Document:

oxbr_ex45

Exhibit 4.5

 

           
           
           
           
           
           
           
           
           
        Description of Securities
Registered Under Section 12 of the Securities Exchange Act of 1934,
as amended

 

As of
December 31, 2019, Oxbridge Re Holdings Limited (the
“Company,” “we,” “us,” and
“our”) had two classes of securities registered under
Section 12 of the Securities Exchange Act of 1934, as amended (the
“Exchange Act”) – our ordinary shares and
warrants to purchase ordinary shares. 

 

The
following description of our capital stock is a summary and does
not purport to be complete. It is subject to and qualified in its
entirety by reference to our Third Amended and Restated Memorandum
and Articles of Association (“Articles”) and our form
of Warrant Agreement (as amended by Amendment #1 to Warrant
Agreement), each of which is filed as an exhibit to our Annual
Report on Form 10-K for the fiscal year ended December 31,
2019 and incorporated by reference herein.

 

 

Ordinary Shares

 

General

 

The
ordinary shares constitute common equity of our company. We are
authorized to issue up to 50,000,000 ordinary shares, par value
$0.001. As of the date of this Annual Report on Form 10-K, our
share capital consists of only the ordinary shares. However,
subject to the provisions in the Articles and without prejudice to
any rights of existing shares, the Board of Directors may create
different classes of shares and may vary the rights of such classes
of shares.

 

Dividends

 

The
Board of Directors may declare dividends and other distributions
out of funds legally available for dividends and in accordance with
the Companies Law of the Cayman Islands (“Companies
Law”) and the Articles. Our ability to pay dividends depends
on the ability of Oxbridge Reinsurance Limited and/or Oxbridge Re
NS, our wholly owned subsidiaries, to pay dividends to us. Oxbridge
Reinsurance Limited and Oxbridge Re NS are subject to the Cayman
Islands regulatory constraints that affect its ability to pay
dividends to us. Under the Cayman Islands law and related
regulations, both Oxbridge Reinsurance Limited and Oxbridge Re NS
must maintain a minimum net worth and may not declare or pay
dividends that would result in non-compliance with such
requirements. In addition, under the Cayman Islands law, we
,Oxbridge Reinsurance Limited or Oxbridge Re NS may not pay or
declare a dividend unless immediately following the date on which
the dividend is proposed to be paid by us, Oxbridge Reinsurance
Limited or Oxbridge Re NS, as the case may be, are able to pay our
or their debts as they fall due in the ordinary course of business.
Accordingly, we may not be able to declare or pay dividends on the
ordinary shares. Except as otherwise provided by the rights
attached to any shares, the Board of Directors may deduct from any
dividend or other distribution payable any holder of our shares all
sums of money payable by such holder to the company.

 

Voting

 

Holders
of our ordinary shares are generally entitled to one vote per
share, other than in circumstances set forth in the Articles. In
certain circumstances, the total voting power of our ordinary
shares held by any one person will be reduced to less than 9.9% of
the total voting power of the total issued and outstanding ordinary
shares. In the event a holder of our ordinary shares acquires
shares representing 9.9% or more of the total voting power of our
total ordinary shares, there will be an effective reallocation of
the voting power of the ordinary shares as described in the
Articles.

 

An
ordinary resolution to be passed by the shareholders requires the
affirmative vote of a simple majority of votes attached to the
ordinary shares cast in a general meeting, while a special
resolution requires the affirmative vote of no less than two-thirds
of votes cast attached to the ordinary shares. A special resolution
will be required for important matters such as a change of name or
making changes to our Articles.

 

Selection of Directors

 

There
are currently four (4) directors on our Board of Directors.
The number of directors may be increased or reduced by an ordinary
resolution passed by a simple majority of the holders of our
shares. Directors may be appointed by an ordinary resolution passed
by a simple majority of the holders of our shares. However, the
Board of Directors may also appoint an additional director,
provided that the appointment does not cause the number of
directors to exceed the number fixed in accordance with the
Articles as the maximum number of directors.

 

Liquidation

 

On a
return of capital on winding up or otherwise (other than on
conversion, redemption or purchase of ordinary shares), assets
available for distribution among the holders of ordinary shares
will be distributed among the holders of the ordinary shares on a
pro rata basis. If our assets available for distribution are
insufficient to repay all of the paid-up capital, the assets will
be distributed so that the losses are borne by our shareholders
proportionately.

 

 

 

 

Preemptive Rights; Redemption Rights; Further Calls and
Assessment

 

Although our
Articles allow us to issue shares with preemptive rights and
redemption rights provisions, the ordinary shares are not subject
to any preemptive rights or redemption rights
provisions.

 

Our
Articles also permit our Board of Directors to make calls upon
holders in respect of monies unpaid on their shares.

 

Variations of Rights of Shares

 

If at
any time, our share capital is divided into different classes of
shares, all or any of the special rights attached to any class of
shares may, subject to the provisions of the Companies Law, be
varied with the sanction of a special resolution passed at a
general meeting of the holders of the shares of that class.
Consequently, the rights of any class of shares cannot be
detrimentally altered without a majority of two-thirds of the vote
of all of the shares in that class. The rights conferred upon the
holders of the shares of any class issued with preferred or other
rights will not, unless otherwise expressly provided by the terms
of issue of the shares of that class, be deemed to be varied by the
creation or issue of further shares ranking pari passu with such
existing class of shares.

 

General Meetings of Shareholders

 

Shareholders’
meetings may be convened by our Board of Directors. Additionally,
on the requisition of shareholders representing not less than
66.66% of the voting rights entitled to vote at general meetings,
the board shall convene an extraordinary general meeting. Advance
notice of at least ten days is required for the convening of our
annual general shareholders’ meeting and any other general
meeting of our shareholders. A quorum required for a meeting of
shareholders consists of at least two shareholders present or by
proxy, representing not less than a majority in par value of the
total issued voting shares in our company.

 

Proceedings of Board of Directors

 

Our
Articles provide that our business is to be managed and conducted
by our Board of Directors. The quorum necessary for the board
meeting may be fixed by the board and, unless so fixed at another
number, will be a majority of the directors.

 

Exempted Company

 

As a
Cayman Islands exempted companies, each of Oxbridge Re Holdings
Limited and Oxbridge Reinsurance Limited is prohibited from trading
in the Cayman Islands with any person, firm or corporation except
in furtherance of our business carried on outside the Cayman
Islands.

