Document:

Exhibit 10.12 

 

THIS INSTRUMENT CONTAINS A CONFESSION
OF JUDGMENT PROVISION WHICH CONSTITUTES A WAIVER OF IMPORTANT RIGHTS YOU MAY HAVE AS A DEBTOR AND ALLOWS THE CREDITOR TO OBTAIN
A JUDGMENT AGAINST YOU WITHOUT ANY FURTHER NOTICE. THIS INSTRUMENT FURTHER CONTAINS A WAIVER OF JURY TRIAL PROVISION WHICH CONSTITUTES
A WAIVER OF IMPORTANT RIGHTS YOU MAY HAVE AS A DEBTOR.

 

 

PROMISSORY NOTE (this “Note”)

 

	US$35,000.00	 	November 24, 2016
	 	 	Charlottesville, VA

  

For value received, Bankole A. Johnson, with address for purposes
hereunder of 11020 Hunters View Road, Ellicott City, MD 21042-6109 (“Johnson") promises to pay to the order of ADial
Pharmaceuticals, L.L.C., a Virginia limited liability company ("ADial"), at 204 East High Street, Charlottesville, VA
22902, (or at such other place as ADial may designate in writing) the sum of $35,000.00 (thirty-five thousand and no/100 dollars)
with interest on or before June 6, 2017 (the "Due Date") under the payment schedule attached hereto as Schedule 1.

 

		1.	Interest. Interest will be calculated at an annual percentage rate of five percent (5%), compounded monthly, beginning
January 6, 2017, until paid in full. Any amounts outstanding under this Note on the 6th day of each month shall be added
to the principal balance of this Note on such date and accrue interest thereafter.

 

		2.	Prepayment. Johnson may prepay this Note (in whole or in part) at any time prior to the Due Date without penalty.

 

		3.	Events of Default. The following are events of default by Johnson (“Default”) under this Note:

 

		a.	the failure of Johnson to pay the amounts due hereunder on or before the date stated on Schedule 1;

		b.	the death of Johnson;

		c.	the filing of bankruptcy proceedings involving Johnson as a Debtor;

		d.	the application for appointment of a receiver for Johnson;

		e.	the making of a general assignment for the benefit of Johnson's creditors;

		f.	the insolvency of Johnson; or

		g.	if Johnson breaches any other term herein.

 

		4.	Effect of Default. Upon a Default, this Note and any other obligations of Johnson to ADial, shall become due immediately,
without demand or notice and this Note shall, notwithstanding the rate stated in Section 1 above, then bear an interest rate of
18% (eighteen percent) per annum (or the maximum amount allowed by law, whichever is less) on any outstanding amounts with interest
compounding monthly. In the event of Default, Johnson will reimburse all reasonable attorney or other collection fees and expenses
incurred by ADial in collecting any amounts due.

 

    	 		 

    	 

    

 

Additionally, Johnson recognizes and agrees that
failure to pay the amounts due under Schedule 1 will cause severe hardship to ADial, including, without limitation, the use of
precious management time and effort, extreme mental and emotional stress on management and its members, and loss of prestige; therefore,
after Default, for each day any amount due hereunder is outstanding, Johnson shall pay to ADial liquidated damages in the amount
of $200.00 (two hundred dollars) per day or the maximum amount per day allowed by law, whichever is less, beginning 15 (fifteen)
days after the failure to make timely payment of any amount due and continuing until all amounts due hereunder are paid in full.

 

Furthermore, Johnson has executed the Irrevocable
Proxy attached as Exhibit A, which proxy shall only become effective in the event that Johnson fails to timely pay the amounts
due hereunder on or before the dates stated on Schedule 1 and which Irrevocable Proxy shall only remain effective until all amounts
then due and owing hereunder are paid in full, thereby curing said default.

 

		5.	Johnson Waivers. Johnson waives demand, protest, notice of nonpayment and any and all lack of diligence or delays in
collection or enforcement of this Note. No renewal or extension of this Note, delay in enforcing any right of ADial under this
Note, or assignment by ADial of this Note shall affect the liability of Johnson. All rights of ADial under this Note are cumulative
and may be exercised concurrently or consecutively at ADial's option. Johnson may not assign this Note.

