Document:

SUBSCRIPTION AGREEMENT

 

This
SUBSCRIPTION Agreement (this “Agreement”) is made as of May 23, 2013 by and between CNS Response, Inc.,
a Delaware corporation (the “Company”), and the investor listed on Schedule A hereto (each, an “Investor”
and together, the “Investors”).

 

Agreement

 

In consideration for
the mutual promises and covenants herein, the parties agree as follows:

 

WHEREAS, the Company
is offering in a private placement up to $2.0 million of its common stock, par value $.0001 per share (“Shares”
or “Common Stock”) for $.25 per share in a private placement to accredited investors pursuant to a Confidential
Offering Memorandum dated May 23, 2013; and

 

WHEREAS, the undersigned
desires to subscribe for and purchase the number of Shares set forth on Schedule A hereto.

 

Section
1 – Purchase and Sale of SHARES

 

1.1Purchase
and Sale of Shares. The Company has authorized the issuance and sale, in accordance
with the terms hereof, of shares of Common Stock, in the aggregate amount of up to $2,000,000 (the “Shares
Cap Amount”). On the terms and subject to the conditions set forth in this Agreement, at
the Closings (as defined below), the Company agrees to issue to each Investor, and the Investor agrees to purchase from the Company,
in the amount set forth on Schedule A.
The Company will sell Shares to more than one Investor, each of whom will enter into Subscription Agreement substantially identical
to this one. The financing pursuant to which the Company is issuing the Shares is hereinafter referred to as the “Financing”.

 

1.2Closings.

 

(a)Initial
Closing. The initial purchase and sale of the Shares shall take place at a closing (the “Initial Closing”)
which shall take place remotely via exchange of documents and signatures at 10:00 a.m. Eastern Time on the business day immediately
following execution and delivery of this Agreement, or at such other place and time as may be agreed to among the Company and the
Investors. At the Initial Closing, the Company shall deliver to each of the Investors purchasing Securities for cash at such closing
a certificate or certification representing such number of Shares as is set forth opposite such Investor’s name on Schedule
A under the column entitled “Purchase Price (Initial Closing)” against receipt of a check subject to collection
or a wire transfer in immediately available funds of the purchase price, to an account designated by the Company. 

 

(b)Additional
Closings. The Company shall have the right, on one or more occasions, to hold additional closings (each, an “Additional
Closing”, and collectively with the Initial Closing, the “Closings”,
and individually, a “Closing”), pursuant to which it shall have the right
to issue and sell additional Shares to additional Investors or existing Investors (provided that no Additional Closings shall take
place later than September 16, 2013). At each Additional Closing, the Company shall deliver to each Investor purchasing Shares
at such closing a certificate or certification representing such number of Shares as is in set forth opposite such Investor’s
name on Schedule A under the column entitled “Purchase Price” against
receipt of a check subject to collection or a wire transfer in immediately available funds of the purchase price, to an account
designated by the Company. By receiving Shares at an Additional Closing, each Investor so receiving Shares thereby represents that
its representations and warranties contained in Section 3 are true and correct as of the date of such Additional Closing. The aggregate
principal amount of Shares that may be issued at Closings hereunder shall, in no event exceed the Share Cap Amount.

 

    	 

    	 

    

 

The obligation of each
Investor to purchase and pay cash for the Shares to be delivered at a Closing is, unless waived by such Investor, subject to the
condition that the Company’s representations and warranties contained in Section 2 are true, complete and correct on and
as of such Closing date. The obligation of the Company to sell and issue Shares to be delivered at a Closing is, unless waived
by the Company, subject to the condition that the relevant Investor’s representations and warranties contained in Section
3 are true, complete and correct on and as of the Closing Date.

 

 

Section
2 - Representations and Warranties

of
the Company

 

The Company represents
and warrants to each Investor as follows:

 

2.1Existence
of Company. The Company is a duly organized Delaware corporation. The Company is validly existing in all jurisdictions where
it conducts its business.

