution, delivery and performance of the Transaction Documents by the Company and the consummation by the
Company of the transactions contemplated hereby and thereby will not: (i) conflict with or result in a violation of any provision
of the Certificate of Incorporation or By-laws or (ii) violate or conflict with, or result in a breach of any provision of, or
constitute a default (or an event which with notice or lapse of time or both could become a default) under, or give to others any
rights of termination, amendment, acceleration or cancellation of, any agreement, indenture, patent, patent license or instrument
to which the Company or any of its Subsidiaries is a party, except for possible violations, conflicts or defaults as would not,
individually or in the aggregate, have a Material Adverse Effect, or (iii) result in a violation of any law, rule, regulation,
order, judgment or decree (including federal and state securities laws and regulations and regulations of any self-regulatory organizations
to which the Company or its securities are subject) applicable to the Company or any of its Subsidiaries or by which any property
or asset of the Company or any of its Subsidiaries is bound or affected. Except for the failure of the Company to hold a shareholder
meeting in 2012, as required by its By-laws, neither the Company nor any of its Subsidiaries is in violation of its Certificate
of Incorporation, By-laws or other organizational documents. Neither the Company nor any of its Subsidiaries is in default (and
no event has occurred which with notice or lapse of time or both could put the Company or any of its Subsidiaries in default) under,
and neither the Company nor any of its Subsidiaries has taken any action or failed to take any action that would give to others
any rights of termination, amendment, acceleration or cancellation of, any agreement, indenture or instrument to which the Company
or any of its Subsidiaries is a party or by which any property or assets of the Company or any of its Subsidiaries is bound or
affected, or for possible defaults as would not, individually or in the aggregate, have a Material Adverse Effect. The businesses
of the Company and its Subsidiaries are not being conducted in violation of any law, rule ordinance or regulation of any governmental
entity, except for possible violations which would not, individually or in the aggregate, have a Material Adverse Effect. Except
as required under the Securities Act, the Exchange Act, the rules and regulations of the OTC Pink Market and any applicable state
securities laws, the Company is not required to obtain any consent, authorization or order of, or make any filing or registration
with, any court, governmental agency, regulatory agency, self regulatory organization or stock market or any third party in order
for it to execute, deliver or perform any of its obligations under this Agreement or to issue and sell the Securities in accordance
with the terms hereof. All consents, authorizations, orders, filings and registrations which the Company is required to obtain
pursuant to the preceding sentence have been obtained or effected on or prior to the date hereof.

 

4.4.            Capitalization.
As of December 11, 2015, the authorized capital stock of the Company consists of (i) 50,000,000 shares of Common Stock, of which
7,123,074 shares are issued and outstanding, 1,288,134 shares are reserved for issuance pursuant to existing warrants to purchase
Common Stock; 2,000,000 are reserved for issuance pursuant to the 2015 Intellinetics, Inc. Equity Incentive Plan, and 5,793,345
shares are reserved for issuance in accordance with all of the outstanding Convertible Notes. Upon the consummation of the Note
Exchange, up to an additional 2,193,708 shares of Common Stock may be issuable upon exercise of the Warrants, and up to an additional
579,834 shares of Common Stock may be issuable upon exercise of the PA Warrants.

 

The Company is currently conducted
a private placement of equity securities simultaneously with the Note Exchange (the “Offering”), pursuant to which
up to 3,333,332 shares of Common Stock may be issued (aside from Common Stock issued in accordance with this Note Exchange), up
to an additional 1,666,666 shares of Common Stock may be issued in accordance with warrants issued pursuant to such Offering, and
up to an additional 333,334 shares of Common Stock may be issued if all the placement agent warrants are exercised in connection
with the Offering.

 

    	 	5	 

     

    

 

Exhibit 10.4

 

The aggregate total number of Common
Stock that could be issued as a result of both this Note Exchange and the Offering is 13,900,219.

 

Except as described above, (i) there
are no outstanding options, warrants, scrip, rights to subscribe for, puts, calls, rights of first refusal, agreements, understandings,
claims or other commitments or rights of any character whatsoever relating to, or securities or rights convertible into or exchangeable
for any shares of capital stock of the Company or any of its Subsidiaries, or arrangements by which the Company or any of its Subsidiaries
is or may become bound to issue additional shares of capital stock of the Company or any of its Subsidiaries, (ii) there are no
agreements or arrangements under which the Company or any of its Subsidiaries is obligated to register the sale of any of its or
their securities under the Securities Act (except for the registration rights provisions contained herein) and (iii) there are
no anti-dilution or price adjustment provisions contained in any security issued by the Company (or in any agreement providing
rights to security holders) that will be triggered by the issuance of the Shares. All of such outstanding shares of capital stock
are, or upon issuance will be, duly authorized, validly issued, fully paid and nonassessable. No shares of capital stock of the
Company are subject to preemptive rights or any other similar rights of the stockholders of the Company or any Lien imposed through
the actions or failure to act of the Company.

 

4.5.            SEC
Information.

 

(a)             Since
the filing of the “Form 10 information” referenced in Section 4.18 of this Agreement, the Company has timely filed
all reports, schedules, forms, statements and other documents required to be filed by it with the SEC pursuant to the reporting
requirements of the Exchange Act (all of the foregoing and all other documents filed with the SEC prior to the date hereof and
all exhibits included therein and financial statements and schedules thereto and documents incorporated by reference therein, being
hereinafter referred to herein as the “SEC Documents”). The SEC Documents have been made available to the Noteholders
via the SEC’s EDGAR system. As of their respective dates, the SEC Documents complied in all material respects with the requirements
of the Exchange Act and the rules and regulations of the SEC promulgated thereunder applicable to the SEC Documents, and none of
the SEC Documents, at the time they were filed with the SEC, contained any untrue statement of a material fact or omitted to state
a material fact required to be stated therein or necessary in order to make the statements therein, in light of the circumstances
under which they were made, not misleading. As of their respective dates, the financial statements of the Company included in the
SEC Documents (“Company Financial Statements”) complied as to form in all material respects with applicable accounting
requirements and the published rules and regulations of the SEC with respect thereto. The Company Financial Statements have been
prepared in accordance with United States generally accepted accounting principles, consistently applied, during the periods involved
(except (i) as may be otherwise indicated in such financial statements or the notes thereto, or (ii) in the case of unaudited interim
statements, to the extent they may not include footnotes or may be condensed or summary statements) and fairly present in all material
respects the consolidated financial position of the Company and its consolidated Subsidiaries as of the dates thereof and the consolidated
results of their operations and cash flows for the periods then ended (subject, in the case of unaudited statements, to normal
year-end audit adjustments). Except as set forth in the Company Financial Statements, the Company has no liabilities, contingent
or otherwise, other than: (i) liabilities incurred in the ordinary course of business subsequent to September 30, 2015 (the fiscal
period end of the Company’s most recently-filed periodic report), and (ii) obligations under contracts and commitments incurred
in the ordinary course of business and not required under generally accepted accounting principles to be reflected in such financial
statements, which, individually or in the aggregate, are not material to the financial condition or operating results of the Company.

 

(b)             The
shares of Common Stock are currently traded on the OTC Pink Market. Except as set forth in the SEC Documents, the Company has not
received notice (written or oral) from the Financial Industry Regulatory Authority to the effect that the Company is not in compliance
with the continued listing and maintenance requirements of such market. The Company is in material compliance with all such listing
and maintenance requirements.

 

    	 	6	 

     

    

 

Exhibit 10.4

 

4.6             Permits;
Compliance. The Company and each of its Subsidiaries is in possession of all franchises, grants, authorizations, licenses,
permits, easements, variances, exemptions, consents, certificates, approvals and orders necessary to own, lease and operate its
properties and to carry on its business as it is now being conducted (collectively, the “Company Permits”), and there
is no action pending or, to the knowledge of the Company, threatened regarding suspension or cancellation of any of the Company
Permits. Neither the Company nor any of its Subsidiaries is in conflict with, or in default or violation of, any of the Company
Permits, except for any such conflicts, defaults or violations which, individually or in the aggregate, would not reasonably be
expected to have a Material Adverse Effect. Since September 30, 2015, neither the Company nor any of its Subsidiaries has received
any notification with respect to possible conflicts, defaults or violations of applicable laws, except for notices relating to
possible conflicts, defaults or violations, which conflicts, defaults or violations would not have a Material Adverse Effect.

 

4.7             Litigation.
Except as set forth in the SEC Documents, there is no action, suit, claim, proceeding, inquiry or investigation before or by any
court, public board, government agency, self-regulatory organization or body pending or, to the knowledge of the Company or any
of its Subsidiaries, threatened against or affecting the Company or any of its Subsidiaries, or their respective businesses, properties
or assets or their officers or directors in their capacity as such, that would have a Material Adverse Effect. The Company is unaware
of any facts or circumstances which might give rise to any of the foregoing. There has not been, and to the Company’s Knowledge,
there is not pending or contemplated, any investigation by the SEC involving the Company, any of its Subsidiaries or any current
or former director or executive officer of the Company or any of its Subsidiaries.

 

4.8             No
Material Changes.

 

Since September 30, 2015, except as set forth
in the SEC Documents, there has not been:

 

		(i)	Any material adverse change in the financial condition,
operations or business of the Company from that shown on the Company Financial Statements, or any material transaction or commitment
effected or entered into by the Company outside of the ordinary course of business;

 

		(ii)	Any effect, change or circumstance which has had, or could reasonably be expected to have, a Material Adverse Effect; or

 

		(iii)	Any incurrence of any material liability outside of the
ordinary course of business.

 

4.9             No
General Solicitation. Neither the Company nor any person participating on the Company’s behalf in the transactions contemplated
hereby has conducted any “general solicitation,” as such term is defined in Regulation D promulgated under the Securities
Act, with respect to any of the Shares being offered hereby.

 

4.10           No
Integrated Offering. Neither the Company, nor any of its affiliates, nor any person acting on its or their behalf, has directly
or indirectly made any offers or sales in any security or solicited any offers to buy any security under circumstances that would
require registration under the Securities Act of the issuance of the Shares to the Noteholders. The issuance of the Shares to the
Noteholders will not be integrated with any other issuance of the Company’s securities (past, current or future) for purposes
of any stockholder approval provisions applicable to the Company or its securities.