 

Further, in the event of Default for failure to
make timely payment of any amount due hereunder,

 

		(a)	Johnson agrees to garnishment of his wages as allowed by Maryland law and hereby agrees to such garnishment and waives any
defense against such garnishment; and

 

		(b)	In addition to any other waivers herein, Johnson specifically waives any defense of the amount and value of the daily liquidated
damages stated in Section 4 above as being $200.00 per day.

 

		6.	Right of Offset. Any amounts that may come due from ADial to Johnson, or any entity controlled by him, including, without
limitation, the trusts described in ADial’s records as En Fideicomiso De Mi Vida 11/23/2010, En Fideicomiso De Mis Suenos
11/23/2010, and En Fideicomiso De Mi Amor 11/23/2010, due to the ownership of equity interests in ADial or otherwise, may first
be used to pay amounts that are due or will be due under this Note (i.e., ADial shall have a right to forgive a portion of this
Note in lieu of paying any amounts that otherwise would be payable to Johnson in his capacity as a member of ADial).

 

		7.	Prohibition of Transfer. Until this Note is retired as paid in full, Johnson shall not assign or transfer any membership
units of ADial owned or controlled by him, including, without limitation, the membership units owned by the trusts described in
ADial’s records as En Fideicomiso De Mi Vida 11/23/2010, En Fideicomiso De Mis Suenos 11/23/2010, and En Fideicomiso De Mi
Amor 11/23/2010, and any such assignment or transfer will be null and void and not recognized by ADial.

 

		8.	Choice of Law & Venue. This Note will be deemed to have been made and delivered in Charlottesville, VA and will
be governed in all respects by the internal laws of the Commonwealth of Virginia without regard to the principles of conflict of
laws. Johnson and ADial each hereby (i) agrees that any legal action arising out of or relating to this Note shall be instituted
exclusively in Charlottesville General District Court (the “Court”), (ii) waives any objection to the venue for any
reason whatsoever, (iii) irrevocably consents to the jurisdiction of the Court in any such action, and (iv) agrees to accept and
acknowledge service or any and all process that may be served in any such action in the Court.

 

    	 	2	 

    	 

    

 

 

		9.	WAIVER OF RIGHT TO JURY TRIAL. JOHNSON HEREBY WAIVES TRIAL BY JURY IN REGARD TO ANY CAUSES OF ACTION, CLAIMS, OBLIGATIONS,
DAMAGES OR ANY COMPLAINTS, WHICH JOHNSON MAY HAVE ARISING OUT OF THIS NOTE AND IN REGARD TO ANY ACTION, OR PROCEEDING, WHICH ADIAL
MAY BRING TO ENFORCE ANY PROVISION OF THIS NOTE. BY THE EXECUTION OF THIS NOTE, JOHNSON HEREBY REPRESENTS THAT JOHNSON IS REPRESENTED
BY COMPETENT COUNSEL WHO HAS FULLY AND COMPLETELY ADVISED JOHNSON OF THE MEANING AND RAMIFICATION OF THE WAIVER OF THE RIGHT TO
A TRIAL BY JURY OR THAT HE HAD AMPLE OPPORTUNITY TO SEEK SUCH ADVICE OF COUNSEL BUT ELECTED NOT TO DO SO.

 

		10.	CONFESSION OF JUDGMENT. THE UNDERSIGNED HEREBY MAKES, CONSTITUTES AND APPOINTS BRIAN S. JOHNSON, ESQUIRE, OF CHARLOTTESVILLE,
VA AS THE UNDERSIGNED’S TRUE AND LAWFUL ATTORNEY-IN-FACT, WITH FULL POWER AND AUTHORITY FOR THE UNDERSIGNED, IN THE UNDERSIGNED’S
NAME, PLACE AND STEAD, TO CONFESS JUDGMENT ON THE UNDERSIGNED’S BEHALF IN THE CIRCUIT COURT OF THE CITY OF CHARLOTTESVILLE,
VIRGINIA, IN THE EVENT OF A DEFAULT HEREUNDER FOR ALL AMOUNTS OWING UNDER THIS NOTE AS SHOWN ON THE RECORDS OF ADIAL. THIS POWER
OF ATTORNEY IS A POWER OF ATTORNEY COUPLED WITH AN INTEREST AND MAY NOT BE TERMINATED BY THE UNDERSIGNED, ITS SUCCESSORS AND ASSIGNS.

