Document:

BLOW & DRIVE INTERLOCK CORPORATION

 

Subscription Agreement

 

Name of Subscriber:

 

Number of Shares Purchased (______ share minimum):

 

Subscription Amount ($_______ per share):

 

State of Residence:

 

A. Subscription. The undersigned hereby
subscribes to the number of shares set forth above of the common stock of Blow & Drive Interlock Corporation (the “Investment
Securities”) a corporation organized and existing under the laws of the State of Delaware (the “Company”), and
agrees to pay for such Investment Securities the amount set forth above in cash or by check subject to collection upon execution
of this subscription agreement.

  

A. Agreements and Understandings of the Undersigned.
The undersigned agrees and understands that:

 

1. The undersigned is entitled to full information
about the Company and its principals. Written materials describing the Company and the Investment Securities (the “Investment
Documents”) have been furnished to the undersigned prior to execution of this subscription agreement and the undersigned
has been given the time required to read such materials, alone or with the undersigned’s advisor(s).

 

2. If the undersigned has made any deposit, escrow
or other payment in whole or in part toward the purchase of the Investment Securities offered hereby before executing this subscription
agreement, the undersigned may elect to either: (i) ratify the undersigned’s investment and receive a credit in full for
such payment by execution of this subscription agreement; or (ii) have returned on demand the full amount of such payment, less
distributions received by the undersigned, if any, plus lawful interest, at which time the undersigned will have no interest in
or further obligation in regard to the Investment Securities offered hereby.

 

3. The undersigned (or the entity for which the
undersigned is acting, if any) will not offer or sell all or any part of the undersigned’s Investment Securities until and
unless the Investment Securities are registered under the Securities Act of 1933, as amended and under applicable state laws or
unless the undersigned has delivered to the Company an opinion of counsel satisfactory to it that such registration is not required.

 

4. No Federal or state agency has made any finding
or determination as to the fairness for investment, nor recommendation or endorsement, of the Investment Securities.

 

5. If the undersigned is neither a United States
citizen nor a resident of the United States, then the undersigned agrees: (a) to supply the Company with any and all information
necessary so that the Company may satisfy any and all United States legal reporting requirements; and (b) to indemnify the Company
for any liability incurred by the Company as a result of its failure to withhold any taxes or comply with any reporting requirements
because the undersigned did not provide the necessary information to the Company to enable it to withhold the necessary taxes or
fully comply with such requirements. Furthermore, if the undersigned is a foreign investor who fails to timely file U.S. Internal
Revenue Service Form 4224 with the Company (the first such Form must be filed in duplicate with the Company prior to the acceptance
of this subscription), the undersigned agrees, at the request of the Company, to execute any and all documents and instruments
requested by the Company in order to consummate a sale or disposition of the Investment Securities as required to comply with law.

 

6. If the undersigned is an organization (other
than a cooperative described in Section 521 of the Internal Revenue Code of 1986, as amended) whose income from the Company will
be exempt from United States income tax, the undersigned shall so advise the Company.

 

    	 

    	 

    

 

7. THE OFFERING OF THESE SECURITIES IS NOT
REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED. AS SUCH THE UNDERSIGNED MUST BEAR THE ECONOMIC RISK OF THE INVESTMENT
FOR AN INDEFINITE PERIOD OF TIME BECAUSE THE SECURITIES CANNOT BE SOLD UNLESS THEY ARE SUBSEQUENTLY REGISTERED UNDER THE SECURITIES
ACT OR AN EXEMPTION FROM SUCH REGISTRATION IS AVAILABLE. RESTRICTIONS WILL BE PLACED ON THE TRANSFERABILITY OF THE SECURITIES.

 

8. THESE SECURITIES HAVE NOT BEEN APPROVED
OR DISAPPROVED BY THE STATE OR JURISDICTION OF THE UNDERSIGNED’S RESIDENCE NOR HAS THE STATE OR JURISDICTION OF THE UNDERSIGNED’S
RESIDENCE PASSED UPON THE ACCURACY OR ADEQUACY OF ANY INFORMATIONAL MATERIALS. 

