Document:

Exhibit 10.22 Lemak IRA Promissory Note

PROMISSORY NOTE

 

Scottsdale, Arizona 

March 29, 2018 

 

FOR VALUE RECEIVED, the undersigned, Northsight Capital, Inc., a corporation with an address of 7580 E. Gray Rd., suite 103, Scottsdale, AZ 85260 (hereinafter referred to as the “Maker”), hereby promises to pay to the order of John Lemak IRA Rollover (Texas Capital Bank Custodian), with a mailing address of 2828 Routh St., Dallas Texas (“Holder”), the sum of TWENTY FIVE THOUSAND DOLLARS ($25,000).  

 

All outstanding principal sums shall be paid by Maker, as set forth below. The entire balance of outstanding principal and other fees and charges shall be due and payable on the earlier of (i) an Event of Default (as defined below) or (ii) June 30, 2018 (the “Maturity Date). There shall be no prepayment penalty.  

 

The unpaid principal balance from time to time outstanding under this note shall accrue and bear interest at a rate per annum equal to eight percent (8.0%), until fully paid. Interest and fees shall be calculated based on a 365/366-day year for the actual number of days elapsed.  In no event shall interest payable hereunder exceed the highest rate permitted by applicable law.  To the extent any interest received by Holder exceeds the maximum amount permitted, such payment shall be credited to principal, and any excess remaining after full payment of principal shall be refunded to Maker.  The principal balance of this note may be prepaid in whole or in part, without premium or penalty, at any time. 

  

Each of the following shall constitute an “Event of Default” hereunder: (i) Maker’s failure to make any payment when due hereunder; (ii) with respect to Maker, the commencement of an action seeking relief under federal or state bankruptcy or insolvency statutes or similar laws, or seeking the appointment of a receiver, trustee or custodian for Maker or all or part of its assets, or the commencement of an involuntary proceeding against Maker under federal or state bankruptcy or insolvency statues or similar laws, which involuntary proceeding is not dismissed or stayed within thirty (30) days; or (iii) if Maker makes an assignment for the benefit of creditors.  If an Events of Default occurs, the obligations under this note shall become immediately due and payable without notice or demand.   

 

Maker agrees to pay all reasonable costs and expenses, including, without limitation, reasonable attorneys’ fees and expenses incurred, or which may be incurred, by Holder in connection with the enforcement and collection of this note.  Such costs and expenses shall be payable upon demand for the same and until so paid shall be added to the principal amount of the note.   

 

Maker hereby waives presentment, demand, notice, protest and all other demands and notices in connection with the delivery, acceptance, performance and enforcement of this note, and assent to extensions of the time of payment or forbearance or other indulgence without notice.  No delay or omission of Holder in exercising any right or remedy hereunder shall constitute a waiver of any such right or remedy.  Acceptance by Holder of any payment after demand shall not be deemed a waiver of such demand.  A waiver on one occasion shall not operate as a bar to or waiver of any such right or remedy on any future occasion. 

 

This instrument contains the entire agreement among Maker and Holder with respect to the transactions contemplated hereby, and supersedes all negotiations, presentations, warranties, commitments, offers, contracts and writings prior to the date hereof relating to the subject matter hereof.  This instrument may be amended, modified, waived, discharged or terminated only by a writing signed by Maker and accepted in writing by Holder.

 

This instrument shall be governed by Arizona law, without regard to the conflict of laws provisions thereof.  For purposes of any action or proceeding involving this note, Maker and Holder hereby expressly submit to the jurisdiction of all federal and state courts located in the State of Arizona and consent to any order, process, notice of motion or other application to or by any of said courts or a judge thereof being served within or without such court’s jurisdiction by registered mail or by personal service, provided a reasonable time for appearance is allowed (but not less than the time otherwise afforded by any law or rule), and waives any right to contest the appropriateness of any action brought in any such court based upon lack of personal jurisdiction, improper venue or forum non conveniens.  

 

This Note shall inure to the benefit of Holder’s successors and assigns. In order to secure the fulfillment of Maker’s obligations hereunder to Holder, the Maker hereby grants to the Holder a security interest in all of the membership interests of Crush Mobile, LLC owned by Maker (the “Collateral”). Maker represents and warrants to Holder that the Collateral is not subject to any liens or encumbrance which is superior to Holder’s lien, provided that Holder acknowledges that Maker is, in consideration of a $50,000 advance, concurrently granting Howard R. Baer and Kae Park a lien in the Collateral which shall be pari passu with Holder’s lien.  The Maker covenants and agrees that it shall not grant any further liens in or otherwise further encumber the Collateral.   

