Document:

Exhibit
10.2

 

INDEMNIFICATION
AGREEMENT

 

THIS
INDEMNIFICATION AGREEMENT (the “Agreement”), dated as of , 20 , is entered into by and between PainReform
Ltd., an Israeli company whose address is 60C Medinat Hayehudim Herzliya, 4676670, Israel (the “Company”),
and the undersigned Director or Officer of the Company whose name appears on the signature page attached hereto (the “Indemnitee”).

 

		WHEREAS,	Indemnitee
                                         is an Office Holder (“Nosse Misra”), as such term is defined in the
                                         Companies Law, 5759—1999, as amended (the “Companies Law” and
                                         “Office Holder” respectively), of the Company;

 

		WHEREAS,	both
                                         the Company and Indemnitee recognize the increased risk of litigation and other claims
                                         being asserted against Office Holders of companies and that highly competent persons
                                         have become more reluctant to serve corporations as directors and officers or in other
                                         capacities unless they are provided with adequate protection through insurance or adequate
                                         indemnification against inordinate risks of claims and actions against them arising out
                                         of their service to, and activities on behalf of, companies;

 

		WHEREAS,	the
                                         Amended and Restated Articles of Association of the Company (the “Articles”)
                                         authorize the Company to indemnify and advance expenses to its Office Holders and provide
                                         for insurance and exculpation to its Office Holders, in each case, to the fullest extent
                                         permitted by applicable law, and this Agreement is provided to Indemnitee in accordance
                                         with applicable law, the Articles and all requisite corporate approvals;

 

		WHEREAS,	the
                                         Company has determined that (i) the increased difficulty in attracting and retaining
                                         competent persons is detrimental to the best interests of the Company’s shareholders
                                         and that the Company should act to assure such persons that there will be increased certainty
                                         of such protection in the future, and (ii) it is reasonable, prudent and necessary for
                                         the Company contractually to obligate itself to indemnify, and to advance expenses on
                                         behalf of, such persons to the fullest extent permitted by applicable law, so that they
                                         will serve or continue to serve the Company free from undue concern that they will not
                                         be so indemnified;

 

		WHEREAS,	the
                                         Company acknowledges that Indemnitee is relying on the obligations of the Company set
                                         forth in this Agreement in agreeing to serve the Company, which obligations are therefore
                                         irrevocable; and

 

		WHEREAS	,
                                         in recognition of Indemnitee’s need for substantial protection against loss
                                         arising from the Indemnitee’s liability, including costs and expenses incurred
                                         by the Indemnitee due to his or her position as an Office Holder, in order to assure
                                         Indemnitee’s continued service to the Company in an effective manner and, in part,
                                         in order to provide Indemnitee with specific contractual assurance that the indemnification,
                                         insurance and exculpation afforded by the Articles will be available to Indemnitee, the
                                         Company wishes to undertake in this Agreement for the indemnification of and the advancing
                                         of expenses to Indemnitee to the fullest extent permitted by applicable law and as set
                                         forth in this Agreement and provide for insurance and exculpation of Indemnitee as set
                                         forth in this Agreement.

 

     

     

    

 

NOW,
THEREFORE, the parties hereto agree as follows:

 

		1.	INDEMNIFICATION
                                         AND INSURANCE.

 

		1.1.	The
                                         Company hereby undertakes to indemnify Indemnitee to the fullest extent permitted by
                                         applicable law and the Articles, as each may be amended from time to time, for any liability
                                         and expense specified in Sections 1.1.1 through 1.1.4 below, imposed on Indemnitee due
                                         to or in connection with an act performed by such Indemnitee, either prior to or after
                                         the date hereof, in Indemnitee’s capacity as an Office Holder, including, without
                                         limitation, as a director, officer, employee, agent, observer or fiduciary of the Company,
                                         any subsidiary thereof or any other corporation, collaboration, partnership, joint venture,
                                         trust or other enterprise, in which Indemnitee serves at any time at the request of the
                                         Company (the “Corporate Capacity”). The term “act performed
                                         in Indemnitee’s capacity as an Office Holder” shall include, without limitation,
                                         any act, omission and failure to act and any other circumstances relating to or arising
                                         from Indemnitee’s service in a Corporate Capacity. Notwithstanding the foregoing,
                                         in the event that the Office Holder is the beneficiary of an indemnification undertaking
                                         provided by a subsidiary of the Company or any other entity, with respect to his or her
                                         Corporate Capacity with such subsidiary or entity, then the indemnification obligations
                                         of the Company hereunder with respect to such Corporate Capacity shall only apply to
                                         the extent that the indemnification by such subsidiary or other entity does not actually
                                         fully cover the indemnifiable liabilities and expenses relating thereto. The following
                                         shall be hereinafter referred to as “Indemnifiable Events”:

