Document:

WWW.EXFILE.COM, INC. -- 888-775-4789 -- ZAP -- EXHIBIT 10.2 TO FORM 8-K

    

    Exhibit
10.2   Subscription Agreement dated June 9, 2009 from The Banks
Development Trust

    

    

    

    SUBSCRIPTION
AGREEMENT

    
      FOR

    

    ZAP

    

    THIS
SUBSCRIPTION AGREEMENT (“Agreement”) is made and entered into by and between
ZAP, a California corporation ("Company”), and the undersigned subscriber(s)
("Investor") who hereby agrees as set forth below.

    

    1.           SUBSCRIPTION.  Investor,
intending to be legally bound, hereby subscribes for:

    

    

    
      	
               
      

            	
              4,000,000
      warrants at $.50

            

    

    
      	
               
      

            	
              4,000,000
      shares at $.25

            

    

    

    

    The
shares are common shares, no par value are referred to as the
“Securities.”  The share certificate(s) representing the Securities
purchase pursuant to the terms of this Agreement shall be delivered concurrent
with the initial payment as provided for in section “j” hereof.

    

    2.           CONDITIONS TO
OFFER.  Investor’s subscription is made subject to the
following terms and conditions:

    

    (a)           The
Company shall have the right to accept or reject this subscription. If the
Company accepts this Subscription, it will execute and redeliver this Agreement
to Investor.

     

    

    
      	
               
      

            	
              (b)

            	
              The
      accuracy and continued accuracy of all representations, warranties and
      agreements of Investor herein, and in the Investor
      Questionnaire.

            

    

    

    3.           RECEIPT OF COMPANY
INFORMATION.   By executing this Subscription Agreement,
Investor hereby acknowledges receiving and reading a copy of the Company’s
Annual Report on Form 10-KSB for the most recent fiscal year, the Definitive
Proxy Statement for the most recent Annual Meeting of Shareholders, Quarterly
Reports on Form 10-QSB filed during the current fiscal year, Current Reports on
Form 8-K filed subsequent to the most recent Quarterly Report on Form 10-QSB, a
description of the Securities being issued to the Investor, the use of the
proceeds being received by the Investor if the Investor is paying cash for the
Securities, and a description of any material changes in the Company’s affairs
that are not disclosed in the documents furnished (collectively, the “Company
Documents”).  Investor understands the special risks in purchasing the
Securities as described in the information provided by the Company, and hereby
acknowledges and agrees that no representations have been made, or if made, will
be relied upon, other than those contained in the documents
furnished.

    

    4.           REPRESENTATIONS AND
WARRANTIES.   By executing the Subscription Agreement,
Investor represents and warrants to the Company that:

    

    (a)           
The Securities are being acquired for Investor’s own account, for investment
purposes 

     

    
      
         

      

      
         

        
          

        

      

      
         

      

    

    only,
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 of 1933, as
amended (“Act”), or the securities laws of any state.

    

    (b)           
Investor understands that the Securities have not been registered under the Act
by reason of issuance in a transaction exempt from the registration requirements
of the Act and that the Securities may not be sold, offered for sale,
transferred, pledged, hypothecated or otherwise disposed of except in compliance
with the Act, that the Company has no intention of registering the Securities
for resale. Investor understands the legal consequences of the foregoing to mean
that the Securities and the economic risk of its investment in the Securities
must be held by Investor for an indefinite period of time.  Investor
cannot transfer the Securities until the later of (1) 6  months from
the date the purchase contemplated by this Agreement is consummated, and (2)
expiration of the restrictions of Rule 144 of the Securities Act of 1933, as
amended.  Investor further understands that the Securities have not
been registered under any state law by reason of their issuance in a transaction
exempt from the registration requirements of state law, and that no federal or
state agency has made any finding or determination as to the fairness of an
investment in, or any recommendation or endorsement of, the
Securities.

    

    (c)
Investor understands that the Securities are “restricted securities” within the
meaning of Rule 144 and that a legend restricting sales or transfers will appear
on any certificates issued to represent such Securities.  Investor
bears the burden to establish the availability of any exemption under Rule 144,
or otherwise, for any transfer which the Investor intends to
make.  Any transferor may be required to furnish an opinion of counsel
satisfactory to the Company that the proposed transfer complies with applicable
federal and state securities laws.