 

9. THESE SECURITIES HAVE NOT BEEN APPROVED
OR DISAPPROVED BY THE SECURITIES AND EXCHANGE COMMISSION NOR HAS THE COMMISSION PASSED UPON THE ACCURACY OR ADEQUACY OF ANY INFORMATIONAL
MATERIALS. ANY REPRESENTATION TO THE CONTRARY IS A CRIMINAL OFFENSE.

 

B. Warranties of the Undersigned. The
undersigned represents and warrants that:

 

1. The undersigned has reached the age of majority
in the state or country in which the undersigned resides.

 

2. The undersigned (or the entity for which the
undersigned is acting, if any) intends to retain indefinitely, and has no present arrangement, understanding or agreement for disposing
of the Investment Securities and takes such Investment Securities solely for the account of the name(s) which appear below.

 

3. If a trust, corporation, partnership, or other
entity, the undersigned: (i) is duly organized and validly existing under the laws of the state of formation; (ii) is duly authorized
and empowered to purchase the Investment Securities; (iii) was not organized exclusively for the purpose of acquiring the Investment
Securities and has an independent reason for existence beyond such investment; (iv) has duly authorized the signatory hereto to
execute this subscription agreement on behalf of the undersigned, and, upon such execution, the subscription agreement and any
related documents shall be a binding obligation of the undersigned; and (v) will, upon request of counsel to the Company, furnish
evidence of the representations and warranties of this subparagraph, including certified copies of the certificate (articles) of
incorporation, articles of (limited) partnership, or other creating or implementing documents.

 

4. If the undersigned is not an Accredited Investor
(described hereinafter) under Regulation D of the General Rules and Regulations of the Securities and Exchange Commission, the
undersigned, either alone or with an advisor(s), has such knowledge and experience in financial and business matters that the undersigned
is capable of evaluating the merits and risks of the prospective investment.

 

5. It has been called to the undersigned’s
attention that this investment involves a high degree of risk, and no assurances are or have been made regarding the economic advantages,
if any, which may inure to the benefit of investors. The economic benefit from an investment in the Investment Securities depends
on the ability of the Company to successfully conduct its business activities. The accomplishment of such goals in turn depends
on many factors beyond the control of the Company or its management. Accordingly, the suitability for any particular investor of
a purchase of the Investment Securities will depend upon, among other things, such investor’s investment objectives and such
investor’s ability to accept speculative risks, including the risk of a total loss of investment in the Investment Securities.
The undersigned and the undersigned’s advisor(s), if any, have carefully reviewed and understand the risk of, and other considerations
relating to, a purchase of the Investment Securities.

 

6. The undersigned is able to bear the economic
risks of this investment, is able to hold the Investment Securities for an indefinite period of time, and has sufficient net worth
to sustain a loss of the entire investment in the Company in the event such loss should occur.

 

    	 

    	 

    

7. The undersigned and the undersigned’s
advisor(s), if any, have relied only upon the information contained in the Investment Documents made available to the undersigned
and the undersigned’s advisor(s). Any other information concerning this offering, whether oral or written, may be incomplete
or inaccurate. Only the Investment Documents are intended to be an accurate description of the offering and its terms.

 

8. The Company has answered all inquiries that
the undersigned and the undersigned’s advisor(s), if any, have made of it concerning the Company or any other matters relating
to the business and proposed operation of the Company and the offer and sale of the Investment Securities. No oral statement, printed
material, or inducement which is contrary to the information contained in the Investment Documents has been given or made by or
on behalf of the Company to the undersigned or the undersigned’s advisor(s), if any.

 

9. All of the representations and information
provided by the undersigned in this subscription agreement and any additional information which the undersigned has furnished to
the Company with respect to the undersigned’s financial position and business experience is accurate and complete as of the
date that this subscription agreement was executed by the undersigned. If there should be any material adverse change in such representations
or information prior to the sale of the Investment Securities subscribed for herein to the undersigned, the undersigned will immediately
furnish accurate and complete information concerning any such material change to the Company.

 

10. The undersigned represents, if the undersigned
is subject to the Employee Retirement Income Security Act of 1974 (“ERISA”), that in making the proposed investment
the undersigned is aware of and has taken into consideration the diversification requirements of Section 404(a)(1)(C) of ERISA,
and has concluded that the proposed investment is a prudent one.