 

		11.	Headings. Heading are for organizational purposes only and have no effect on this Note.

 

		12.	Invalid Provisions. If any provisions of this Agreement shall be held to be invalid or unenforceable, the remaining
provisions shall continue to be valid and enforceable, and if by limiting any such provision it would become valid or enforceable,
then such provision shall be deemed to be written, construed, and enforced as so limited.
	 	 	 

	By:	/s/ Bankole A. Johnson(seal)	 	 
	 	Bankole A. Johnson	 	 

 

    	 	3	 

    	 

    

 

 

 

COMMONWEALTH OF VIRGINIA

CITY/COUNTY OF _______________________, to-wit:

 

The foregoing instrument was acknowledged
before me ________________________________, Notary Public, this ____ day of November, 2016, by _________________.

 

 

	 	 	 	 
	 	 	Notary Public	 

Registration Number __________________

My commission expires: ___/____/20____

 

    	 	4	 

    	 

    

 

 

Schedule 1

Payment Schedule

 

 

 

 

    	 	5	 

    	 

    

IRREVOCABLE PROXY

 

The undersigned, a member of ADial Pharmaceuticals, L.L.C.,
a Virginia limited liability company (the “Company”), hereby irrevocably (to the fullest extent permitted by law) appoints
and constitutes the Board of Directors of the Company as the attorney and proxy of the undersigned with full power of substitution
and re-substitution, to the full extent of the undersigned’s rights with respect to (a) the outstanding membership units
of the Company owned of record by the undersigned or controlled by the undersigned as of the date of this proxy, including, without
limitation, the membership units originally owned by John F. Riccardi’s that were subjected to a proxy in favor of the undersigned
and the membership units owned by the trusts with names En Fideicomiso De Mi Vida 11/23/2010, En Fideicomiso De Mis Suenos 11/23/2010,
and En Fideicomiso De Mi Amor 11/23/2010 in the Company’s records and (b) any and all other membership units of the Company
that the undersigned may acquire on or after the date hereof (membership units in (a) and (b) are, collectively, the “Units”).
The undersigned warrants that there are no other irrevocable proxies in place covering the Units as of the signing of this Proxy,
and upon the execution hereof, any other prior proxies that may have been given by the undersigned with respect to any of the Units
are hereby revoked. The undersigned further agrees that no subsequent proxies will be given with respect to any of the Units, and
if given in violation of this explicit agreement, they shall be of no force or effect.

 

The attorney and proxy named above will be empowered, and may
exercise this proxy, to vote the Units at any time at any meeting of the members of the Company, however called, or in connection
with any solicitation of written consents from the members of the Company, on all matters to come before the members, including
but not limited to the approval of the sale and issuance of additional membership units by the Company. Notwithstanding anything
else herein, the undersigned retains the sole right to, and does not grant a right to sell, vote to sell, or otherwise commit to
sell or hypothecate the Units.

 

This proxy shall be binding upon the heirs, estate, executors,
personal representatives, successors and assigns of the undersigned (including any transferee of any of the Units).

 

This proxy shall be construed in accordance with, and governed
in all respects by, the internal laws of the Commonwealth of Virginia (without giving effect to principles of conflicts of laws).

 

This proxy is related to that certain Promissory Note between
the undersigned and the Company dated November 24, 2016 (the “Note”) and subject to the terms of Section 4 of the Note.

 

This proxy shall be automatically canceled and of no further
effect upon the retirement of the Note as fully paid and is not cancellable for any other reason.

