Document:

Exhibit 4.1

 

	NUMBER	SHARES

 

C
______

 

LIFESCI ACQUISITION
II CORP.

 

INCORPORATED UNDER
THE LAWS OF THE STATE OF DELAWARE

 

COMMON STOCK

 

SEE REVERSE FOR

CERTAIN DEFINITIONS

 

CUSIP
53229E 103 

This Certifies that

 

is the owner of

 

FULLY PAID AND NON-ASSESSABLE SHARES
OF COMMON STOCK OF

 

LIFESCI ACQUISITION
II CORP.

 

transferable on
the books of the Company in person or by duly authorized attorney upon surrender of this certificate properly endorsed. 

The Company will
be forced to liquidate if it is unable to complete an initial business combination within the meaning as defined in and the time
period as required by its Amended and Restated Certificate of Incorporation, as the same may be amended from time to time.

This certificate is not valid unless countersigned by the Transfer Agent and registered by the Registrar.

Witness the facsimile seal of the Company and the facsimile signatures of its duly authorized officers.

 

[Corporate Seal]

 

Dated:

 

	 	 	 
	CHAIRMAN	 	SECRETARY

 

    

     

    

 

The following abbreviations,
when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according
to applicable laws or regulations:

 

TEN COM –        as tenants in common              UNIF
GIFT MIN ACT - _____ Custodian ______

TEN ENT –         as tenants by the entireties                                                (Cust)                      (Minor)

JT TEN –             as joint tenants with
right of survivorship                      under Uniform Gifts to Minors

                             and not as tenants in common                                           Act
______________

 (State)

 

Additional abbreviations
may also be used though not in the above list.

 

LifeSci Acquisition
II Corp.

 

The Company will furnish
without charge to each stockholder who so requests the powers, designations, preferences and relative, participating, optional
or other special rights of each class of shares or series thereof of the Company and the qualifications, limitations, or restrictions
of such preferences and/or rights. This certificate and the shares represented thereby are issued and shall be held subject to
all the provisions of the Company’s Amended and Restated Certificate of Incorporation and all amendments thereto and resolutions
of the Board of Directors providing for the issue of preferred stock (copies of which may be obtained from the secretary of the
Company), to all of which the holder of this certificate by acceptance hereof assents.

 

For value received, ___________________________
hereby sells, assigns and transfers unto

 

PLEASE INSERT SOCIAL SECURITY OR OTHER

IDENTIFYING NUMBER OF ASSIGNEE

 

	
         
	 

 

 

(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS,
INCLUDING ZIP CODE, OF ASSIGNEE)

 

 

 

 

                                                                                                                                                                                                                                                                              shares
of common stock represented by the within Certificate, and do hereby irrevocably constitute and appoint

 

                                                                                                                                                                                                                                                                      Attorney
to transfer the said stock on the books of the within named Company with full power of substitution in the premises.

 

Dated                                              

 

	 	 	 
		Notice:	The signature to this assignment must correspond with the name as
written upon the face of the certificate in every particular, without alteration or enlargement or any change whatever.

 

Signature(s) Guaranteed:

 

                                                                                                                                                                           

THE SIGNATURE(S) SHOULD BE GUARANTEED
BY AN ELIGIBLE GUARANTOR INSTITUTION

(BANKS, STOCKBROKERS, SAVINGS
AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH

MEMBERSHIP IN AN APPROVED SIGNATURE
GUARANTEE MEDALLION PROGRAM,

PURSUANT TO SEC RULE 17Ad-15).

 

The holder of this certificate shall be entitled to receive
funds from the trust account established in connection with the Company’s initial public offering only in the event of the
Company’s liquidation upon failure to consummate a business combination within the required time period set forth in the
Company’s Amended and Restated Certificate of Incorporation as the same may be amended from time to time (the “Certificate”),
or if the holder seeks to convert his or her shares of common stock upon consummation of a business combination or in connection
with certain amendments to the Certificate. In no other circumstances shall the holder have any right or interest of any kind in
or to the trust account.Exhibit 4.2

 