 

C. “Non-Resident Alien” Status
(if applicable). By indication below, the undersigned represents and warrants that the undersigned (or the entity for which
the undersigned is acting, if any) is not a citizen of the United States or Canada and is not, and has no present intention of
becoming, a resident of the United States (defined as being any natural person physically present within the United States for
at least 183 days in a 12-month consecutive period or any entity who maintained an office in the United States at any time during
a 12-month consecutive period). The undersigned understands that the Company may rely upon the representations and warranty of
this paragraph as a basis for an exemption from registration of the Investment Securities under the Securities Act of 1933, as
amended, and the provisions of relevant state securities laws.

 

_____ CHECK HERE IF NOT
A CITIZEN/RESIDENT OF THE UNITED STATES OR CANADA.

 

D. “Accredited Investor” Status.
The investment securities to which this subscription relates are offered and sold under an exemption from registration provided
by Rule 506 of Regulation D of the General Rules and Regulations of the Securities and Exchange Commission. In addition to the
other requirements of Rule 506, sales of the investment securities are limited to no more than 35 persons who are not Accredited
Investors as that term is defined in Regulation D.

 

Unless indicated otherwise herein, the undersigned
falls within one of the following definitions of Accredited Investor:

 

For individuals:

 

	“	The undersigned is a natural person whose individual net worth, or joint net worth with spouse, exceeds $1,000,000 (without including the value of the undersigned’s primary residence) at the time of purchase of the Investment Securities.
	 	 
	“	The undersigned is a natural person who had an individual income in excess of $200,000 in each of the last two years or joint income with spouse in excess of $300,000 in each of those years and reasonably expects to reach the same income level in the current year.
	 	 
	“	The undersigned is either a director, executive officer or general partner of the Company, or a director, executive officer or general partner of a general partner of the Company.

 

    	 

    	 

    

 

If an Accredited Investor, the undersigned further certifies that:
(i) the undersigned (or the undersigned’s professional advisor(s)) has the capacity to protect the undersigned’s interests
in this investment; (ii) the undersigned is able to bear the economic risks of this investment; and (iii) the amount of the investment
does not exceed 10% of the undersigned’s net worth or joint net worth with spouse.

 

For entities:

 

	“	The undersigned is any institutional investor as provided in Regulation Section 230.501(a)(1) under the Securities Act of 1933.
	 	 
	“	The undersigned is a private business development company within the meaning of Section 202(a)(22) of the Investment Advisers Act of 1940.
	 	 
	“	The undersigned is any organization described in Section 501(c)(3) of the Internal Revenue Code, not formed for the specific purpose of acquiring the Investment Securities, with total assets in excess of $5,000,000.
	 	 
	“	The undersigned is a trust with total assets in excess of $5,000,000, not formed for the special purpose of acquiring the Investment Securities, whose investment is directed by a person described in Regulation Section 230.506(b)(2)(ii) under the Securities Act of 1933.
	 	 
	“	The undersigned is an entity owned entirely by any of the persons described above.

 

E. Suitability Information for Investors
who are not Accredited Investors. If the undersigned does NOT meet the definition above of an accredited investor, the
undersigned must be able to check the following.

 

_______ I am NOT an Accredited Investor. I have such knowledge and
experience in financial and business matters that I (alone or together with a Purchaser Representative) am capable of evaluating
the merits and risks of this investment.

 

If the undersigned is not an Accredited Investor, the Company may
require that the undersigned utilize the services of a Purchaser Representative or equivalent advisor who may be required to complete
a Purchaser Representative Questionnaire.

 

F. Acceptance and Conditions of Investment.

 

The undersigned agrees and is aware that:

 

1. The Company reserves the unrestricted right
to reject any subscription, and no subscription will be binding unless and until accepted by it. A subscription from a non-accredited
investor will not be accepted if the maximum limitation on the number of non-accredited investors has already been reached.