Executed as an instrument under seal, as of the date first above written. This Note shall not become an obligation of the Maker until countersigned by Holder and returned to Maker.

 

MAKER: 

 

WITNESS:Northsight Capital, Inc. 

 

_____________________________________ ______________________________________ 

WitnessJohn P. Venners, EVP Operations  

Print Name: ___________________________

 

 

ACCEPTED AND AGREED BY HOLDER

 

John Lemak IRA Rollover (Texas Capital Bank Custodian)

 

_____________________________________

By: John Lemak, duly authorized

2Exhibit 4.3

 

THIS WARRANT AND THE SHARES ISSUABLE HEREUNDER
HAVE NOT BEEN REGISTERED UNDER THE SECURITIES LAWS OF ANY STATE AND, EXCEPT AS PROVIDED HEREIN, MAY NOT BE OFFERED, SOLD OR OTHERWISE
TRANSFERRED, PLEDGED OR HYPOTHECATED UNLESS AND UNTIL REGISTERED OR EXEMPT UNDER APPLICABLE STATE SECURITIES LAWS.

 

APOLLO MEDICAL HOLDINGS, INC.

 

Common Stock Purchase Warrant

 

	Warrant Number: ______________	 	Issue Date: December 8, 2017

 

THIS COMMON STOCK PURCHASE
WARRANT (the “Warrant”) certifies that, for value received, ____________ or permitted and registered assigns
(the “Holder”) is entitled, at any time prior to 5:00 p.m., Pacific time, on December 8, 2022 (the “Expiration
Date”), to purchase from Apollo Medical Holdings, Inc., a Delaware corporation (“Company”), up to
the number of fully paid and non-assessable shares (the “Shares”) of Common Stock, par value $0.001 per share,
of Company (the “Common Stock”) specified above (the “Warrant Number”) at an exercise price
of $11.00 per Share (the “Warrant Exercise Price”) or to convert this Warrant into Shares, in each case subject
to the provisions and upon the terms and conditions set forth in this Warrant. This Warrant has been issued in connection with
the Agreement and Plan of Merger, dated as of December 21, 2016 (as amended on March 30, 2017 and October 17, 2017, the “Merger
Agreement”), among the Company, Apollo Acquisition Corp., a wholly-owned subsidiary of the Company, Network Medical Management,
Inc. and Kenneth Sim, M.D. as the Shareholders’ Representative. Capitalized terms used herein and not defined shall have
the meanings given thereto in the Merger Agreement.

 

1.            EXERCISE.

 

1.1            Method
of Exercise. Holder may exercise this Warrant in whole or in part to purchase the Shares for cash by (a) delivering to Company,
in accordance with Section 5.2, a duly executed copy of a Notice of Exercise in substantially the form attached as Appendix
1 not less than sixty one (61) days prior to the date of exercise (unless the Company otherwise agrees to a shorter notice
period), and (b) causing this Warrant to be delivered to Company, in accordance with Section 5.2, as soon as reasonably
practicable on or following the date on which the Notice of Exercise is delivered to Company (but no later than within sixty one
(61) days following the date on which the Notice of Exercise is delivered to Company). Unless Holder is exercising the conversion
right provided for in Section 1.2, Holder shall, within three (3) Trading Days following the date of exercise as aforesaid,
also deliver to Company a certified or bank cashier’s check, wire transfer of immediately available funds (to an account
designated by Company), or other form of payment acceptable to Company, in the amount of the aggregate Warrant Exercise Price for
the Shares being purchased. As used herein, “Trading Day” means a day on which the Principal Trading Market
is open for trading.

 

    	Common Stock Purchase Warrant dated December 8, 2017	- 1 -	 
	(exercise price of $11.00 per Share)	 	 

     

    

 