    

    (d)           Investor
and its advisors have been provided with information concerning the Company,
including, without limitation, the Company Documents, and have read the Company
Documents and have been afforded an opportunity to ask such questions of the
Company’s officers and representatives concerning the Company’s property,
business, operations, financial condition, assets, liabilities and other
relevant matters as they have deemed necessary or desirable, and have been given
all such information as has been requested, in order to evaluate the merits and
risks of the prospective investment contemplated herein.  Investor and
its advisors have been provided with full and free access and opportunity to
inspect, There view, examine, and inquire about all books, records, and
information, including financial information, of the Company, its business and
affairs and have made such inspection, review, examination, due diligence and
inquiry as they have deemed appropriate.  Investor has reviewed the
merits and evaluated the risks of the investment with its own tax and legal
counsel to the extent deemed advisable.

    

    (e)           Investor
has such knowledge and experience in financial and business matters, that
Investor is capable of evaluating the merits and risks of the purchase of the
Securities.  Investor understands that the acquisition of the
Securities is a high risk and speculative investment involving the risk of total
loss.

    

    (f)           Investor
has the financial ability to bear the economic risk of its investment, has
adequate means of providing for its current needs and personal contingencies,
and has no need for liquidity with respect to its investment in the
Securities.  Investor's overall commitment to investments, including
the Securities, which are not readily marketable, is not disproportionate to
Investor's net worth.

    

    
      
         

      

      
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    (g)           
INVESTOR HAS RECEIVED AND READ THE COMPANY DOCUMENTS AND FULLY RECOGNIZES THE
RISKS OF INVESTMENT IN THE SECURITIES.  In making Investor's decision
to purchase Securities herein subscribed for, Investor has relied solely upon
independent investigations made by Investor or Investor's investment advisers,
if any, and not solely upon the Company Documents.  Investor
understands that an investment in the Securities involves certain risks and
Investor has taken full cognizance of and understands such risks.

    

    (h)           Each
representation and warranty of Investor contained herein and all information
furnished by Investor to the Company, including the information furnished by
Investor in the Investor Questionnaire, is true correct and complete in all
respects.

    

    

    

               (i)Company
and its officers and directors shall take such actions as may be required by law
to remove the Rule 144 restrictions immediately upon 6 months having elapsed
from the date of purchase of the Securities.  This obligation shall
apply to each the 4,000,000 shares of stock (Securities) being purchased at this
time, as well as to the Securities issued in consideration of the 4,000,000
warrants that are being issued concurrently herewith.  This shall
include, but not be limited to the Company having its legal counsel issue an
opinion letter in form satisfactory to the transfer agent, or such other person
or entity, as may be required, to have the Rule 144 restriction immediately
removed from the Securities such that the same are immediately freely and
without restriction saleable or transferrable by Investor.

    

              (j)
Investor shall pay for the 4,000,000 shares of stock (Securities) in the
following manner: (1) the sum of five hundred thousand dollars upon execution of
this Subscription Agreement and (2) the balance of five hundred thousand dollars
commencing on January 1, 2010 and continuing thereafter on the first day of each
month until fully paid an amount equal to the lesser of (a) one-half of the
general and administrative expenses of the corporation for the preceding
calendar month or (b) the sum of fifty thousand dollars.  Company
warrants and represents that all funds provided for herein with respect to the
purchase of the Securities shall only be used for the Company’s general and
administrative expenses.

    

    The
foregoing representations and warranties are made by Investor, and the
information furnished by Investor in the Investor Questionnaire has been so
furnished, with the intent that the same will be relied upon in determining its
suitability as a purchaser of Securities. Investor undertakes to notify the
Company immediately of any change in any representation or warranty or other
information relating to Investor set forth herein or in the Investor
Questionnaire.  If more than one person is signing this Agreement,
each representation and warranty shall be a joint and several of each such
person.

    

    5.           INDEMNIFICATION.  Investor
hereby agrees to indemnify and hold harmless the Company and all directors,
officers, employees, agents and affiliates from any and all damages, losses,
expenses or costs (including reasonable attorney’s fees) which they may incur by
reason of Investor’s failure to fulfill all of the terms and conditions of this
Subscription Agreement or by reason of Investor’s breach of any of the
representations, warranties or agreements contained in this Subscription
Agreement or in the Investor Questionnaire.  All statements,
representations, warranties or covenants in the indemnification contained in
this Subscription Agreement shall survive the acceptance of this
subscription.