 

Register of Members

 

Under
Cayman Islands law, the register of members (shareholders) is prima
facie evidence of title to shares and this register would not
record a third-party interest in such shares. However, there are
certain limited circumstances where an application may be made to a
Cayman Islands court for a determination on whether the register of
members reflects the correct legal position. Further, the Cayman
Islands court has the power to order that the register of members
maintained by a company be rectified where it considers that such
register of members does not reflect the correct legal position.
The register of members is not filed with, and it does not need to
be approved by, the Cayman Islands authorities. Under Cayman
Islands law, every person or entity that acquires our shares must
have his, her or its name entered on our register of members in
order to be considered a shareholder.

 

Warrants

 

Each
warrant may be exercised to purchase one ordinary share from us at
a purchase price of $7.50 per share. The warrants can be exercised
at any time until Marcy 26, 2024. The warrants are exercised by
surrendering to us the warrants to be exercised, with an exercise
form included therein duly completed and executed, and paying to us
the exercise price per share in cash or check payable to us. At any
time while there is an effective registration statement available
for the issuance of shares issuable pursuant to the warrants, the
warrants may be exercised only with a cash payment. If a
registration statement is not available for the issuance of the
underlying shares, the warrants may be exercised on a cashless
net-share basis. We are obligated under the warrants to use our
best efforts to maintain an effective registration statement with
respect to the issuance of the underlying shares. However, under no
circumstances will a holder of warrants be entitled to settle the
warrants for cash, even in the absence of an effective registration
statement.

 

 

 

 

As long
as any warrants remain outstanding, ordinary shares to be issued
upon the exercise of warrants will be adjusted in the event of one
or more stock splits, readjustments or reclassifications. In the
event of the foregoing, the remaining number of ordinary shares
still subject to the warrants shall be increased or decreased to
reflect proportionately the increase or decrease in the number of
ordinary shares outstanding and the exercise price per share shall
be decreased or increased as the case may be, in the same
proportion.

 

We have
reserved a sufficient number of ordinary shares for issuance upon
exercise of the warrants and such shares, when issued in accordance
with the terms of the warrants, will be fully paid and
non-assessable. Fractional shares will not be issued upon the
exercise of warrants, and no payment will be made with respect to
any fractional shares to which any warrant holder might otherwise
be entitled upon exercise of warrants. No adjustments as to
previously declared or paid cash dividends, if any, will be made
upon any exercise of warrants.

 

The
holders of the warrants as such are not entitled to vote, receive
dividends or to exercise any of the rights of holders of ordinary
shares for any purpose until such warrants shall have been duly
exercised and payment of the purchase price shall have been
made.

 

If for
at least ten (10) trading days within any period of twenty (20)
consecutive trading days, including the last trading day of the
period, the closing price per ordinary exceeds 125% of the
warrant’s exercise price, we may cancel any warrants
remaining outstanding and unexercised. The date upon which we may
cancel such warrants must be a date which is more than thirty
(30) calendar days, but less than sixty (60) calendar
days, after a notice is mailed by first class mail to all
registered holders of the warrants following the satisfaction of
the conditions described above, or such longer time as may be
required by regulatory authorities. The notice of cancellation must
be mailed by us on or before the ninetieth (90th) calendar day
following the last trading day of any twenty (20) consecutive
trading day period that triggers our right to cancel any
warrants.

 

Book-Entry Form

 

Individual
certificates will not be issued for the ordinary shares and
warrants. Instead, one or more global certificates are deposited by
us with DTC and registered in the name of Cede & Co., as
nominee for DTC. The global certificates evidence all of the
ordinary shares and warrants outstanding at any time. Accordingly,
holders of our shares and warrants are limited to
(1) participants in DTC such as banks, brokers, dealers and
trust companies (“DTC Participants”), (2) those
who maintain, either directly or indirectly, a custodial
relationship with a DTC Participant (“Indirect
Participants”), and (3) those banks, brokers, dealers,
trust companies and others who hold interests in the securities
through DTC Participants or Indirect Participants. The securities
are only transferable through the book-entry system of DTC. Holders
who are not DTC Participants may transfer their securities through
DTC by instructing the DTC Participant holding their securities (or
by instructing the Indirect Participant or other entity through
which their securities are held) to transfer the securities.
Transfers will be made in accordance with standard securities
industry practice.

 

 

Anti-Takeover Provisions

 

Some
provisions of our Articles may discourage, delay or prevent a
change of control of our company or management that shareholders
may consider favorable, including provisions that:

 

●

authorize
our Board of Directors to issue shares in one or more series and to
designate the price, rights, preferences, privileges and
restrictions of such shares without any further vote or action by
our shareholders;

 

●

prohibit
cumulative voting (the ordinary shares will generally be entitled
to one vote per share other than in the circumstances noted in the
Articles); and

 

●

establish
requirements for proposing matters that can be acted on by
shareholders at extraordinary general meetings.

 

However, under
Cayman Islands law, our directors may only exercise the rights and
powers granted to them under our Articles for a proper purpose and
for what they believe in good faith to be in the best interests of
our company.Exhibit 4.1

 

NEITHER THIS SECURITY NOR THE SECURITIES
FOR WHICH THIS SECURITY IS EXERCISABLE HAVE BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES COMMISSION
OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES
ACT”), AND, ACCORDINGLY, MAY NOT BE OFFERED OR SOLD EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES
ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE SECURITIES
ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS. THIS SECURITY AND THE SECURITIES ISSUABLE UPON EXERCISE OF THIS SECURITY
MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT OR OTHER LOAN SECURED BY SUCH SECURITIES.

 

COMMON STOCK PURCHASE WARRANT

 

DARIOHEALTH
CORP.

 

THIS COMMON STOCK PURCHASE
WARRANT (the “Warrant”) certifies that, for value received, The Vitality Group, LLC or its assigns (the “Holder”)
is entitled, subject to the vesting terms contained herein, upon the terms and the limitations on exercise and the conditions hereinafter
set forth to subscribe for and purchase from DarioHealth Corp., a Delaware corporation (the “Company”), up to
500,000 shares (as subject to vesting and adjustment hereunder, the “Warrant Shares”) of the Company’s
common stock (the “Common Stock”). The Warrant Shares shall be issued to the Holder pursuant to annual sales
generated by The Vitality Group, LLC (“Vitality”) of the Company’s products as set forth in a Strategic
Alliance Agreement between Vitality and the Company, as amended on March 17, 2020 (the “Amended Agreement”).
The purchase price of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section
3(b).