 

2.2Authority to Execute.
The execution, delivery and performance by the Company of this Agreement and the issuance of the Shares are within the Company’s
corporate powers, have been duly authorized by all necessary corporate action, do not and will not conflict with any provision
of law or organizational document of the Company (including its Certificate of Incorporation or Bylaws) or of any agreement or
contractual restrictions binding upon or affecting the Company or any of its property and need no further stockholder or creditor
consent.

 

2.3No Stockholder
Approval Required. No approval of the Company’s stockholders is required for (i) the entry by the Company into this Agreement,
or (ii) the issuance of the Shares contemplated by this Agreement.

 

2.4Valid Issuance.
The Shares will be, validly issued, fully paid and nonassessable and free of restrictions on transfer other than restrictions on
transfer under, applicable state and federal securities laws and liens or encumbrances created by or imposed by the Investor. Assuming
the accuracy of the representations of the Investor in Section 3 of this Agreement, and the Shares will be issued in compliance
with all applicable federal and state securities laws.

 

    	2

    	 

    

 

2.5Binding
Obligation. This Agreement is, a valid and binding obligation of the Company enforceable against the Company in accordance
with its terms, subject, as to enforcement of remedies, to applicable bankruptcy, insolvency, moratorium, reorganization and similar
laws affecting creditors’ rights generally and to general equitable principles.

 

2.6Litigation.
Other than the litigation disclosed in the Company’s most recent SEC Reports (as defined below), no litigation or governmental
proceeding is pending or threatened against the Company which may have a materially adverse effect on the financial condition,
operations or prospects of the Company, and to the knowledge of the Company, no basis therefore exists.

 

2.7Intellectual
Property. To the best of the Company’s knowledge, the Company owns or possesses sufficient legal rights to all patents,
trademarks, service marks, trade names, copyrights, trade secrets, licenses, information and other proprietary rights and processes
necessary for its business as now conducted and as presently proposed to be conducted, without any known infringement of the rights
of others. There are no outstanding options, licenses or agreements of any kind relating to the foregoing proprietary rights, nor
is the Company bound by or a party to any options, licenses or agreements of any kind with respect to the patents, trademarks,
service marks, trade names, copyrights, trade secrets, licenses, information and other proprietary rights and processes of any
other person or entity other than such licenses or agreements arising from the purchase of “off the shelf” or standard
products.

 

2.8SEC Reports.The
Company has filed all forms, reports, schedules, proxy statements, registration statements and other documents (including all exhibits
thereto) required to be filed by it with the Securities and Exchange Commission (the “SEC”) pursuant to the
federal securities laws and the SEC rules and regulations thereunder, together with all certifications required pursuant to the
Sarbanes-Oxley Act of 2002 (the “Sarbanes-Oxley Act”) (as they have been amended since the time of their filing,
including all exhibits thereto, the “SEC Reports”). Each of the SEC Reports complied in all material respects
with the applicable requirements of the Securities Act of 1933, as amended (the “Securities Act”) and the Securities
Exchange Act of 1934, as amended (the “Exchange Act”), the Sarbanes-Oxley Act and the rules and regulations
of the SEC under all of the foregoing. None of the SEC Reports contained any untrue statement of a material fact or omitted to
state a material fact required to be stated therein or necessary in order to make the statements therein, in light of the circumstances
under which they were made, not misleading.

 

Section
3 - Representations and Warranties

of
the Investors

 

Each Investor represents
and warrants to the Company as follows:

 

3.1Authorization;
Binding Obligations. The Investor has full power and authority to enter into this Agreement and this Agreement constitutes
a valid and legally binding obligation of the Investor, enforceable against the Investor in accordance with its terms, subject,
as to enforcement of remedies, to applicable bankruptcy, insolvency, moratorium, reorganization and similar laws affecting creditors’
rights generally and to general equitable principles.

 

    	3

    	 

    

 

3.2Accredited
Investor. The Investor is an “accredited investor” within the meaning of SEC Rule 501 of Regulation D promulgated
under the Securities Act.

 

3.3Investment
for Own Account. The Shares are being acquired for his, her or its own account, for investment and not with a view to, or for
resale in connection with, any distribution or public offering thereof within the meaning of the Securities Act.

