Document:

COMMON
STOCK PURCHASE WARRANT

 

GUARDION
HEALTH SCIENCES, INC.

 

	Warrant
    Shares: [_______]	Initial
    Exercise Date: [____], 2019

 

THIS
COMMON STOCK PURCHASE WARRANT (this “Warrant”) certifies that, for value received, _____________ or its assigns
(the “Holder”) is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter
set forth, at any time on or after the date hereof (the “Initial Exercise Date”) and on or prior to 5:00 p.m.
(New York City time) on [_____]1 (the “Termination Date”) but not thereafter, to subscribe
for and purchase from Guardion Health Sciences, Inc., a Delaware corporation (the “Company”), up to ______
shares (as subject to adjustment hereunder, the “Warrant Shares”) of Common Stock. The purchase price of one
share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b). This Warrant shall
initially be issued and maintained in the form of a security held in book-entry form and the Depository Trust Company or its nominee
(“DTC”) shall initially be the sole registered holder of this Warrant, subject to the Holder’s right
to elect to receive a Warrant in certificated form pursuant to the terms of the Warrant Agent Agreement, in which case this sentence
shall not apply.

 

Section
1. Definitions. In addition to the terms defined elsewhere in this Warrant, the following terms have the meanings
indicated in this Section 1:

 

“Affiliate”
means any Person that, directly or indirectly through one or more intermediaries, controls or is controlled by or is under common
control with a Person, as such terms are used in and construed under Rule 405 under the Securities Act.

 

“Bid
Price” means, for any date, the price determined by the first of the following clauses that applies: (a) if the Common
Stock is then listed or quoted on a Trading Market, the bid price of the Common Stock for the time in question (or the nearest
preceding date) on the Trading Market on which the Common Stock is then listed or quoted as reported by Bloomberg L.P. (based
on a Trading Day from 9:30 a.m. (New York City time) to 4:02 p.m. (New York City time)), (b) if OTCQB or OTCQX is not a Trading
Market, the volume weighted average price of the Common Stock for such date (or the nearest preceding date) on OTCQB or OTCQX
as applicable, (c) if the Common Stock is not then listed or quoted for trading on OTCQB or OTCQX and if prices for the Common
Stock are then reported in the “Pink Sheets” published by OTC Markets Group, Inc. (or a similar organization or agency
succeeding to its functions of reporting prices), the most recent bid price per share of the Common Stock so reported, or (d)
in all other cases, the fair market value of a share of Common Stock as determined by an independent appraiser selected in good
faith by the Holders of a majority in interest of the Warrants then outstanding and reasonably acceptable to the Company, the
fees and expenses of which shall be paid by the Company.

 

“Business
Day” means any day except any Saturday, any Sunday, any day which is a federal legal holiday in the United States or
any day on which banking institutions in the State of New York are authorized or required by law or other governmental action
to close.

 

“Commission”
means the United States Securities and Exchange Commission.

 

“Common
Stock” means the common stock of the Company, par value $0.001 per share, and any other class of securities into which
such securities may hereafter be reclassified or changed.

 

“Common
Stock Equivalents” means any securities of the Company or the Subsidiaries which would entitle the holder thereof to
acquire at any time Common Stock, including, without limitation, any debt, preferred stock, right, option, warrant or other instrument
that is at any time convertible into or exercisable or exchangeable for, or otherwise entitles the holder thereof to receive,
Common Stock..

 

1 Insert
the date that is the five year anniversary of the Initial Exercise Date; provided, however, that, if such date is not a Trading
Day, insert the immediately following Trading Day.

 

    	 	-1-	 

    	 

    

 

“Exchange
Act” means the Securities Exchange Act of 1934, as amended, and the rules and regulations promulgated thereunder.

 

“Person”
means an individual or corporation, partnership, trust, incorporated or unincorporated association, joint venture, limited liability
company, joint stock company, government (or an agency or subdivision thereof) or other entity of any kind.

 

“Registration
Statement” means the Company’s registration statement on Form S-1 (File No. [______]).

 

“Securities
Act” means the Securities Act of 1933, as amended, and the rules and regulations promulgated thereunder.

 

“Trading
Day” means a day on which the Common Stock is traded on a Trading Market.

 

“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 American, the Nasdaq Capital Market, the Nasdaq Global Market, the Nasdaq Global Select Market
or the New York Stock Exchange (or any successors to any of the foregoing).

 

“Transfer
Agent” means VStock Transfer, LLC, the current transfer agent of the Company with a mailing address of 8 Lafayette Place,
Woodmere, New York 11598, a phone number of (212) 828-8436 and an email address of [                ]@vstock.com,
and any successor transfer agent of the Company.

  

“VWAP”
means, for any date, the price determined by the first of the following clauses that applies: (a) if the Common Stock is then
listed or quoted on a Trading Market, the daily volume weighted average price of the Common Stock for such date (or the nearest
preceding date) on the Trading Market on which the Common Stock is then listed or quoted as reported by Bloomberg L.P. (based
on a Trading Day from 9:30 a.m. (New York City time) to 4:02 p.m. (New York City time)), (b) if OTCQB or OTCQX is not a Trading
Market, the volume weighted average price of the Common Stock for such date (or the nearest preceding date) on OTCQB or OTCQX
as applicable, (c) if the Common Stock is not then listed or quoted for trading on OTCQB or OTCQX and if prices for the Common
Stock are then reported on the Pink Open Market (or a similar organization or agency succeeding to its functions of reporting
prices), the most recent bid price per share of the Common Stock so reported, or (d) in all other cases, the fair market value
of a share of Common Stock as determined by an independent appraiser selected in good faith by the holders of a majority in interest
of the Warrants then outstanding and reasonably acceptable to the Company, the fees and expenses of which shall be paid by the
Company.

 

“Warrant
Agent Agreement” means that certain warrant agent agreement, dated on or about the Initial Exercise Date, between the
Company and the Warrant Agent.

 

“Warrant
Agent” means the Transfer Agent and any successor warrant agent of the Company.

 

“Warrants”
means this Warrant and other Common Stock purchase warrants issued by the Company pursuant to the Registration Statement.

 

    	 	-2-	 

    	 

    

 

Section
2. Exercise.