    

    6.           REVOCATION.  Except
to the extent permitted by applicable securities laws, Investor agrees that
Investor shall not cancel, terminate or revoke this Subscription Agreement or
any agreement 

     

    
      
         

      

      
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    hereunder,
and that this Subscription Agreement shall survive Investor’s death, disability,
insolvency and bankruptcy.

    

    7.           APPLICABLE LAW;
VENUE.  This Agreement shall be construed in accordance with
the laws of the State of California and deemed executed in Santa Rosa,
California.  The venue of any action brought upon this Agreement or
with respect to the undersigned’s Securities in the Company or any of the events
surrounding his purchase thereof will be in the state or federal courts situated
in Sonoma County, California to which jurisdiction Investor
consents.  Investor hereby waives his right to trial by jury with
respect to any action referenced in this Section 7.

    

    8.           MISCELLANEOUS
PROVISIONS. This Agreement sets
forth the entire agreement of the parties hereto with respect to the subject
matter hereof, and supersedes all prior oral and written negotiations,
representations, agreements and understandings of the parties.  This
Agreement shall not be amended, altered or modified except by a written
instrument signed by all of the parties hereto.  This Agreement shall
be governed by, construed and enforced in accordance with the internal laws of
the State of California. This Agreement shall be binding upon and inure to the
benefit of the parties hereto and their respective heirs, successors, assigns
and legal representatives.  This Subscription Agreement shall be
effective upon the date of its acceptance and execution by the
Company.

    
 

     

     

     

    
 

    
      
         

      

      
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              ZAP

            

    

    

    
      	
               
      

            	
              INVESTOR
      SIGNATURE/SUBSCRIPTION AGREEMENT

            

    

    

    

    

    The
undersigned has received the Company Documents and has read this entire
Subscription Agreement together with such Company Documents.  This
Subscription Agreement has been executed this 9th day of June, 2009 at Oakland,
CA.

    

    Exact
Name on Investor Account: The Banks Development Trust

    

    

    Signature
:    /s/ Ronald S
Berg                     

    Ronald
S. Berg, Trustee

    

    (This
signature should be that of (i) the Investor(s), or (ii) in the case of a trust,
partnership or corporation, the signature should be that of the representative
of the Investor such as the trustee, general partner or corporate
officer).

    

    

    
      	
              Print
      Name: 

            	
              Ronald
      S. Berg

            

    

    

    
      	
              Print
      Title: 

            	
              Trustee
      of The Banks Development Trust

            

    

     

    
      	
              Address
      Street: 

            	
              Ronald S. Berg, Esq., Berg
      and Berg, L.L.P. Post
      Office Box 8817 Calabasas,
      CA 91372-8817

            

    

    

     

    Agreed
and Accepted:

    ZAP,
a California corporation

    

    

    BY:

    

    Name: Steven
Schneider                           

    Title:
Chief Executive
Officer                   

    

    Date:   June
9, 2009

    

     

    
      
         

      

      
        5WWW.EXFILE.COM, INC. -- 888-775-4789 -- ZAP -- EXHIBIT 10.3 TO FORM 8-K

    Exhibit
10.3   Warrant to Purchase Common Stock dated June 9, 2009 issued
to The Banks Group,LLC

    

    

    THIS WARRANT (THIS “WARRANT”)
AND THE SECURITIES
ISSUABLE UPON EXERCISE OF THIS WARRANT HAVE NOT BEEN REGISTERED UNDER THE
SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES ACT”), OR ANY STATE
SECURITIES LAW, AND MAY NOT BE OFFERED FOR SALE OR SOLD UNLESS A REGISTRATION
STATEMENT UNDER SUCH ACT AND APPLICABLE STATE SECURITIES LAWS SHALL BE EFFECTIVE
WITH RESPECT THERETO, OR AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT
AND APPLICABLE STATE SECURITIES LAWS IS AVAILABLE IN CONNECTION WITH SUCH OFFER
OR SALE. THIS WARRANT AND THE SECURITIES ISSUABLE UPON EXERCISE HEREOF (I) MAY BE PLEDGED OR
HYPOTHECATED IN CONNECTION WITH A BONA FIDE MARGIN LOAN OR OTHER FINANCING
SECURED BY SUCH SECURITIES OR (II) MAY BE TRANSFERRED OR ASSIGNED TO AN
AFFILIATE OF THE HOLDER HEREOF WITHOUT THE NECESSITY OF AN OPINION OF COUNSEL OR
THE CONSENT OF THE ISSUER HEREOF.