 

4.11           No
Brokers. Except as set forth in Section 9.1, the Company has taken no action which would give rise to any claim by any person
for brokerage commissions, transaction fees or similar payments relating to this Agreement or the transactions contemplated hereby.

 

    	 	7	 

     

    

 

Exhibit 10.4

 

4.12           Internal
Controls. The Company is in material compliance with the provisions of the Sarbanes-Oxley Act of 2002 currently applicable
to the Company. The Company and the Subsidiaries maintain a system of internal accounting controls sufficient to provide reasonable
assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in
accordance with generally accepted accounting principles. The Company has established disclosure controls and procedures (as defined
in Exchange Act Rules 13a-14 and 15d-14) for the Company and designed such disclosure controls and procedures to ensure that material
information relating to the Company, including the Subsidiaries, is made known to the certifying officers by others within those
entities, particularly during the period in which the Company’s most recently filed period report under the Exchange Act,
as the case may be, is being prepared. The Company's certifying officers have evaluated the effectiveness of the Company's controls
and procedures as of the end of the period covered by the most recently filed periodic report under the Exchange Act (such date,
the “Evaluation Date”). The Company presented in its most recently filed periodic report under the Exchange Act the
conclusions of the certifying officers about the effectiveness of the disclosure controls and procedures based on their evaluations
as of the Evaluation Date. Since the Evaluation Date, there have been no significant changes in the Company's internal controls
(as such term is defined in Item 308 of Regulation S-K) or, to the Company's Knowledge, in other factors that could significantly
affect the Company's internal controls. The Company maintains and will continue to maintain a standard system of accounting established
and administered in accordance with GAAP and the applicable requirements of the Exchange Act.

 

4.13           Disclosure.
The Company confirms that neither it nor any other Person acting on its behalf has provided any of the Noteholders or their agents
or counsel with any information that constitutes or could reasonably be expected to constitute material, non-public information
concerning the Company or any of its Subsidiaries, other than the existence of the transactions contemplated by this Agreement
and the other Transaction Documents. The Company understands and confirms that each of the Noteholders will rely on the foregoing
representations in effecting transactions in securities of the Company. All disclosure provided to the Noteholders regarding the
Company and its Subsidiaries, their businesses and the transactions contemplated hereby, including the schedules to this Agreement,
furnished by or on behalf of the Company or any of its Subsidiaries is true and correct in all material respects and does not contain
any untrue statement of a material fact or omit to state any material fact necessary in order to make the statements made therein,
in the light of the circumstances under which they were made, not misleading. Each press release issued by the Company or any of
its Subsidiaries during the twelve (12) months preceding the date of this Agreement did not at the time of release contain any
untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary in order to make
the statements therein, in the light of the circumstances under which they are made, not misleading. No event or circumstance has
occurred or information exists with respect to the Company or any of its Subsidiaries or its or their business, properties, liabilities,
results of operations or financial conditions, which, under applicable law, rule or regulation, requires public disclosure at or
before the date hereof or announcement by the Company but which has not been so publicly disclosed. The Company acknowledges and
agrees that no Noteholder makes or has made any representations or warranties with respect to the transactions contemplated hereby
other than those specifically set forth in Section 3.

 

4.14           Intellectual
Property Rights. The Company and its Subsidiaries own or possess adequate rights or licenses to use all trademarks, trade names,
service marks, service mark registrations, service names, patents, patent rights, copyrights, original works, inventions, licenses,
approvals, governmental authorizations, trade secrets and other intellectual property rights and all applications and registrations
therefor (“Intellectual Property Rights”) necessary to conduct their respective businesses as now conducted and as
presently proposed to be conducted. None of the Company’s or its Subsidiaries’ Intellectual Property Rights have expired,
terminated or been abandoned, or are expected to expire, terminate or be abandoned, within two (2) years from the date of this
Agreement. The Company has no knowledge of any infringement by the Company or any of its Subsidiaries of Intellectual Property
Rights of others. Except as set forth in the SEC Documents, there is no claim, action or proceeding being made or brought, or to
the Company’s Knowledge, being threatened, against the Company or any of its Subsidiaries regarding their Intellectual Property
Rights. The Company is not aware of any facts or circumstances which might give rise to any of the foregoing infringements or claims,
actions or proceedings. The Company and each of its Subsidiaries have taken reasonable security measures to protect the secrecy,
confidentiality and value of all of their Intellectual Property Rights, except where failure to take such measures would not, either
individually or in the aggregate, reasonably be expected to result in a Material Adverse Effect.

 

4.15           Tax
Status. Except for occurrences that would not, either individually or in the aggregate, reasonably be expected to result in
a Material Adverse Effect, the Company and each of its Subsidiaries (i) has timely made or filed all foreign, federal and state
income and all other tax returns, reports and declarations required by any jurisdiction to which it is subject, (ii) has timely
paid all taxes and other governmental assessments and charges that are material in amount, shown or determined to be due on such
returns, reports and declarations, except those being contested in good faith and (iii) has set aside on its books provision reasonably
adequate for the payment of all taxes for periods subsequent to the periods to which such returns, reports or declarations apply.
There are no unpaid taxes in any material amount claimed to be due by the taxing authority of any jurisdiction, and the officers
of the Company and its Subsidiaries know of no basis for any such claim. The Company is not operated in such a manner as to qualify
as a passive foreign investment company, as defined in Section 1297 of the U.S. Internal Revenue Code of 1986, as amended.

 

    	 	8	 

     

    

 

Exhibit 10.4

 

4.16           Acknowledgement
Regarding Noteholders’ Trading Activity. It is understood and acknowledged by the Company that (i) following the public
disclosure of the transactions contemplated by the Transaction Documents in accordance with the terms thereof, none of the Noteholders
have been asked by the Company or any of its Subsidiaries to agree, nor has any Noteholder agreed with the Company or any of its
Subsidiaries, to desist from effecting any transactions in or with respect to (including, without limitation, purchasing or selling,
long and/or short) any securities of the Company, or “derivative” securities based on securities issued by the Company
or to hold any of the Shares for any specified term; (ii) any Noteholder, and counterparties in “derivative” transactions
to which any such Noteholder is a party, directly or indirectly, presently may have a “short” position in the Common
Stock which was established prior to such Noteholder’s knowledge of the transactions contemplated by the Transaction Documents;
and (iii) each Noteholder shall not be deemed to have any affiliation with or control over any arm’s length counterparty
in any “derivative” transaction. The Company further understands and acknowledges that following the public disclosure
of the transactions contemplated by the Transaction Documents, one or more Noteholders may engage in hedging and/or trading activities
at various times during the period that the Shares are outstanding, and such hedging and/or trading activities, if any, can reduce
the value of the existing stockholders’ equity interest in the Company both at and after the time the hedging and/or trading
activities are being conducted. The Company acknowledges that such aforementioned hedging and/or trading activities do not constitute
a breach of this Agreement or any other Transaction Document or any of the documents executed in connection herewith or therewith.

 

4.17           Manipulation
of Price. Neither the Company nor any of its Subsidiaries has, and, to the Company’s Knowledge, no Person acting on their
behalf has, directly or indirectly, (i) taken any action designed to cause or to result in the stabilization or manipulation of
the price of any security of the Company or any of its Subsidiaries to facilitate the sale or resale of any of the Shares, (ii)
sold, bid for, purchased, or paid any compensation for soliciting purchases of, any of the Shares (other than the Placement Agent),
or (iii) paid or agreed to pay to any Person any compensation for soliciting another to purchase any other securities of the Company
or any of its Subsidiaries (other than the Placement Agent).

 

4.18           Shell
Company Status. The Company was previously a “shell issuer”, as defined in Rule 144(i)(1), promulgated under the
Securities Act. The Company confirms that: (i) effective February 10, 2012, it ceased to be a “shell issuer”; (ii)
it has not been a “shell issuer” between February 10, 2012 and the date of this Agreement; (iii) it is subject to the
reporting requirements of Section 13 of the Exchange Act; (iv) it has filed all reports and other materials required to be filed
by Section 13 of the Exchange Act during the 12 month period prior to the date of this Agreement, and (v) more than one year ago,
it filed current “Form 10 information”, as defined in Rule 144(i)(3), with the SEC, which reflects that it is not a
“shell issuer”.

 

5.            Registration
Rights.

 

5.1.          Mandatory
Registration. The Company shall prepare and, as soon as practicable, but in no event later than 90 days after the effective
date of this Agreement, file with the SEC a Registration Statement on Form S-3 covering the resale of all of the Registrable Securities,
provided that if Form S-3 is unavailable for such a registration, the Company shall register the resale of the Registrable Securities
on another appropriate form reasonably acceptable to the Noteholders and (ii) undertake to register the resale of the Registrable
Securities on Form S-3 as soon as such form is available, provided that the Company shall maintain the effectiveness of all Registration
Statements then in effect and the availability for use of each prospectus contained therein until such time as a Registration Statement
on Form S-3 covering the resale of all the Registrable Securities has been declared effective by the SEC and the prospectus contained
therein is available for use. The Company shall use commercially reasonable efforts to have such initial Registration Statement,
and each other Registration Statement required to be filed pursuant to the terms of this Agreement, declared effective by the SEC
as soon as practicable, but in no event later than 180 days after the effective date of this Agreement (or 90 days after such date
when the Company is then obligated to file another Registration Statement).

 

    	 	9	 

     

    

 

Exhibit 10.4

 

5.2.          PiggyBack
Registration. Whenever the Company proposes to register any of its securities under the Securities Act, whether for its own
account or for the account of another stockholder (except for the registration of securities (A) to be offered pursuant to an employee
benefit plan on Form S-8 or (B) pursuant to a registration made on Form S-4, or any successor forms then in effect) at any time
and the registration form to be used may be used for the registration of the Registrable Securities (a “Piggyback Registration”),
it will so notify in writing all holders of Registrable Securities no later than the earlier to occur of (i) the tenth (10th)
day following the Company’s receipt of notice of exercise of other demand registration rights, or (ii) thirty (30) days prior
to the anticipated filing date. Subject to the provisions of this Agreement, the Company will include in the Piggyback Registration
all Registrable Securities, on a pro rata basis based upon the total number of Registrable Securities with respect to which the
Company has received written requests for inclusion within ten (10) business days after the applicable holder’s receipt of
the Company’s notice.