 

a) Exercise
of Warrant. Subject to the provisions of Section 2(e) herein, 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 Warrant Agent (or such other office or agency of the Company as it may designate by notice
in writing to the registered Holder at the address of the Holder appearing on the books of the Company) of a duly executed facsimile
copy or PDF copy submitted by e-mail (or e-mail attachment) of the Notice of Exercise in the form annexed hereto (the “Notice
of Exercise”). Within the earlier of (i) two (2) Trading Days and (ii) the number of Trading Days comprising the Standard
Settlement Period (as defined in Section 2(d)(i) herein) following the date of exercise as aforesaid, the Holder shall deliver
the aggregate Exercise Price for the Warrant Shares specified in the applicable Notice of Exercise by wire transfer or cashier’s
check drawn on a United States bank unless the cashless exercise procedure specified in Section 2(c) below is specified in the
applicable Notice of Exercise. No ink-original Notice of Exercise shall be required, nor shall any medallion guarantee (or other
type of guarantee or notarization) of any Notice of Exercise be required. Notwithstanding anything herein to the contrary, the
Holder shall not be required to physically surrender this Warrant to the Company or the Warrant Agent 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 or Warrant Agent for cancellation within three (3) Trading Days of the date on which the final Notice
of Exercise is delivered to the Company. Partial exercises of this Warrant resulting in purchases of a portion of the total number
of Warrant Shares available hereunder shall have the effect of lowering the outstanding number of Warrant Shares purchasable hereunder
in an amount equal to the applicable number of Warrant Shares purchased. The Holder and the Company shall maintain records showing
the number of Warrant Shares purchased and the date of such purchases. The Company or Warrant Agent shall deliver any objection
to any Notice of Exercise within one (1) Trading Day of receipt of such notice. The Holder and any assignee, by acceptance
of this Warrant, acknowledge and agree that, by reason of the provisions of this paragraph, following the purchase of a portion
of the Warrant Shares hereunder, the number of Warrant Shares available for purchase hereunder at any given time may be less than
the amount stated on the face hereof.

 

Notwithstanding
the foregoing in this Section 2(a), a Holder whose interest in this Warrant is a beneficial interest in certificate(s) representing
this Warrant held in book-entry form through DTC (or another established clearing corporation performing similar functions), shall
effect exercises made pursuant to this Section 2(a) by delivering to DTC (or such other clearing corporation, as applicable) the
appropriate instruction form for exercise, complying with the procedures to effect exercise that are required by DTC (or such
other clearing corporation, as applicable), subject to a Holder’s right to elect to receive a Warrant in certificated form
pursuant to the terms of the Warrant Agent Agreement, in which case this sentence shall not apply.

  

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

 

c) Cashless
Exercise. If at the time of exercise hereof there is no effective registration statement registering, or the prospectus contained
therein is not available for the issuance of the Warrant Shares to the Holder, then this Warrant may also be exercised, in whole
or in part, at such time by means of a “cashless exercise” in which the Holder shall be entitled to receive a number
of Warrant Shares equal to the quotient obtained by dividing [(A-B) (X)] by (A), where:

 

 

	 	(A)
    =	as
    applicable: (i) the VWAP on the Trading Day immediately preceding the date of the applicable Notice of Exercise if such Notice
    of Exercise is (1) both executed and delivered pursuant to Section 2(a) hereof on a day that is not a Trading Day or (2) both
    executed and delivered pursuant to Section 2(a) hereof on a Trading Day prior to the opening of “regular trading hours”
    (as defined in Rule 600(b)(64) of Regulation NMS promulgated under the federal securities laws) on such Trading Day, (ii)
    at the option of the Holder, either (y) the VWAP on the Trading Day immediately preceding the date of the applicable Notice
    of Exercise or (z) the Bid Price of the Common Stock on the principal Trading Market as reported by Bloomberg L.P. as of the
    time of the Holder’s execution of the applicable Notice of Exercise if such Notice of Exercise is executed during “regular
    trading hours” on a Trading Day and is delivered within two (2) hours thereafter (including until two (2) hours after
    the close of “regular trading hours” on a Trading Day) pursuant to Section 2(a) hereof or (iii) the VWAP on the
    date of the applicable Notice of Exercise if the date of such Notice of Exercise is a Trading Day and such Notice of Exercise
    is both executed and delivered pursuant to Section 2(a) hereof after the close of “regular trading hours” on such
    Trading Day;
	 	 	 
	 	(B)
    =	the
    Exercise Price of this Warrant, as adjusted hereunder; and

 

    	 	-3-	 

    	 

    

 

	 	(X)
    =	the
    number of Warrant Shares that would be issuable upon exercise of this Warrant in accordance with the terms of this Warrant
    if such exercise were by means of a cash exercise rather than a cashless exercise.

 

In
addition, a cashless exercise may occur after during the period from thirty (30) days from the effective date of the registration
statement  (the “Effective Date”) filed with the Commission in connection with this Warrant until
the one year anniversary of the Effective Date (the “Cashless Period”), if the VWAP of the Common Stock on
any Trading Day during the Cashless Period fails to exceed the Exercise Price in effect as of the date hereof (subject to adjustment
for any stock splits, stock dividends, stock combinations, recapitalizations and similar events). In such event, in lieu of the
formula, the aggregate number of Warrant Shares issuable in such cashless exercise pursuant to any given Notice of Exercise electing
to effect a cashless exercise shall equal the product of (x) the aggregate number of Warrant Shares that would be issuable upon
exercise of this Warrant in accordance with the terms of this Warrant if such exercise were by means of a cash exercise rather
than a cashless exercise and (y) 1.0.

 

If
Warrant Shares are issued in such a cashless exercise, the parties acknowledge and agree that in accordance with Section 3(a)(9)
of the Securities Act, the Warrant Shares shall take on the registered characteristics of the Warrants being exercised. The Company
agrees not to take any position contrary to this Section 2(c).

 

d) Mechanics
of Exercise.

 

i. Delivery
of Warrant Shares Upon Exercise. The Company shall cause the Warrant Shares purchased hereunder to be transmitted by the Transfer
Agent to the Holder by crediting the account of the Holder’s or its designee’s balance account with The Depository
Trust Company through its Deposit or Withdrawal at Custodian system (“DWAC”) if the Company is then a participant
in such system and either (A) there is an effective registration statement permitting the issuance of the Warrant Shares to or
resale of the Warrant Shares by the Holder or (B) this Warrant is being exercised via cashless exercise, and otherwise by physical
delivery of a certificate, registered in the Company’s share register in the name of the Holder or its designee, for the
number of Warrant Shares to which the Holder is entitled pursuant to such exercise to the address specified by the Holder in the
Notice of Exercise by the date that is the earliest of (i) two (2) Trading Days after the delivery to the Company or Warrant Agent
of the Notice of Exercise, (ii) one (1) Trading Day after delivery of the aggregate Exercise Price to the Company and (iii) the
number of Trading Days comprising the Standard Settlement Period after the delivery to the Company of the Notice of Exercise (such
date, the “Warrant Share Delivery Date”). Upon delivery of the Notice of Exercise, the Holder shall be deemed
for all corporate purposes to have become the holder of record of the Warrant Shares with respect to which this Warrant has been
exercised, irrespective of the date of delivery of the Warrant Shares, provided that payment of the aggregate Exercise Price (other
than in the case of a cashless exercise) is received within the earlier of (i) two (2) Trading Days and (ii) the number of Trading
Days comprising the Standard Settlement Period following delivery of the Notice of Exercise. If the Company fails for any reason
to deliver to the Holder the Warrant Shares subject to a Notice of Exercise by the Warrant Share Delivery Date, the Company shall
pay to the Holder, in cash, as liquidated damages and not as a penalty, for each $1,000 of Warrant Shares subject to such exercise
(based on the VWAP of the Common Stock on the date of the applicable Notice of Exercise), $10 per Trading Day (increasing to $20
per Trading Day on the fifth (5th)Trading Day after such liquidated damages begin to accrue) for each Trading Day after
such Warrant Share Delivery Date until such Warrant Shares are delivered or Holder rescinds such exercise. The Company agrees
to maintain a transfer agent that is a participant in the FAST program so long as this Warrant remains outstanding and exercisable.
As used herein, “Standard Settlement Period” means the standard settlement period, expressed in a number of
Trading Days, on the Company’s primary Trading Market with respect to the Common Stock as in effect on the date of delivery
of the Notice of Exercise.