 

3.4Knowledge
and Experience. The Investor has such knowledge and experience in financial and business matters that (s)he is capable of evaluating
the merits and risks of an investment in the Shares and of making an informed investment decision with respect thereto, has the
ability and capacity to protect his/her interests and can bear the economic risk of the acceptance of the Shares, including a total
loss of his/her investment.

 

3.5 Opportunity
to Ask Questions. The Investor has had the opportunity to ask questions and receive answers from the Company or any authorized
person acting on its behalf concerning the Company and its business and to obtain any additional information, to the extent possessed
by the Company (or to the extent it could have been acquired by the Company without unreasonable effort or expense) necessary to
verify the accuracy of the information received by the Investor. In connection therewith, the Investor acknowledges that (s)he
has had the opportunity to discuss the Company’s business, management and financial affairs with the Company’s management
or any authorized person acting on its behalf.

 

3.6.Receipt
of Information. The Investor has received and reviewed all the information concerning the Company, the Securities and the Shares,
both written and oral, that the Investor desires. Without limiting the generality of the foregoing, the Investor has been furnished
with or has had the opportunity to acquire, and to review: all information, both written and oral, that the Investor desires with
respect to the Company’s business, management, financial affairs and prospects. In determining whether to make this investment,
the Investor has relied solely on his/her own knowledge and understanding of the Company and its business and prospects based upon
the Investor’s own due diligence investigations and the Company’s filings with the SEC.

 

Section
4 - Miscellaneous

 

4.1No Waiver;
Cumulative Remedies. No failure or delay on the part of any party to this Agreement in exercising any right or remedy under,
or pursuant to, this Agreement shall operate as a waiver thereof, nor shall any single or partial exercise of any such right, remedy
or power preclude other or further exercise thereof, or the exercise of any other right, remedy or power. The remedies in this
Agreement are cumulative and are not exclusive of any remedies provided by law.

 

4.2Amendments
and Waivers. Except as otherwise expressly set forth in this Agreement, any term of this Agreement may be amended (either retroactively
or prospectively) with the written consent of the Company and the Investor. Any amendment effected in accordance with this Section
4.2 shall be binding upon each Investor, each future holder of Securities and the Company.

 

    	4

    	 

    

 

4.3Notices,
Etc. All notices, requests, consents and other communications hereunder to any party shall be deemed to be sufficient if contained
in a written instrument delivered in person; sent by facsimile transmission; sent by electronic mail; duly sent by first class
registered or certified mail, return receipt requested, postage prepaid; or duly sent by overnight delivery service (e.g.,
Federal Express) addressed to such party (i) if to the Company, at the address, fax number or electronic mail address, as applicable,
set forth on the signature page hereof or (ii) if to an Investor, at the address, fax number or electronic mail address, as applicable,
set forth on Schedule A hereto, or at such other address, fax number or electronic mail address as may hereafter be designated
in writing by the addressee to the sender. All such notices, advises and communications shall be deemed to have been received:
(a) in the case of personal delivery, on the date of such delivery; (b) in the case of facsimile or electronic mail transmission,
on the date of transmission; and (c) in the case of mailing or delivery by service, on the date of delivery as shown on the return
receipt or delivery service statement.

 

4.4Governing
Law. This Agreement shall be governed by and construed in accordance with the laws of the State of California, without regard
to the conflicts of law provisions of the State of California or of any other state. The Company and each Investor consent to personal
jurisdiction in Orange County, California.

 

4.5Severability.
If any term in this Agreement is held to be illegal or unenforceable, the remaining portions of this Agreement shall not be affected,
and this Agreement shall be construed and enforced as if this Agreement did not contain the term held to be illegal or unenforceable.

 

4.6Binding Effect.
This Agreement shall be binding upon and inure to the benefit of the Company and each Investor and their respective successors
and assigns.