 

5.3.          Expenses.
All fees and expenses incident to the performance of or compliance with this Agreement by the Company shall be borne by the Company,
whether or not any Registrable Securities are sold pursuant to the Registration Statement. The fees and expenses referred to in
the foregoing sentence shall include, without limitation, (i) all registration and filing fees (including, without limitation,
fees and expenses (A) with respect to filings required to be made with the trading market on which the Common Stock is then listed
for trading, and (B) in compliance with applicable state securities or Blue Sky laws, (ii) processing expenses of the Placement
Agent, including, but not limited to, printing expenses, messenger, telephone and delivery expenses and customary marketing expenses,
(iii) fees and disbursements of counsel and independent public accountants for the Company, (iv) fees and disbursements of one
counsel to the Placement Agent, and (v) filing fees and counsel fees of the Placement Agent if a determination is made that a FINRA
Rule 5110 filing is required to be made with respect to the Registration Statement.

 

5.4.          Offering.
In the event the staff of the SEC (the “Staff”) or the SEC seeks to characterize any offering pursuant
to a Registration Statement filed pursuant to this Agreement as constituting an offering of securities by, or on behalf of,
the Company, or in any other manner, such that the Staff or the SEC do not permit such Registration Statement to
become effective and used for resales in a manner that does not constitute such an offering and that permits the continuous resale
at the market by the Noteholders participating therein (or as otherwise may be acceptable to each Noteholder) without
being named therein as an “underwriter,” then the Company shall reduce the number of shares to be included in such
Registration Statement until such time as the Staff and the SEC shall so permit such Registration Statement to become effective
as aforesaid. In making such reduction, the Company shall (X) reduce, and if necessary, eliminate, in order, (i) any Registrable
Securities that are not Shares or PA Warrant Shares then (ii) any Registrable Securities that are not Shares, then (Y) if necessary,
reduce the number of shares to be included by all Noteholders on a pro rata basis (based upon the number of Registrable Securities
otherwise required to be included for each Noteholder) unless the inclusion of shares by a particular Noteholder or a particular
set of Noteholders are resulting in the Staff or the SEC’s “by or on behalf of the Company” offering position,
in which event the shares held by such Noteholder or set of Noteholders shall be the only shares subject to reduction (and if by
a set of Noteholders on a pro rata basis by such Noteholders or on such other basis as would result in the exclusion of the least
number of shares by all such Noteholders).  In addition, in the event that the Staff or the SEC requires any Noteholder seeking
to sell securities under a Registration Statement filed pursuant to this Agreement to be specifically identified as an “underwriter” in
order to permit such Registration Statement to become effective, and such Noteholder does not consent to being so named as an underwriter
in such Registration Statement, then, in each such case, the Company shall reduce the total number of Registrable Securities
to be registered on behalf of such Noteholder, until such time as the Staff or the SEC does not require such identification
or until such Noteholder accepts such identification and the manner thereof. Notwithstanding anything else to the foregoing,
any reduction pursuant to this paragraph will first reduce all securities that are not Registrable Securities. In the
event of any reduction in Registrable Securities pursuant to this paragraph, an affected Noteholder shall have the right
to require, upon delivery of a written request to the Company signed by such Noteholder, the Company to file a registration statement
within thirty (30) days of such request (subject to any restrictions imposed by Rule 415 promulgated by the SEC under the Securities
Act or required by the Staff or the SEC) for resale by such Noteholder in a manner acceptable to such Noteholder, and
the Company shall following such request cause to be and keep effective such registration statement in the same manner as
otherwise contemplated in this Agreement for registration statements hereunder, in each case until such time as: (i)
all Registrable Securities held by such Noteholder have been registered and sold pursuant to an effective Registration Statement
in a manner acceptable to such Noteholder or (ii) all Registrable Securities may be resold by such Noteholder without
restriction (including, without limitation, volume limitations) pursuant to Rule 144 (taking account of any Staff position with
respect to “affiliate” status) and without the need for current public information required by Rule 144(c)(1) (or Rule
144(i)(2), if applicable) or (iii) such Noteholder agrees to be named as an underwriter in any such Registration Statement in a
manner acceptable to such Noteholder as to all Registrable Securities held by such Noteholder and that have not theretofore been
included in a Registration Statement under this Agreement (it being understood that the special demand right under this sentence
may be exercised by a Noteholder multiple times and with respect to limited amounts of Registrable Securities in order to permit
the resale thereof by such Noteholder as contemplated above).

 

    	 	10	 

     

    

 

Exhibit 10.4

 

5.5.         Indemnification.

 

(a)          Indemnification
by the Company. The Company will indemnify and hold harmless each Noteholder and its officers, directors, members, shareholders,
partners, representatives, employees and agents, successors and assigns, and each other person, if any, who controls such Noteholder
within the meaning of the Securities Act, against any losses, obligations, claims, damages, liabilities, contingencies, judgments,
fines, penalties, charges, costs (including, without limitation, court costs, reasonable attorneys’ fees and costs of defense
and investigation), amounts paid in settlement or expenses, joint or several, (collectively, “Claims”) incurred in
investigating, preparing or defending any action, claim, suit, inquiry, proceeding, investigation or appeal taken from the foregoing
by or before any court or governmental, administrative or other regulatory agency, body or the SEC, whether pending or threatened,
whether or not an indemnified party is or may be a party thereto, to which any of them may become subject insofar as such Claims
(or actions or proceedings, whether commenced or threatened, in respect thereof) arise out of or are based upon: (i) any untrue
statement or alleged untrue statement of any material fact contained in any Registration Statement, any preliminary prospectus
or final prospectus contained therein, or the Private Placement Memorandum, or any amendment or supplement thereof; (ii) any blue
sky application or other document executed by the Company specifically for that purpose or based upon written information furnished
by the Company filed in any state or other jurisdiction in order to qualify any or all of the Registrable Securities under the
securities laws thereof (any such application, document or information herein called a “Blue Sky Application”);
(iii) the omission or alleged omission to state therein a material fact required to be stated therein or necessary to make the
statements therein not misleading; (iv) any violation by the Company or its agents of any rule or regulation promulgated under
the Securities Act applicable to the Company or its agents and relating to action or inaction required of the Company in connection
with such registration; or (v) any failure to register or qualify the Registrable Securities included in any such Registration
Statement in any state where the Company or its agents has affirmatively undertaken or agreed in writing that the Company will
undertake such registration or qualification on a Noteholder’s behalf and will reimburse such Noteholder, and each such officer,
director or member and each such controlling person for any legal or other expenses reasonably incurred by them in connection with
investigating or defending any such Claim or action; provided, however, that the Company will not be liable in any
such case if and to the extent that any such loss, claim, damage or liability arises out of or is based upon an untrue statement
or alleged untrue statement or omission or alleged omission so made in conformity with information furnished by such Noteholder
or any such controlling person in writing specifically for use in such Registration Statement or Prospectus.

 

(b)          Indemnification
by the Noteholders. Each Noteholder agrees, severally but not jointly, to indemnify and hold harmless, to the fullest extent
permitted by law, the Company, its directors, officers, employees, stockholders, partner, representatives and each person who controls
the Company (within the meaning of the Securities Act) against any Claims resulting from any untrue statement of a material fact
or any omission of a material fact required to be stated in the Registration Statement or Prospectus or preliminary prospectus
or amendment or supplement thereto or necessary to make the statements therein not misleading, to the extent, but only to the extent
that such untrue statement or omission is contained in any information furnished in writing by such Noteholder to the Company specifically
for inclusion in such Registration Statement or Prospectus or amendment or supplement thereto. In no event shall the liability
of a Noteholder be greater in amount than the dollar amount of the proceeds (net of all expense paid by such Noteholder in connection
with any claim relating to this Section 5.3 and the amount of any damages such Noteholder has otherwise been required to pay by
reason of such untrue statement or omission) received by such Noteholder upon the sale of the Registrable Securities included in
the Registration Statement giving rise to such indemnification obligation.

 

    	 	11	 

     

    

 

Exhibit 10.4

 

(c)          Conduct
of Indemnification Proceedings. Any person entitled to indemnification hereunder shall (i) give prompt notice to the indemnifying
party of any claim with respect to which it seeks indemnification and (ii) permit such indemnifying party to assume the defense
of such claim with counsel reasonably satisfactory to the indemnified party; provided that any person entitled to indemnification
hereunder shall have the right to employ separate counsel and to participate in the defense of such claim, but the fees and expenses
of such counsel shall be at the expense of such person unless (a) the indemnifying party has agreed to pay such fees or expenses,
or (b) the indemnifying party shall have failed to assume the defense of such claim or employ counsel reasonably satisfactory to
such person or (c) in the reasonable judgment of any such person, based upon written advice of its counsel, a conflict of interest
exists between such person and the indemnifying party with respect to such claims (in which case, if the person notifies the indemnifying
party in writing that such person elects to employ separate counsel at the expense of the indemnifying party, the indemnifying
party shall not have the right to assume the defense of such claim on behalf of such person); and provided, further,
that the failure of any indemnified party to give notice as provided herein shall not relieve the indemnifying party of its obligations
hereunder, except to the extent that such failure to give notice shall materially adversely affect the indemnifying party in the
defense of any such claim or litigation. It is understood that the indemnifying party shall not, in connection with any proceeding
in the same jurisdiction, be liable for fees or expenses of more than one separate firm of attorneys at any time for all such indemnified
parties. No indemnifying party will, except with the consent of the indemnified party, which consent shall not be unreasonably
withheld or delayed, consent to entry of any judgment or enter into any settlement that does not include as an unconditional term
thereof the giving by the claimant or plaintiff to such indemnified party of a release from all liability in respect of such claim
or litigation.