 

		1.1.1.	a
                                         financial liability imposed on Indemnitee in favor of another person by any court judgment,
                                         including a judgment given as a result of a settlement or an arbitrator’s award
                                         which has been confirmed by a court in respect of an act performed by the Indemnitee.
                                         For purposes of Section 1 of this Agreement, the term “person” shall
                                         include, without limitation, a natural person, firm, partnership, joint venture, trust,
                                         company, corporation, limited liability entity, unincorporated organization, estate,
                                         government, municipality, or any political, governmental, regulatory or similar agency
                                         or body;

 

		1.1.2.	reasonable
                                         Expenses (as defined below) expended by Indemnitee as a result of an investigation or
                                         proceeding instituted against him or her by an authority authorized to conduct such investigation
                                         or proceeding, provided that (1) no indictment (as defined in the Companies Law) was
                                         filed against such Indemnitee as a result of such investigation or proceeding; and (2)
                                         no financial liability in lieu of a criminal proceeding (as defined in the Companies
                                         Law) was imposed upon him or her as a result of such investigation or proceeding or if
                                         such financial liability was imposed, it was imposed with respect to an offence that
                                         does not require proof of criminal intent, or in connection with a financial sanction;

 

		1.1.3.	reasonable
                                         Expenses expended by Indemnitee or that were imposed on Indemnitee by a court in a proceeding
                                         filed against the Indemnitee by the Company or in its name or by any other person or
                                         in a criminal charge in respect of which the Indemnitee was acquitted or in a criminal
                                         charge in respect of which the Indemnitee was convicted for an offence that does not
                                         require proof of criminal intent;

 

		1.1.4.	a
                                         financial liability imposed upon Indemnitee and reasonable Expenses expended by Indemnitee
                                         as a result of an administrative proceeding instituted against Indemnitee. Without derogating
                                         from the generality of the foregoing, such liability or Expense will include a payment
                                         which Indemnitee is obligated to make to an injured party as set forth in Section 52(54)(a)(1)(a)
                                         of the Israeli Securities Law, 1968 — 5728 (the “Securities Law”)
                                         and Expenses that Indemnitee incurred in connection with a proceeding under Chapters
                                         H’3, H’4 or I’1 of the Securities Law; and

 

		1.1.5.	any
                                         other event, occurrence, matter or circumstance under any law with respect to which the
                                         Company may, or will be able to, indemnify the Indemnitee (including, without limitation
                                         in accordance with Section 50P of the Israeli Economic Competition Law, 5758-1988 (the
                                         “RTP Law”), if and to the extent applicable).

 

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For
the purpose of this Agreement, “Expenses” shall include, without limitation, attorneys’ fees and all
other costs, expenses and obligations paid or incurred by Indemnitee in connection with investigating, defending, being a witness
in or participating in (including on appeal), or preparing to defend, be a witness in or participate in any claim, action, suit,
proceeding, alternative dispute resolution mechanism, hearing, inquiry or investigation relating to any matter for which indemnification
hereunder may be provided, and costs and expenses paid or incurred by Indemnitee in successfully enforcing this Agreement. Expenses
shall be considered paid or incurred by Indemnitee at such time as Indemnitee is required to pay or incur such cost or expenses,
including upon receipt of an invoice or payment demand. The Company shall pay the Expenses in accordance with the provisions of
Section 1.3.