 

Dated: November 24, 2016

 

	 	 	 	 
	 	 	 	 
	Signed:	(seal)	 	 
	 	Bankole A. Johnson	 	 
	 	 	 	 

    	 	6	 

    	 

    

 

 

 

COMMONWEALTH OF VIRGINIA

CITY/COUNTY OF _______________________, to-wit:

 

The foregoing instrument was acknowledged
before me ________________________________, Notary Public, this ____ day of November, 2016, by _________________,

 

 

	 	 	 	 
	 	 	Notary Public	 

 

Registration Number __________________

My commission expires: ___/____/20____

 

    	 	7Exhibit
4.9

 

ADial
Pharmaceuticals, LLC

Option
Agreement

  

	Recipient:	Tony
    Goodman (“Recipient”)
	Effective
    Date:	July
    1, 2017 (“Effective Date”)
	Option
    for:	60,000
    Class A Units (the “Units”)
	Exercise
    Price:	$1.06
    per Unit (“Exercise Price”)
	Expiration
    Date:	June
    30, 2027 (“Expiration Date”)

 

THIS
OPTION AGREEMENT (this “Agreement”) is made and entered into effective as the Effective Date by and between ADial
Pharmaceuticals, LLC, a limited liability company organized under the laws of the Commonwealth of Virginia (the "Company"),
and Recipient. Any and all other Option Agreements, if any, issued to Recipient and effective on or before the Effective
Date are hereby canceled and of no further effect whatsoever.

 

All
capitalized terms used herein shall have the same meaning that they have in the Company’s Second Amended and Restated Operating
Agreement dated February 3, 2014 (the “Operating Agreement”), unless otherwise indicated or unless the context otherwise
requires. As used herein, the terms “employ”, “employed”, “employment” refer to and mean the
obligation to provide services to the Company or the holding of office in the Company as a director, officer, employee or consultant,
as applicable. For clarity, if Recipient is a non-employee director, a non-employee officer or a consultant, use of these terms
herein does not confer or imply an employee relationship between the Company and Recipient as that term is used in the context
of labor applications.

  

WITNESSETH:

 

WHEREAS
the Company desires to give its directors, officers, employees and consultants an added incentive to promote the growth of the
Company through the participation in the equity of the Company;

 

WHEREAS,
the Company desires to grant to Recipient an option to purchase the Units, on the terms and conditions hereinafter set forth;

 

NOW,
THEREFORE, for and in consideration of the premises and the mutual agreements and covenants hereinafter set forth and of other
good and valuable consideration, the receipt, adequacy and sufficiency of which are hereby acknowledged, the parties hereto agree
as follows:

 

1.             GRANT
OF OPTION. Subject to the terms and conditions of this Agreement, including the vesting provisions of Section 3 below, the
Company hereby grants to Recipient the right and option (the "Option") to purchase the Units, subject to the terms herein,
including, without limitation, the vesting provisions set forth in Section 3 herein.

 

     

     

    

 

The
Units which are subject to the Option are sometimes referred to herein as the “Option Units.”

 

2.             OPTION.

 

(a)       Option
Price. The price to purchase each Option Unit shall be the Exercise Price.

 

(b)       Exercise
of Option. Subject to subparagraph (f) hereof, Recipient may exercise this Option with respect to all or any portion of his
vested Option Units at any time prior to the Expiration Date.

 

(c)       Manner
of Exercise. This Option may be exercised by delivering written notice of exercise in the form of the Exercise Letter, a form
of which is at Exhibit A, paying the purchase price set forth herein, and by delivering a completed Member Signature Page, a form
of which is attached as Exhibit B, binding Recipient into the Operating Agreement to the Chief Executive Officer of the Company,
in person, or by mail, postage prepaid, addressed to the attention of the Chief Executive Officer at the location at which the
Company then maintains its principal office, and if so mailed, the date of mailing will be considered the date of exercise.

 

(d)       Person
Who May Exercise Option. During the lifetime of Recipient, this Option shall be exercisable only by Recipient, or if Recipient
is disabled, by his duly appointed guardian or legal representative.

 

(e)       Operating
Agreement. In accordance with the Company’s Operating Agreement, all Units of the Company are subject to certain restrictions.
Upon the exercise of an Option, Recipient (or his or her guardian, legal representative or personal representative, as applicable)
agrees to execute and be bound by the terms and conditions of such Operating Agreement, as a precondition of being issued any
Units.

 

(f)       Termination
of Option. Notwithstanding any other provisions to the contrary, this Option, to the extent that it has not previously been
exercised or that Recipient’s employment has been terminated for any reason, including termination by resignation or by
reason of death or disability, prior to vesting (which will terminate this Option), will terminate upon the Expiration Date hereof.