 

(d)          Contribution.
If for any reason the indemnification provided for in the preceding paragraphs (a) and (b) is unavailable to an indemnified party
or insufficient to hold it harmless, other than as expressly specified therein, then the indemnifying party shall contribute to
the amount paid or payable by the indemnified party as a result of such Claim in such proportion as is appropriate to reflect the
relative fault of the indemnified party and the indemnifying party, as well as any other relevant equitable considerations. No
person guilty of fraudulent misrepresentation within the meaning of Section 11(f) of the Securities Act shall be entitled to contribution
from any person not guilty of such fraudulent misrepresentation. In no event shall the contribution obligation of a holder of Registrable
Securities be greater in amount than the dollar amount of the proceeds (net of all expenses paid by such holder in connection with
any claim relating to this Section 5.3 and the amount of any damages such holder has otherwise been required to pay by reason of
such untrue or alleged untrue statement or omission or alleged omission) received by it upon the sale of the Registrable Securities
giving rise to such contribution obligation.

 

5.6.          Cooperation
by Noteholder. Each Noteholder shall furnish to the Company or the Underwriter, as applicable, such information regarding the
Noteholder and the distribution proposed by it as the Company may reasonably request in connection with any registration or offering
referred to in this Section 5. Each Noteholder shall cooperate as reasonably requested by the Company in connection with the preparation
of the registration statement with respect to such registration, and for so long as the Company is obligated to file and keep effective
such registration statement, shall provide to the Company, in writing, for use in the registration statement, all such information
regarding the Noteholder and its plan of distribution of the Shares included in such registration as may be reasonably necessary
to enable the Company to prepare such registration statement, to maintain the currency and effectiveness thereof and otherwise
to comply with all applicable requirements of law in connection therewith.

 

    	 	12	 

     

    

 

Exhibit 10.4

 

6.            Transfer
Restrictions.

 

6.1.          Transfer
or Resale. Each Noteholder understands that:

 

(i)          Except
as provided in the registration rights provisions set forth above, the sale or resale of all or any portion of the Shares has not
been and is not being registered under the Securities Act or any applicable state securities laws, and all or any portion of the
Shares may not be transferred unless:

 

(A)         the
Shares are sold pursuant to an effective registration statement under the Securities Act;

 

(B)         the
Noteholder shall have delivered to the Company, at the cost of the Company, a customary opinion of counsel that shall be in form,
substance and scope reasonably acceptable to the Company, to the effect that the Shares to be sold or transferred may be sold or
transferred pursuant to an exemption from such registration;

 

(C)         the
Shares are sold or transferred to an “affiliate” (as defined in Rule 144 promulgated under the Securities Act (or a
successor rule) (“Rule 144”)) of the Noteholder who agrees to sell or otherwise transfer the Shares only in
accordance with this Section 6.1 and who is an Accredited Investor;

 

(D)         the
Shares are sold pursuant to Rule 144; or

 

(E)         the
Shares are sold pursuant to Regulation S under the Securities Act (or a successor rule) (“Regulation S”);

 

and, in each case, the Noteholder shall have delivered
to the Company, at the cost of the Company, a customary opinion of counsel, in form, substance and scope reasonably acceptable
to the Company. Notwithstanding the foregoing or anything else contained herein to the contrary, the Shares may be pledged as collateral
in connection with a bona fide margin account or other lending arrangement.

 

6.2           Transfer
Agent Instructions. If a Noteholder provides the Company with a customary opinion of counsel, that shall be in form, substance
and scope reasonably acceptable to the Company, to the effect that a public sale or transfer of such Shares may be made without
registration under the Securities Act and such sale or transfer is effected, the Company shall permit the transfer and promptly
instruct its transfer agent to issue one or more certificates, free from restrictive legend, in such name and in such denominations
as specified by such Noteholder. The Company acknowledges that a breach by it of its obligations hereunder will cause irreparable
harm to the Noteholders, by vitiating the intent and purpose of the transactions contemplated hereby. Accordingly, the Company
acknowledges that the remedy at law for a breach of its obligations under this Section 6.2 may be inadequate and agrees, in the
event of a breach or threatened breach by the Company of the provisions of this Section, that the Noteholders shall be entitled,
in addition to all other available remedies, to an injunction restraining any breach and requiring immediate transfer, without
the necessity of showing economic loss and without any bond or other security being required.

 

6.3           Public
Information.  At any time during the period commencing from the effective date of this Agreement and ending on the two
(2) year anniversary of such date, if the Company shall fail for any reason to satisfy the current public information requirement
under Rule 144(c) (a “Public Information Failure”) then, in addition to such Noteholder’s other available
remedies, the Company shall pay to each Noteholder, in cash, as partial liquidated damages and not as a penalty, by reason of any
such delay in or reduction of its ability to sell the Shares, an amount in cash equal to one percent (1.0%) of the aggregate Conversion
Amount for each Noteholder on the day of a Public Information Failure and on every thirtieth (30th) day (pro-rated for
periods totaling less than thirty days) thereafter until the earlier of (a) the date such Public Information Failure is cured and
(b) such time that such public information is no longer required for the Noteholders to transfer the Shares pursuant to Rule 144. 
The payments to which a Noteholder shall be entitled pursuant to this Section 6.3 are referred to herein as “Public Information
Failure Payments.”  Public Information Failure Payments shall be paid on the earlier of (i) the last day
of the calendar month during which such Public Information Failure Payments are incurred and (ii) the third (3rd)
Business Day after the event or failure giving rise to the Public Information Failure Payments is cured. In the event the
Company fails to make Public Information Failure Payments in a timely manner, such Public Information Failure Payments
shall bear interest at the rate of 1.5% per month (prorated for partial months) until paid in full. Nothing herein shall limit
such Noteholder’s right to pursue actual damages for the Public Information Failure, and such Noteholder shall have the right
to pursue all remedies available to it at law or in equity including, without limitation, a decree of specific performance and/or
injunctive relief.

 

    	 	13	 

     

    

 

Exhibit 10.4

 

6.3           Holding
Period.  Notwithstanding anything else to the foregoing, for the purposes of Rule 144, the Company acknowledges that the
holding period of the Note may be tacked onto the holding period of each of the Shares and the Warrants, and the Company agrees
not to take a position contrary to this Section 6.3. The Company agrees to take all actions, including, without limitation, obtaining
customary legal opinions necessary to comply with the foregoing.

 

7.            Miscellaneous.

 

7.1.          Compensation
of Placement Agent. The Noteholder acknowledges that it is aware that the Placement Agent will receive from the Company, in
consideration for its services as financial advisor and placement agent in respect of the transactions contemplated hereby, (a)
a commission success fee equal to 8% of the face value (including accrued unpaid interest) of the Notes that are converted in connection
with this Note Exchange, payable in cash, (b) an expense allowance, which shall include reimbursement of legal expenses incurred
in connection with the transactions contemplated hereby, not to exceed $30,000 without the Company’s prior written approval,
payable in cash, (c) reimbursement for all filing fees the Placement Agent is required to pay the Financial Industry Regulatory
Authority (“FINRA”) and reasonable fees and expenses of legal counsel to Placement Agent in connection with such filings
with FINRA; and (d) five-year warrants to purchase such number of shares of the Company’s Common Stock equal to ten
percent (10%) of the number of shares issued in connection with this Note Exchange, at an exercise price equal to $0.715 per share.
The Placement Agent is also receiving additional compensation in connection with the Offering.

 

7.2.          Notices.
All notices, requests, demands and other communications provided in connection with this Agreement shall be in writing and shall
be deemed to have been duly given at the time when hand delivered, delivered by express courier, or sent by facsimile (with receipt
confirmed by the sender’s transmitting device) in accordance with the contact information provided below or such other contact
information as the parties may have duly provided by notice.

 

The Company:

 

	Intellinetics, Inc.	With a copy to:	Kegler, Brown, Hill & Ritter Co., L.P.A.
	 	 	 
	2190 Dividend Drive	 	65 E. State St., Ste 1800
	 	 	 
	Columbus, Ohio 43228-3806	 	Columbus, Ohio 43215
	 	 	 	 	 
	Telephone:	(614) 388-8909	 	Telephone:	(614) 462-5400
	 	 	 	 	 
	Attention:	Mr. Matthew L. Chretien,	 	Facsimile:	(614) 464-2634
	 	President and Chief Executive Officer	 	 	 
	 	 	 	Attention:	Erin C. Herbst

 

The Noteholders:

 

As per the contact information provided on the signature
pages hereof.

 

    	 	14	 

     

    

 

Exhibit 10.4

 

Taglich Brothers, Inc.:

 

	Taglich Brothers, Inc.	With a copy to: 	Sichenzia Ross Friedman Ference LLP
	 	 	 
	275 Madison Avenue, Suite 1618	 	61 Broadway, 32nd Floor
	 	 	 
	New York, NY 10016	 	New York, New York 10006
	 	 	 
	Telephone:	(212) 661-6886	 	Telephone:  	(212) 930-9700
	 	 	 	 	 
	Facsimile:	(212) 661-6824	 	Facsimile:	(212) 930-9725
	 	 	 	 	 
	Attention:	Robert C. Schroeder	 	Attention:	Marc J. Ross, Esq.
	 	 	 	 	 
	 	Vice President, Investment Banking	 	 	 

 

7.3           Survival
of Representations and Warranties. Each party hereto covenants and agrees that the representations and warranties of such party
contained in this Agreement shall survive the effective date of this Agreement. Each Noteholder shall be responsible only for its
own representations, warranties, agreements and covenants hereunder.

 

7.4          Indemnification.

 

(a)          The
Company agrees to indemnify and hold harmless each Noteholder and its Affiliates and their respective directors, officers, employees
and agents from and against any and all losses, claims, damages, liabilities and expenses (including without limitation reasonable
attorney fees and disbursements and other expenses incurred in connection with investigating, preparing or defending any action,
claim or proceeding, pending or threatened and the costs of enforcement thereof) (collectively, “Losses”) to
which such Person may become subject as a result of any breach of representation, warranty, covenant or agreement made by or to
be performed on the part of the Company under the Transaction Documents, and will reimburse any such Person for all such amounts
as they are incurred by such Person.