 

    	 	-4-	 

    	 

    

 

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

 

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

 

iv. Compensation
for Buy-In on Failure to Timely Deliver Warrant Shares Upon Exercise. In addition to any other rights available to the Holder,
if the Company fails to cause the Transfer Agent to transmit to the Holder the Warrant Shares in accordance with the provisions
of Section 2(d)(i) above pursuant to an exercise on or before the Warrant Share Delivery Date (other than any such failure that
is solely due to any action or inaction by the Holder with respect to such exercise), and if after such date the Holder is required
by its broker to purchase (in an open market transaction or otherwise) or the Holder’s brokerage firm otherwise purchases,
shares of Common Stock to deliver in satisfaction of a sale by the Holder of the Warrant Shares which the Holder anticipated receiving
upon such exercise (a “Buy-In”), then the Company shall (A) pay in cash to the Holder the amount, if any, by
which (x) the Holder’s total purchase price (including brokerage commissions, if any) for the shares of Common Stock so
purchased exceeds (y) the amount obtained by multiplying (1) the number of Warrant Shares that the Company was required to deliver
to the Holder in connection with the exercise at issue times (2) the price at which the sell order giving rise to such purchase
obligation was executed, and (B) at the option of the Holder, either reinstate the portion of the Warrant and equivalent number
of Warrant Shares for which such exercise was not honored (in which case such exercise shall be deemed rescinded) or deliver to
the Holder the number of shares of Common Stock that would have been issued had the Company timely complied with its exercise
and delivery obligations hereunder. For example, if the Holder purchases Common Stock having a total purchase price of $11,000
to cover a Buy-In with respect to an attempted exercise of shares of Common Stock with an aggregate sale price giving rise to
such purchase obligation of $10,000, under clause (A) of the immediately preceding sentence the Company shall be required to pay
the Holder $1,000. The Holder shall provide the Company written notice indicating the amounts payable to the Holder in respect
of the Buy-In and, upon request of the Company, evidence of the amount of such loss. Nothing herein shall limit a Holder’s
right to pursue any other remedies available to it hereunder, at law or in equity including, without limitation, a decree of specific
performance and/or injunctive relief with respect to the Company’s failure to timely deliver shares of Common Stock upon
exercise of the Warrant as required pursuant to the terms hereof.

 

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

 

    	 	-5-	 

    	 

    

 

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

 

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

 

e) Holder’s
Exercise Limitations. The Company shall not effect any exercise of this Warrant, and a Holder shall not have the right to
exercise any portion of this Warrant, pursuant to Section 2 or otherwise, to the extent that after giving effect to such issuance
after exercise as set forth on the applicable Notice of Exercise, the Holder (together with the Holder’s Affiliates, and
any other Persons acting as a group together with the Holder or any of the Holder’s Affiliates (such Persons, “Attribution
Parties”)), would beneficially own in excess of the Beneficial Ownership Limitation (as defined below). For purposes of
the foregoing sentence, the number of shares of Common Stock beneficially owned by the Holder and its Affiliates and Attribution
Parties shall include the number of shares of Common Stock issuable upon exercise of this Warrant with respect to which such determination
is being made, but shall exclude the number of shares of Common Stock which would be issuable upon (i) exercise of the remaining,
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 2(e), beneficial ownership shall be calculated in accordance with Section 13(d) of the Exchange Act
and the rules and regulations promulgated thereunder, it being acknowledged by the Holder that the Company is not representing
to the Holder that such calculation is in compliance with Section 13(d) of the Exchange Act and the Holder is solely responsible
for any schedules required to be filed in accordance therewith. To the extent that the limitation contained in this Section 2(e)
applies, the determination of whether this Warrant is exercisable (in relation to other securities owned by the Holder together
with any Affiliates and Attribution Parties) and of which portion of this Warrant is exercisable shall be in the sole discretion
of the Holder, and the submission of a Notice of Exercise shall be deemed to be the Holder’s determination of whether this
Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates and Attribution Parties)
and of which portion of this Warrant is exercisable, in each case subject to the Beneficial Ownership Limitation, and the Company
shall have no obligation to verify or confirm the accuracy of such determination. In addition, a determination as to any group
status as contemplated above shall be determined in accordance with Section 13(d) of the Exchange Act and the rules and regulations
promulgated thereunder. For purposes of this Section 2(e), in determining the number of outstanding shares of Common Stock, a
Holder may rely on the number of outstanding shares of Common Stock as reflected in (A) the Company’s most recent periodic
or annual report filed with the Commission, as the case may be, (B) a more recent public announcement by the Company or (C) a
more recent written notice by the Company or the Transfer Agent setting forth the number of shares of Common Stock outstanding.
Upon the written or oral request of a Holder, the Company shall within one Trading Day confirm orally and in writing to the Holder
the number of shares of Common Stock then outstanding. In any case, the number of outstanding shares of Common Stock shall be
determined after giving effect to the conversion or exercise of securities of the Company, including this Warrant, by the Holder
or its Affiliates or Attribution Parties since the date as of which such number of outstanding shares of Common Stock was reported.
The “Beneficial Ownership Limitation” shall be [4.99% /9.99%] of the number of shares of the Common Stock outstanding
immediately after giving effect to the issuance of shares of Common Stock issuable upon exercise of this Warrant. The Holder,
upon notice to the Company, may increase or decrease the Beneficial Ownership Limitation provisions of this Section 2(e), provided
that the Beneficial Ownership Limitation in no event exceeds 9.99% of the number of shares of the Common Stock outstanding immediately
after giving effect to the issuance of shares of Common Stock upon exercise of this Warrant held by the Holder and the provisions
of this Section 2(e) shall continue to apply. Any increase in the Beneficial Ownership Limitation will not be effective until
the 61st day after such notice is delivered to the Company. The provisions of this paragraph shall be construed
and implemented in a manner otherwise than in strict conformity with the terms of this Section 2(e) to correct this paragraph
(or any portion hereof) which may be defective or inconsistent with the intended Beneficial Ownership Limitation herein contained
or to make changes or supplements necessary or desirable to properly give effect to such limitation. The limitations contained
in this paragraph shall apply to a successor holder of this Warrant.

 

    	 	-6-	 

    	 

    

 

Section
3. Certain Adjustments.