     

    

     

    WARRANT

     

    TO
PURCHASE COMMON STOCK

    

    OF

     

    ZAP

     

    

     

    Issue
Date: June 9, 2009 Warrant No. 1

    

    THIS CERTIFIES that The Banks Group
LLC, a California limited liability company or any permitted subsequent holder
hereof (the “Holder”),
has the right to purchase from ZAP, a California corporation (the “Company”),
up to Four Million (4,000,000) fully paid and nonassessable shares of the
Company’s common stock, no par value (the “Common
Stock”), subject to adjustment as provided herein, at a price per share
equal to the Exercise Price (as defined below), at any time and from time to
time beginning on the date on which this Warrant is issued (the “Issue
Date”) and ending at 5:00 p.m., Pacific Standard time, on June 1, 2014
or, if such day is not a Business Day, on the next succeeding Business Day (the
“Expiration
Date”). This Warrant is issued pursuant to a Subscription Agreement,
dated as of June 9, 2009 (the “Securities
Purchase Agreement”).  Capitalized terms used herein and not
otherwise defined shall have the respective meanings set forth in the Securities
Purchase Agreement.

    

    1.           EXERCISE.

    

    (a)           Right to Exercise; Exercise
Price.  The Holder shall have the right to exercise this
Warrant at any time and from time to time during the period beginning on the
Issue Date and ending at 5 p.m., Pacific Standard time, on the Expiration Date
as to all or any part of the shares 

     

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    of Common
Stock covered hereby (the “Warrant
Shares”).  The “Exercise
Price” for each Warrant Share purchased by the Holder upon the exercise
of this Warrant shall be $0.50.

    

    (b)           Exercise
Notice.  In order to exercise this Warrant, the Holder shall
notify the Company at any time prior to 5:00 p.m., Pacific Standard time, on the
Business Day on which the Holder wishes to effect such exercise (the “Exercise
Date”), to the Company an executed copy of the notice of exercise in the
form attached hereto as Exhibit A
(the “Exercise
Notice”) and (ii) in the case of a Cash Exercise (as defined below),
deliver the Exercise Price to the Company by wire transfer of immediately
available funds.  The Holder shall promptly thereafter deliver the
original Warrant to the Company for cancellation (and replacement with a new
Warrant if exercised in part) pursuant to Section
1(d) of this Warrant.  Subject to Section
8(d), the Exercise Notice shall also state
the name or names in which the Warrant Shares issuable on such exercise shall be
issued if other than the Holder.

    

    (c)           Holder of
Record.  The Holder shall, for all purposes, be deemed to have
become the holder of record of the Warrant Shares specified in an Exercise
Notice on the Exercise Date specified therein, irrespective of the date of
delivery of such Warrant Shares. Except as specifically provided herein, nothing
in this Warrant shall be construed as conferring upon the Holder hereof any
rights as a stockholder of the Company prior to the Exercise Date.

    

    (d)           Cancellation of
Warrant.  This Warrant shall be canceled upon its exercise and,
if this Warrant is exercised in part, the Company shall, at the time that it
delivers Warrant Shares to the Holder pursuant to such exercise as provided
herein, issue a new warrant, and deliver to the Holder a certificate
representing such new warrant, with terms identical in all respects to this
Warrant (except that such new warrant shall be exercisable into the number of
shares of Common Stock with respect to which this Warrant shall remain
unexercised); provided,
however, that the Holder shall be entitled to exercise all or any portion
of such new warrant at any time following the time at which this Warrant is
exercised, regardless of whether the Company has actually issued such new
warrant or delivered to the Holder a certificate therefor.

    

    (e)           Stock Splits, Stock
Interests, Etc.  If, at any time on or after the Issue Date,
the number of outstanding shares of Common Stock is increased by a stock split,
stock dividend,  reclassification or other similar event, the Exercise
Price shall be proportionately reduced and the number of shares of Common Stock
shall be proportionately increased such that there shall have been no dilution
to Holder, or if the number of outstanding shares of Common Stock is decreased
by a reverse stock split, combination, reclassification or other similar event,
the Exercise Price shall be proportionately increased. The Company shall notify
the Holder and the Company’s transfer agent of such change.