THIS WARRANT AND THE
SHARES ISSUABLE UPON EXERCISE OF THIS WARRANT HAVE BEEN ACQUIRED FOR INVESTMENT PURPOSES ONLY AND MAY NOT BE TRANSFERRED UNTIL
(i) A REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “1933 ACT”) SHALL HAVE BECOME
EFFECTIVE WITH RESPECT THERETO OR (ii) RECEIPT BY THE COMPANY OF AN OPINION OF COUNSEL REASONABLY SATISFACTORY TO THE COMPANY
TO THE EFFECT THAT REGISTRATION UNDER THE 1933 ACT IS NOT REQUIRED IN CONNECTION WITH SUCH PROPOSED TRANSFER NOR IS SUCH TRANSFER
IN VIOLATION OF ANY APPLICABLE STATE SECURITIES LAWS. THIS LEGEND SHALL BE ENDORSED UPON ANY WARRANT ISSUED IN EXCHANGE FOR THIS
WARRANT OR ANY SHARES ISSUABLE UPON EXERCISE OF THIS WARRANT.

 

WARRANT TO PURCHASE

SHARES OF COMMON STOCK

 

OF

 

LIFESCI ACQUISITION II CORP.

 

[__] 2020

 

W-[__]

 

This is to Certify
That, FOR VALUE RECEIVED, LIFESCI HOLDINGS LLC, or his, her or its assigns (“Holder”), is entitled to purchase,
subject to the provisions of this Warrant, from LIFESCI ACQUISITION II CORP., Delaware
corporation (the “Company”), 3,033,333 fully paid, validly issued and nonassessable shares of the Company’s
common stock, par value $0.0001 per share (the “Shares”) at a price of $11.50 per share. The number of Shares
to be received upon the exercise of this Warrant and the price to be paid for each Share may be adjusted from time to time as hereinafter
set forth. The Shares deliverable upon such exercise, as adjusted from time to time, are hereinafter sometimes referred to as “Warrant
Shares,” and the exercise price for a Share in effect at any time, as adjusted from time to time, is hereinafter sometimes
referred to as the “Exercise Price.”

 

(a)              
EXERCISE OF WARRANT. This Warrant may be exercised in whole or in part at any time on the later of (i) 30 days after the consummation
by the Company of its initial merger, share exchange, asset acquisition, share purchase, reorganization or other similar business
combination with one or more businesses or entities (the “Business Combination”) (as described more fully in
the Registration Statement on Form S-1 (No. 333-249480) as filed with the Company or (ii) 12 months from the closing of the public
offering of the Company’s Shares, and terminating at 5:00 p.m., New York City time on five years from the consummation of
the Business Combination (the “Expiration Date”). Each Warrant not exercised on or before the Expiration Date
shall become void, and all rights thereunder and all rights in respect thereof under this Agreement shall cease at the close of
business on the Expiration Date. The Company in its sole discretion may extend the duration of the Warrants by delaying the Expiration
Date; provided, however, that the Company will provide at least ten (10) days’ prior written notice of any such extension
to registered holders of the Warrants and, provided further that any such extension shall be identical in duration among all the
Warrants.

 

    

     

    

 

(1)              
This Warrant may be exercised by presentation and surrender hereof to the Company at its principal office with the Purchase
Form annexed hereto (the “Purchase Form”) duly executed and accompanied by payment of the Exercise Price for
the number of Warrant Shares specified in such Purchase Form (which may take the form of a “cashless exercise” pursuant
to Section (a)(2) if so indicated in the Purchase Form).

 

(2)              
The Holder shall pay the Exercise Price in immediately available funds; provided, however, that the Holder may, in the Holder’s
sole discretion, satisfy its obligation to pay the Exercise Price through a “cashless exercise”, in which event the
Company shall issue to the Holder the number of Warrant Shares determined as follows:

 

X = Y(A-B)/A

 

where

 

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

 

Y = the total number of Warrant Shares
with respect to which this Warrant is being exercised.

 

A = the Fair Market Value (as defined
below) of one Share on the trading day immediately preceding the date on which Holder elects to exercise this Warrant by means
of a “cashless exercise.”

 

B = the Exercise Price then in effect
for the applicable Warrant Shares at the time of such exercise.