 

a) Stock
Dividends and Splits. If the Company, at any time while this Warrant is outstanding: (i) pays a stock dividend or otherwise
makes a distribution or distributions on shares of its Common Stock or any other equity or equity equivalent securities payable
in shares of Common Stock (which, for avoidance of doubt, shall not include any shares of Common Stock issued by the Company upon
exercise of this Warrant), (ii) subdivides outstanding shares of Common Stock into a larger number of shares, (iii) combines (including
by way of reverse stock split) outstanding shares of Common Stock into a smaller number of shares, or (iv) issues by reclassification
of shares of the Common Stock any shares of capital stock of the Company, then in each case the Exercise Price shall be multiplied
by a fraction of which the numerator shall be the number of shares of Common Stock (excluding treasury shares, if any) outstanding
immediately before such event and of which the denominator shall be the number of shares of Common Stock outstanding immediately
after such event, and the number of shares issuable upon exercise of this Warrant shall be proportionately adjusted such that
the aggregate Exercise Price of this Warrant shall remain unchanged. Any adjustment made pursuant to this Section 3(a) shall become
effective immediately after the record date for the determination of stockholders entitled to receive such dividend or distribution
and shall become effective immediately after the effective date in the case of a subdivision, combination or re-classification.

 

b) Subsequent
Rights Offerings. In addition to any adjustments pursuant to Section 3(a) above, if at any time the Company grants, issues
or sells any Common Stock Equivalents or rights to purchase stock, warrants, securities or other property pro rata to all (or
substantially all) of the record holders of any class of shares of Common Stock (the “Purchase Rights”), then
the Holder will be entitled to acquire, upon the terms applicable to such Purchase Rights, the aggregate Purchase Rights which
the Holder could have acquired if the Holder had held the number of shares of Common Stock acquirable upon complete exercise of
this Warrant (without regard to any limitations on exercise hereof, including without limitation, the Beneficial Ownership Limitation)
immediately before the date on which a record is taken for the grant, issuance or sale of such Purchase Rights, or, if no such
record is taken, the date as of which the record holders of shares of Common Stock are to be determined for the grant, issue or
sale of such Purchase Rights (provided, however, 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).

 

c) 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 all (or substantially all) of holders of shares of Common
Stock, by way of return of capital or otherwise (including, without limitation, any distribution of cash, stock or other securities,
property or options by way of a dividend, spin off, reclassification, corporate rearrangement, scheme of arrangement or other
similar transaction) (a “Distribution”), at any time after the issuance of this Warrant, then, in each such
case, the Holder shall be entitled to participate in such Distribution to the same extent that the Holder would have participated
therein if the Holder had held the number of shares of Common Stock acquirable upon complete exercise of this Warrant (without
regard to any limitations on exercise hereof, including without limitation, the Beneficial Ownership Limitation) immediately before
the date of which a record is taken for such Distribution, or, if no such record is taken, the date as of which the record holders
of shares of Common Stock are to be determined for the participation in such Distribution (provided, however,
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).

 

    	 	-7-	 

    	 

    

 

d) 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 2(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 2(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 in accordance with the provisions of this Section 3(d) pursuant to written agreements 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). 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, the provisions of this Warrant referring to the “Company” 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. For the avoidance
of doubt, if, at any time while this Warrant is outstanding, a Fundamental Transaction occurs, pursuant to the terms of this Section
3(d), the Holder shall not be entitled to receive more than one of (i) the 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, or (ii) the assumption by the Successor Entity of all of the obligations of the Company under this Warrant
and the option to receive a security of the Successor Entity evidenced by a written instrument substantially similar in form and
substance to this Warrant.

 

    	 	-8-	 

    	 

    

 

e)
[Reserved.]

 

f) Calculations.
All calculations under this Section 3 shall be made to the nearest cent or the nearest 1/100th of a share, as the case may be.
For purposes of this Section 3, the number of shares of Common Stock deemed to be issued and outstanding as of a given date shall
be the sum of the number of shares of Common Stock (excluding treasury shares, if any) issued and outstanding.

 

g) Notice
to Holder.

 

i. Adjustment
to Exercise Price. Whenever the Exercise Price is adjusted pursuant to any provision of this Section 3, the Company shall
promptly deliver to the Holder by 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
twenty (20) calendar days prior to the applicable record or effective date hereinafter specified, a notice (unless such information
is filed with the Commission, in which case a notice shall not be required) 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.

 

    	 	-9-	 

    	 

    

 

Section
4. Transfer of Warrant.

 

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

 

b) New
Warrants. If this Warrant is not held in global form through DTC (or any successor depository), this Warrant may be divided
or combined with other Warrants upon presentation hereof at the aforesaid office of the Company, together with a written notice
specifying the names and denominations in which new Warrants are to be issued, signed by the Holder or its agent or attorney.
Subject to compliance with Section 4(a), as to any transfer which may be involved in such division or combination, the Company
shall execute and deliver a new Warrant or Warrants in exchange for the Warrant or Warrants to be divided or combined in accordance
with such notice. All Warrants issued on transfers or exchanges shall be dated the initial issuance date of this Warrant and shall
be identical with this Warrant except as to the number of Warrant Shares issuable pursuant thereto.

 

c) Warrant
Register. The Company shall register this Warrant, upon records to be maintained by the Warrant Agent for that purpose (the
“Warrant Register”), in the name of the record Holder hereof from time to time. The Company and the Warrant
Agent 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.

 

Section
5.Miscellaneous.

 

a) No
Rights as Stockholder Until Exercise; No Settlement in Cash. This Warrant does not entitle the Holder to any voting rights,
dividends or other rights as a stockholder of the Company prior to the exercise hereof as set forth in Section 2(d)(i), except
as expressly set forth in Section 3. Without limiting the rights of a Holder to receive Warrant Shares on a “cashless exercise,”
and to receive the cash payments contemplated pursuant to Sections 2(d)(i) and 2(d)(iv), In no event, including if the Company
is for any reason unable to issue and deliver Warrant Shares upon exercise of this Warrant as required pursuant to the terms hereof,
shall the Company be required to net cash settle an exercise of this Warrant or cash settle in any other form.

 

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.

 

    	 	-10-	 

    	 

    

 

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.

  

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) Governing
Law. All questions concerning the construction, validity, enforcement and interpretation of this Warrant shall be governed
by and construed and enforced in accordance with the internal laws of the State of New York, without regard to the principles
of conflicts of law thereof. Each party agrees that all legal proceedings concerning the interpretations, enforcement and defense
of the transactions contemplated by this Warrant (whether brought against a party hereto or their respective affiliates, directors,
officers, shareholders, partners, members, employees or agents) shall be commenced exclusively in the state and federal courts
sitting in the City of New York. Each party hereby irrevocably submits to the exclusive jurisdiction of the state and federal
courts sitting in the City of New York, Borough of Manhattan for the adjudication of any dispute hereunder or in connection herewith
or with any transaction contemplated hereby or discussed herein, and hereby irrevocably waives, and agrees not to assert in any
suit, action or proceeding, any claim that it is not personally subject to the jurisdiction of any such court, that such suit,
action or proceeding is improper or is an inconvenient venue for such proceeding. Each party hereby irrevocably waives personal
service of process and consents to process being served in any such suit, action or proceeding by mailing a copy thereof via registered
or certified mail or overnight delivery (with evidence of delivery) to such party at the address in effect for notices to it under
this Warrant and agrees that such service shall constitute good and sufficient service of process and notice thereof. Nothing
contained herein shall be deemed to limit in any way any right to serve process in any other manner permitted by law. If either
party shall commence an action, suit or proceeding to enforce any provisions of this Warrant, the prevailing party in such action,
suit or proceeding shall be reimbursed by the other party for their reasonable attorneys’ fees and other costs and expenses
incurred with the investigation, preparation and prosecution of such action or proceeding. Notwithstanding the foregoing, nothing
in this paragraph shall limit or restrict the federal district court in which a Holder may bring a claim under the federal securities
laws.