 

Section 1.Number
of Warrant Shares; Exercise and Termination Date.

 

a) Number of Warrant Shares. Vitality will be issued the 2020 Warrant Shares, 2021 Warrant Shares, 2022 Warrant Shares,
and the 2023 Warrant Shares (each, as defined below), following the filing of Company’s Annual Report on Form 10-K with the
U.S. Securities and Exchange Commission for the Company’s 2020, 2021, 2022, and 2023fiscal year, respectively, and in no
event later than 45 days from date of the applicable Form 10-K filing (the date in each such year, the “Initial Exercise
Date”).

 

		i.	Subject to the Company generating from customers of Vitality
annual revenues, in accordance with generally accepted accounting principles in the United States (such revenues, the “Annual
Revenues” and accounting principles, “GAAP”) as computed by the Company, in the amount of at least
$500,000 during the calendar year 2020 (the “2020 Threshold”), Vitality will have the right to purchase 25,000
Warrant Shares, and one (1) additional share Warrant Share per each additional $20 in Annual Revenues above the 2020 Threshold
generated from customers (the “2020 Warrant Shares”); provided, however, that in no event shall the number
of 2020 Warrant Shares exceed 125,000 in the aggregate.

 

    	 	1	 

     

    

 

 

		ii.	Subject to the Company generating from customers Annual Revenues in the amount of at least $1,000,000
during the calendar year 2021 (the “2021 Threshold”) as computed by the Company, Vitality will have the right
to purchase 25,000 Warrant Shares, and one (1) additional Warrant Share per each additional $40 in revenues above the 2021 Threshold
generated from customers (the “2021 Warrant Shares”); provided, however, that in no event shall the number of
2021 Warrant Shares exceed 125,000 in the aggregate.

		iii.	Subject to the Company generating from customers Annual Revenues in the amount of at least $1,500,000
during the calendar year 2022 (the “2022 Threshold”), Vitality will have the right to purchase 25,000 Warrant
Shares, and one (1) additional Warrant Share per each additional $60 in revenues above the 2022 Threshold generated from customers
(the “2022 Warrant Shares”); provided, however, that in no event shall the number of 2022 Warrant Shares exceed
125,000 in the aggregate.

		iv.	Subject to the Company generating from customers Annual Revenues in the amount of at least $2,000,000
during the calendar year 2023 (the “2023 Threshold”), Vitality will have the right to purchase 25,000 Warrant
Shares, and one (1) additional Warrant Share per each additional $80 in revenues above the 2022 Threshold generated from customers
(the “2023 Warrant Shares”); provided, however, that in no event shall the number of 2023 Warrant Shares exceed
125,000 in the aggregate.

 

b)  Exercise Period. The 2020 Warrant Shares, 2021 Warrant Shares, 2022 Warrant Shares, and 2023 Warrant Shares (collectively
referred to herein as the “Warrant Shares”) may be purchased by the Holder pursuant to, and subject to, the
terms of this Warrant at any time on or after the Initial Exercise Date and on or prior to the close of business on the third anniversary
of the Initial Exercise Date of each of the 2020 Warrant Shares, 2021 Warrant Shares, 2022 Warrant Shares, and 2023 Warrant Shares,
subject to Section 3(d) (the “Termination Date”), but not thereafter.

 

Section 2.Consulting
Agreement. This Warrant is being issued to the Holder pursuant to the terms of the Amended Agreement.

 

Section 3.Exercise.

 

		a)	Exercise of Warrant. Exercise of the purchase rights represented by this Warrant may be
made, in whole or in part, at any time or times on or after the Initial Exercise Date and on or before the Termination Date by
delivery to the Company or the Transfer Agent (or such other office or agency that the Company may designate by notice in writing
to the registered Holder at the address of the Holder appearing on the books of the Company), as applicable, of a duly executed
facsimile copy or PDF copy submitted by electronic (or e-mail attachment) of the Notice of Exercise in the form annexed hereto.
Within the earlier of (i) three (3) Trading Days and (ii) the number of Trading Days comprising the Standard Settlement Period
(as defined in Section 3(d)(i) herein) following the date of exercise as aforesaid, the Holder shall deliver the aggregate Exercise
Price for the shares specified in the applicable Notice of Exercise by wire transfer or cashier’s check drawn on a United
States bank. No ink-original Notice of Exercise shall be required, nor shall any medallion guarantee (or other type of guarantee
or notarization) of any Notice of Exercise form be required. Notwithstanding anything herein to the contrary, the Holder shall
not be required to physically surrender this Warrant to the Company until the Holder has purchased all of the Warrant Shares available
hereunder and the Warrant has been exercised in full, in which case, the Holder shall surrender this Warrant to the Company for
cancellation within three (3) Trading Days of the date the final Notice of Exercise is delivered to the Company. Partial exercises
of this Warrant resulting in purchases of a portion of the total number of Warrant Shares available hereunder shall have the effect
of lowering the outstanding number of Warrant Shares purchasable hereunder in an amount equal to the applicable number of Warrant
Shares purchased. The Holder and the Company shall maintain records showing the number of Warrant Shares purchased and the date
of such purchases. The Company shall deliver any objection to any Notice of Exercise within one (1) Business Day of receipt of
such notice. The Holder and any assignee, by acceptance of this Warrant, acknowledge and agree that, by reason of the provisions
of this paragraph, following the purchase of a portion of the Warrant Shares hereunder, the number of Warrant Shares available
for purchase hereunder at any given time may be less than the amount stated on the face hereof. For purposes of this warrant
 “Trading Day” means a day on which the principal Trading Market is open for trading. “Trading Market”
means any of the following markets or exchanges on which the Common Stock is listed or quoted for trading on the date in question:
the NYSE MKT, the Nasdaq Capital Market, the Nasdaq Global Market, the Nasdaq Global Select Market, the New York Stock Exchange
or the OTC Bulletin Board or OTCQB Marketplace operated by OTC Markets Group, Inc. (or any successors to any of the foregoing).

 

		b)	Exercise Price. The exercise price per share of
the Common Stock under this Warrant shall be $5.941,
subject to adjustment hereunder (the “Exercise Price”).

 

		c)	Mechanics of Exercise.