 

2. A legend in substantially the following form
will be placed on any certificate(s) evidencing the Investment Securities:

 

THESE SECURITIES CANNOT BE SOLD, TRANSFERRED OR OTHERWISE DISPOSED
OF BY ANY INVESTOR TO ANY OTHER PERSON OR ENTITY UNLESS SUBSEQUENTLY REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND
UNDER APPLICABLE LAW OF THE STATE OR JURISDICTION WHERE SOLD, TRANSFERRED OR DISPOSED OF, UNLESS SUCH SALE, TRANSFER OR DISPOSITION
SHALL QUALIFY UNDER AN ALLOWED EXEMPTION TO SUCH REGISTRATION. 

 

3. Stop transfer instructions will be placed with
respect to the Investment Securities so as to restrict resale or other transfer thereof subject to further items hereof, including
the provisions of the legend set forth above.

 

    	 

    	 

    

  

4. Unless otherwise provided by law, the legend
and stop transfer instructions described above will be placed with respect to any new certificate(s) or other document(s) issued
upon presentment by the undersigned of certificate(s) or other document(s) for transfer.

 

G. Registration Rights. The undersigned,
or subsequent holder of the Investment Securities, shall have the right to have the Investment Securities included in the first
registration statement effected by the Company for any of its stock or other securities under the Securities Act of 1933, as amended,
(other than a registration statement relating solely to the sale of securities to participants in a Company stock plan, a Form
S-4 registration statement, or a registration on any other form which does not include substantially the same information as would
be required to be included in a registration statement covering the sale of the Investment Securities). Holders who wish their
Investment Securities included in such registration statement shall comply with reasonable conditions imposed by the Company, including
the furnishing of certain information required to be included in the registration statement. The expenses of the registration statement
will be borne by the Company except for expenses (such as the advice of an attorney, accountant or financial advisor) incurred
by the holder individually.

 

H. Accuracy of Information Given. The
undersigned certifies that the undersigned has given the information contained herein to the best of the undersigned’s knowledge
and answers thereto are complete and accurate. The undersigned agrees that the foregoing representations and warranties shall survive
the purchase of the Investment Securities as well as any acceptance of this subscription for the Investment Securities.

 

I. Election of Purchaser Representative.
The undersigned understands that the undersigned is entitled to be advised by a Purchaser Representative or an equivalent advisor
in making a decision to invest and that (unless the undersigned is an Accredited Investor) the undersigned must be so advised if
the undersigned does not have sufficient knowledge and experience in financial and business matters to evaluate the merits and
risks of this investment.

 

J. Indemnification. The undersigned acknowledges
that the undersigned understands the meaning and legal consequences of the representations and warranties hereof, and hereby agrees
to indemnify and hold harmless the Company, its affiliates, attorneys, accountants, agents, employees and any selling securityholder
from and against any and all loss, damage or liability, including, without limitation, reasonable attorneys fees incurred as a
result of such breach, due to or arising out of a breach of any such representations or warranties. This indemnification shall
not require that the Company shall have been determined by any Federal, state or other authority or person to have qualified for
any exemption from the registration provisions of Federal or state securities laws, rules or regulations.

 

K. Arbitration. The undersigned hereby
agrees that any and all claims (other than claims for injunctive or other equitable relief) now or at any time hereafter as to
which the Company, its affiliates, attorneys, accountants, agents or employees and the undersigned, the undersigned’s successors
or assigns may be adverse parties, whether arising out of this agreement or from any other cause, will be resolved by arbitration
before the American Arbitration Association. Each party irrevocably consents to subject matter and personal jurisdiction before
the American Arbitration Association. The parties covenant that under no conditions will any of them file any action at law against
any other or bring any claim in any forum other than before the American Arbitration Association, and they agree that any litigation,
if filed, shall be immediately dismissed upon application and shall be referred for arbitration hereunder with costs and attorneys’
fees to the prevailing party. The situs of arbitration and any counterclaims shall be selected by the person against whom arbitration
is sought provided that such situs is within the United States and is the situs of such person’s principal residence or place
of business. Any dispute concerning situs shall be determined by the American Arbitration Association.