 

    	 	-11-	 

    	 

    

 

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

 

g) 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. Without limiting any other provision
of this Warrant, if the Company willfully and knowingly fails to comply with any provision of this Warrant, which results in any
material damages to the Holder, the Company shall pay to the Holder such amounts as shall be sufficient to cover any costs and
expenses including, but not limited to, reasonable attorneys’ fees, including those of appellate proceedings, incurred by
the Holder in collecting any amounts due pursuant hereto or in otherwise enforcing any of its rights, powers or remedies hereunder.

 

h) Notices.
Any and all notices or other communications or deliveries to be provided by the Holders hereunder including, without limitation,
any Notice of Exercise, shall be in writing and delivered personally, by facsimile or e-mail, or sent by a nationally recognized
overnight courier service, addressed to the Company, at 15150 Avenue of Science, Suite 200, San Diego, California 92128, Attention:
Chief Executive Officer, facsimile number (858) 605-9055, E-mail: mfavish@guardionhealth.com, or such other facsimile number,
email address or address as the Company may specify for such purposes by notice to the Holders. Any and all notices or other communications
or deliveries to be provided by the Company hereunder shall be in writing and delivered personally, by facsimile or e-mail, or
sent by a nationally recognized overnight courier service addressed to each Holder at the facsimile number, e-mail address or
address of such Holder appearing on the books of the Company. Any notice or other communication or deliveries hereunder shall
be deemed given and effective on the earliest of (i) the time of transmission, if such notice or communication is delivered via
facsimile at the facsimile number or via e-mail at the e-mail address set forth in this Section prior to 5:30 p.m. (New York City
time) on any date, (ii) the next Trading Day after the time of transmission, if such notice or communication is delivered via
facsimile at the facsimile number or via e-mail at the e-mail address set forth in this Section on a day that is not a Trading
Day or later than 5:30 p.m. (New York City time) on any Trading Day, (iii) the second Trading Day following the date of mailing,
if sent by U.S. nationally recognized overnight courier service, or (iv) upon actual receipt by the party to whom such notice
is required to be given. To the extent that any notice provided hereunder constitutes, or contains, material, non-public information
regarding the Company or any Subsidiaries, the Company shall simultaneously file such notice with the Commission pursuant to a
Current Report on Form 8-K.

 

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, on the one hand,
and the Holder, on the other hand.

 

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

 

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

 

o)
Warrant Agent Agreement .  If this Warrant is held in global form through DTC (or any successor depositary), this
Warrant is issued subject to the Warrant Agent Agreement.  To the extent any provision of this Warrant conflicts with the
express provisions of the Warrant Agent Agreement, the provisions of this Warrant shall govern and be controlling.

 

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

 

(Signature
Page Follows)

 

    	 	-12-	 

    	 

    

 

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.

 

	GUARDION
    HEALTH SCIENCES, INC.	 
	 	 	 
	By:	 	 
	Name:	              	 
	Title:	 	 

 

 

    	 	-13-	 

    	 

    

 

NOTICE
OF EXERCISE

 

TO:
GUARDION HEALTH SCIENCES, INC.

 

(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; or

 

[  ]
if permitted the cancellation of such number of Warrant Shares as is necessary, in accordance with the formula set forth in subsection
2(c), to exercise this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless exercise
procedure set forth in subsection 2(c).

 

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

 

_______________________________

 

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

 

_______________________________

 

_______________________________

 

_______________________________

 

[SIGNATURE
OF HOLDER]

 

Name
of Investing Entity: ________________________________________________________________________

 

Signature
of Authorized Signatory of Investing Entity: _________________________________________________

 

Name
of Authorized Signatory: ___________________________________________________________________

 

Title
of Authorized Signatory: ____________________________________________________________________

 

Date:
_____________________________________________________________________________

 

    	 	-14-	 

    	 

    

 

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:	 	 

 

    	 	-15-Exhibit 10.21

 

AMENDED AND RESTATED OFFERING DEPOSIT
ACCOUNT AGENCY AGREEMENT

 

This AMENDED
AND RESTATED OFFERING DEPOSIT ACCOUNT AGENCY AGREEMENT (this “Agreement”) dated as of this ___ day of
_________, 2019, by and among Leaping Group Co., Ltd., its subsidiaries and affiliates or any other corporate entities that
may be utilized from time to time (the “Company”), having an address at Room 2010, Huaruntiexi Centre,
No.158, Jianshe East Road, Tiexi District, Shenyang City, Liaoning Province, P.R. China, and BOUSTEAD SECURITIES, LLC,
serving as the representative of the underwriters (the “Underwriter”), having an address at 6 Venture,
Suite 265, Irvine, CA 92618 USA, and Sutter Securities Clearing, LLC (formerly known as FinTech Clearing, LLC, the
“Deposit Account Agent”), a broker-dealer registered with the Securities and Exchange Commission
(“SEC”), having an office at 6 Venture, Suite 265, Irvine, CA 92618 USA. All capitalized terms not herein
defined shall have the meaning ascribed to them in that certain prospectus filed with the United States SEC dated January 2,
2019, under File Number 333-229116, including all attachments, schedules and exhibits thereto, as amended from time to time
(the “Prospectus”).

 

WITNESSETH:

 

WHEREAS, the
Company, the Underwriter and the Deposit Account Agent entered into that certain Offering Deposit Account Agency Agreement dated
as of October 17, 2018 (“Original Agreement”);

 

WHEREAS, the
Company, the Underwriter and the Deposit Account Agent desire to amend and restate the Original Agreement in its entirety and enter
into this Agreement; WHEREAS, pursuant to the terms of the Prospectus the Company desires to sell (the “Offering”)
a minimum of $6,000,000 (the “Minimum Amount”) and a maximum of $20,000,000 (the “Maximum Amount”)
of its ordinary shares (the “Shares”). The minimum investment per subscriber is one hundred shares (which minimum
investment may be waived by Company); and

 

WHEREAS, unless
the Minimum Amount is sold by September 30, 2019 (the “Final Termination Date”), the Offering shall terminate,
and all funds shall be returned to the subscribers in the Offering, and if the Minimum Amount is met, the Offering may continue
until the Final Termination Date; and

 