  

 

1
25% above closing market price, as listed on Nasdaq.com on the date of the Amendment.

 

    	 	2	 

     

    

 

 

i.           
Delivery of Warrant Shares Upon Exercise. Warrant Shares purchased hereunder shall be transmitted by the Transfer
Agent to the Holder by crediting the account of the Holder’s or its designee’s balance account with The Depository
Trust Company through its Deposit or Withdrawal at Custodian system (“DWAC”) if the Company is then a participant
in such system and either (A) there is an effective registration statement permitting the issuance of the Warrant Shares to or
resale of the Warrant Shares by the Holder or (B) the Warrant Shares are eligible for resale by the Holder without volume or manner-of-sale
limitations pursuant to Rule 144, and otherwise by physical delivery of a certificate, registered in the Company’s share
register in the name of the Holder or its designee, for the number of Warrant Shares to which the Holder is entitled pursuant to
such exercise to the address specified by the Holder in the Notice of Exercise by the date that is the earlier of (i) one (1) Trading
Day and (ii) the number of Trading Days comprising the Standard Settlement Period after the delivery to the Company of the Notice
of Exercise (such date, the “Warrant Share Delivery Date”). Upon delivery of the Notice of Exercise, the Holder
shall be deemed for all corporate purposes to have become the holder of record of the Warrant Shares with respect to which this
Warrant has been exercised, irrespective of the date of delivery of the Warrant Shares, provided that payment of the aggregate
Exercise Price is received within the earlier of (i) three Trading Days and (ii) the number of Trading Days comprising the Standard
Settlement Period following delivery of the Notice of Exercise. As used herein, “Standard Settlement Period”
means the standard settlement period, expressed in a number of Trading Days, on the Company’s primary Trading Market with
respect to the Common Stock as in effect on the date of delivery of the Notice of Exercise.

 

ii.             Delivery of New Warrants Upon Exercise. If this Warrant shall have been exercised in part, the Company shall, at
the request of a Holder and upon surrender of this Warrant certificate, at the time of delivery of the Warrant Shares, deliver
to the Holder a new Warrant evidencing the rights of the Holder to purchase the unpurchased Warrant Shares called for by this Warrant,
which new Warrant shall in all other respects be identical with this Warrant.

 

iii.          Rescission Rights. If the Company fails to cause the Transfer Agent to transmit to the Holder the Warrant Shares
pursuant to Section 3(d)(i) by the Warrant Share Delivery Date, then the Holder will have the right to rescind such exercise.

 

iv.          No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued upon
the exercise of this Warrant. As to any fraction of a share which the Holder would otherwise be entitled to purchase upon such
exercise, the Company shall, at its election, either pay a cash adjustment in respect of such final fraction in an amount equal
to such fraction multiplied by the Exercise Price or round up to the next whole share.

 

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v.           Charges, Taxes and Expenses. Issuance of Warrant Shares shall be made without charge to the Holder for any issue
or transfer tax or other incidental expense in respect of the issuance of such Warrant Shares, all of which taxes and expenses
shall be paid by the Company, and such Warrant Shares shall be issued in the name of the Holder or in such name or names as may
be directed by the Holder; provided, however, that in the event that Warrant Shares are to be issued in a name other
than the name of the Holder, this Warrant when surrendered for exercise shall be accompanied by the Assignment Form attached hereto
duly executed by the Holder and the Company may require, as a condition thereto, the payment of a sum sufficient to reimburse it
for any transfer tax incidental thereto. The Company shall pay all Transfer Agent fees required for same-day processing of any
Notice of Exercise and all fees to the Depository Trust Company (or another established clearing corporation performing similar
functions) required for same-day electronic delivery of the Warrant Shares.

 

vi.          Closing of Books. The Company will not close its stockholder books or records in any manner which prevents the timely
exercise of this Warrant, pursuant to the terms hereof.

 

d)       Holder’s
Exercise Limitations. The Company shall not effect any exercise of this Warrant, and a Holder shall not have the right to exercise
any portion of this Warrant, pursuant to Section 3 or otherwise, to the extent that after giving effect to such issuance after
exercise as set forth on the applicable Notice of Exercise, the Holder (together with the Holder’s Affiliates, and any other
Persons acting as a group together with the Holder or any of the Holder’s Affiliates (such Persons, “Attribution
Parties”)), would beneficially own in excess of the Beneficial Ownership Limitation (as defined below).  For purposes
of the foregoing sentence, the number of shares of Common Stock beneficially owned by the Holder and its Affiliates and Attribution
Parties shall include the number of shares of Common Stock issuable upon exercise of this Warrant with respect to which such determination
is being made, but shall exclude the number of shares of Common Stock which would be issuable upon (i) exercise of the remaining,
nonexercised portion of this Warrant beneficially owned by the Holder or any of its Affiliates or Attribution Parties and (ii)
exercise or conversion of the unexercised or nonconverted portion of any other securities of the Company (including, without limitation,
any other Common Stock Equivalents) subject to a limitation on conversion or exercise analogous to the limitation contained herein
beneficially owned by the Holder or any of its Affiliates or Attribution Parties.  Except as set forth in the preceding sentence,
for purposes of this Section 3(e), beneficial ownership shall be calculated in accordance with Section 13(d) of the Exchange Act
and the rules and regulations promulgated thereunder, it being acknowledged by the Holder that the Company is not representing
to the Holder that such calculation is in compliance with Section 13(d) of the Exchange Act and the Holder is solely responsible
for any schedules required to be filed in accordance therewith. To the extent that the limitation contained in this Section 3(e)
applies, the determination of whether this Warrant is exercisable (in relation to other securities owned by the Holder together
with any Affiliates and Attribution Parties) and of which portion of this Warrant is exercisable shall be in the sole discretion
of the Holder, and the submission of a Notice of Exercise shall be deemed to be the Holder’s determination of whether this
Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates and Attribution Parties)
and of which portion of this Warrant is exercisable, in each case subject to the Beneficial Ownership Limitation, and the Company
shall have no obligation to verify or confirm the accuracy of such determination. In addition, a determination as to any group
status as contemplated above shall be determined in accordance with Section 13(d) of the Exchange Act and the rules and regulations
promulgated thereunder. For purposes of this Section 3(e), in determining the number of outstanding shares of Common Stock, a Holder
may rely on the number of outstanding shares of Common Stock as reflected in (A) the Company’s most recent periodic or annual
report filed with the Commission, as the case may be, (B) a more recent public announcement by the Company or (C) a more recent
written notice by the Company or the Transfer Agent setting forth the number of shares of Common Stock outstanding.  Upon
the written or oral request of a Holder, the Company shall within two Trading Days confirm orally and in writing to the Holder
the number of shares of Common Stock then outstanding.  In any case, the number of outstanding shares of Common Stock shall
be determined after giving effect to the conversion or exercise of securities of the Company, including this Warrant, by the Holder
or its Affiliates or Attribution Parties since the date as of which such number of outstanding shares of Common Stock was reported.
The “Beneficial Ownership Limitation” shall be 9.99% of the number of shares of the Common Stock outstanding
immediately after giving effect to the issuance of shares of Common Stock issuable upon exercise of this Warrant. The Holder, upon
notice to the Company, may increase or decrease the Beneficial Ownership Limitation provisions of this Section 3(e), provided that
the Beneficial Ownership Limitation in no event exceeds 9.99% of the number of shares of the Common Stock outstanding immediately
after giving effect to the issuance of shares of Common Stock upon exercise of this Warrant held by the Holder and the provisions
of this Section 3(e) shall continue to apply. Any increase in the Beneficial Ownership Limitation will not be effective until the
61st day after such notice is delivered to the Company. The provisions of this paragraph shall be construed and implemented
in a manner otherwise than in strict conformity with the terms of this Section 3(e) to correct this paragraph (or any portion hereof)
which may be defective or inconsistent with the intended Beneficial Ownership Limitation herein contained or to make changes or
supplements necessary or desirable to properly give effect to such limitation. The limitations contained in this paragraph shall
apply to a successor holder of this Warrant.