 

4.7Transfer
of Shares. Notwithstanding the legend required to be placed on the Shares by applicable law, no registration statement or opinion
of counsel shall be necessary: (a) for a transfer of Shares to the respective estate of each Investor or for a transfer of Shares
by gift, will or intestate succession of each Investor to his or her spouse or to the siblings, lineal descendants or ancestors
each Investor or his or her spouse, if the transferee agrees in writing to be subject to the terms hereof to the same extent as
if he or she were the original Investor hereunder; or (b) for a transfer of Shares pursuant to SEC Rule 144 or any successor rule,
or for a transfer of Shares pursuant to a registration statement declared effective by the SEC under the Securities Act relating
to the Securities.

 

4.8Survival
of Representations, Warranties and Covenants. The representations and warranties of the parties contained in or made pursuant
to this Agreement shall survive the execution and delivery of this Agreement indefinitely, and shall in no way be affected by any
investigation of the subject matter thereof made by or on behalf of the other parties. The covenants of the parties contained in
or made pursuant to this Agreement shall survive the execution and delivery of this Agreement until such time as the Notes have
been paid in full.

 

4.9California
Commissioner of Corporations. THE SALE OF THE SECURITIES WHICH ARE THE SUBJECT OF THIS AGREEMENT HAS NOT BEEN QUALIFIED WITH
THE COMMISSIONER OF CORPORATIONS OF THE STATE OF CALIFORNIA AND THE ISSUANCE OF THE SECURITIES OR PAYMENT OR RECEIPT OF ANY PART
OF THE CONSIDERATION FOR SUCH SECURITIES PRIOR TO THE QUALIFICATION IS UNLAWFUL, UNLESS THE SALE OF SECURITIES IS EXEMPT FROM QUALIFICATIONS
BY SECTION 25100, 25102 OR 25105 OF THE CALIFORNIA CORPORATIONS CODE. THE RIGHTS OF ALL PARTIES TO THIS AGREEMENT ARE EXPRESSLY
CONDITIONED UPON SUCH QUALIFICATION BEING OBTAINED, UNLESS THE SALE IS SO EXEMPT.

 

[Remainder of Page Intentionally Left
Blank]

 

    	5

    	 

    

  

IN WITNESS WHEREOF,
the parties hereto have caused this Agreement to be duly executed and delivered by their proper and duly authorized officers as
of the date first written above.

 

 

	 	CNS RESPONSE, INC. 
	 	 	 
	 	 	 
	 	By:	 
	 	 	Name: Paul Buck
	 	 	Title:   Chief Financial Officer
	 	 	 
	Address/Fax Number/E-mail Address for Notice:	 	 
	 	 	 
	85 Enterprise, Suite 410	 	 
	Aliso Viejo, CA 92656	 	 
	Fax: (866) 867 4446	 	 
	pbuck@cnsresponse.com	 	 
	 	 	 
	 	 	 
	 	 	INVESTOR:
	 	 	 
	 	 	 
	 	By:	 
	 	 	Name:
	 	 	 
	 	 	 
	 	 	Title: 

 

[SIGNATURE PAGE TO SUBSCRIPTION AGREEMENT]

 

    	 

    	 

    

SCHEDULE A

 

	Name, Address, Fax Number, E-Mail Address and Tax ID Number of Investor 	
        Aggregate Purchase Price 

         

	
         

         

        Name:_________________________________

         

        Address:_______________________________

         

        ______________________________________

         

        Fax:__________________________________

         

        Email:_________________________________

         

        Tax ID:________________________________

         
	
         

         

         

        $______________________

	TOTAL:CNS RESPONSE, INC. 

OMNIBUS AMENDMENT TO

 

SECURED CONVERTIBLE PROMISSORY NOTES
(THE “OCTOBER 2010 NOTES”) ISSUED IN THE AGGREGATE PRINCIPAL AMOUNT OF $3.0239 MILLION PURSUANT TO THE NOTE AND WARRANT
PURCHASE AGREEMENT DATED AS OF OCTOBER 1, 2010 BY AND BETWEEN THE COMPANY AND THE INVESTORS SIGNATORY THERETO

 

SECURED CONVERTIBLE PROMISSORY NOTES
(THE “JANUARY 2011 NOTES”) ISSUED IN THE AGGREGATE PRINCIPAL AMOUNT OF $2.5 MILLION PURSUANT TO THE NOTE AND WARRANT
PURCHASE AGREEMENT DATED AS OF JANUARY 11, 2011 BY AND BETWEEN THE COMPANY AND THE INVESTORS SIGNATORY THERETO