WHEREAS, the
Company and Underwriter desire to establish a deposit account with the Deposit Account Agent into which the Company and Underwriter
shall instruct investors introduced to the Company by Underwriter (the “Investors”) to wire funds made payable
to the order of “Sutter Securities Clearing, as Deposit Account Agent for the Investors in Leaping Group Co., Ltd.” and Deposit
Account Agent is willing to accept said wires for the payment of money in accordance with the terms hereinafter set forth;

 

WHEREAS, the
Company, as issuer, and Underwriter, as an introducing broker-dealer, represent and warrant to the Deposit Account Agent that they
will comply with all of their respective obligations under applicable state and federal securities laws and regulations with respect
to sale of the Offering;

 

    	 	 	 

     

    

  

WHEREAS, the
Company and Underwriter represent and warrant to the Deposit Account Agent that they have not stated to any individual or entity
that the Deposit Account Agent’s duties will include anything other than those duties stated in this Agreement; and

 

WHEREAS, the
Company and Underwriter warrant to the Deposit Account Agent that a copy of each document that has been delivered to Investors
and third parties that include Deposit Account Agent’s name and duties, has been attached hereto as Schedule I.

 

NOW, THEREFORE,
IT IS AGREED as follows:

 

1.           Delivery
of Deposit Funds.

 

(a)          Underwriter
and the Company shall instruct Investors to wire transfer to “Sutter Securities Clearing, as Deposit Account Agent for the Investors
in Leaping Group Co., Ltd.” Account No. _____________, at Pacific Mercantile Bank, SWIFT Code PMERUS66 and ABA Routing Number
122242869 in each case, with the name and address of the individual or entity making payment. In the event any Investor’s
address is not provided to Deposit Account Agent by the Investor, then Underwriter and/or the Company agree to promptly provide
Deposit Account Agent with such information in writing. The wire transfers shall be deposited into a non-interest-bearing account
at Pacific Mercantile Bank (the “Deposit Account”).

 

(b)          The
collected funds deposited into the Deposit Account are referred to as the “Deposit Funds.”

 

(c)          The
Deposit Account Agent shall have no duty or responsibility to enforce the collection or demand payment of any funds deposited into
the Deposit Account. If, for any reason, any check deposited into the Deposit Account shall be returned unpaid to the Deposit Account
Agent, the sole duty of the Deposit Account Agent shall be to return the check to the Investor and advise the Company and Underwriter
promptly thereof.

 

2.           Release
of Deposit Funds. The Deposit Funds shall be paid by the Deposit Account Agent in accordance with the following:

 

(a)          In
the event that the Company and Underwriter advise the Deposit Account Agent in writing that the Offering has been terminated (the
“Termination Notice”), the Deposit Account Agent shall promptly return the funds paid by each Investor to said
Investor without interest or offset within one (1) business day.

 

(b)          If
prior to 3:00 P.M. Pacific Time on the Final Termination Date, the Deposit Account Agent receives written notice, in the form
of Exhibit A, attached hereto and made a part hereof, and signed by the Company and Underwriter, stating that the
Final Termination Date has been extended for a period of no more than 90 days (the “Extension Notice”),
then the Final Termination Date shall be so extended and such date shall be the new “Final Termination Date”.

 

    	 	 	 

     

    

  

(c)          Provided
that the Deposit Account Agent does not receive the Termination Notice in accordance with Section 2(a) and there is the Minimum
Amount deposited into the Deposit Account on or prior to the Final Termination Date or the date stated in the Extension Notice,
if any, received by the Deposit Account Agent in accordance with Section 2(b) above, the Deposit Account Agent shall, upon receipt
of written instructions, in the form of Exhibit B, attached hereto and made a part hereof, or in a form and substance satisfactory
to the Deposit Account Agent, received from the Company and Underwriter, pay the Deposit Funds in accordance with such written
instructions, such payment or payments to be made by wire transfer within one (1) business day of receipt of such written instructions.
Such instructions must be received by the Deposit Account Agent no later than 3:00 PM Pacific Time on a Business Day for the Deposit
Account Agent to process such instructions that Business Day.

 

(d)          If
by 3:00 P.M. Pacific time on the later of the Final Termination Date or the date stated in the Extension Notice, if any, that the
Deposit Account Agent has received in accordance with Section 2(b) above, the Deposit Account Agent has not received written instructions
from the Company and Underwriter regarding the disbursement of the Deposit Funds or the total amount of the Deposit Funds is less
than the Minimum Amount, then the Deposit Account Agent shall promptly return the Deposit Funds to the Investors without interest
or offset within one (1) business day. The Deposit Funds returned to each Investor shall be free and clear of any and all claims
of the Deposit Account Agent.

 

(e)          The
Deposit Account Agent shall not be required to pay any uncollected funds or any funds that are not available for withdrawal.

 

(f)           If
the Final Termination Date or any date that is a deadline under this Agreement for giving the Deposit Account Agent notice or instructions
or for the Deposit Account Agent to take action is not a Business Day, then such date shall be the Business Day that immediately
preceding that date. A “Business Day” is any day other than a Saturday, Sunday or a day that a SEC-registered
broker-dealer is not legally obligated to be opened.

 

3.           Acceptance
by Deposit Account Agent. The Deposit Account Agent hereby accepts and agrees to perform its obligations hereunder, provided
that:

 

(a)          The
Deposit Account Agent may act in reliance upon any signature believed by it to be genuine and may assume that any person who has
been designated by Underwriter or the Company to give any written instructions, notice or receipt, or make any statements in connection
with the provisions hereof has been duly authorized to do so. Deposit Account Agent shall have no duty to make inquiry as to the
genuineness, accuracy or validity of any statements or instructions or any signatures on statements or instructions. The names
and true signatures of each individual authorized to act singly on behalf of the Company and Underwriter are stated in Schedule
II, which is attached hereto and made a part hereof. The Company and Underwriter may each remove or add one or more of its
authorized signers stated on Schedule II by notifying the Deposit Account Agent of such change in accordance with this Agreement,
which notice shall include the true signature for any new authorized signatories.

 

(b)          The
Deposit Account Agent may act relative hereto in reliance upon advice of counsel in reference to any matter connected herewith.
The Deposit Account Agent shall not be liable for any mistake of fact or error of judgment or law, or for any acts or omissions
of any kind, unless caused by its willful misconduct or gross negligence.

 

    	 	 	 

     

    

  

(c)          Underwriter
and the Company agree to indemnify and hold the Deposit Account Agent harmless from and against any and all claims, losses, costs,
liabilities, damages, suits, demands, judgments or expenses (including but not limited to reasonable attorney’s fees) claimed
against or incurred by Deposit Account Agent arising out of or related, directly or indirectly, to this Agreement unless caused
by the Deposit Account Agent’s gross negligence or willful misconduct.

 

(d)          In
the event that the Deposit Account Agent shall be uncertain as to its duties or rights hereunder, the Deposit Account Agent shall
be entitled to (i) refrain from taking any action other than to keep safely the Deposit Funds until it shall be directed otherwise
by a court of competent jurisdiction, or (ii) deliver the Deposit Funds to a court of competent jurisdiction.