 

For purposes of this Warrant, “Fair
Market Value” means, for any security as of any date, the price determined by the first of the following clauses that applies:
(a) if the Shares are then listed on a national securities exchange, the daily volume weighted average price of the Shares for
such date (or the nearest preceding date) on the trading market on which the Shares are then listed as reported by Bloomberg L.P.
(based on a Trading Day from 9:30 a.m. (New York City time) to 4:00 p.m. (New York City time)), (b)  if the Shares are quoted
on the OTC Bulletin Board or the OTC Market, the average closing bid price on such market for the five most recently completed
trading days, (c) if paragraphs (a) or (b) are not applicable, if an appraiser hired by the Company has provided a report
on the fair market value of a Share within the 12-month period preceding the date on which Holder elects to exercise this Warrant
by means of a “cashless exercise,” the fair market value of a share of Shares as determined by such appraiser, or (d)
if none of the foregoing is applicable, the price determined by the Board of Directors of the Company in good faith.

 

(b)               Effective
Time of Exercise. Each exercise of this Warrant shall be deemed to have been effected immediately prior to the close
of business on the day on which the Purchase Form has been delivered to the Company (the “Exercise Date”)
as provided in Section (a). At such time, the person or persons in whose name or names any certificates for Warrant
Shares shall be issuable upon such exercise as provided in Section (c) below shall be deemed to have become the holder
or holders of record of the Warrant Shares represented by such certificates. Notwithstanding the foregoing, if the Holder or
any assignee does not enter into the Shareholders’ Agreement within three (3) business days of being requested to do so
by the Company, then the exercise of this Warrant will be deemed to not have been effective and void ab initio and the Holder
or any assignee shall return any securities received by them pursuant to Section (c) to the Company.

 

    2

     

    

 

(c)              
Delivery to Holder.

 

(1)              
As soon as practicable after the exercise of this Warrant in whole or in part, and in any event within five (5) business
days thereafter, the Company will cause to be issued in the name of, and delivered to, the Holder, or as such Holder (upon payment
by such Holder of any applicable transfer taxes) may direct:

 

(A)                       
a certificate or certificates for the number of Warrant Shares to which such Holder shall be entitled, and

 

(B)                       
in case such exercise is in part only, a new warrant or warrants of like tenor, exercisable for in the aggregate the number
of Shares equal (giving effect to any adjustment therein) to the number of Shares called for on the face of this Warrant minus
the number of such shares purchased by the Holder upon such exercise.

 

(2)              
To the extent permitted by law and except as provided in this Warrant, the Company’s obligations to issue and deliver
Warrant Shares in accordance with the terms hereof are absolute and unconditional, irrespective of any action or inaction by the
Holder to enforce the same, any waiver or consent with respect to any provision hereof, the recovery of any judgment against any
person or entity or any action to enforce the same, or any setoff, counterclaim, recoupment, limitation or termination, or any
breach or alleged breach by the Holder or any other person or entity of any obligation to the Company or any violation or alleged
violation of law by the Holder or any other person or entity, and irrespective of any other circumstance that might otherwise limit
such obligation of the Company to the Holder in connection with the issuance of Warrant Shares. Nothing herein shall limit the
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 the Warrant as required pursuant to the terms hereof.

 

(d)              
RESERVATION OF SHARES. The Company shall at all times reserve for issuance and/or delivery upon exercise of this Warrant
such number of Shares (as adjusted pursuant to the terms hereof) as shall be required for issuance and delivery upon exercise of
this Warrant. The Company covenants that all Warrant Shares so issuable and deliverable shall, upon issuance and the payment of
the applicable Exercise Price in accordance with the terms hereof, be duly and validly authorized, issued and fully paid and nonassessable.
The Company will take all such action as may be reasonably necessary to assure that such Warrant Shares may be issued as provided
herein without violation of any applicable law or regulation, or of any requirements of any securities exchange or automated quotation
system upon which the Shares may be listed.

 

    3

     

    

 

(e)              
 FRACTIONAL SHARES. No fractional shares or scrips representing fractional shares shall be issued upon the exercise of this
Warrant. With respect to any fraction of a share called for upon any exercise hereof, the Company shall pay to the Holder an amount
in cash equal to such fraction multiplied by the fair market value of a Share.

 

(f)               
LOSS OR DESTRUCTION OF WARRANT. Upon receipt by the Company of evidence satisfactory to it of the loss, theft, destruction
or mutilation of this Warrant, and (in the case of loss, theft or destruction) of reasonably satisfactory indemnification, and
upon surrender and cancellation of this Warrant, if mutilated, the Company will execute and deliver a new Warrant of like tenor
and date.

 

(g)                 
RIGHTS OF THE HOLDER. The Holder shall not, by virtue hereof, be entitled to any rights of a shareholder in the Company,
either at law or equity, and the rights of the Holder are limited to those expressed in this Warrant and are not enforceable against
the Company except to the extent set forth herein.