 

SECURED CONVERTIBLE PROMISSORY NOTES
(THE “OCTOBER 2011 NOTES”) ISSUED IN THE AGGREGATE PRINCIPAL AMOUNT OF $2.0 MILLION PURSUANT TO THE AMENDED AND RESTATED
NOTE AND WARRANT PURCHASE AGREEMENT DATED AS OF NOVEMBER 11, 2011 BY AND BETWEEN THE COMPANY AND THE INVESTORS SIGNATORY THERETO

 

UNSECURED CONVERTIBLE PROMISSORY NOTE
(THE “FEBRUARY 2012 NOTE”) ISSUED IN THE AGGREGATE PRINCIPAL AMOUNT OF $90,000 ON FEBRUARY 29, 2012

 

This Omnibus Amendment
(the “Amendment”) to the convertible notes identified above (as previously amended, the “Prior Notes”),
is made as of August 12, 2013 (the “Effective Date”) by and among CNS Response, Inc., a Delaware company (the “Company”)
and the other parties listed on the signature pages hereto (the “Note Holders”). All capitalized terms set forth herein
shall have the meanings given to such terms in the Prior Notes, unless otherwise defined herein. The holders of the Prior Notes
are referred to herein as the “Note Holders.”

 

RECITALS

 

A. The Company and
the Note Holders are parties to one or more note and warrant purchase agreements identified above (the “Prior Purchase Agreements”).

 

B. The Company and
certain of the Note Holders subsequently entered into conversion agreements in June 2011, May 2012 and June 2012 with respect to
such holders’ Prior Notes.

 

C. The Company and
a majority in aggregate principal amount outstanding of each class of Prior Notes identified above entered into an Amended and
Restated Consent, Note Amendment and Warrant Forfeiture Agreement, dated as of October 24, 2012 (the “October 2012 Agreement”),
pursuant to which, among other matters, the maturity date of the Prior Notes was extended to October 1, 2013, the conversion price
of the Prior Notes was set at $1.00, subject to adjustment as provided in the Prior Notes, the full ratchet anti-dilution provision
was removed from the terms of the Prior Notes and the warrants issued in connection therewith, the Note Holders agreed to the termination
and cancellation of the common stock purchase warrants (the “Warrants”) received in connection with the Prior Purchase
Agreements, and the Note Holders consented to a new issuance of convertible notes (the October 2012 Notes) and to subordinate their
security interests to that of the holders of such new notes.

 

D. The Company and
the Note Holders desire to temporarily amend provisions of the Prior Notes regarding the conversion of the Notes, and the Note
Holders desire to consent to related matters.

 

    	 

    	 

    

 

E. The Company and
the Note Holders desire to amend provisions of the Prior Notes to extend the Maturity Date (as defined in the Prior Notes).

 

F. Each class of Prior
Notes may be amended only upon the written consent of the Company and the holders of at least the majority in aggregate principal
amount outstanding of the notes of such class and the holders of a majority of each class, where appropriate, intend to take action
to require the conversion of all notes in each such class.

 

AGREEMENT

 

In consideration of the mutual promises
contained herein and other good and valuable consideration, receipt of which is hereby acknowledged, the Company agrees on behalf
of themselves and as holders of a majority in aggregate principal amount outstanding of each class of the Prior Notes, as follows:

 

1. Amendment of Prior Notes to lower
Conversion Price Temporarily. Section 6(b) of the Prior Notes is hereby amended to change the conversion price of the Prior
Notes from $1.00 to $0.25, subject to adjustment as provided in the terms of the Prior Notes, for a period of 30 days commencing
on July 10, 2013 (the “Offer Period”), as set forth in the Offer Letter to All Holders of $1.00 Convertible Notes to
Convert such $1.00 Notes and Interest Thereon Into Shares of Common Stock of CNS Response, Inc., dated July 10, 2013 sent by the
Company to the Note Holders, in substantially the form attached hereto as Exhibit A (the “Offer Letter”).