1.2            Conversion
Right. In lieu of exercising this Warrant to purchase Shares for cash in accordance with Section 1.1, Holder may, at
its option, from time to time convert this Warrant, in whole or in part and without any obligation to pay the Warrant Exercise
Price, into that number of Shares determined by dividing (x) the aggregate Fair Market Value of the Shares in respect of which
this Warrant is being converted minus the aggregate Warrant Exercise Price of such Shares by (y) the Fair Market Value of one (1)
Share. The Fair Market Value of one (1) Share shall be determined pursuant to Section 1.3. Holder may exercise such conversion
right under this Warrant in whole or in part by (a) delivering to Company, in accordance with Section 5.2, a duly executed
copy of a Notice of Exercise in substantially the form attached as Appendix l not less than sixty one (61) days prior to
the date of conversion (unless the Company otherwise agrees to a shorter notice period), and (b) causing this Warrant to be delivered
to Company, in accordance with Section 5.2, as soon as reasonably practicable on or following the date on which Notice of
Exercise is delivered to Company (but no later than within two (2) Trading Days following the date on which the Notice of Exercise
is delivered to Company). Any reference in this Warrant to the “exercise” of this Warrant or events to occur upon or
in connection with the exercise of this Warrant, including without limitation, all provisions of Section 2, will apply equally
and with the same equitable effect to any conversion of this Warrant even if reference is not specifically made to conversion of
this Warrant.

 

1.3            Fair
Market Value. For purposes of this Warrant, “Fair Market Value” shall mean, with respect to one (1) Share,
the price determined by the first of the following clauses that applies: (a) the average of the daily volume weighted average trading
price of the Common Stock on the Principal Trading Market for the five (5) Trading Days immediately prior to the date on which
the Notice of Exercise for exercising the conversion right under this Warrant is delivered to Company, or (b) if the Common Stock
is not so listed or quoted, as reasonably determined in good faith by the board of directors of the Company. As used herein, (i)
“Principal Trading Market” means the Trading Market on which the Common Stock is primarily listed on and quoted
for trading, and (ii) “Trading Market” means any of the following markets or exchanges on which the Common Stock
is listed or quoted for trading on the date in question: the NYSE MKT, the Nasdaq Capital Market, the Nasdaq Global Market, the
Nasdaq Global Select Market, the New York Stock Exchange, OTC Pink, OTCQB or OTCQX (or any successors to any of the foregoing).

 

1.4            Delivery
of Certificate and New Warrant. Within three (3) Trading Days after Holder exercises under Section 1.1 or converts under
Section 1.2 this Warrant and, if applicable, Company receives payment of the aggregate Warrant Exercise Price, Company shall
deliver to Holder certificates (or, if consistent with Company’s practice for issuing shares of Common Stock, non-certificated
Shares represented by book-entry on the records of Company or Company’s transfer agent (the “Book-Entry Shares”))
for the Shares so acquired and, if this Warrant has not been fully exercised or converted and has not expired, a new warrant of
like tenor representing the Shares not so acquired. The Shares shall be deemed to have been issued, and Holder or any other Person
designated by Holder to be named therein shall be deemed to have become a holder of record of such Shares for all purposes as of
the date this Warrant shall have been exercised or converted. If Company fails to deliver a certificate or certificates (or, if
applicable, Book-Entry Shares) for the Shares as provided herein, in addition to any other remedy available to Holder hereunder,
at law or in equity, Holder shall have the right to rescind the exercise or conversion of this Warrant. The Holder acknowledges
and understands that any stock certificates issued hereunder and any Warrant issued in replacement of this Warrant upon its exercise,
in whole or in part, or for any other reason, shall have the legends placed thereon as appear on the first page of this Warrant.

 

    	Common Stock Purchase Warrant dated December 8, 2017	- 2 -	 
	(exercise price of $11.00 per Share)	 	 

     

    

 

1.5           
Fractional Shares. No fractional Share shall be issuable upon exercise or conversion of this Warrant, and the number of
Shares to be issues shall be rounded down to the nearest whole Share. If a fractional share interest arises upon any exercise or
conversion of this Warrant, Company shall eliminate such fractional share interest by paying Holder cash in the amount computed
by multiplying the fractional share interest by the Fair Market Value (as determined pursuant to Section 1.3) of a full
Share.

 

2.            ANTI-DILUTION
PROVISIONS; ADJUSTMENT IN WARRANT NUMBER AND WARRANT EXERCISE PRICE. The Warrant Exercise Price and Warrant Number shall be
subject to adjustment from time to time as provided in this Section 2.