 

(e)          The
Deposit Account Agent shall have no duty, responsibility or obligation to interpret or enforce the terms of any agreement other
than Deposit Account Agent’s obligations hereunder, and the Deposit Account Agent shall not be required to make a request
that any monies be delivered to the Deposit Account, it being agreed that the sole duties and responsibilities of the Deposit Account
Agent shall be to the extent not prohibited by applicable law (i) to accept checks or other instruments for the payment of money
and wire transfers delivered to the Deposit Account Agent for the Deposit Account and deposit said checks and wire transfers into
the non-interest bearing Deposit Account, and (ii) to disburse or refrain from disbursing the Deposit Funds as stated above, provided
that the checks received by the Deposit Account Agent have been collected and are available for withdrawal.

 

4.           Term
of Deposits. This Agreement shall terminate upon the disbursement of all Deposit Funds in the Deposit Account pursuant
to Section 2(c), Section 2(d), Section 6 or Section 7 (except with respect to provisions hereof which are specifically intended
to survive such termination).

 

5.           Deposit
Account Statements and Information. The Deposit Account Agent agrees to send to the Company and/or the Underwriter a copy of
the Deposit Account periodic statement, upon request and to also provide the Company and/or Underwriter, or their designee, upon
request other deposit account information, including Deposit Account balances, by telephone or by computer communication, to the
extent practicable. The Company and Underwriter agree to complete and sign all forms or agreements required by the Deposit Account
Agent for that purpose. The Company and Underwriter each consent to the Deposit Account Agent’s release of such Deposit Account
information to any of the individuals designated by Company or Underwriter, which designation has been signed in accordance with
Section 3(a) by any of the persons in Schedule II.  Further, the Company and Underwriter have an option to receive
e-mail notification of incoming and outgoing wire transfers. If this e-mail notification service is requested and subsequently
approved by the Deposit Account Agent, the Company and Underwriter agrees to provide a valid e-mail address and other information
necessary to set-up this service and sign all forms and agreements required for such service. The Company and Underwriter each
consent to the Deposit Account Agent’s release of wire transfer information to the designated e-mail address(es). The Deposit
Account Agent’s liability for failure to comply with this section shall not exceed the cost of providing such information.

 

    	 	 	 

     

    

  

6.           Resignation
and Termination of the Deposit Account Agent. The Deposit Account Agent may resign at any time by giving 30 days’ prior
written notice of such resignation to Underwriter and the Company. Upon providing such notice, the Deposit Account Agent shall
have no further obligation hereunder except to hold as depositary the Deposit Funds that it receives until the end of such 30-day
period. In such event, the Deposit Account Agent shall not take any action, other than receiving and depositing Investors’
checks and wire transfers in accordance with this Agreement, until the Company has designated a banking corporation, trust company,
attorney or other person as successor. Upon receipt of such written designation signed by Underwriter and the Company, the Deposit
Account Agent shall promptly deliver the Deposit Funds to such successor and shall thereafter have no further obligations hereunder.
If such instructions are not received within 30 days following the effective date of such resignation, then the Deposit Account
Agent may deposit the Deposit Funds held by it pursuant to this Agreement with a clerk of a court of competent jurisdiction pending
the appointment of a successor. In either case provided for in this Section, the Deposit Account Agent shall be relieved of all
further obligations and released from all liability thereafter arising with respect to the Deposit Funds.

 

7.           Termination.
Except as otherwise specifically provided herein, this Agreement shall terminate on the later of the final closing date of the
Offering, or the Final Termination Date, as applicable (except with respect to provisions hereof which are specially intended to
survive such termination). The Company and Underwriter may terminate the appointment of the Deposit Account Agent hereunder upon
written notice specifying the date upon which such termination shall take effect, which date shall be at least 30 days from the
date of such notice. In the event of such termination, the Company and Underwriter shall, within 30 days of such notice, appoint
a successor deposit account agent and the Deposit Account Agent shall, upon receipt of written instructions signed by the Company
and Underwriter, turn over to such successor deposit account agent all of the Deposit Funds; provided, however, that
if the Company and Underwriter fail to appoint a successor deposit account agent within such 30-day period, such termination notice
shall be null and void and the Deposit Account Agent shall continue to be bound by all of the provisions hereof. Upon receipt of
the Deposit Funds, the successor deposit account agent shall become the deposit account agent hereunder and shall be bound by all
of the provisions hereof and Deposit Account Agent shall be relieved of all further obligations and released from all liability
thereafter arising with respect to the Deposit Funds and under this Agreement.

 

8.           Investment.
All funds received by the Deposit Account Agent shall be held only in non-interest-bearing accounts at Pacific Mercantile Bank.

 

9.           Compensation.
Deposit Account Agent shall be entitled, for the duties to be performed by it hereunder, to a fee as set forth on Schedule III.
In addition, the Company shall be obligated to reimburse Deposit Account Agent for all fees, costs and expenses incurred or that
become due in connection with this Agreement or the Deposit Account, including reasonable attorney’s fees. Neither the modification,
cancellation, termination or rescission of this Agreement nor the resignation or termination of the Deposit Account Agent shall
affect the right of Deposit Account Agent to retain the amount of any fee which has been paid, or to be reimbursed or paid any
amount which has been incurred or becomes due, prior to the effective date of any such modification, cancellation, termination,
resignation or rescission. To the extent the Deposit Account Agent has incurred any such expenses, or any such fee becomes due,
prior to any closing, the Deposit Account Agent shall advise the Company and the Company shall direct all such amounts to be paid
directly at any such closing.

 

    	 	 	 

     

    

  

10.         Notices.
All notices, requests, demands and other communications required or permitted to be given hereunder shall be in writing and shall
be deemed to have been duly given if sent by hand-delivery, by electronic mail (followed by first-class mail), by nationally recognized
overnight courier service or by prepaid registered or certified mail, return receipt requested, to the addresses set forth below:

 

If to Underwriter:

 

Boustead
Securities, LLC

6 Venture,
Suite 265

Irvine, CA
92618 USA

Attention:
Keith Moore, CEO

Email: keith@boustead1828.com

 

If to the Company:

 

Leaping Group
Co., Ltd.

Room 2010,
Huaruntiexi Centre, No.158, Jianshe East Road

Tiexi District,
Shenyang City, Liaoning Province

P.R. China

Attention:
Mr. Tao Jiang, Chief Executive Officer

Email: jiangtao@mediayz.com

 

With a copy to:

 

Hunter Taubman
Fischer & Li, LLC

1450 Broadway,
26th Floor

New York,
NY 10018

Attn: Ying
Li, Esq.