 

The parties shall restrict themselves to claims for compensatory
damages. No claims shall be made by any party for lost profits, punitive or similar damages. The parties agree that any award or
decision by the American Arbitration Association shall be final and non-appealable except as to errors of law. Any appeal from
an award of the arbitrator shall be taken to the appropriate court having jurisdiction over the situs of the arbitration. No bond
shall be required of any party on appeal, and no enforcement of the award shall be granted until a determination of the appeal
is final or until time to take an appeal has expired. Each party shall pay their own attorneys fees and costs of the arbitration
and any appeal.

 

    	 

    	 

    

 

It is the intent of the parties and their affiliates to deal with
all disputes between them by arbitration to the maximum degree allowed by law (including claims against any party’s current
or former attorneys, accountants, agents, employees, successors or assigns), and if any claim or claims should be held not subject
to arbitration, only such claim or claims shall be excluded from this paragraph.

 

PLEASE EXECUTE THE ATTACHED SIGNATURE PAGE

 

    	 

    	 

    

 

BLOW & DRIVE INTERLOCK CORPORATION

 

Signature Page to Subscription Agreement

 

	 
	Name of Subscriber
	 
	 
	Street
	 
	 
	City, State, Zip Code

 

	$	

Amount of Subscription

 

	By	 

Signature

  

	Date:	 

 

	Taxpayer Identification Number 	 
	 	(Social Security number for individuals)

 

Status (if not individual):

 

	(  ) Trust	(  ) Corporation
	(  ) Partnership	(  ) Other 	 
	(  ) IRA		(describe)

 

Title to be Taken By (if not individual):

 

	(  ) Joint Tenant with	 
	 	(name of co-tenant)

 

	(  ) Other (describe):	 
	 	 

 

Accepted:

 

BLOW & DRIVE INTERLOCK CORPORATION

 

	By	 	 
	 	 
	Date:Exhibit 4.1

 

	 	 	WKN: A12UKR
	 	Innocoll AG	 
	 	 	ISIN: DE000A12UKR
	 	mit Sitz in Saal an der Donau	 
	 		Ordnungs-Nr.  001
	 	Globalurkunde	 

 

über bis zu [·]
auf den Namen der Citigroup Global Markets Deutschland AG, Frankfurt am Main, lautende Stammaktien in Form von Stückaktien

 

Aktiennummern 1 bis [·]

 

Die Anzahl der in dieser Globalurkunde verbrieften und
begebenen Aktien ergibt sich aus der aktuellen virtuellen Depotdokumentation der Clearstream Banking AG.

 

Diese Globalurkunde ist ausschließlich zur Verwahrung
bei der Clearstream Banking AG, Frankfurt am Main, bestimmt.

 

Zu dieser Globalurkunde wurde kein Globalgewinnanteilschein
ausgefertigt.

 

Die in dieser Globalurkunde verbrieften Aktien sind
ab dem 01. Januar 2014 gewinnberechtigt.

 

Regensburg, im
Juli 2014

 

Innocoll AG

 

	 	 	 
	Gordon Dunn	 	Jonathan Symonds
	Vorstand	 	Vorsitzender des Aufsichtsrats

 

    	 

    	 

    

 

Convenience Translation

 

	 	Innocoll AG	Security Identification 
	 	 	Number (WKN):
	 	 	A12UKR

 

ISIN: DE000A12UKR

 

with registered seat in Saal
an der Donau

 

Order number: 001

 

Global Share Certificate(1)

 

regarding up to [•] registered ordinary
shares with no par value in the name of Citigroup Global Markets Deutschland AG, Frankfurt am Main,

 

Share numbers: 1 through [•]

 

The number of shares which are evidenced and issued
through this global share certificate results from the current virtual custody documentation of Clearstream Banking AG.

 

This global share certificate is made exclusively for
custody by Clearstream Banking AG, Frankfurt am Main.

 

There is no global dividend coupon issued together with
this global share certificate.

  

The shares which are evidenced by this global share certificate
participate in the profits of the company starting from January 1, 2014.

 

Regensburg, in July 2014

 

Innocoll AG

 

		 	
	Gordon Dunn	 	Jonathan Symonds
	Member of the Management Board	 	Chairman of the Supervisory Board

 

 

(1) This convenience translation into the English language
is for information purposes only and is not a valid share certificate.

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