 

2.1            Dividends,
Subdivisions and Combinations. If Company, at any time and from time to time, (i) takes a record of the holders of its Common
Stock for the purpose of entitling them to receive, or otherwise declares or distributes, a dividend payable in, or other distribution
of, additional shares of Common Stock or Common Stock Equivalents, (ii) splits or subdivides its outstanding shares of Common Stock
into a greater number of shares of Common Stock or Common Stock Equivalents, or (iii) combines its outstanding shares of Common
Stock into a smaller number of shares of Common Stock or Common Stock Equivalents, then, in each such case, (a) the Warrant Number
shall be adjusted to equal the product of (x) the Warrant Number in effect immediately prior to the adjustment multiplied by (y)
a fraction, the numerator of which is equal to the number of shares of Common Stock outstanding immediately after such adjustment
and the denominator of which is equal to the number of shares of Common Stock outstanding immediately prior to the adjustment,
and (b) the Warrant Exercise Price shall be adjusted pursuant to Section 2.2. As used herein, “Common Stock Equivalents”
means any securities of the Company or its subsidiaries which would entitle the holder thereof to acquire at any time equity securities,
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.

 

2.2            Adjustment
of Warrant Exercise Price. Upon any adjustment of the Warrant Number as provided in Section 2.1, the Warrant Exercise
Price shall be adjusted to be equal to the product of (i) the Warrant Exercise Price in effect immediately prior to such adjustment
multiplied by (ii) the quotient of the Warrant Number in effect immediately prior to such adjustment divided by the Warrant Number
in effect immediately after such adjustment.

 

2.3            Determination
of Adjustments. Upon any event that shall require an adjustment pursuant to this Section 2, Company shall promptly calculate
such adjustment in accordance with the terms of this Warrant and prepare a certificate setting forth, in reasonable detail, such
adjustment, the method of calculation thereof and the facts upon which such adjustment is based.

 

    	Common Stock Purchase Warrant dated December 8, 2017	- 3 -	 
	(exercise price of $11.00 per Share)	 	 

     

    

 

3.            CERTAIN
AGREEMENTS. Company hereby covenants and agrees as follows:

 

3.1            Shares
to be Fully Paid. All Shares shall, upon issuance in accordance with the terms of this Warrant, be duly and validly issued,
fully paid and non-assessable.

 

3.2            Reservation
of Shares. Until the Expiration Date, Company at all times shall have authorized, and reserved for the purpose of issuance
upon exercise of this Warrant, a sufficient number of shares of Common Stock to provide for the exercise of this Warrant in full.

 

3.3            Successors
and Assigns. This Warrant shall be binding upon any entity succeeding to Company by merger, consolidation, or acquisition of
all or substantially all Company’s assets or all or substantially all of Company’s outstanding capital stock or otherwise.

 

4.            TRANSFER
AND REPLACEMENT OF WARRANT.

 

4.1            Restriction
on Transfer. Subject to this Section 4.1, this Warrant and the rights granted to Holder are transferable and assignable,
in whole or in part, upon surrender of this Warrant, together with a properly executed assignment in substantially the form attached
as Appendix 2, at the office or agency of Company referred to in Section 4.4. Nothing in this Warrant shall prohibit
Holder from assigning, delegating or transferring this Warrant and Holder’s rights and obligations under this Warrant to
an Affiliate of Holder. Otherwise, Holder may not assign, delegate or otherwise transfer (whether by operation of law, by contract
or otherwise) its rights and obligations under this Warrant, or any portion hereof or thereof, to any Person whose principal business
is providing integrated healthcare services or who otherwise is a competitor of Company as determined reasonably and in good faith
by the board of directors of the Company. Until due presentment for registration of transfer on the books of Company, Company may
treat the registered holder hereof as the owner of this Warrant and Holder for all purposes, and Company shall not be affected
by any notice to the contrary.

 

4.2            Replacement
of Warrant. Upon receipt of evidence reasonably satisfactory to Company of the loss, theft, destruction or mutilation of this
Warrant and, in the case of any such loss, theft or destruction, upon delivery of an indemnity agreement reasonably satisfactory
in form and amount to Company, or, in the case of any such mutilation, upon surrender and cancellation of this Warrant, Company,
at its expense, shall execute and deliver to Holder, in lieu thereof, a new Warrant of like tenor.

 

4.3            Cancellation;
Payment of Expenses. Upon the surrender of this Warrant in connection with any transfer, exchange or replacement, this Warrant
shall be promptly canceled by Company. Company shall pay all taxes (other than securities transfer taxes) and all other expenses
(other than legal expenses, if any, incurred by Holder or transferees) and charges payable in connection with the preparation,
execution, and delivery of a new Warrant issued to Holder or transferees, as applicable.