 

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Section 4.Certain
Adjustments.

 

a)                 
Stock Dividends and Splits. If the Company, at any time while this Warrant is outstanding: (i) pays a stock dividend
or otherwise makes a distribution or distributions on shares of its Common Stock or any other equity or equity equivalent securities
payable in shares of Common Stock (which, for avoidance of doubt, shall not include any shares of Common Stock issued by the Company
upon exercise of this Warrant), (ii) subdivides outstanding shares of Common Stock into a larger number of shares, (iii) combines
(including by way of reverse stock split) outstanding shares of Common Stock into a smaller number of shares or (iv) issues by
reclassification of shares of the Common Stock any shares of capital stock of the Company, then in each case the Exercise Price
shall be multiplied by a fraction of which the numerator shall be the number of shares of Common Stock (excluding treasury shares,
if any) outstanding immediately before such event and of which the denominator shall be the number of shares of Common Stock outstanding
immediately after such event, and the number of shares issuable upon exercise of this Warrant shall be proportionately adjusted
such that the aggregate Exercise Price of this Warrant shall remain unchanged. Any adjustment made pursuant to this Section 4(a)
shall become effective immediately after the record date for the determination of stockholders entitled to receive such dividend
or distribution and shall become effective immediately after the effective date in the case of a subdivision, combination or re-classification.

 

b)                 
[RESERVED]

 

c)                 
Subsequent Rights Offerings. In addition to any adjustments pursuant to Section 4(a) above, if at any time the Company
grants, issues or sells any Common Stock Equivalents or rights to purchase stock, warrants, securities or other property pro rata
to the record holders of any class of shares of Common Stock (the “Purchase Rights”), then the Holder will be
entitled to acquire, upon the terms applicable to such Purchase Rights, the aggregate Purchase Rights which the Holder could have
acquired if the Holder had held the number of shares of Common Stock acquirable upon exercise of the number of Warrant Shares that
would have been issuable upon such exercise (without regard to any limitations on exercise hereof, including without limitation,
the Beneficial Ownership Limitation) immediately before the date on which a record is taken for the grant, issuance or sale of
such Purchase Rights, or, if no such record is taken, the date as of which the record holders of shares of Common Stock are to
be determined for the grant, issue or sale of such Purchase Rights (provided, however, to the extent that the Holder’s right
to participate in any such Purchase Right would result in the Holder exceeding the Beneficial Ownership Limitation, then the Holder
shall not be entitled to participate in such Purchase Right to such extent (or beneficial ownership of such shares of Common Stock
as a result of such Purchase Right to such extent) and such Purchase Right to such extent shall be held in abeyance for the Holder
until such time, if ever, as its right thereto would not result in the Holder exceeding the Beneficial Ownership Limitation).

 

d)                 
Pro Rata Distributions. During such time as this Warrant is outstanding, if the Company shall declare or make
any dividend or other distribution of its assets (or rights to acquire its assets) to holders of shares of Common Stock, by way
of return of capital or otherwise (including, without limitation, any distribution of cash, stock or other securities, property
or options by way of a dividend, spin off, reclassification, corporate rearrangement, scheme of arrangement or other similar transaction)
(a “Distribution”), at any time after the issuance of this Warrant, then, in each such case, the Holder shall
be entitled to participate in such Distribution to the same extent that the Holder would have participated therein if the Holder
had held the number of shares of Common Stock acquirable upon exercise of the number of Warrant Shares that would have been issuable
upon such exercise (without regard to any limitations on exercise hereof, including without limitation, the Beneficial Ownership
Limitation) immediately before the date of which a record is taken for such Distribution, or, if no such record is taken, the date
as of which the record holders of shares of Common Stock are to be determined for the participation in such Distribution (provided,
however, to the extent that the Holder's right to participate in any such Distribution would result in the Holder exceeding
the Beneficial Ownership Limitation, then the Holder shall not be entitled to participate in such Distribution to such extent (or
in the beneficial ownership of any shares of Common Stock as a result of such Distribution to such extent) and the portion of such
Distribution shall be held in abeyance for the benefit of the Holder until such time, if ever, as its right thereto would not result
in the Holder exceeding the Beneficial Ownership Limitation).