 

		1.2.	Notwithstanding
                                         anything herein to the contrary, the Company’s undertaking to indemnify the Indemnitee
                                         in advance under Section 1.1.1 shall only be with respect to events described in Exhibit
                                         A hereto. The Board of Directors of the Company (the “Board”)
                                         has determined that the categories of events listed in Exhibit A are likely
                                         to occur in light of the operations of the Company. The maximum amount of indemnification
                                         payable by the Company under Section 1.1.1 of this Agreement with respect to all persons
                                         with respect to whom the Company undertook to indemnify under agreements similar to this
                                         Agreement (the “Indemnifiable Persons”), for all events described
                                         in Exhibit A shall be as set forth in Exhibit A hereto (the
                                         “Limit Amount”). If the Limit Amount is insufficient to cover all
                                         the indemnity amounts payable with respect to all Indemnifiable Persons, then such amount
                                         shall be allocated to such Indemnifiable Persons pro rata according to the percentage
                                         of their culpability, as finally determined by a court in the relevant claim, or, absent
                                         such determination or in the event such persons are parties to different claims, based
                                         on an equal pro rata allocation among such Indemnifiable Persons. The Limit Amount payable
                                         by the Company as described in Exhibit A is deemed by the Company to be
                                         reasonable in light of the circumstances. The indemnification provided under Section
                                         1.1.1 herein shall not be subject to the limitations imposed by this Section 1.2 and
                                         Exhibit A if and to the extent such limits are no longer required by the
                                         Companies Law.

 

		1.3.	If
                                         so requested by Indemnitee, and subject to the Company’s repayment and reimbursement
                                         rights set forth in Sections 3 and 5 below, the Company shall pay amounts to cover Indemnitee’s
                                         Expenses with respect to which Indemnitee is entitled to be indemnified under Section
                                         1.1 above, as and when incurred. The payments of such amounts shall be made by the Company
                                         directly to the Indemnitee’s legal and other advisors, as soon as practicable,
                                         but in any event no later than fifteen (15) days after written demand by such Indemnitee
                                         therefor to the Company, and any such payment shall be deemed to constitute indemnification
                                         hereunder. All amounts paid as indemnification hereunder shall be grossed up to cover
                                         any tax payment that Indemnitee may be required to make if the indemnification payments
                                         are taxable, subject to the Limit Amount if required by applicable law. As part of the
                                         aforementioned undertaking, the Company will make available to Indemnitee any security
                                         or guarantee that Indemnitee may be required to post in accordance with an interim decision
                                         given by a court, governmental or administrative body, or an arbitrator, including for
                                         the purpose of substituting liens imposed on Indemnitee’s assets.

 

		1.4.	The
                                         Company’s obligation to indemnify Indemnitee and advance Expenses in accordance
                                         with this Agreement shall be for such period as Indemnitee shall be subject to any actual,
                                         possible or threatened claim, action, suit, demand or proceeding or any inquiry or investigation,
                                         whether civil, criminal or investigative, arising out of the Indemnitee’s service
                                         in the Corporate Capacity as described in Section 1.1 above, whether or not Indemnitee
                                         is still serving in such position (the “Indemnification Period).

 

		1.5.	The
                                         Company undertakes that, subject to the mandatory limitations under applicable law and
                                         the Articles, as in effect from time to time, as long as it may be obligated to provide
                                         indemnification and advance Expenses under this Agreement, the Company will purchase
                                         and maintain in effect directors’ and officers’ liability insurance, which
                                         will include coverage for the benefit of the Indemnitee, providing coverage in amounts
                                         as reasonably determined by the Board; provided that, the Company shall have no obligation
                                         to obtain or maintain directors and officers insurance policy if the Company determines
                                         in good faith that such insurance is not reasonably available, the premium costs for
                                         such insurance are disproportionate to the amount of coverage provided, or the coverage
                                         provided by such insurance is so limited by exclusions that it provides an insufficient
                                         benefit. The Company hereby undertakes to notify the Indemnitee thirty (30) days prior
                                         to the expiration or termination of such directors’ and officers’ liability
                                         insurance.

 

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		1.6.	The
                                         Company undertakes to give prompt written notice of the commencement of any claim hereunder
                                         to the insurers in accordance with the procedures set forth in each of the policies.
                                         The Company shall thereafter diligently take all actions reasonably necessary under the
                                         circumstances to cause such insurers to pay, on behalf of Indemnitee, all amounts payable
                                         as a result of such action, suit, proceeding, inquiry or investigation in accordance
                                         with the terms of such policies. The above shall not derogate from Company’s authority
                                         to freely negotiate or reach any compromise with the insurer which is reasonable at the
                                         Company’s sole discretion provided that the Company shall act in good faith and
                                         in a diligent manner.