 

4.4            Register.
Company shall maintain, at its principal executive offices (or such other office or agency of Company as it may designated by notice
to Holder), a register for this Warrant, in which Company shall record the name and address of the Person in whose name this Warrant
has been issued, as well as the name and address of each transferee and each prior owner of this Warrant.

 

    	Common Stock Purchase Warrant dated December 8, 2017	- 4 -	 
	(exercise price of $11.00 per Share)	 	 

     

    

 

5.            MISCELLANEOUS.

 

5.1            Term.
This Warrant is exercisable or convertible in whole or in part at any time and from time to time before or on the Expiration Date
on no less than sixty-one (61) days’ prior written notice to the Company (unless the Company otherwise agrees to a shorter
notice period).

 

5.2            Notices.
All demands, notices, approvals, consents, requests, and other communications hereunder shall be in writing and shall be deemed
to have been given when the writing is delivered, if given or delivered by hand, overnight delivery service or facsimile transmitter
(with confirmed receipt), or five (5) days after being mailed, if mailed, by first class, registered or certified mail, postage
prepaid, to the address or telecopy number set forth below. If any time period for giving notice or taking action hereunder expires
on a day that is not a Trading Day, the time period shall automatically be extended to the Trading Day immediately following such
day. Such notices, demands, requests, consents and other communications shall be sent to the following Persons at the following
addresses:

 

if to Company:

 

Apollo Medical Holdings, Inc.

700 N. Brand Blvd., Suite 220

Glendale, California 91203

Attention: Chief Executive Officer

Telephone: (818) 396-8050

Fax: (818) 844-3888

 

if to Holder:

 

______________________

______________________

Attention: _____________

Telephone: ____________

Fax:                             

 

Company or Holder may, by notice given hereunder,
designate any further or different addresses or telecopy numbers to which subsequent demands, notices, approvals, consents, requests
or other communications shall be sent or persons to whose attention the same shall be directed.

 

5.3            Waivers.
The rights and remedies provided for herein are cumulative and not exclusive of any right or remedy that may be available to Holder
whether at law, in equity, or otherwise. No delay, forbearance, or neglect by Holder, whether in one or more instances, in the
exercise of any right, power, privilege, or remedy hereunder or in the enforcement of any term or condition of this Warrant shall
constitute or be construed as a waiver thereof. No waiver of any provision hereof, or consent required hereunder, or any consent
or departure from this Warrant, shall be valid or binding unless expressly and affirmatively made in writing and duly executed
by Holder. No waiver shall constitute or be construed as a continuing waiver or a waiver in respect of any subsequent breach, either
of similar or different nature, unless expressly so stated in such writing.

 

    	Common Stock Purchase Warrant dated December 8, 2017	- 5 -	 
	(exercise price of $11.00 per Share)	 	 

     

    

 

5.4            Specific
Enforcement. The parties hereto agree that irreparable damage would occur in the event that any of the provisions of this Warrant
were not performed in accordance with their specific intent or were otherwise breached. It is accordingly agreed that the parties
shall be entitled to an injunction or injunctions to prevent or cure breaches of the provisions of this Warrant and to enforce
specifically the terms and provisions hereof, in addition to any other remedy to which they may be entitled by law or equity.

 

5.5            Counterparts.
This Warrant may be executed simultaneously in two or more counterparts, any one of which need not contain the signatures of more
than one party, but all such counterparts taken together shall constitute one and the same Warrant. Counterparts may be delivered
via facsimile, electronic mail (including pdf) or other transmission method and any counterpart so delivered shall be deemed to
have been duly and validly delivered and be valid and effective for all purposes.

 

5.6            Governing
Law. This Warrant shall be governed by and construed in accordance with the laws of the State of California, without giving
effect to any choice or conflict of law provision or rule (whether of the State of California or any other jurisdiction) that would
cause the application of the laws of any jurisdiction other than the State of California. Holder agrees that all legal proceedings
concerning the interpretations, enforcement and defense of the transactions contemplated by this Warrant (whether brought against
Holder, the Company 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 County of Los Angeles. Each party hereby irrevocably
submits to the exclusive jurisdiction of the state and federal courts sitting in the County of Los Angeles 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.

 

5.7            Amendment.
This Warrant may be amended, modified, or supplemented only pursuant to a written instrument making specific reference to this
Warrant and signed by Company and Holder.

 

5.8            Severability.
Whenever 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 is held to be invalid or unenforceable in any respect, such invalidity or unenforceability
shall not render invalid or unenforceable any other provision of this Warrant.