 

    	 	5	 

     

    

 

e)                 
Fundamental Transaction. If, at any time while this Warrant is outstanding, (i) the Company, directly or indirectly,
in one or more related transactions effects any merger or consolidation of the Company with or into another Person, (ii) the Company,
directly or indirectly, effects any sale, lease, license, assignment, transfer, conveyance or other disposition of all or substantially
all of its assets in one or a series of related transactions, (iii) any, direct or indirect, purchase offer, tender offer or exchange
offer (whether by the Company or another Person) is completed pursuant to which holders of Common Stock are permitted to sell,
tender or exchange their shares for other securities, cash or property and has been accepted by the holders of 50% or more of the
outstanding Common Stock, (iv) the Company, directly or indirectly, in one or more related transactions effects any reclassification,
reorganization or recapitalization of the Common Stock or any compulsory share exchange pursuant to which the Common Stock is effectively
converted into or exchanged for other securities, cash or property, or (v) the Company, directly or indirectly, in one or more
related transactions consummates a stock or share purchase agreement or other business combination (including, without limitation,
a reorganization, recapitalization, spin-off or scheme of arrangement) with another Person or group of Persons whereby such other
Person or group acquires more than 50% of the outstanding shares of Common Stock (not including any shares of Common Stock held
by the other Person or other Persons making or party to, or associated or affiliated with the other Persons making or party to,
such stock or share purchase agreement or other business combination) (each a “Fundamental Transaction”), then,
upon any subsequent exercise of this Warrant, the Holder shall have the right to receive, for each Warrant Share that would have
been issuable upon such exercise immediately prior to the occurrence of such Fundamental Transaction, at the option of the Holder
(without regard to any limitation in Section 3(e) on the exercise of this Warrant), the number of shares of Common Stock of the
successor or acquiring corporation or of the Company, if it is the surviving corporation, and any additional consideration (the
 “Alternate Consideration”) receivable as a result of such Fundamental Transaction by a holder of the number
of shares of Common Stock for which this Warrant is exercisable immediately prior to such Fundamental Transaction (without regard
to any limitation in Section 3(e) on the exercise of this Warrant). For purposes of any such exercise, the determination of the
Exercise Price shall be appropriately adjusted to apply to such Alternate Consideration based on the amount of Alternate Consideration
issuable in respect of one share of Common Stock in such Fundamental Transaction, and the Company shall apportion the Exercise
Price among the Alternate Consideration in a reasonable manner reflecting the relative value of any different components of the
Alternate Consideration. If holders of Common Stock are given any choice as to the securities, cash or property to be received
in a Fundamental Transaction, then the Holder shall be given the same choice as to the Alternate Consideration it receives upon
any exercise of this Warrant following such Fundamental Transaction. The Company shall cause any successor entity in a Fundamental
Transaction in which the Company is not the survivor (the “Successor Entity”) to assume in writing all of the
obligations of the Company under this Warrant, to the extent that the Amendment is still in effect, in accordance with the provisions
of this Section 4(e) pursuant to written agreements in form and substance reasonably satisfactory to the Holder and approved by
the Holder (without unreasonable delay) prior to such Fundamental Transaction and shall, at the option of the Holder, deliver to
the Holder in exchange for this Warrant a security of the Successor Entity evidenced by a written instrument substantially similar
in form and substance to this Warrant which is exercisable for a corresponding number of shares of capital stock of such Successor
Entity (or its parent entity) equivalent to the shares of Common Stock acquirable and receivable upon exercise of this Warrant
(without regard to any limitations on the exercise of this Warrant) prior to such Fundamental Transaction, and with an exercise
price which applies the exercise price hereunder to such shares of capital stock (but taking into account the relative value of
the shares of Common Stock pursuant to such Fundamental Transaction and the value of such shares of capital stock, such number
of shares of capital stock and such exercise price being for the purpose of protecting the economic value of this Warrant immediately
prior to the consummation of such Fundamental Transaction), and which is reasonably satisfactory in form and substance to the Holder.
Upon the occurrence of any such Fundamental Transaction, the Successor Entity shall succeed to, and be substituted for (so that
from and after the date of such Fundamental Transaction and the provisions of this Warrant shall refer instead to the Successor
Entity), and may exercise every right and power of the Company and shall assume all of the obligations of the Company under this
Warrant with the same effect as if such Successor Entity had been named as the Company herein.

 

    	 	6	 

     

    

 

f)                  
Calculations. All calculations under this Section 4 shall be made to the nearest cent or the nearest 1/100th of a
share, as the case may be. For purposes of this Section 4, the number of shares of Common Stock deemed to be issued and outstanding
as of a given date shall be the sum of the number of shares of Common Stock (excluding treasury shares, if any) issued and outstanding.

 

g)                 
Notice to Holder.

 

i.           
Adjustment to Exercise Price. Whenever the Exercise Price is adjusted pursuant to any provision of this Section 4,
the Company shall promptly deliver to the Holder by facsimile or email a notice setting forth the Exercise Price after such adjustment
and any resulting adjustment to the number of Warrant Shares and setting forth a brief statement of the facts requiring such adjustment.

 

ii.           
Notice to Allow Exercise by Holder. If (A) the Company shall declare a dividend (or any other distribution in whatever
form) on the Common Stock, (B) the Company shall declare a special nonrecurring cash dividend on or a redemption of the Common
Stock, (C) the Company shall authorize the granting to all holders of the Common Stock rights or warrants to subscribe for or purchase
any shares of capital stock of any class or of any rights, (D) the approval of any stockholders of the Company shall be required
in connection with any reclassification of the Common Stock, any consolidation or merger to which the Company is a party, any sale
or transfer of all or substantially all of the assets of the Company, or any compulsory share exchange whereby the Common Stock
is converted into other securities, cash or property, or (E) the Company shall authorize the voluntary or involuntary dissolution,
liquidation or winding up of the affairs of the Company, then, in each case, the Company shall cause to be delivered by facsimile
or email to the Holder at its last facsimile number or email address as it shall appear upon the Warrant Register of the Company,
at least 20 calendar days prior to the applicable record or effective date hereinafter specified, a notice stating (x) the date
on which a record is to be taken for the purpose of such dividend, distribution, redemption, rights or warrants, or if a record
is not to be taken, the date as of which the holders of the Common Stock of record to be entitled to such dividend, distributions,
redemption, rights or warrants are to be determined or (y) the date on which such reclassification, consolidation, merger, sale,
transfer or share exchange is expected to become effective or close, and the date as of which it is expected that holders of the
Common Stock of record shall be entitled to exchange their shares of the Common Stock for securities, cash or other property deliverable
upon such reclassification, consolidation, merger, sale, transfer or share exchange; provided that the failure to deliver such
notice or any defect therein or in the delivery thereof shall not affect the validity of the corporate action required to be specified
in such notice. To the extent that any notice provided in this Warrant constitutes, or contains, material, non-public information
regarding the Company or any of the Subsidiaries, the Company shall simultaneously file such notice with the Commission pursuant
to a Current Report on Form 8-K. The Holder shall remain entitled to exercise this Warrant during the period commencing on the
date of such notice to the effective date of the event triggering such notice except as may otherwise be expressly set forth herein.