 

(h)                 
CERTAIN ADJUSTMENTS. The Exercise Price and number of Warrant Shares issuable upon exercise of this Warrant are subject
to adjustment from time to time as set forth in this Section (h).

 

(1)              
Share Capitalizations and Sub-Divisions. If the Company, at any time while this Warrant is outstanding, (i) declares a share
capitalization on its Shares or otherwise makes a distribution on any class of shares that is payable in Shares, (ii) subdivides
its outstanding Shares into a larger number of shares, or (iii) combines its outstanding Shares into a smaller number of shares,
then, in each such case, the Exercise Price shall be multiplied by a fraction, the numerator of which shall be the number Shares
outstanding immediately before such event and the denominator of which shall be the number of Shares outstanding immediately after
such event. Any adjustment made pursuant to this Section (h)(1) shall become effective immediately after the record date
for the determination of shareholders entitled to receive such dividend or distribution, and any adjustment pursuant to clause
(ii) or (iii) of this Section (h)(1) shall become effective immediately after the effective date of such subdivision or
combination.

 

(2)              
Number of Warrant Shares. Simultaneously with any adjustment to the Exercise Price pursuant to Section (h)(1), the
number of Warrant Shares that may be purchased upon exercise of this Warrant shall be increased or decreased proportionately, so
that after such adjustment the aggregate Exercise Price payable hereunder for the increased or decreased number of Warrant Shares
shall be the same as the aggregate Exercise Price in effect immediately prior to such adjustment.

 

    4

     

    

 

(3)               Fundamental
Transactions. If, at any time while this Warrant is outstanding (i) the Company effects any merger or consolidation of the
Company with or into another Person, (ii) the Company effects any sale of all or substantially all of its assets or a
majority of its Shares is acquired by a third party, in each case, in one or a series of related transactions, (iii) any
tender offer or exchange offer (whether by the Company or a third party that is conducting such an offer pursuant to an
agreement or arrangement with the Company) is completed pursuant to which all or substantially all of the holders of Shares
are permitted to tender or exchange their shares for other securities, cash or property, or (iv) the Company effects any
reorganization or reclassification of Shares or any compulsory share exchange pursuant to which the Shares are effectively
converted into or exchanged for other securities, cash or property (other than as a result of a subdivision or combination of
Shares covered by Section (h)(1) above) (in any such case, a “Fundamental Transaction”), then the
Holder shall have the right thereafter to receive, upon exercise of this Warrant, the same amount and kind of securities,
cash or property as it would have been entitled to receive upon the occurrence of such Fundamental Transaction if it had
been, immediately prior to such Fundamental Transaction, the holder of the number of Warrant Shares then issuable upon
exercise in full of this Warrant without regard to any limitations on exercise contained herein (the “Alternate
Consideration”). The Company shall not effect any such Fundamental Transaction unless prior to or simultaneously
with the consummation thereof, any successor to the Company, surviving entity or the corporation purchasing or otherwise
acquiring such assets or other appropriate corporation or Person shall assume the obligation to deliver to the Holder, such
Alternate Consideration as, in accordance with the foregoing provisions, the Holder may be entitled to receive, and the other
obligations under this Warrant. The provisions of this Section (h)(3) shall similarly apply to subsequent transactions
analogous of a Fundamental Transaction type.

 

(4)              
Notice of Adjustments. Upon the occurrence of each adjustment pursuant to this Section (h), the Company at its expense
will, at the written request of the Holder, promptly compute such adjustment, in good faith, in accordance with the terms of this
Warrant and prepare a certificate setting forth such adjustment, including a statement of the adjusted Exercise Price and adjusted
number or type of Warrant Shares or other property issuable upon exercise of this Warrant (as applicable), describing the transactions
giving rise to such adjustments and showing in detail the facts upon which such adjustment is based. Upon written request, the
Company will promptly deliver a copy of each such certificate to the Holder and to the Company’s transfer agent.