 

    	Common Stock Purchase Warrant dated December 8, 2017	- 6 -	 
	(exercise price of $11.00 per Share)	 	 

     

    

 

5.9            Descriptive
Headings; No Strict Construction. The descriptive headings of this Warrant are inserted for convenience only and do not constitute
a substantive part of this Warrant. If an ambiguity or question of intent or interpretation arises, this Warrant shall be construed
as if drafted jointly by the parties hereto, and no presumption or burden of proof shall arise favoring or disfavoring any party
by virtue of the authorship of any of the provisions of this Warrant. The parties agree that prior drafts of this Warrant shall
be deemed not to provide any evidence as to the meaning of any provision hereof or the intention of the parties hereto with respect
to this Warrant.

 

[signature page follows]

 

    	Common Stock Purchase Warrant dated December 8, 2017	- 7 -	 
	(exercise price of $11.00 per Share)	 	 

     

    

 

IN WITNESS WHEREOF,
the parties have duly executed and delivered this Common Stock Purchase Warrant by their duly authorized representatives as of
the date first above written.

 

	 	COMPANY:	 
	 	 	 
	 	APOLLO MEDICAL HOLDINGS, INC.	 
	 	 	 	 	 
	 	By:	 	 	 
	 	Name:	 	Thomas Lam, M.D.	 
	 	Title:	 	Co-Chief Executive Officer	 
	 	 	 	 	 
	 	 	 	 	 
	 	HOLDER:	 
	 	 	 	 	 
	 	 	 
	 	(Print Name)	 
	 	 	 	 	 
	 	 	 
	 	(Signature)  	 

 

    	Signature Page to Common Stock Purchase Warrant
	dated December 8, 2017 (exercise price of $11.00 per Share)

     

    

 

APPENDIX 1

 

FORM OF NOTICE OF EXERCISE

 

		TO:	APOLLO MEDICAL HOLDINGS,
INC.

 

 

1.              The
undersigned hereby elects to purchase ______ Shares of the Common Stock of Apollo Medical Holdings, Inc. pursuant to the terms
of the attached Common Stock Purchase Warrant dated December 8, 2017 (at an exercise price of $11.00 per Share) (the “Warrant”)
issued to the undersigned (or the undersigned’s predecessor or assignor), and shall tender payment of the exercise price
in full in accordance with the terms of the Warrant.

 

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

 

		 ̈	lawful money of the United
States; or

 

		 ̈	the cancellation of such
number of Shares as is necessary, in accordance with the formula set forth in Section 1.2 of the Warrant, to exercise the
Warrant with respect to the maximum number of Shares purchasable pursuant to the cashless exercise procedure set forth in Section
1.2 of the Warrant.

 

3.              Please
issue a certificate or certificates (or, if applicable, Book-Entry Shares) representing said Shares in the name of the undersigned
or in such other name as is specified below:

 

The Shares shall be delivered
by physical delivery of a certificate (or, if applicable, Book-Entry Shares) to:

 

	[SIGNATURE OF HOLDER]	 
	 	 
	Name of Holder:	 
	Name of Authorized Signatory:	 
	Title of Authorized Signatory:	 
	Date:	 

 

Date of exercise under Section 1.1 of
the Warrant or date of exercise of conversion right under Section 1.2 of the Warrant is the date this Notice is deemed effectively
given under Section 5.2 of this Warrant.

 

     

     

    

 

APPENDIX 2

 

ASSIGNMENT FORM

 

(To assign the foregoing Warrant, execute this
form and supply required information.

Do not use this form to exercise the Warrant.)

 

FOR VALUE RECEIVED,

 

(check first box OR fill in number
of Shares in second box)

 

		 ̈	all of the Warrant dated
December 8, 2017 (exercise price of $11.00 per Share) (the “Warrant”)

 

OR

 

[_______] shares of the foregoing
Warrant

 

and all rights evidenced thereby are hereby
assigned to:

 

	 	 (“Transferee”) whose address is 	 
	 	 	 
	.

 

	 	Dated:	 	 	, 	 	 

 

	 	Holder’s Signature:	 	 
	 	 	 	 
	 	Holder’s Address:	 	 
	 	 	 	 
	 	 	 	 

  

The undersigned Transferee hereby accepts the
foregoing assignment and agrees to be bound by all of the terms and provisions of the Warrant being assigned hereby.

 

	 	Dated:	 	 	, 	 	 

 

	 	Transferee’s Signature:

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