 

    	 	7	 

     

    

 

Section 5.Transfer
of Warrant.

 

a)                 
Transferability. Subject to compliance with any applicable securities laws and the reasonable request of any documentation
or information by the Company, this Warrant and all rights hereunder (including, without limitation, any registration rights) are
transferable, in whole or in part, upon surrender of this Warrant at the principal office of the Company or its designated agent,
together with a written assignment of this Warrant substantially in the form attached hereto duly executed by the Holder or its
agent or attorney and funds sufficient to pay any transfer taxes payable upon the making of such transfer. Upon such surrender
and, if required, such payment, the Company shall execute and deliver a new Warrant or Warrants in the name of the assignee or
assignees, as applicable, and in the denomination or denominations specified in such instrument of assignment, and shall issue
to the assignor a new Warrant evidencing the portion of this Warrant not so assigned, and this Warrant shall promptly be cancelled.
Notwithstanding anything herein to the contrary, the Holder shall not
be required to physically surrender this Warrant to the Company unless the Holder has assigned this Warrant in full, in which case,
the Holder shall surrender this Warrant to the Company within three (3) Trading Days of the date the Holder delivers an assignment
form to the Company assigning this Warrant full. The Warrant, if properly assigned in accordance herewith, may be exercised
by a new holder for the purchase of Warrant Shares without having a new Warrant issued.

 

b)                 
New Warrants. This Warrant may be divided or combined with other Warrants upon presentation hereof at the aforesaid
office of the Company, together with a written notice specifying the names and denominations in which new Warrants are to be issued,
signed by the Holder or its agent or attorney. Subject to compliance with Section 5(a), as to any transfer which may be involved
in such division or combination, the Company shall execute and deliver a new Warrant or Warrants in exchange for the Warrant or
Warrants to be divided or combined in accordance with such notice. All Warrants issued on transfers or exchanges shall be dated
the original Issue date and shall be identical with this Warrant except as to the number of Warrant Shares issuable pursuant thereto.

 

c)                 
Warrant Register. The Company shall register this Warrant, upon records to be maintained by the Company for that
purpose (the “Warrant Register”), in the name of the record Holder hereof from time to time. The Company may
deem and treat the registered Holder of this Warrant as the absolute owner hereof for the purpose of any exercise hereof or any
distribution to the Holder, and for all other purposes, absent actual notice to the contrary.

 

d)                 
Representation by the Holder. The Holder, by the acceptance hereof, represents and warrants that it is acquiring
this Warrant and, upon any exercise hereof, will acquire the Warrant Shares issuable upon such exercise, for its own account and
not with a view to or for distributing or reselling such Warrant Shares or any part thereof in violation of the Securities Act
or any applicable state securities law, except pursuant to sales registered or exempted under the Securities Act.

 

Section 6.Miscellaneous.

 

a)                 
No Rights as Stockholder Until Exercise. This Warrant does not entitle the Holder to any voting rights, dividends
or other rights as a stockholder of the Company prior to the exercise hereof as set forth in Section 3(d)(i), except as expressly
set forth in Section 4.

 

    	 	8	 

     

    

 

b)                 
Loss, Theft, Destruction or Mutilation of Warrant. The Company covenants that upon receipt by the Company of evidence
reasonably satisfactory to it of the loss, theft, destruction or mutilation of this Warrant or any stock certificate relating to
the Warrant Shares, and in case of loss, theft or destruction, of indemnity or security reasonably satisfactory to it (which, in
the case of the Warrant, shall not include the posting of any bond), and upon surrender and cancellation of such Warrant or stock
certificate, if mutilated, the Company will make and deliver a new Warrant or stock certificate of like tenor and dated as of such
cancellation, in lieu of such Warrant or stock certificate.

 

c)                 
Saturdays, Sundays, Holidays, etc. If the last or appointed day for the taking of any action or the expiration of
any right required or granted herein shall not be a Business Day, then, such action may be taken or such right may be exercised
on the next succeeding Business Day.

 

d)                 
Authorized Shares.

 

The Company covenants
that, during the period the Warrant is outstanding, it will reserve from its authorized and unissued Common Stock a sufficient
number of shares to provide for the issuance of the Warrant Shares upon the exercise of any purchase rights under this Warrant.
The Company further covenants that its issuance of this Warrant shall constitute full authority to its officers who are charged
with the duty of issuing the necessary Warrant Shares upon the exercise of the purchase rights under this Warrant. The Company
will take all such reasonable action as may be necessary to assure that such Warrant Shares may be issued as provided herein without
violation of any applicable law or regulation, or of any requirements of the Trading Market upon which the Common Stock may be
listed. The Company covenants that all Warrant Shares which may be issued upon the exercise of the purchase rights represented
by this Warrant will, upon exercise of the purchase rights represented by this Warrant and payment for such Warrant Shares in accordance
herewith, be duly authorized, validly issued, fully paid and nonassessable and free from all taxes, liens and charges created by
the Company in respect of the issue thereof (other than taxes in respect of any transfer occurring contemporaneously with such
issue).

 

Except and
to the extent as waived or consented to by the Holder, the Company shall not by any action, including, without limitation, amending
its certificate of incorporation or through any reorganization, transfer of assets, consolidation, merger, dissolution, issue or
sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms of this
Warrant, but will at all times in good faith assist in the carrying out of all such terms and in the taking of all such actions
as may be necessary or appropriate to protect the rights of Holder as set forth in this Warrant against impairment. Without limiting
the generality of the foregoing, the Company will (i) not increase the par value of any Warrant Shares above the amount payable
therefor upon such exercise immediately prior to such increase in par value, (ii) take all such action as may be necessary or appropriate
in order that the Company may validly and legally issue fully paid and nonassessable Warrant Shares upon the exercise of this Warrant
and (iii) use commercially reasonable efforts to obtain all such authorizations, exemptions or consents from any public regulatory
body having jurisdiction thereof, as may be, necessary to enable the Company to perform its obligations under this Warrant.

 

    	 	9	 

     

    

 

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.