Email: yli@htflawyers.com

 

If to Deposit Account
Agent:

 

Sutter Securities Clearing, LLC

6 Venture, Suite 265

Irvine, CA 92618

Attn: Robert A. Maley, President

Email: robert.maley@sutterus.com

Fax: +1 310 504 3704

 

    	 	 	 

     

    

  

11.         General.

 

(a)          This
Agreement 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 entirely performed within such State, without regard to choice of law principles and any action brought hereunder
shall be brought in the courts of the State of California, located in the County of Orange. Each party hereto irrevocably waives
any objection on the grounds of venue, forum non-conveniens or any similar grounds and irrevocably consents to service of process
by mail or in any manner permitted by applicable law and consents to the jurisdiction of said courts. EACH OF THE PARTIES HERETO
HEREBY WAIVES ALL RIGHT TO TRIAL BY JURY IN ANY ACTION, PROCEEDING OR COUNTERCLAIM ARISING OUT OF THE TRANSACTIONS CONTEMPLATED
BY THIS AGREEMENT.

 

(b)          This
Agreement sets forth the entire
agreement and understanding of the parties with respect to the matters contained herein and supersedes all prior agreements, arrangements
and understandings relating thereto.

 

(c)          All
of the terms and conditions of this Agreement shall be binding upon, and inure to the benefit of and be enforceable by, the parties
hereto, as well as their respective successors and assigns.

 

(d)          This
Agreement may be amended, modified, superseded or canceled, and any of the terms or conditions hereof may be waived, only by a
written instrument executed by each party hereto or, in the case of a waiver, by the party waiving compliance. The failure of any
party at any time or times to require performance of any provision hereof shall in no manner affect its right at a later time to
enforce the same. No waiver of any party of any condition, or of the breach of any term contained in this Agreement, whether by
conduct or otherwise, in any one or more instances shall be deemed to be or construed as a further or continuing waiver of any
such condition or breach or a waiver of any other condition or of the breach of any other term of this Agreement. No party may
assign any rights, duties or obligations hereunder unless all other parties have given their prior written consent.

 

(e)          If
any provision included in this Agreement proves to be invalid or unenforceable, it shall not affect the validity of the remaining
provisions.

 

(f)           This
Agreement and any modification or amendment of this Agreement may be executed in several counterparts or by separate instruments
and all of such counterparts and instruments shall constitute one agreement, binding on all of the parties hereto.

 

12.         Form
of Signature. The parties hereto agree to accept an electronic mail transmission copy of their respective actual signatures
as evidence of their actual signatures to this Agreement and any modification or amendment of this Agreement; provided,
however, that each party who produces an electronic mail signature agrees, by the express terms hereof, to place, promptly
after transmission of his or her signature by electronic mail, a true and correct original copy of his or her signature in overnight
mail to the address of the other party.

 

13.        No
Third-Party Beneficiaries.  This Agreement is solely for the benefit of the parties and their respective successors
and permitted assigns, and no other person has any right, benefit, priority, or interest under or because of the existence of this
Agreement.

 

[SIGNATURE PAGE FOLLOWS]

 

    	 	 	 

     

    

 

IN WITNESS WHEREOF, the parties
have duly executed this Agreement as of the date first set forth above.

 

	Leaping Group Co., Ltd.	 	Boustead Securities, LLC
	 	 	 	 	 
	By:	 	 	By:	 
	 	Name: Bo Jiang	 	 	Name: Keith Moore
	 	Title:  Chairman	 	 	Title: CEO
	 	 	 	 	 
	Sutter Securities Clearing, LLC	 	 	 
	 	 	 	 	 
	By:	 	 	 	 
	 	Name: Robert A. Maley			 
	 	Title: President	 	 	 
	 	 	 	 	 
		 	 	 	 
	 			 	 
	 		 	 	 

 

    	 	 	 

     

    

 

Schedule I

 

OFFERING DOCUMENTS

 

    	 	 	 

     

    

 

Schedule II

 

The Deposit Account
Agent is authorized to accept instructions signed or believed by the Deposit Account Agent to be signed by any one of the following
on behalf of the Company and Underwriter.

 

Leaping Group Co.,
Ltd.

 

	Name	 	True Signature
	 	 	 
	Bo Jiang, Chairman	 	 

 

Boustead Securities, LLC

 

	Name	 	True Signature
	 	 	 
	Keith Moore, CEO	 	 
	 	 	 
	Dan McClory, Managing Director	 	 

 

    	 	 	 

     

    

  

Schedule III

 

Fee Schedule

 

	Service	 	Fee	 
	Cash Management Fee	 	 	0.5%
                                         of the Minimum Amount 	 
	CIP/AML check (applied to each subscriber)	 	$	2.00	 
	Wire Transfers – Incoming (Domestic or Foreign)	 	$	5.00	 
	Wire Transfers – Outgoing (Domestic)	 	$	10.00	 
	Wire Transfers – Outgoing (Foreign)	 	$	25.00	 
	NACHA Upload per file	 	$	5.00	 
	ACH per transaction (incoming or outgoing)	 	$	0.50	 
	ACH Exceptions (incoming or outgoing)	 	$	2.00	 
	Check Processing (incoming or outgoing)	 	$	10.00	 

 

    	 	 	 

     

    

  

Exhibit A

 

EXTENSION NOTICE

 

Date:

 

Sutter Securities Clearing, LLC

6 Venture, Suite 265 Irvine, CA 92618

Attention: Robert A. Maley, President

 

Dear Mr. Maley:

 

In accordance with the terms of
Section 2(b) of a Deposit Account Agreement dated ___ _______, by and among Leaping Group Co., Ltd. (the
“Company”), Boustead Securities, LLC (the “Underwriter”), and Sutter Securities Clearing, LLC (the
“Deposit Account Agent”), the Company and Underwriter hereby notifies the Deposit Account Agent that the
Termination Date has been extended to ____________, 2019, the Final Termination Date.

 

Very truly yours,

 

Leaping Group Co., Ltd.

 

	By:	     	 
	Name:	 
	Title:	 

 

Boustead Securities, LLC

 

	By:	     	 
	Name: Keith Moore	 
	Title: CEO	 

 

    	 	 	 

     

    

 

Exhibit B

 

FORM OF DEPOSIT RELEASE NOTICE

 

Date:

 

Sutter Securities Clearing, LLC

6 Venture, Suite 265

Irvine, CA 92618

Attention: Robert A. Maley, President

 

Dear Mr. Maley:

 

In accordance with the terms of
Section 2(d) of the Amended and Restated Offering Deposit Account Agency Agreement dated as of ________ __, 2019 (the
“Deposit Account Agreement”), by and between Leaping Group Co., Ltd. (the “Company”), Sutter
Securities Clearing, LLC (the “Deposit Account Agent”) and Boustead Securities, LLC (the
"Underwriter"), the Company and Underwriter hereby notify the Deposit Account Agent that the ________ closing will
be held on ___________ for gross proceeds of $_________.

 

PLEASE DISTRIBUTE FUNDS BY WIRE TRANSFER
AS FOLLOWS (wire instructions attached):

 

	________________________:	$
	 	 
	________________________:	$
	 	 
	________________________:	$

 

Very truly yours,

 

Leaping Group Co., Ltd.

 

	By:	     	 
	Name:	 
	Title:	 

 

Boustead Securities, LLC

 

	By:	     	 
	Name: Keith Moore	 
	Title: CEO

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