     

    (1)                 Distributions.  If,
at any time after the Issue Date, the Company declares or makes any distribution
of cash or any other assets (or rights to acquire such assets) to holders of
Common Stock, including without limitation any dividend or distribution to the
Company’s stockholders in shares (or rights to acquire shares) of capital stock
of a subsidiary) (a 

     

    
      
        
        

      

      
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    “Distribution”),
the Company shall deliver written notice of such Distribution (a “Distribution
Notice”) to the Holder at least fifteen (15) days prior to the earlier to
occur of (i) the record date for determining stockholders entitled to such
Distribution (the “Record
Date”) or (ii) the date on which such Distribution is made (the “Distribution
Date”) (the earlier of such dates being referred to as the “Determination
Date”).  Upon receipt of the Distribution Notice, the Holder
shall promptly (but in no event later than three (3) Business Days) notify the
Company whether it has elected (A) to receive the same amount and type of assets
(including, without limitation, cash) being distributed as though the Holder
were, on the Determination Date, a holder of a number of shares of Common Stock
into which this Warrant is exercisable as of such Determination Date (such
number of shares to be determined without giving effect to any limitations on
such exercise) or (B) upon any exercise of this Warrant on or after the
Distribution Date, to reduce the Exercise Price in effect on the Business Day
immediately preceding the Record Date by an amount equal to the fair market
value of the assets to be distributed divided by the number
of shares of Common Stock as to which such Distribution is to be made, such fair
market value to be reasonably determined in good faith by the independent
members of the Company’s Board of Directors.  Upon receipt of such
election notice from the Holder, the Company shall timely effectuate the
transaction or adjustment contemplated herein. Notwithstanding the foregoing, no
adjustment shall be made pursuant to this section if such adjustment would
result in an increase in the Exercise Price.

     

    8.           MISCELLANEOUS.

     

    (a)           Failure to Exercise Rights
not Waiver.  No failure or delay on the part of the Holder in
the exercise of any power, right or privilege hereunder shall operate as a
waiver thereof, nor shall any single or partial exercise of any such power,
right or privilege preclude any other or further exercise thereof. All rights
and remedies of the Holder hereunder are cumulative 

     

    
      
        
        

      

      
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    and not
exclusive of any rights or remedies otherwise available. In the event that the
Company breaches any of its obligations hereunder to issue Warrant Shares or pay
any amounts as and when due, the Company shall bear all costs incurred by the
Holder in collecting such amount, including without limitation reasonable legal
fees and expenses.

     

    (b)           Notices. Any notice,
demand or request required or permitted to be given by the Company or the Holder
pursuant to the terms of this Warrant shall be in writing and shall be deemed
delivered (i) when delivered personally or by verifiable facsimile transmission,
unless such delivery is made on a day that is not a Business Day, in which case
such delivery will be deemed to be made on the next succeeding Business Day,
(ii) on the next Business Day after timely delivery to an overnight courier and
(iii) on the Business Day actually received if deposited in the U.S. mail
(certified or registered mail, return receipt requested, postage prepaid),
addressed as follows:

     

    
    

     

    
      	 	      
              If to the
      Company:

               

              ZAP

              501 Fourth
      Street

              Santa Rosa,
      California  95401

               

               

              If to the
      Holder:

               

              Mr. Jeffrey G.
      Banks, Manager

              P O Box
      10287

              Oakland California
      94610 

            

    

     

     

    and if to
the Holder at the above address and to such address for such party as shall
appear on the signature page of the Securities Purchase Agreement executed by
such party, or as shall be designated by such party in writing to the other
parties hereto in accordance this Section
8(b).

    

    (c)           Amendments and
Waivers.  No amendment, modification or other change to, or
waiver of any provision of, this Warrant or any other Warrant may be made unless
such amendment, modification or change, or request for waiver, is (A) set forth
in writing and is signed by the Company and Holder and (B) applied to all of the
Warrants.  Upon the satisfaction of the conditions described in (A)
and (B), this Warrant shall be deemed to incorporate the amendment,
modification, change or waiver effected thereby as of the effective date
thereof.