 

2. Amendment of Prior Notes to Extend
Maturity Date. Subsection (i) of the first paragraph of each Prior Note is hereby amended and restated in its entirety to read
as follows:

 

“(i) the maturity
date of October 1, 2014,”

 

3. Consent of Note Holders. The
Note Holders hereby affirm, consent to and ratify (i) the automatic conversion of all Prior Notes not then converted, at a conversion
price of $0.25, subject to adjustment as provided in the terms of the Prior Notes, with the effective date of such conversion being
August 9, 2013 and (ii) all actions previously taken by a majority in aggregate principal amount outstanding of each class of Prior
Notes and Warrants under the October 2012 Agreement.

 

4. No Other Amendments. Except as
expressly set forth above, all of the terms and conditions of the Prior Notes remain in full force and effect.

 

5. Representations
and Warranties of Note Holders. Each Note Holder hereby acknowledges, represents and warrants to the Company as follows:

 

Authority.
Each Note Holder has, as appropriate, full power and legal capacity and all corporate right, power, legal capacity and authority
to enter into this Amendment. The execution, delivery and performance of this Amendment has been duly and validly approved and
authorized by each Note Holder.

 

Acknowledgment
of Receipt of Offer Letter, Annual Report and Quarterly Report. Each Note Holder acknowledges receipt of the Offer
Letter, the Company’s annual report on Form 10-K for the year ended September 30, 2012 and the Company’s quarterly
report on Form 10-Q for the quarter ended March 31, 2013.

 

Accredited Investor.
Each Note Holder is an “accredited investor” within the meaning of SEC Rule 501 of Regulation D promulgated under the
Securities Act.

 

Investment for
Own Account. The shares of the Common Stock to be issued upon conversion of the Prior Notes in accordance herewith and
with the Offer Letter are being, and will be, acquired for his, her or its own account, for investment and not with a view to,
or for resale in connection with, any distribution or public offering thereof within the meaning of the Securities Act.

 

    	-2-

    	 

    

 

No Registration.
Each Note Holder understands that the shares of the Company common stock (the “Common Stock”) to be issued upon conversion
of the Prior Note(s) in accordance herewith and with the Offer Letter have not been registered under the Securities Act of 1933,
as amended (the “Securities Act”) on the ground that the issuance thereof is exempt under Section 4(2) of the Act and/or
Regulation D as a transaction by an issuer not involving any public offering and that, in the view of the Securities and Exchange
Commission (“SEC”), the statutory basis for the exception claimed would not be present if any of the representations
and warranties of the Note Holder contained in this Amendment were untrue or, notwithstanding the Note Holder’s representations
and warranties, the Note Holder currently had in mind acquiring any of such shares of Common Stock for resale upon the occurrence
or non-occurrence of some predetermined event.

 

Knowledge and
Experience. Each Note Holder has such knowledge and experience in financial and business matters that (s)he is capable
of evaluating the merits and risks of an investment in the shares of Common Stock and of making an informed investment decision
with respect thereto, has the ability and capacity to protect his/her interests and can bear the economic risk of the acceptance
of the shares of Common Stock, including a total loss of his/her investment.

 

Speculative Investment.
Each Note Holder acknowledges that an investment in the shares of Common Stock underlying the Prior Notes is speculative and involves
a high degree of risk and that such Note Holder can bear the economic risk of the acceptance of such shares, including a total
loss of his, her or its investment. Each Note Holder recognizes and understands that no federal, state, or other agency has recommended
or endorsed the conversion of the Prior Notes and issuance of the underlying Common Stock.

 

Opportunity to
Ask Questions. Each Note Holder has had the opportunity to ask questions and receive answers from the Company or
any authorized person acting on its behalf concerning the Company and its business and to obtain any additional information, to
the extent possessed by the Company (or to the extent it could have been acquired by the Company without unreasonable effort or
expense) necessary to verify the accuracy of the information received by each such Note Holder. In connection therewith, each Note
Holder acknowledges that (s)he has had the opportunity to discuss the Company’s business, management and financial affairs
with the Company’s management or any authorized person acting on its behalf.