 

(5)              
Notices To Warrant Holders. So long as this Warrant shall be outstanding, (i) if the Company shall pay any dividend
or make any distribution of cash, securities or other property in respect of its Shares or (ii) if the Company shall offer
to the holders of Shares for subscription or purchase by them any share of any class or any other rights or (iii) if any capital
reorganization of the Company, reclassification of the shares of the Company, consolidation or merger of the Company with or into
another corporation, sale, lease or transfer of all or substantially all of the property and assets of the Company to another corporation,
if the Company authorizes or approves, enters into any agreement contemplating or solicits shareholder approval for any Fundamental
Transaction (each as defined below) , or voluntary or involuntary dissolution, liquidation or winding up of the Company shall be
effected, then in any such case, the Company shall cause to be mailed to the Holder, at least fifteen days prior the date specified
in (x) or (y) below, as the case may be, a notice containing a brief description of the proposed action and stating the
date on which (x) a record is to be taken for the purpose of such dividend, distribution or rights, or (y) such reclassification,
reorganization, consolidation, merger, conveyance, lease, Fundamental Transaction, sales or issuances, dissolution, liquidation
or winding up is to take place and the date, if any is to be fixed, as of which the holders of Shares or other securities shall
receive cash or other property deliverable upon such reclassification, reorganization, consolidation, merger, conveyance, lease,
Fundamental Transaction, sales or issuances, dissolution, liquidation or winding up.

 

    5

     

    

 

(i)                    NOTICES.
Any notice or request hereunder shall be in writing and may be given only by, and shall be deemed to have been received upon:
(a) registered or certified mail, return receipt requested, on the date on which such notice or request is received as
indicated in such return receipt; (b) delivery by a nationally recognized overnight courier, one business day after deposit
with such courier; or (c) facsimile or other electronic transmission upon telephone or further electronic communication from
the recipient acknowledging receipt (whether automatic or manual from recipient) of such facsimile or other electronic
transmission. In the case of the Company, such notices and communications shall be addressed to LifeSci Acquisition II Corp.,
250 W. 55th St., #3401, New York, NY 10019, Attn: Andrew McDonald, Chief Executive Officer, unless the Company shall notify
the Holder that notices and communications should be sent to a different address (or facsimile number or electronic mail
address), in which case such notices and communications shall be sent to the address (or facsimile number or electronic mail
address) specified by the Company. In the case of the Holder, such notices and communications shall be addressed to its
address as set forth in the signature page hereto, unless the Holder shall notify the Company that notices and communications
should be sent to a different address (or facsimile number or electronic mail address), in which case such notices and
communications shall be sent to the address (or facsimile number or electronic mail address) specified by the Holder.

 

(j)                   
NO NET-CASH SETTLEMENT. Except as otherwise provided herein, in no event will the Holder be entitled to receive a net-cash
settlement or other consideration in lieu of physical settlement in securities.

 

(k)                 
MODIFICATION OF AGREEMENT. The provisions of this Warrant may from time to time be amended, modified or waived, by the Company
and the holder of this Warrant.

 

(l)                   
CHARGES, TAXES AND EXPENSES. Issuance and delivery of a reasonable number of certificates representing Shares upon exercise
of this Warrant shall be made without charge to the Holder for any issue or transfer tax, transfer agent fee or other incidental
tax or expense in respect of the issuance of such certificates, all of which taxes and expenses shall be paid by the Company; provided,
however, that the Company shall not be required to pay any tax that may be payable in respect of any transfer involved in the registration
of any certificates for Warrant Shares or the Warrants in a name other than that of the Holder or an affiliate thereof. The Holder
shall be responsible for all other tax liability that may arise as a result of holding or transferring this Warrant or receiving
Warrant Shares upon exercise hereof.

 

(m)            
SUCCESSORS AND ASSIGNS. This Warrant and the rights of the Holder hereunder may not be transferred and/or assigned by the
Holder in any way whatsoever, and no transaction in respect thereof shall be made, either for consideration or for no consideration.
This Warrant may not be assigned by the Company without the written consent of the Holder except to a successor in the event of
a Fundamental Transaction. This Warrant shall be binding on and inure to the benefit of the parties hereto and the Company’s
successors. Subject to the preceding sentence, nothing in this Warrant shall be construed to give to any person or entity other
than the Company and the Holder any legal or equitable right, remedy or cause of action under this Warrant. This Warrant may be
amended only in writing signed by the Company and the Holder, or the Company’s successors.

 

    6

     

    

 

(n)              
GOVERNING LAW.

 

THIS WARRANT
SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK.