     

    
      
         

      

      
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    (d)           Transfer of
Warrant.  The Holder may sell, transfer or otherwise dispose of
all or any part of this Warrant (including without limitation pursuant to a
pledge) to any person or entity as long as such sale, transfer or disposition is
the subject of an effective registration statement under the Securities Act of
1933, as amended, and applicable state securities laws, or is exempt from
registration thereunder, and is otherwise made in accordance with the applicable
law and applicable provisions of the Securities Purchase
Agreement.  From and after the date of any such sale, transfer or
disposition, the transferee hereof shall be deemed to be the holder of the
portion of this Warrant acquired by such transferee, and the Company shall, as
promptly as practicable, issue and deliver to such transferee a new Warrant
identical in all respects to this Warrant, in the name of such transferee. The
Company shall be entitled to treat the original Holder as the holder of this
entire Warrant unless and until it receives written notice of the sale, transfer
or disposition hereof.   Company and its officers and directors
shall take such action as may be required by law to remove the Rule 144
restrictions, if any, immediately upon six months having elapsed from the
Exercise Date.  This obligation shall apply to all, or any part, of
the Common Stock purchased by Holder pursuant to the terms of this
Warrant.  This shall include, but not be limited to, the Company
having legal counsel issue an opinion letter in form satisfactory to the
transfer agent, or such other person or entity, as may be required by law, to
have the Rule 144 restriction immediately removed from the Common Shares such
that the same are immediately freely and without restriction saleable or
transferable by Holder.

     

    (e)           Lost or Stolen
Warrant.  Upon receipt by the Company of evidence of the loss,
theft, destruction or mutilation of this Warrant, and (in the case of loss,
theft or destruction) of indemnity or security reasonably satisfactory to the
Company, and upon surrender and cancellation of this Warrant, if mutilated, the
Company shall execute and deliver to the Holder a new Warrant identical in all
respects to this Warrant.

     

    (f)           Governing
Law.  This Warrant shall be governed by and construed in
accordance with the laws of the State of California applicable to contracts made
and to be performed entirely within the State of California.

     

    (g)           Successors and
Assigns.  The terms and conditions of this Warrant shall inure
to the benefit of and be binding upon the respective successors (whether by
merger or otherwise) and permitted assigns of the Company and the Holder. The
Company may not assign its rights or obligations under this Warrant except as
specifically required or permitted pursuant to the terms hereof.

     

    
 

    
      
         

      

      
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    [Signature
Page to Follow]

    

    

    

    

    

    

    

    

    
 

    
      
         

      

      
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    IN
WITNESS WHEREOF, the Company has duly executed and delivered this Warrant as of
the Issue Date.

    

    

    

     

    
      	 	      
              ZAP

              

              

              By
      /s/    
      Steven
      Schneider                    
      

              Steven
      Schneider

              CEO 

            

    

     

    

    

    
      
         

      

      
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    EXHIBIT A to
WARRANT

    

    EXERCISE
NOTICE

    

    

    The undersigned Holder hereby
irrevocably exercises the right to purchase   of the shares
of Common Stock (“Warrant Shares”) of
ZAP evidenced by the attached Warrant (the “Warrant”).  Capitalized
terms used herein and not otherwise defined shall have the respective meanings
set forth in the Warrant.

    

    1.           Form
of Exercise Price.  The Holder intends that payment of the Exercise
Price shall be made as:

    

    ______ a Cash Exercise with
respect to _________________ Warrant Shares; and/or

    

    ______ a Cashless Exercise
with respect to _________________ Warrant Shares, as permitted by the attached
Warrant.

    

    2.           Payment
of Exercise Price.  In the event that the Holder has elected a Cash
Exercise with respect to some or all of the Warrant Shares to be issued pursuant
hereto, the Holder shall pay the sum of $________________ to the Company in
accordance with the terms of the Warrant.

    

    

    Date:
______________________

    

    

    ___________________________________

    Name of Registered Holder

    

    By:  _______________________________

           Name:

           Title:

    

    

    

    Holder Requests Delivery to
be made: (check one)

    

    
      	
              

            	
              By
      Delivery of Physical Certificates to the Above
  Address

            

    

    

    
      	
              

            	
              Through
      Depository Trust Corporation

            

    

    (Account  )

     

     

    
      
         

      

      
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