 

(b)          Promptly
after receipt by any Noteholder (the “Indemnified Person”) of notice of any demand, claim or circumstances which
would or might give rise to a claim or the commencement of any action, proceeding or investigation in respect of which indemnity
may be sought pursuant to Section 9.4, such Indemnified Person shall promptly notify the Company in writing and the Company shall
assume the defense thereof, including the employment of counsel reasonably satisfactory to such Indemnified Person, and shall assume
the payment of all fees and expenses; provided, however, that the failure of any Indemnified Person so to
notify the Company shall not relieve the Company of its obligations hereunder except to the extent that the Company is materially
prejudiced by such failure to notify. In any such proceeding, any Indemnified Person shall have the right to retain its own counsel,
but the fees and expenses of such counsel shall be at the expense of such Indemnified Person unless: (i) the Company and the Indemnified
Person shall have mutually agreed to the retention of such counsel; or (ii) in the reasonable judgment of counsel to such Indemnified
Person representation of both parties by the same counsel would be inappropriate due to actual or potential differing interests
between them. The Company shall not be liable for any settlement of any proceeding effected without its written consent, which
consent shall not be unreasonably withheld, but if settled with such consent, or if there be a final judgment for the plaintiff,
the Company shall indemnify and hold harmless such Indemnified Person from and against any loss or liability (to the extent stated
above) by reason of such settlement or judgment. Without the prior written consent of the Indemnified Person, which consent shall
not be unreasonably withheld, the Company shall not effect any settlement of any pending or threatened proceeding in respect of
which any Indemnified Person is or could have been a party and indemnity could have been sought hereunder by such Indemnified Party,
unless such settlement includes an unconditional release of such Indemnified Person from all liability arising out of such proceeding.

 

7.5.          Entire
Agreement. This Agreement contains the entire agreement between the parties hereto in respect of the subject matter contained
herein and supersedes all prior agreements and understandings of the parties, oral and written, with respect to the subject matter
contained herein.

 

    	 	15	 

     

    

 

Exhibit 10.4

 

7.6          Third
Party Beneficiaries. This Agreement is intended for the benefit of the parties hereto and their respective permitted successors
and assigns, and, except for the Placement Agent and other registered broker-dealers, if any, who are specifically agreed to be
and acknowledged by each party as third party beneficiaries hereof, is not for the benefit of, nor may any provision hereof be
enforced by, any other person.

 

7.7.          Successors
and Assigns. This Agreement shall be binding upon and inure to the benefit of the parties and their successors and assigns.
Neither the Company nor any Noteholder shall assign this Agreement or any rights or obligations hereunder without the prior written
consent of the other. Notwithstanding the foregoing, but subject to the provisions of Section 6.1 hereof, any Noteholder may, without
the consent of the Company, assign its rights hereunder to any person that purchases Shares in a private transaction from a Noteholder
or to any of its “affiliates,” as that term is defined under the 1934 Act.

 

7.8.          Public
Disclosures. The Company shall (x) on or before 8:30 a.m., New York time, on the first (1st) Business Day after
the date of this Agreement, (x) issue a press release (the “Press Release”) reasonably acceptable to the Noteholders
disclosing all the material terms of the transactions contemplated by the Transaction Documents and (y) on or before 8:30 a.m.,
New York time, within three (3) Business Days after the date of this Agreement, file a Current Report on Form 8-K describing all
the material terms of the transactions contemplated by the Transaction Documents in the form required by the 1934 Act and attaching
all the material Transaction Documents (including, without limitation, this Agreement (and all schedules to this Agreement) (including
all attachments, the “8-K Filing”). From and after the issuance of the Press Release, the Company shall have
disclosed all material, non-public information (if any) delivered to any of the Noteholders by the Company in connection with the
transactions contemplated by the Transaction Documents. Neither the Company nor any Noteholder shall issue any press releases or
any other public statements with respect to the transactions contemplated hereby; provided, however, the Company shall be entitled,
without the prior approval of any Noteholder, to make the Press Release and any other press release or other public disclosure
with respect to such transactions (i) in substantial conformity with the 8-K Filing and contemporaneously therewith and (ii) as
is required by applicable law and regulations (provided that in the case of clause (i) each Noteholder shall be consulted by the
Company in connection with any such press release or other public disclosure prior to its release). Without the prior written consent
of the applicable Noteholder (which may be granted or withheld in such Noteholder’s sole discretion), the Company shall not
disclose the name of such Noteholder in any filing (other than the 8-K Filing, any Registration Statement registering the Shares
and any other filing as is required by applicable law and regulations), announcement, release or otherwise.

 

7.9.          Binding
Effect; Benefits. This Agreement and all the provisions hereof shall be binding upon and inure to the benefit of the parties
hereto and their respective successors and permitted assigns; nothing in this Agreement, expressed or implied, is intended to confer
on any persons other than the parties hereto or their respective successors and permitted assigns, any rights, remedies, obligations
or liabilities under or by reason of this Agreement.

 

7.10.        Amendment;
Waivers. All modifications, amendments or waivers to this Agreement shall require the written consent of both the Company and
a majority-in-interest of the Noteholders (based on the number of Shares issued hereunder).

 

7.11.        Applicable
Law; Disputes. This Agreement shall be governed by and construed in accordance with the laws of the State of New York without
giving effect to the conflict of law provisions thereof, and the parties hereto irrevocably submit to the exclusive jurisdiction
of the United States District Court for the Southern District of New York, or, if jurisdiction in such court is lacking, the Supreme
Court of the State of New York, New York County, in respect of any dispute or matter arising out of or connected with this Agreement

 

7.12.        Further
Assurances. Each party hereto shall do and perform or cause to be done and performed all such further acts and shall execute
and deliver all such other agreements, certificates, instruments and documents as any other party hereto reasonably may request
in order to carry out the intent and accomplish the purposes of this Agreement and the consummation of the transactions contemplated
hereby.

 

    	 	16	 

     

    

 

Exhibit 10.4

 

7.13.        Counterparts.
This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original and all of which
taken together shall constitute one and the same instrument. This Agreement may also be executed via facsimile, which shall be
deemed an original.

 

7.14         Independent
Nature of Noteholders. The obligations of each Noteholder under this Agreement or other transaction document are several and
not joint with the obligations of any other Noteholder, and no Noteholder shall be responsible in any way for the performance of
the obligations of any other Noteholder under this Agreement or any other transaction document. Each Noteholder shall be responsible
only for its own representations, warranties, agreements and covenants hereunder. The decision of each Noteholder to obtain Shares
pursuant to this Agreement has been made by such Noteholder independently of any other Noteholder and independently of any information,
materials, statements or opinions as to the business, affairs, operations, assets, properties, liabilities, results of operations,
condition (financial or otherwise) or prospects of the Company which may have been made or given by any other Noteholder or by
any agent or employee of any other Noteholder, and no Noteholder or any of its agents or employees shall have any liability to
any other Noteholder (or any other person) relating to or arising from any such information, materials, statements or opinions.
Nothing contained herein or in any other transaction document, and no action taken by any Noteholder pursuant hereto or thereto,
shall be deemed to constitute the Noteholders as a partnership, an association, a joint venture or any other kind of entity, or
create a presumption that the Noteholders are in any way acting in concert or as a group with respect to such obligations or the
transactions contemplated by this Agreement. Except as otherwise provided in this Agreement or any other transaction document,
each Noteholder shall be entitled to independently protect and enforce its rights arising out of this Agreement or out of the other
transaction documents, and it shall not be necessary for any other Noteholder to be joined as an additional party in any proceeding
for such purpose. Each Noteholder has been represented by its own separate legal counsel in connection with the transactions contemplated
hereby.

 

[SIGNATURE PAGES
IMMEDIATELY FOLLOW]

 

    	 	17	 

     

    

 

Exhibit 10.4

 

IN WITNESS WHEREOF, the undersigned
Noteholders and the Company have caused this Note Exchange Agreement to be duly executed as of the date first above written.

 

	 	INTELLINETICS, INC.
	 	 	 
	 	By:	 
	 	 	Matthew L. Chretien
	 	 	President and Chief Executive Officer
	 	 	 
	 	NOTEHOLDERS:

 

The Noteholders executing the Signature Page in the form attached hereto as Annex A and delivering the same to the Company or its agents shall be deemed to have executed this Agreement and agreed to the terms hereof.

 

    	 	18	 

     

    

 

Exhibit 10.4

 

Annex A

 

Note Exchange Agreement

 

Noteholder Counterpart Signature
Page

 

The undersigned, desiring to: (i) enter into this Note
Exchange Agreement dated as of _________ __, 201__ (the “Agreement”), with the undersigned, Intellinetics,
Inc., a Nevada corporation (the “Company”), in or substantially in the form furnished to the undersigned and
(ii) exchange the Notes as set forth below, hereby agrees to exchange such Notes issued by the Company as of the effective date
of the Agreement and further agrees to join the Agreement as a party thereto, with all the rights and privileges appertaining
thereto, and to be bound in all respects by the terms and conditions thereof. The undersigned specifically acknowledges having
read the representations in the Agreement section entitled “Representations, Warranties and Acknowledgments of the Noteholders,”
and hereby represents that the statements contained therein are complete and accurate with respect to the undersigned as a Noteholder.

	 	 	 	 
	 	Name of Noteholder:
	 	 	 	 
	 	If an entity:
	 	 	 	 
	 	Print Name of Entity:
	 	 	 	 
	 	 
	 	 	 	 
	 	By:	 
	 	 	Name:	 
	 	 	Title:	 

 

	 	If an individual:
	 	 	 
	 	Print Name:	 

 

	 	Signature:	 

 

	 	If joint individuals:
	 	 	 
	 	Print Name:	 

 

	 	Signature:	 
	 	 	 
	 	All Noteholders:

 

	 	Address:	 
	 	 

 

	 	Telephone No.:	 
	 	Facsimile No.:	 
	 	Email Address:	 

 

	 	The Noteholder hereby elects to exchange Note(s) with a principal amount of $____________ (to be completed by Noteholder) in accordance with the conversion rate set forth in such Note, under the terms and conditions of the Note Exchange Agreement.