 

ANY LEGAL ACTION
OR PROCEEDING WITH RESPECT TO THIS WARRANT SHALL BE BROUGHT IN THE COURTS OF THE STATE OF NEW YORK OR OF THE UNITED STATES OF AMERICA
FOR THE SOUTHERN DISTRICT OF NEW YORK, AND, BY EXECUTION AND DELIVERY OF THIS WARRANT, EACH PARTY HEREBY ACCEPTS FOR ITSELF AND
(TO THE EXTENT PERMITTED BY LAW) IN RESPECT OF ITS PROPERTY, GENERALLY AND UNCONDITIONALLY, THE JURISDICTION OF THE AFORESAID COURTS.
EACH PARTY HEREBY IRREVOCABLY WAIVES ANY OBJECTION, INCLUDING, WITHOUT LIMITATION, ANY OBJECTION TO THE LAYING OF VENUE OR BASED
ON THE GROUNDS OF FORUM NON CONVENIENS, WHICH IT MAY NOW OR HEREAFTER HAVE TO THE BRINGING OF ANY SUCH ACTION OR PROCEEDING IN
SUCH RESPECTIVE JURISDICTIONS. THIS SUBMISSION TO JURISDICTION IS NON-EXCLUSIVE AND DOES NOT PRECLUDE A PARTY FROM OBTAINING JURISDICTION
OVER ANOTHER PARTY IN ANY COURT OTHERWISE HAVING JURISDICTION.

 

EACH PARTY
IRREVOCABLY CONSENTS TO THE SERVICE OF PROCESS OF ANY OF THE AFOREMENTIONED COURTS IN ANY SUCH ACTION OR PROCEEDING BY THE MAILING
OF COPIES THEREOF BY REGISTERED OR CERTIFIED MAIL, POSTAGE PREPAID, TO IT AT THE ADDRESS SPECIFIED HEREIN OR
SUCH OTHER ADDRESS AS IS SPECIFIED PURSUANT TO THE TERMS HEREOF (OR ITS ASSIGNMENT AND ASSUMPTION), SUCH SERVICE TO BECOME
EFFECTIVE 30 DAYS AFTER SUCH MAILING. NOTHING HEREIN SHALL AFFECT THE RIGHT OF A PARTY OR ANY HOLDER TO SERVE PROCESS IN ANY OTHER
MANNER PERMITTED BY LAW OR TO COMMENCE LEGAL PROCEEDINGS OR OTHERWISE PROCEED AGAINST ANOTHER PARTY IN ANY OTHER JURISDICTION.

 

 

[remainder of page intentionally
left blank]

 

    7

     

    

 

IN WITNESS WHEREOF, the Company has caused
this Warrant to be duly executed as of the date of this Warrant.

 

	 	LIFESCI ACQUISITION II CORP.
	 	 
	 	By:	              
	 	 	Name: Andrew McDonald
	 	 	Title:   Chief Executive Officer

 

	Holder:	 
	 	 
	Accepted and Agreed:	 
	 	 
	LIFESCI HOLDINGS, LLC	 
	 	 
	By:	          	 
	Name:	 
	Title:	 

 

    8

     

    

 

PURCHASE FORM

 

                                 Dated ____________________

 

(1)       The
undersigned hereby irrevocably elects to exercise the within Warrant to the extent of purchasing Shares of LifeSci Acquisition
II Corp. (or such number of Shares or other securities or property to which the undersigned is entitled in lieu thereof or in addition
thereto under the provisions of the Warrant).

 

		(2)	_______ (a) The undersigned hereby elects to make payment with the enclosed bank draft, certified
check or money order payable to the Company in payment of the exercise price determined under, and on the terms specified in, the
Warrant, or
	 	 	 

_______ (b)
The undersigned hereby elects to make payment on a cashless basis.

 

(3) The undersigned hereby
irrevocably directs that the said shares be issued and delivered as follows:

 

	Name(s) in Full	 	Address(es)	 	Number of Shares (net of any Shares used to exercise on a cashless basis	 	S.S. or IRS #
	 	 	 	 	 	 	 

(4) If the Warrant was not exercised in
full, please check the following: ___

 

The undersigned hereby irrevocably
directs that any remaining portion of the warrant be issued and delivered as follows:

 

	Name(s) in Full	 	Address(es)	 	Number of Shares	 	S.S. or IRS #
	 	 	 	 	 	 	 

 

______________________________________________________________

Signature of Holder

______________________________________________________________

Print Name

 

    9

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00317-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00317-of-00352.parquet"}]]