 

Receipt of Information.
Each Note Holder has received and reviewed all the information concerning the Company, the Prior Notes and the shares of Common
Stock underlying such Prior Notes, both written and oral, that the Note Holder desires. Without limiting the generality of the
foregoing, the Note Holder has been furnished with or has had the opportunity to acquire, and to review: all information, both
written and oral, that the Note Holder desires with respect to the Company’s business, management, financial affairs and
prospects. In determining whether to make this investment, the Note Holder has relied solely on his/her own knowledge and understanding
of the Company and its business based upon the Note Holder’s own due diligence investigations and the Company’s filings
with the SEC.

 

Stop Transfer
Instructions. Because of the legal restrictions imposed on resale or transfer of the Common Stock underlying the
Prior Notes, each Note Holder understands that the Company shall have the right to note stop-transfer instructions in its records,
and each Note Holder has been informed of the Company’s intention to do so. Any sales, transfers, or other dispositions of
such shares of Common Stock by the Note Holder, will be made in compliance with the Act and any other applicable securities laws,
and all applicable rules and regulations promulgated thereunder and the terms of this Amendment.

 

    	-3-

    	 

    

 

6. Release. Each Note Holder hereby
releases and forever discharges the Company and its predecessors, successors, assigns and each of them, and each past, present,
and future director, partner, subsidiary, division or entity or affiliated corporation, and each past, present or future employee,
agent, representative, attorney, accountant, officer, director, stockholder, subscriber, and all persons acting by, through, under
or in concert with them, or any of them, of and from any and all claims, actions, causes of action, suits, debts, liens, demands,
contracts, liabilities, agreements, costs, expenses, or losses of any type, whether known or unknown, fixed or contingent, which
such Note Holder had, now has, or may hereafter have, arising out of or resulting from issuance of the Prior Notes and Warrants
under the Prior Purchase Agreements and all amendments, modifications, terminations and cancellations thereof, or the shares of
capital stock of the Company otherwise issuable upon conversion of the Prior Notes or exercise of the Warrants, including, without
limitation, any such claims and other rights related to or arising from any promise, guaranty or grant (oral or written) by the
Company to be issued or otherwise acquire or receive an equity interest in the Company, including but not limited to: (i) all claims
to any equity interest in the Company other than as provided for herein, (ii) any and all claims with respect to rights of notice
under the Prior Notes or applicable law, other than as provided for herein, effective at such time as the Prior Notes have been
converted.

 

7. Governing Law. This Amendment
will be governed by and construed in accordance with the laws of the State of Delaware, regardless of the laws that might otherwise
govern under applicable principles of conflicts of law.

 

8. Counterparts. This Amendment
may be executed in any number of counterparts, each of which when so executed and delivered will be deemed an original, and all
of which together shall constitute one and the same instrument.

 

9. Facsimile and Electronic Signatures.
This Amendment may be executed and delivered by facsimile or electronic transmission and upon such delivery the facsimile or electronic
signature will be deemed to have the same effect as if the original signature had been delivered to the other party. The original
signature copy shall be subsequently delivered to the other parties. The failure to deliver the original signature copy and/or
the non-receipt of the original signature copy shall have no effect upon the binding and enforceable nature of this Amendment.

 

[SIGNATURE PAGES FOLLOW]

 

    	-4-

    	 

    

  

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

	 	
        CNS Response, Inc. 

         

         

        By:______________________

        Name: 

        Title:

 

(1) Interest will continue to accrue through to the end of
the offer period and will be converted.

	
        Holders of Prior Notes

        and Address of Holders:
	Class of Existing Notes	
        Aggregate Principal Amount(s)

        $
	
        Accrued and unpaid interest at June 30,
        2013 (1)

        $
	Number of Shares of Common Stock Issuable Upon  Conversion of Principal and Interest
	
         

         

        By:

        ____________________________________________

         
	 	 	 	 
	
         

        By:

        ____________________________________________

         
	 	 	 	 
	
         

         

        By:

        ____________________________________________

         

        
	 	 	 	 
	Grand Total				

 

    	-5-

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