 

    	 	19	 

     

    

 

Exhibit 10.4

 

Exhibit A-1

 

Schedule of Noteholders

 

	Noteholder	 	
        Date of

        Note
	 	
        Outstanding

        Principal Amount of

        Note to be

        Exchanged
	 	
        Accrued and

        Unpaid Interest
	 	Conversion Price	 	Shares 

Issued	 	
        Warrants

        Issued

	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	TOTAL	 	 	 	 	 	 	 	 	 	 	 	 

 

    	 	20Exhibit 10.5

 

PURSUANT
TO THE TERMS OF SECTION 1 OF THIS WARRANT, ALL OR A PORTION OF THIS WARRANT MAY HAVE BEEN EXERCISED, AND THEREFORE THE ACTUAL NUMBER
OF WARRANT SHARES REPRESENTED BY THIS WARRANT MAY BE LESS THAN THE AMOUNT SET FORTH ON THE FACE HEREOF.

 

INTELLINETICS,
INC.

 

Warrant No. ______

 

WARRANT
TO PURCHASE COMMON STOCK

 

VOID AFTER 5:00 P.M., EASTERN TIME,

ON THE EXPIRATION DATE

 

THIS WARRANT AND ANY SHARES ACQUIRED UPON
THE EXERCISE OF THIS WARRANT HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “ACT”), AND
MAY NOT BE SOLD, PLEDGED, HYPOTHECATED, DONATED OR OTHERWISE TRANSFERRED WITHOUT COMPLIANCE WITH THE REGISTRATION OR QUALIFICATION
PROVISIONS OF APPLICABLE FEDERAL AND STATE SECURITIES LAWS OR WITHOUT DELIVERING AN OPINION OF COUNSEL REASONABLY SATISFACTORY
TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED.

 

FOR VALUE RECEIVED, Intellinetics,
Inc., a Nevada corporation (the “Company”), hereby agrees to sell upon the terms and on the
conditions hereinafter set forth, at any time commencing on the date hereof but no later than 5:00 p.m., Eastern Time, on ________
__, 202_ (the “Expiration Date”), to ____________ _________, or his, her or its registered assigns (the
“Holder”), under the terms as hereinafter set forth, _____________________________ (_________) fully
paid and non-assessable shares of the Company’s Common Stock, par value $0.001 per share (the “Common
Stock”), at a purchase price per share of $0.65 (the “Warrant Price”), pursuant to the
terms and conditions set forth in this warrant (this “Warrant”). The number of shares of Common Stock
issued upon exercise of this Warrant (“Warrant Shares”) and the Warrant Price are subject to adjustment
in certain events as hereinafter set forth.

 

This Warrant is issued
pursuant to a Note Exchange Agreement dated ________ __, 201_.

 

1.            Exercise
of Warrant.

 

(a)          The
Holder may exercise this Warrant according to the terms and conditions set forth herein by delivering to the Company (whether via
facsimile or otherwise) at any time prior to the Expiration Date (such date of exercise, the “Exercise Date”)
(i) the Exercise Notice attached hereto as Exhibit A (the “Exercise Notice”) (having then been
duly executed by the Holder), and (ii) unless the Warrant is being exercised pursuant to a Cashless Exercise (as defined below),
cash, a certified check, a bank draft or wire transfer in payment of the purchase price, in lawful money of the United States of
America, for the number of Warrant Shares specified in the Exercise Form. The Holder shall not be required to deliver the original
of this Warrant in order to effect an exercise hereunder. Execution and delivery of an Exercise Form with respect to less than
all of the Warrant Shares shall have the same effect as cancellation of the original of this Warrant and issuance of a new Warrant
evidencing the right to purchase the remaining number of Warrant Shares. Execution and delivery of an Exercise Form for all of
the then-remaining Warrant Shares shall have the same effect as cancellation of the original of this Warrant after delivery of
the Warrant Shares in accordance with the terms hereof.

 

     

     

    

 

(b)          On
or before the second (2nd) Trading Day following the later of (i) the date on which the Company has received an Exercise
Notice or (ii) the date on which the Company receives payment of the exercise price (which shall not apply for cashless exercises),
the Company shall transmit an acknowledgment of confirmation of receipt of such Exercise Notice to the Holder and the Company’s
transfer agent (the “Transfer Agent”). On or before the third (3rd) Trading Day following
the later of (i) the date on which the Company has received such Exercise Notice or (ii) the date on which the Company receives
the exercise price (which shall not apply for cashless exercises) (such later date, the “Delivery Date”),
the Company shall (X) provided that the Transfer Agent is participating in The Depository Trust Company (“DTC”)
Fast Automated Securities Transfer Program, upon the request of the Holder, credit such aggregate number of shares of Common Stock
to which the Holder is entitled pursuant to such exercise to the Holder’s or its designee’s balance account with DTC
through its Deposit/ Withdrawal at Custodian system, or (Y) if the Transfer Agent is not participating in the DTC Fast Automated
Securities Transfer Program, issue and deliver to the Holder or, at the Holder’s instruction pursuant to the Exercise Notice,
the Holder’s agent or designee, in each case, sent by reputable overnight courier to the address as specified in the applicable
Exercise Notice, a certificate, registered in the Company’s share register in the name of the Holder or its designee (as
indicated in the applicable Exercise Notice), for the number of shares of Common Stock to which the Holder is entitled pursuant
to such exercise. Upon the later of (i) the date on which the Company has received the Exercise Notice or (ii) the date on which
the Company receives the exercise price (which shall not apply for cashless exercises), 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 such Warrant Shares are credited to the Holder’s DTC account or the date of delivery of the certificates evidencing
such Warrant Shares (as the case may be). Notwithstanding the foregoing, if a Holder has not received certificates for all Warrant
Shares prior to the fifth (5th) business day after the Delivery Date with respect to an exercise of any portion of this
Warrant for any reason, then Holder shall have the right, but not the obligation, at any time thereafter until receipt of all the
Warrant Shares relating to the Exercise Notice, to rescind the Exercise Notice by providing notice to the Company (the “Rescission
Notice”). Upon delivery of a Rescission Notice to the Company, the Holder shall regain the rights of a Holder of
this Warrant with respect to such unexercised portions of this Warrant and the Company shall, as soon as practicable, return such
unexercised Warrant to the Holder or, if the Warrant has not been surrendered, adjust its records to reflect that such portion
of this Warrant has not been exercised. In addition, if the Company fails to deliver to the Holder a certificate or certificates
representing the Warrant Shares pursuant to an exercise by the close of business on the fifth Trading Day after its receipt of
the Exercise Amount, and if after such fifth Trading Day the Holder is required by its broker to purchase (in an open market transaction
or otherwise) 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 (i) pay in cash to the
Holder the amount 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 (A) the number of Warrant Shares that the Company was
required to deliver to the Holder in connection with the exercise at issue times (B) the price at which the sell order giving rise
to such purchase obligation was executed, or (ii) 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 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 Warrant Shares with an aggregate sale price giving rise to such purchase obligation of $10,000, under clause (i) 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, together with applicable confirmations and
other evidence reasonably requested by the Company. 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 certificates representing Warrant Shares upon exercise of
this Warrant as required pursuant to the terms hereof.

 

(c)          This
Warrant may be exercised in whole or in part so long as any exercise in part hereof would not involve the issuance of fractional
Warrant Shares. If exercised in part, at the request of the Holder and upon delivery of the original Warrant, the Company shall
deliver to the Holder a new Warrant, identical in form to this Warrant, in the name of the Holder, evidencing the right to purchase
the number of Warrant Shares as to which this Warrant has not been exercised, which new Warrant shall be signed by the President
or Chief Executive Officer of the Company. The term Warrant as used herein shall include any subsequent Warrant issued as provided
herein.

 

(d)          Notwithstanding
any provisions herein to the contrary, in lieu of exercising this Warrant by cash payment in the manner set forth in Section 1(a),
the Holder may, in its sole discretion, elect to exercise this Warrant, or a portion hereof, and to pay for the Warrant Stock by
way of cashless exercise (a “Cashless Exercise”). If the Holder wishes to effect a cashless exercise,
the Holder shall deliver the Exercise Notice duly executed by such Holder or by such Holder’s duly authorized attorney, at
the principal office of the Company, or at such other office or agency as the Company may designate in writing prior to the date
of such exercise, in which event the Company shall issue to the Registered Holder the number of Warrant Shares computed according
to the following equation:

 

    	 	2	 

     

    

 

 

; where

 

X = the number of Warrant
Shares to be issued to the Registered Holder.

 

Y = the Warrant Shares
purchasable under this Warrant or, if only a portion of the Warrant is being exercised, the portion of the Warrant Shares being
exercised.

 

A = the Fair Market Value
(defined below) of one share of Common Stock on the Exercise Date.

 

B = the Exercise Price
(as adjusted pursuant to the provisions of this Warrant).

 

For purposes of this
Section 1(d), the “Fair Market Value” of one share of Common Stock on the Exercise Date shall have one of the following
meanings:

 

(1)         if
the Common Stock is traded on a national securities exchange registered with the Securities Exchange Commission pursuant to the
Securities Exchange Act of 1934, as amended, the Fair Market Value shall be deemed to be the average of the Closing Prices over
a five trading day period immediately prior to the Exercise Date. For the purposes of this Warrant, “Closing Price”
means the closing sale price of one share of Common Stock, as reported by Bloomberg; or

 

(2)         if
the Common Stock is not traded on a national securities exchange, the Fair Market Value shall be deemed to be the average of the
closing bid prices price over the ten (10) trading day period ending immediately prior to the Exercise Date; or

 

(3)         if
neither (1) nor (2) is applicable, the Fair Market Value shall be at the commercially reasonable price per share which the Company
could obtain on the Exercise Date from a willing buyer (not a current employee or director) for shares of Common Stock sold by
the Company, from authorized but unissued shares, as determined in good faith by the Company’s Board of Directors.