 

3.             VESTING.
The Option granted hereunder will vest monthly in equal 1/36th increments during the three years from the date of this
agreement and while Recipient is a Director of the Company so that on the 1st day of the first month after the Effective
Date (i.e. August 1, 2017), the Option may only be exercised in relation to 1/36th of the Units, after the 2nd
month the Option may only be exercised in relation to 2/36th of the Units, and so forth so that all Units subject
to the Option will be fully vested on July 1 of the third year. In the event of a Liquidity Event (defined below), the Option
shall fully vest simultaneously with such Liquidity Event unless such Liquidity Event is as part of an Adjusting Event (defined
in Section 5 below) with the intent of facilitating a public offering of securities of the Company. For purposes of this Agreement
a “Liquidity Event” means (i) any transaction or series of related transactions by the Company or its equity holders
in which a majority of the voting power of the members is transferred to one or more persons who were not previously equity holders
of the Company, (ii) any merger or consolidation of the Company with or into any other entity, after which the members of the
Company do not hold, either directly or indirectly, a majority of the voting equity of the surviving entity, or (iii) a sale of
all or substantially all of the operating assets of the Company.

 

    	 	2	 

     

    

 

4.             TRANSFERABILITY.
This Agreement and any rights hereunder shall be nontransferable and nonassignable by Recipient, except that it may be transferred
in the event of Recipient’s death to Recipient’s heirs.

 

5.             ADJUSTMENT
OF UNITS. In the event of any recapitalization, reclassification, split-up or consolidation of, or other change in, the Units,
or an exchange of the outstanding Units of the Company, in connection with a merger, consolidation, reincorporation or other reorganization
of the Company for a different number of Units or for shares of stock or other securities of the Company or for Units or other
securities of the other company (an “Adjusting Event”), then the Board of Directors shall, in such manner as they
shall determine in their sole discretion, appropriately adjust the number of the Option Units or the number of Units or other
securities that shall then be subject to this Option and/or the Exercise Price per Unit or share that must be paid thereafter
upon exercise of this Option and may, in such manner as they shall determine in their sole discretion, modify this agreement to
take into account the new structure and entity, including, without limitation, potentially binding the Option under an option
plan as then approved or placing restrictions on the sale and/or registration of securities acquired under this Agreement.

 

6.             INVESTMENT
REPRESENTATION. Recipient hereby represents, warrants and agrees that:

 

(a)       He
understands the offer of Units under this Agreement is made pursuant to a claim of exemption from the registration provisions
of the Securities Act of 1933, as amended (the “Act”) and applicable state securities law;

 

(b)       The
Company is not obligated to issue Units upon exercise of this Option until there has been compliance with any Federal or state
laws or regulations that the Company may deem applicable;

 

(c)       The
Option Units will be purchased for his own account for investment purposes only and not with a view to resale or distribution
thereof;

 

(d)       The
Option Units may be unregistered and, if so, will be required to be held indefinitely, unless such Units are subsequently registered
or an exemption from registration is then available; and

 

(e)       The
Company is under no obligation to register the Option Units, to comply with any such exemption or to supply Recipient with any
information necessary to enable him to make routine sales of such Units under Rule 144 or any other rule or regulation of the
Securities and Exchange Commission.

 

7.             NO
RIGHTS AS MEMBER OR TO EMPLOYMENT. The Recipient shall not have any interest in or membership rights with respect to any Units
that are subject to this Option until such Units have been issued and delivered to Recipient pursuant to the exercise of this
Option. Furthermore, this Option does not confer upon Recipient any rights of employment with the Company, including without limitation
any right to continue in the employ of the Company, nor does it affect the right of the Company to terminate the services provided
by Recipient as a Director of the Company at any time, with or without cause, or to continue or alter the terms of such services.