 

e)                 
Jurisdiction. This Warrant and disputes arising hereunder shall be governed by and construed and enforced in accordance
with the laws of the State of Delaware applicable to agreements made and to be performed wholly within such State, without regard
to its conflict of law rules. Any action brought by either party against the other concerning the transaction contemplated by this
Warrant shall be brought only in the state courts of Delaware or in the federal courts located in the state of Delaware. The parties
to this Warrant hereby irrevocably waive any objection to jurisdiction and venue of any action instituted hereunder and shall not
assert any defense based on lack of jurisdiction or venue or based upon forum non conveniens. The Company and Holder waive trial
by jury.

 

f)                  
Restrictions. The Holder acknowledges that the Warrant Shares acquired upon the exercise of this Warrant, if not
registered, will have restrictions upon resale imposed by state and federal securities laws.

 

g)                 
Nonwaiver and Expenses. No course of dealing or any delay or failure to exercise any right hereunder on the part
of Holder shall operate as a waiver of such right or otherwise prejudice the Holder’s rights, powers or remedies, notwithstanding
the fact that all rights hereunder terminate on the Termination Date. If the Company willfully and knowingly fails to comply with
any provision of this Warrant, which results in any material damages to the Holder, the Company shall pay to the Holder such amounts
as shall be sufficient to cover any costs and expenses including, but not limited to, reasonable attorneys’ fees, including
those of appellate proceedings, incurred by the Holder in collecting any amounts due pursuant hereto or in otherwise enforcing
any of its rights, powers or remedies hereunder.

 

h)                 
Notices. All notices will be in writing and will be effective when delivered in person, sent by certified mail or
by private carrier (Federal Express, UPS or equivalent), or sent via facsimile and confirmed by letter, to the party to whom it
is addressed at the following addresses or such other address as such party may advise the other in writing:

 

To the Company:

 

DarioHealth
Corp.

8 HaToKhen
Street

Caesarea Industrial
Park

3088900, Israel

Attn: Erez
Raphael, Chief Executive Officer

 

With a copy
to:

 

Zysman, Aharoni,
Gayer and Sullivan & Worcester, LLP

1633 Broadway,
32nd Floor

New York, NY
10019

Attention:
Oded Har-Even, Esq.

 

To the Holder:

 

The Vitality
Group, LLC

200 W Monroe
Street. Suite 1900

Chicago, IL
60606

Attention:

 

    	 	10	 

     

    

 

i)                  
Limitation of Liability. No provision hereof, in the absence of any affirmative action by the Holder to exercise
this Warrant to purchase Warrant Shares, and no enumeration herein of the rights or privileges of the Holder, shall give rise to
any liability of the Holder for the purchase price of any Common Stock or as a stockholder of the Company, whether such liability
is asserted by the Company or by creditors of the Company.

 

j)                  
Remedies. The Holder, in addition to being entitled to exercise all rights granted by law, including recovery of
damages, will be entitled to specific performance of its rights under this Warrant. The Company agrees that monetary damages would
not be adequate compensation for any loss incurred by reason of a breach by it of the provisions of this Warrant and hereby agrees
to waive and not to assert the defense in any action for specific performance that a remedy at law would be adequate.

 

k)                 
Successors and Assigns. Subject to applicable securities laws, this Warrant and the rights and obligations evidenced
hereby shall inure to the benefit of and be binding upon the successors and permitted assigns of the Company and the successors
and permitted assigns of Holder. The provisions of this Warrant are intended to be for the benefit of any Holder from time to time
of this Warrant and shall be enforceable by the Holder or holder of Warrant Shares.

 

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

 

m)              
Severability. Wherever possible, each provision of this Warrant shall be interpreted in such manner as to be effective
and valid under applicable law, but if any provision of this Warrant shall be prohibited by or invalid under applicable law, such
provision shall be ineffective to the extent of such prohibition or invalidity, without invalidating the remainder of such provisions
or the remaining provisions of this Warrant.

 

n)                 
Headings. The headings used in this Warrant are for the convenience of reference only and shall not, for any purpose,
be deemed a part of this Warrant.

 

 

********************

 

(Signature Page Follows)

 

    	 	11	 

     

    

 

 

IN WITNESS WHEREOF, the
Company has caused this Warrant to be executed by its officer thereunto duly authorized as of the date first above indicated.

 

 

	 	DARIOHEALTH CORP.
	 	 	 
	 	 	 
	 	By:	 
	 	 	Name: Zvi Ben-David
	 	 	Title: Chief Financial Officer

 

  

    	 	12	 

     

    

 

NOTICE OF EXERCISE

 

To:dariohealth
corp.

 

(1)  
The undersigned hereby elects to purchase ________ Warrant Shares of the Company pursuant to the terms of the attached Warrant
(only if exercised in full), and tenders herewith payment of the exercise price in full, together with all applicable transfer
taxes, if any.

 

(2)  
Payment shall take the form of (check applicable box):

 

[  ] in lawful
money of the United States.

 

(3)  
Please issue said Warrant Shares in the name of the undersigned or in such other name as is specified below:

 

_______________________________

 

 

The Warrant Shares shall be delivered to
the following DWAC Account Number:

 

_______________________________

 

_______________________________

 

_______________________________

 

(4) Accredited Investor.
The undersigned is an “accredited investor” as defined in Regulation D promulgated under the Securities Act of 1933,
as amended.

 

[SIGNATURE
OF HOLDER]

 

Name of Investing Entity: ________________________________________________________________________

Signature of Authorized Signatory of
Investing Entity: __________________________________________________

Name of Authorized Signatory: ____________________________________________________________________

Title of Authorized Signatory: _____________________________________________________________________

Date: ________________________________________________________________________________________

 

 

     

     

    

 

 

EXHIBIT B

 

ASSIGNMENT
FORM

(To assign the foregoing Warrant, execute
this form and supply required information. Do not use this form to purchase shares.)

 

FOR VALUE RECEIVED, the foregoing Warrant
and all rights evidenced thereby are hereby assigned to

 

	Name:	 
	 	(Please Print)
	 	 
	Address:	 
	 	(Please Print) 
	 	 
	Phone Number:	 
	 	 
	Email Address:	 
	 	 
	Dated: _______________ __, ______	 
	 	 
	Holder’s Signature: ___________________________________	 
	 	 
	Holder’s Address: ___________________________________

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