 

For illustration purposes
only, if this Warrant entitles the Holder the right to purchase 100,000 Warrant Shares and the Holder were to exercise this Warrant
for 50,000 Warrant Shares at a time when the Exercise Price per share was $1.00 and the Fair Market Value of each share of Common
Stock was $2.00 on the Exercise Date, as applicable, the cashless exercise calculation would be as follows:

 

X = 50,000 ($2.00-$1.00)

2.00

 

X = 25,000

 

Therefore, the number
of Warrant Shares to be issued to the Holder after giving effect to the cashless exercise would be 25,000 Warrant Shares and this
Warrant would then entitle the Holder to purchase 50,000 Warrant Shares, reflecting the portion of this Warrant not exercised by
the Holder. For purposes of Rule 144 promulgated under the Securities Act of 1933, as amended (the “Securities Act”),
it is intended, understood and acknowledged that the Warrant Shares issued in the cashless exercise transaction described pursuant
to Section 1(c) shall be deemed to have been acquired by the Holder, and the holding period for the shares of Warrant Shares shall
be deemed to have commenced, on the date of the Holder’s acquisition of the Warrant.

 

(e)          No
fractional Warrant Shares or scrip representing fractional Warrant Shares shall be issued upon the exercise of this Warrant. The
Company shall pay cash in lieu of such fractional Warrant Shares. The price of a fractional Warrant Share shall equal the product
of (i) the closing price of the Common Stock on the exchange or market on which the Common Stock is then traded (if the Common
Stock is not then publicly traded, then upon the Fair Market Value per share of the Common Stock (as determined by the Company’s
Board of Directors)), and (ii) the applicable fraction.

 

    	 	3	 

     

    

 

(f)          Except
as provided in Section 4 hereof, the Company shall pay any and all documentary stamp or similar issue or transfer taxes payable
in respect of the issue or delivery of Warrant Shares on exercise of this Warrant.

 

(g)          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.

 

2.            Disposition
of Warrant Shares and Warrant.

 

(a)          The
Holder hereby acknowledges that: (i) this Warrant and any Warrant Shares purchased pursuant hereto are not being registered (A)
under the Securities Act of 1933 (the “Act”) on the ground that the issuance of this Warrant is exempt
from registration under Section 4(a)(2) of the Act as not involving any public offering, or (B) under any applicable state securities
law because the issuance of this Warrant does not involve any public offering; and (ii) that the Company’s reliance on the
registration exemption under Section 4(a)(2) of the Act and under applicable state securities laws is predicated in part on the
representations hereby made to the Company by the Holder. The Holder represents and warrants that he, she or it is acquiring this
Warrant and will acquire Warrant Shares for investment for his, her or its own account, with no present intention of dividing his,
her or its participation with others or reselling or otherwise distributing this Warrant or Warrant Shares.

 

(b)          The
Holder hereby agrees that he, she or it will not sell, transfer, pledge or otherwise dispose of (collectively, “Transfer”)
all or any part of this Warrant and/or Warrant Shares unless and until he, she or it shall have first obtained an opinion, reasonably
satisfactory to counsel for the Company, of counsel (competent in securities matters, selected by the Holder and reasonably satisfactory
to the Company) to the effect that the proposed Transfer may be made without registration under the Act and without registration
or qualification under any state law.

 

(c)          If,
at the time of issuance of Warrant Shares, no registration statement is in effect with respect to such shares under applicable
provisions of the Act and the Warrant Shares may not be sold pursuant to Rule 144 of the Act, the Company may, at its election,
require that any stock certificate evidencing Warrant Shares shall bear legends reading substantially as follows:

 

“THE SALE, TRANSFER, PLEDGE
OR OTHER DISPOSITION OF THE SHARES REPRESENTED BY THIS CERTIFICATE IS SUBJECT TO CERTAIN RESTRICTIONS SET FORTH IN THE WARRANT
PURSUANT TO WHICH THESE SHARES WERE PURCHASED FROM THE COMPANY. COPIES OF SUCH RESTRICTIONS ARE ON FILE AT THE PRINCIPAL OFFICES
OF THE COMPANY. NO TRANSFER OF SUCH SHARES OR OF THIS CERTIFICATE (OR OF ANY SHARES OR OTHER SECURITIES (OR CERTIFICATES THEREFOR)
ISSUED IN EXCHANGE FOR OR IN RESPECT OF SUCH SHARES) SHALL BE EFFECTIVE UNLESS AND UNTIL THE TERMS AND CONDITIONS SET FORTH IN
THE WARRANT HAVE BEEN COMPLIED WITH.”

 

“THE SHARES REPRESENTED BY
THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AND MAY NOT BE SOLD, TRANSFERRED, PLEDGED OR OTHERWISE
DISPOSED OF IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933 (THE “ACT”) OR AN
OPINION OF COUNSEL SATISFACTORY TO THE ISSUER OF THIS CERTIFICATE THAT REGISTRATION IS NOT REQUIRED UNDER THE ACT.”

 

    	 	4	 

     

    

 

In addition, so long as the foregoing legend
may remain on any stock certificate evidencing Warrant Shares, the Company may maintain appropriate “stop transfer”
orders with respect to such certificates and the shares represented thereby on its books and records and with those to whom it
may delegate registrar and transfer functions.

 

3.            Reservation
of Shares. The Company hereby agrees that at all times there shall be reserved for issuance upon the exercise of this
Warrant such number of shares of the Common Stock as shall be required for issuance upon exercise of this Warrant. The Company
further agrees that all Warrant Shares will be duly authorized and will, upon issuance and payment of the exercise price therefor,
be validly issued, fully paid and non-assessable, free from all taxes, liens, charges and encumbrances with respect to the issuance
thereof, other than taxes, if any, in respect of any transfer occurring contemporaneously with such issuance and other than transfer
restrictions imposed by federal and state securities laws.

 

Except and to the extent
as waived or consented to in writing by the Holder, the Company shall not by any action, including, without limitation, amending
its certificate or articles 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. Without limiting the generality
of the foregoing, the Company will (a) 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, (b) 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
(c) use commercially reasonable efforts to obtain all such authorizations, exemptions or consents from any public regulatory body
having jurisdiction thereof as may be necessary to enable the Company to perform its obligations under this Warrant.

 

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

 

4.            Exchange,
Transfer or Assignment of Warrant. Subject to Section 2, this Warrant is exchangeable, without expense, at the option
of the Holder, upon presentation and surrender hereof to the Company or at the office of its stock transfer agent, if any, for
other Warrants of the Company (“Warrants”) of different denominations, entitling the Holder or Holders
thereof to purchase in the aggregate the same number of Warrant Shares purchasable hereunder. Subject to Section 2, upon surrender
of this Warrant to the Company or at the office of its stock transfer agent, if any, with the Assignment Form attached hereto
as Exhibit B (the “Assignment Form”) duly executed and funds sufficient to pay any transfer tax,
the Company shall, without charge, execute and deliver a new Warrant in the name of the assignee named in the Assignment Form
and this Warrant shall promptly be canceled. Subject to Section 2, this Warrant may be divided or combined with other Warrants
that carry the same rights upon presentation hereof at the office of the Company or at the office of its stock transfer agent,
if any, together with a written notice specifying the names and denominations in which new Warrants are to be issued and signed
by the Holder hereof.

 

5.           Capital
Adjustments. This Warrant is subject to the following further provisions:

 

(a)          Recapitalization,
Reclassification and Succession. If any recapitalization of the Company or reclassification of its Common Stock or any merger
or consolidation of the Company into or with a corporation or other business entity, or the sale or transfer of all or substantially
all of the Company’s assets or of any successor corporation’s assets to any other corporation or business entity (any
such corporation or other business entity being included within the meaning of the term “successor corporation”) shall
be effected, at any time while this Warrant remains outstanding and unexpired, then, as a condition of such recapitalization, reclassification,
merger, consolidation, sale or transfer, lawful and adequate provision shall be made whereby the Holder of this Warrant thereafter
shall have the right to receive upon the exercise hereof as provided in Section 1 and in lieu of the Warrant Shares immediately
theretofore issuable upon the exercise of this Warrant, such shares of capital stock, securities or other property as may be issued
or payable with respect to or in exchange for the number of outstanding shares of Common Stock equal to the number of Warrant Shares
immediately theretofore issuable upon the exercise of this Warrant had such recapitalization, reclassification, merger, consolidation,
sale or transfer not taken place, and in each such case, the terms of this Warrant shall be applicable to the shares of stock or
other securities or property receivable upon the exercise of this Warrant after such consummation.

 

    	 	5	 

     

    

 

(b)          Subdivision
or Combination of Shares. If the Company at any time while this Warrant remains outstanding and unexpired shall subdivide or
combine its Common Stock, the number of Warrant Shares purchasable upon exercise of this Warrant shall be proportionately adjusted.

 

(c)          Stock
Dividends and Distributions. If the Company at any time while this Warrant is outstanding and unexpired shall issue or pay
the holders of its Common Stock, or take a record of the holders of its Common Stock for the purpose of entitling them to receive,
a dividend payable in, or other distribution of, Common Stock, then the number of Warrant Shares purchasable upon exercise of this
Warrant shall be adjusted to the number of shares of Common Stock that Holder would have owned immediately following such action
had this Warrant been exercised immediately prior thereto.

 

(d)          Price
Adjustments. Whenever the number of Warrant Shares purchasable upon exercise of this Warrant is adjusted pursuant to Sections
5(a), 5(b) or 5(c), the then applicable Warrant Price shall be proportionately adjusted.

 

(e)          Certain
Shares Excluded. The number of shares of Common Stock outstanding at any given time for purposes of the adjustments set forth
in this Section 5 shall exclude any shares then directly or indirectly held in the treasury of the Company.