 

    	 	3	 

     

    

 

8.             DRAG-ALONG
PROVISIONS. The Company shall have the right, but not the obligation, to “call”, effective immediately prior to
a Liquidity Event (defined below), any and all unexercised portions of the Option, as fully vested in accordance with Section
3 above, and to issue, subject to all terms and conditions of the Operating Agreement, to Recipient such Units to which Recipient
would be entitled upon Recipient’s exercise of the fully vested Option. Upon the Company’s exercise of such call right,
the Exercise Price under this Agreement for such Units shall be immediately due and payable to the Company, and the Company shall
be entitled (i) to deduct such price from any amounts due to Recipient or (ii) to effect a redemption of such number of Units
at fair market value (reasonably determined in the discretion of the Board of Directors) as shall be necessary to pay such purchase
price. Notwithstanding any other provision of this Agreement, the purchase price of Units issued upon exercise of the Company’s
call right shall be no greater than the fair market value of such Units. The Recipient agrees to execute such documentation as
is reasonably requested to document the issuance of Units to Recipient, including, but not limited to, the Operating Agreement
then in effect.

 

9.             WITHHOLDING
TAXES. As a condition of exercise of this Option, the Company may, in its sole discretion, withhold or require Recipient to
pay or reimburse the Company for any taxes which the Company determines are required to be withheld in connection with the grant
or any exercise of this Option. The Recipient understands that the Option granted hereunder does not qualify for favorable tax
treatment under Section 422 of the Internal Revenue Code as an “incentive stock option.”

 

10.           HEIRS
AND SUCCESSORS. This Agreement and all terms and conditions hereof shall be binding upon the Company and its successors and
assigns, and upon Recipient and his or her heirs, legatees and legal representatives.

 

11.           GOVERNING
LAW. This Agreement shall be interpreted, governed, and enforced in accordance with the laws of the Commonwealth of Virginia,
notwithstanding its choice of law principles. The invalidity or unenforceability of any portion hereof shall in no way affect
the validity or enforceability of any other portion of this Agreement, and any portion held to be invalid or unenforceable shall
be deemed modified, restricted, or omitted to the extent necessary to make this Agreement enforceable.

 

IN
WITNESS WHEREOF, the Company has caused this Agreement to be executed by its duly authorized representative and Recipient has
executed this Agreement, all as of the date and year first above written.

 

	ADial
    Pharmaceuticals, LLC	 	Recipient
	 	 	 
	By:	/s/
    William B. Stilley	 	By:	/s/ Tony Goodman
	 	William
    B. Stilley, CEO	 	 	Tony Goodman

  

    	 	4	 

     

    

 

Exhibit
A

 

Option
Exercise Letter

  

_____________,
20__

  

ADial
Pharmaceuticals, L.L.C.

204
E. High St.

Charlottesville,
VA 22902

Attention:
CEO

 

Gentlemen:

 

In
connection with my purchase of ______________ membership units (the “Units”) of ADial Pharmaceuticals, L.L.C., a Virginia
limited liability company (the “Company”) pursuant and subject to the terms and conditions of the option agreement
between me and the Company dated __________________, (the “Option Agreement”) and the Company’s Operating Agreement
of __________________, as amended (the “Operating Agreement”), I am delivering this investment letter. Unless otherwise
defined herein, capitalized terms used in this investment letter shall have the same meanings ascribed to them in the Operating
Agreement.

 

In
connection with my acquisition of Units in the Company, I represent and warrant the following:

 

(1)       I
understand that by virtue of this investment, I will have acquired a Membership Interest in the Company. Furthermore, I acknowledge
that I have received a copy of the Operating Agreement and agree to be bound by the terms and conditions therein.

 

(2)       I
have sufficient knowledge and experience in financial and business matters to be capable of evaluating the merits and risks of
this investment and understand and acknowledge that my rights and privileges with respect to the Units, including, without limitation,
any rights to transfer the Units, are all subject to the provisions of the Articles of Organization and the Operating Agreement
of the Company, as the same may be amended from time to time.

 

(3)       I
understand that this investment involves a high degree of risk because the Company has a limited operating history and that there
is no guarantee of profitability or continued operation of the Company.

 

(4)       I
am acquiring the Units pursuant to the terms of the Option Agreement entered into in connection with my serving as a Director
of the Company. I acknowledge that I am able to bear the economic risk of this investment, and that I might have to hold the Units
for an indefinite period of time, since the Units have not been registered. Furthermore, I acknowledge that I might have to bear
a complete economic loss, in the event that the business does not succeed.