 

(f)          Deferral
and Cumulation of De Minimis Adjustments. The Company shall not be required to make any adjustment pursuant to this Section
5 if the amount of such adjustment would be less than one percent (1%) of the Warrant Price in effect immediately before the event
that would otherwise have given rise to such adjustment. In such case, however, any adjustment that would otherwise have been required
to be made shall be made at the time of and together with the next subsequent adjustment which, together with any adjustment or
adjustments so carried forward, shall amount to not less than one percent (1%) of the Warrant Price in effect immediately before
the event giving rise to such next subsequent adjustment. All calculations under this Section 5 shall be made to the nearest cent
or to the nearest one-hundredth of a share, as the case may be, but in no event shall the Company be obligated to issue fractional
Warrant Shares or fractional portions of any securities upon the exercise of the Warrant.

 

(g)          Duration
of Adjustment. Following each computation or readjustment as provided in this Section 5, the new adjusted Warrant Price and
number of Warrant Shares purchasable upon exercise of this Warrant shall remain in effect until a further computation or readjustment
thereof is required.

 

6.            Notice
to Holders.

 

(a)          Notice
of Record Date. In case:

 

(i)          the
Company shall take a record of the holders of its Common Stock (or other stock or securities at the time receivable upon the exercise
of this Warrant) for the purpose of entitling them to receive any dividend (other than a cash dividend payable out of earned surplus
of the Company) or other distribution, or any right to subscribe for or purchase any shares of stock of any class or any other
securities, or to receive any other right;

 

(ii)         of
any capital reorganization of the Company, any reclassification of the capital stock of the Company, any consolidation with or
merger of the Company into another corporation, or any conveyance of all or substantially all of the assets of the Company to another
corporation; or

 

(iii)        of
any voluntary dissolution, liquidation or winding-up of the Company;

 

    	 	6	 

     

    

 

then, and in each such case, the Company
will mail or cause to be mailed to the Holder hereof at the time outstanding a notice specifying, as the case may be, (i) the date
on which a record is to be taken for the purpose of such dividend, distribution or right, and stating the amount and character
of such dividend, distribution or right, or (ii) the date on which such reorganization, reclassification, consolidation, merger,
conveyance, dissolution, liquidation or winding-up is to take place, and the time, if any, is to be fixed, as of which the holders
of record of Common Stock (or such stock or securities at the time receivable upon the exercise of this Warrant) shall be entitled
to exchange their shares of Common Stock (or such other stock or securities) for securities or other property deliverable upon
such reorganization, reclassification, consolidation, merger, conveyance, dissolution or winding-up. Such notice shall be mailed
at least ten (10) calendar days prior to the record date therein specified, or if no record date shall have been specified therein,
at least ten (10) days prior to such specified date.

 

(b)          Certificate
of Adjustment. Whenever any adjustment shall be made pursuant to Section 5 hereof, the Company shall promptly provide the Holder
with prompt written notice, signed and certified by its Chairman, Chief Executive Officer, President or a Vice President, setting
forth in reasonable detail the event requiring the adjustment, the amount of the adjustment, the method by which such adjustment
was calculated and the Warrant Price and number of Warrant Shares purchasable upon exercise of this Warrant after giving effect
to such adjustment.

 

7.            Loss,
Theft, Destruction or Mutilation. Upon receipt by the Company of evidence satisfactory to it, in the exercise of its reasonable
discretion, of the ownership and the loss, theft, destruction or mutilation of this Warrant and, in the case of loss, theft or
destruction, of indemnity reasonably satisfactory to the Company and, in the case of mutilation, upon surrender and cancellation
thereof, the Company will execute and deliver in lieu thereof, without expense to the Holder, a new Warrant of like tenor dated
the date hereof.

 

8.            Warrant
Holder Not a Stockholder. The Holder of this Warrant, as such, shall not be entitled by reason of this Warrant to any
rights whatsoever as a stockholder of the Company, including but not limited to voting rights. No provision hereof, in the absence
of any affirmative action by Holder to exercise this Warrant to purchase Warrant Shares, and no enumeration herein of the rights
or privileges of Holder, shall give rise to any liability of 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.

 

9.            Registration
Rights. The Holder shall have the registration rights with respect to its Warrant Shares set forth in that certain Note
Exchange Agreement, dated as of ________ __, 201__, between such purchasers and the Company.

 

10.          Notices.
Any notice provided for in this Warrant must be in writing and must be either personally delivered, mailed by first class
mail (postage prepaid and return receipt requested), or sent by reputable overnight courier service (charges prepaid) to the recipient
at the address below indicated:

 

If to the Company:

 

Intellinetics,
Inc.

2190
Dividend Drive

Columbus, OH 43215

Attention:  Mr. Matthew L. Chretien, 

               President
and Chief Executive Officer

 

If to the Holder:

 

To the address of such
Holder set forth on the books and records of the Company.

 

or such other address
or to the attention of such other person as the recipient party shall have specified by prior written notice to the sending party.
Any notice under this Warrant will be deemed to have been given (a) if personally delivered, upon such delivery, (b) if mailed,
five days after deposit in the U.S. mail, or (c) if sent by reputable overnight courier service, one business day after such services
acknowledges receipt of the notice.

 

    	 	7	 

     

    

 

11.          Choice
of Law. THIS WARRANT IS ISSUED UNDER AND SHALL FOR ALL PURPOSES BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS
OF THE STATE OF NEVADA, WITHOUT GIVING EFFECT TO ITS CONFLICTS OF LAW RULES.

 

12.          Submission
to Jurisdiction. EACH OF THE HOLDER AND THE COMPANY SUBMITS TO THE JURISDICTION OF ANY STATE OR FEDERAL COURT SITTING
IN THE COUNTY OF NEW YORK, STATE OF NEW YORK, IN ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS WARRANT AND AGREES
THAT ALL CLAIMS IN RESPECT OF THE ACTION OR PROCEEDING MAY BE HEARD AND DETERMINED IN ANY SUCH COURT. EACH OF THE HOLDER AND THE
COMPANY ALSO AGREE NOT TO BRING ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS WARRANT IN ANY OTHER COURT. EACH OF
THE PARTIES WAIVES ANY DEFENSE OF INCONVENIENT FORUM TO THE MAINTENANCE OF ANY ACTION OR PROCEEDING SO BROUGHT AND WAIVES ANY
BOND, SURETY, OR OTHER SECURITY THAT MIGHT BE REQUIRED OF ANY OTHER PARTY WITH RESPECT THERETO.

 

13.          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.

 

14.          Miscellaneous.

 

(a)          Remedies.
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.

 

(b)          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 of the Company and the successors and permitted assigns of Holder. The provisions
of this Warrant are intended to be for the benefit of all Holders from time to time of this Warrant and shall be enforceable by
any such Holder or holder of Warrant Shares.

 

(c)          Amendment.
This Warrant may be modified or amended or the provisions hereof waived with the written consent of the Company and the Holder.

 

(d)          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.

 

[Remainder of page intentionally
left blank]

 

    	 	8	 

     

    

 

IN WITNESS WHEREOF,
the Company has duly caused this Warrant to be signed on its behalf, in its corporate name and by a duly authorized officer, as
of this ___ day of ________ 201_.

 

	 	INTELLINETICS, INC.
	 	 	 
	 	By:	 
	 	 	Matthew L. Chretien
	 	 	President and Chief Executive Officer

 

    	 	9	 

     

    

 

Exhibit 10.5

 

EXHIBIT A

 

EXERCISE NOTICE

 

TO BE EXECUTED BY THE REGISTERED HOLDER
TO EXERCISE THIS

WARRANT TO PURCHASE COMMON STOCK

 

Intellinetics,
Inc.

 

The undersigned holder
hereby exercises the right to purchase _________________ of the shares of Common Stock (“Warrant Shares”)
of Intellinetics, Inc., a Nevada corporation (the “Company”), evidenced by Warrant to Purchase Common
Stock No. _______ (the “Warrant”). Capitalized terms used herein and not otherwise defined shall have
the respective meanings set forth in the Warrant.

 

1.            Form
of Exercise Price. The Holder intends that payment of the Exercise Price shall be made as:

 

		____________	a “Cash Exercise” with respect to _________________ Warrant Shares; and/or

 

		____________	a “Cashless Exercise” with respect to _______________ Warrant Shares.

 

2.            Payment
of Exercise Price. In the event that the Holder has elected a Cash Exercise with respect to some or all of the Warrant Shares
to be issued pursuant hereto, the Holder shall pay the exercise price in the sum of $___________________ to the Company in accordance
with the terms of the Warrant.

 

3.            Delivery
of Warrant Shares. The Company shall deliver to Holder, or its designee or agent as specified below, __________ Warrant Shares
in accordance with the terms of the Warrant. Delivery shall be made to Holder, or for its benefit, to the following address:

 

_______________________

_______________________

_______________________

_______________________

 

4.            Fractional
Shares. In lieu of receipt of a fractional share of Common Stock, the undersigned will receive a check representing payment
therefor.

 

Date: _______________ __, ______

 

	 	 
	Name of Registered Holder	 

 

	By:	 	 
	 	Name:	 	 
	 	Title:	 	 

 

    	 	A-1	 

     

    

 

Exhibit 10.5

 

EXHIBIT B

 

ASSIGNMENT
FORM

 

Intellinetics,
Inc.

2190
Dividend Drive

Columbus, OH 43215

Attention:  Mr. Matthew L. Chretien, 

               President and
Chief Executive Officer

 

FOR VALUE RECEIVED, ________________________________________
hereby sells, assigns and transfers unto

 

(Please print assignee’s name, address
and Social Security/Tax Identification Number)

 

________________________________________________

 

________________________________________________

 

________________________________________________

 

the right to purchase shares of common
stock, par value $0.001 per share, of Intellinetics, Inc., a Nevada corporation (the “Company”), represented
by this Warrant to the extent of shares as to which such right is exercisable and does hereby irrevocably constitute and appoint
____________________________, Attorney, to transfer the same on the books of the Company with full power of substitution in the
premises.

 

	Dated:	 	 	 
	 	 	 	PRINT WARRANT HOLDER NAME
	 	 	 	 
	 	 	 	 
	 	 	 	Name:
	 	 	 	Title:
	 	 	 	 
	Witness:	 	 
	 	 	 
	 	 	 

 

    	 	B-1

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