 

(5)       In
making my decision to acquire Units of the Company, I have relied upon independent investigations made by me. I have taken the
opportunity to examine any and all documents and, to the extent I have deemed necessary, to ask pertinent questions and receive
answers, concerning the terms and conditions of my acquisition of such Units or any other matter pertaining to such investment,
and to obtain any additional information necessary to verify the accuracy of the information given to me.

  

    	 	5	 

     

    

 

Exhibit
A

 

(6)       I
understand that the Units will not be registered under the Securities Act of 1933, as amended (the “Act”), and that
the Units that I acquire cannot be sold to any person except pursuant to the terms of the Operating Agreement and in full compliance
with all applicable federal and state securities laws.

 

(7)       I
understand that no federal or state agency has passed upon the Units or made any finding or determination concerning the fairness
of this investment.

 

(8)       I
am acquiring the Units for my own investment account and have no intention, agreement or arrangement to redistribute, divide,
assign or transfer the Units or to sell them to any other person.

 

(9)       I
have reviewed with my own tax advisors the immediate and prospective federal, state, local and foreign tax consequences of this
investment, and I am relying solely on the statements of such advisors and not on the statements or representations of the Company
or any of its agents with respect to such tax consequences or any other matter. I have not relied on any advice given by the Company’s
legal counsel.

 

(10)       I
have adequate net worth and means of providing for my current and future needs and possible contingencies and have no need for
liquidity in this investment. My commitment to investments that are not readily marketable is not disproportionate to my net worth
and my investment in the Units covered by this letter and will not cause my overall commitment to become excessive.

 

(11)       The
foregoing representations and warranties shall survive my acquisition of the Units in the Company, and I agree to indemnify and
hold harmless the Company and its directors, officers, agents and representatives, for and from any and all losses, liabilities,
claims, damages and expenses, including, without limitation, attorneys fees and dispute costs, caused by my breach of any agreement,
representation or warranty contained herein or as a result of the reliance of the Company or any other indemnities on such agreement,
representation or warranty.

 

	 	Sincerely,
	 	 
	 	 
	 	Signature:	 
	 	 
	 	Printed Name:	 

 

    	 	6	 

     

    

 

Exhibit
B

 

ADIAL
PHARMACEUTICALS, L.L.C.

MEMBER
SIGNATURE PAGE

 

In
consideration for the sale of LLC Units in ADial Pharmaceuticals, L.L.C., a Virginia limited liability company (the “LLC”),
by the LLC to the undersigned, the undersigned hereby approves and consents to, and agrees to be bound by, the terms of that certain
operating agreement of the ADial Pharmaceuticals, L.L.C. effective _________________, as may be amended and/or restated from time
to time (the “Operating Agreement”) and concurrently herewith enters into the Operating Agreement with all existing
members of the LLC by executing and delivering to the LLC this Member Signature Page.

 

Upon
the undersigned’s execution and delivery of this Member Signature Page, the undersigned’s delivery of all monies and/or
other items required by management of the LLC, and acceptance of this Member Signature Page by the LLC, the undersigned shall
become a Member of the LLC.

 

If
the undersigned is purchasing LLC Units jointly with another, all such joint owners must execute this Member Signature Page.

 

Effective
Date: ________________, 2017.

  

	Member
        Name:

         

        ______________________________________

         

        Signed:________________________________

        Print:
        _________________________________

        Title
        (if required): ________________________

         

        ____________________________________

        Fed.
        Tax ID/Social Security Number

         

        Address:

         ____________________________________

         ____________________________________

         ____________________________________

         

        Email
        Address:

         

        ___________________________________

        
	Co-Member
        Name (if applicable):

         

        ______________________________________

         

        Signed:
________________________________        

        Print:
__________________________________        

        Title
        (if required): _________________________

         

        ____________________________________

        Fed.
        Tax ID/Social Security Number

         

        Address:

         ______________________________________

         ______________________________________

         ______________________________________

        Email
        Address:

         

         ______________________________________

 

	 	Accepted on behalf of ADial Pharmaceuticals,
    L.L.C.
	 	 	 
	 	By:	
	 	 	William B. Stilley
	 	 	CEO

 

 

7

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