 

		1.7.	In
                                         making a determination with respect to entitlement to indemnification hereunder, the
                                         person or persons or entity making such determination shall presume that Indemnitee is
                                         entitled to indemnification under this Agreement if Indemnitee has requested it, and
                                         the Company shall have the burden of proof to overcome that presumption in connection
                                         with the making of any determination contrary to that presumption.

 

		2.	SPECIFIC
                                         LIMITATIONS ON INDEMNIFICATION.

 

Notwithstanding
anything to the contrary in this Agreement, the Company shall not indemnify or advance Expenses to Indemnitee with respect to
(i) any act, event or circumstance with respect to which it is prohibited to do so under applicable law, or (ii) a counter claim
made by the Company or in its name in connection with a claim against the Company filed by the Indemnitee.

 

		3.	REPAYMENT
                                         OF EXPENSES.

 

		3.1.	In
                                         the event that the Company provides or is required to provide indemnification with respect
                                         to Expenses hereunder and at any time thereafter the Company determines, based on advice
                                         from its legal counsel, that the Indemnitee was not entitled to such payments, the amounts
                                         so indemnified by the Company will be promptly repaid by Indemnitee, unless the Indemnitee
                                         disputes the Company’s determination, in which case the Indemnitee’s obligation
                                         to repay to the Company shall be postponed until such dispute is resolved by a court
                                         of competent jurisdiction in a final and non-appealable order.

 

		3.2.	Indemnitee’s
                                         obligation to repay the Company for any Expenses or other sums paid hereunder shall be
                                         deemed as a loan given to Indemnitee by the Company subject to the minimum interest rate
                                         prescribed by Section 3(9) of the Income Tax Ordinance [New Version], 1961, or any other
                                         legislation replacing it, which is not considered a taxable benefit.

 

		4.	SUBROGATION.

 

In
the event of payment under this Agreement, the Company shall be subrogated to the extent of such payment to all of the rights
of recovery of Indemnitee, who shall execute all documents required and shall do everything that may be necessary to secure such
rights, including the execution of such documents necessary to enable the Company effectively to bring suit to enforce such rights.

 

		5.	REIMBURSEMENT.

 

The
Company shall not be liable under this Agreement to make any payment in connection with any Indemnifiable Event to the extent
Indemnitee has otherwise actually received payment under any insurance policy or otherwise (without any obligation of Indemnitee
to repay any such amount) of the amounts otherwise indemnifiable hereunder. Any amounts paid to Indemnitee under such insurance
policy or otherwise after the Company has indemnified Indemnitee for such liability or Expense shall be repaid to the Company
as soon as practical upon receipt by Indemnitee, in accordance with the terms set forth in Section 3.2.

 

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The
Company hereby acknowledges that the Indemnitee has now or may have in the future certain rights to indemnification, advancement
of expenses and/or insurance provided by third parties (the “Third Party Indemnitor”), and the Company hereby
agrees (i) that the Company is the indemnitor of first resort (i.e., its obligations to the Indemnitee are primary and any obligation
of any Third Party Indemnitor to advance expenses or to provide indemnification for the same expenses or liabilities incurred
by the Indemnitee are secondary), (ii) it shall be required to advance the full amount of expenses incurred by the Indemnitee
and shall be liable for the full amount of all expenses, judgments, penalties, fines and amounts paid in settlement to the fullest
extent legally permitted and as required by the terms of this Agreement and/or the Articles (or any other agreement between the
Company and the Indemnitee), without regard to any rights the Indemnitee may have against the Third Party Indemnitors, and (iii)
that it irrevocably waives, relinquishes and releases any Third Party Indemnitor from any and all claims against any Third Party
Indemnitor for contribution, subrogation or any other recovery of any kind of respect of the subject matters of this Agreement.
Without altering or expanding any of the Company’s indemnification obligations hereunder, the Company further agrees that
no advancement or payment by any Third Party Indemnitor on the Indemnitee’s behalf with respect to any claim for which Indemnitee
has sought indemnification from the Company shall affect the foregoing and any Third Party Indemnitor shall have a right of contribution
and/or be subrogated to the extent of such advancement or payment to all of the rights of recovery of the Indemnitee against the
Company. The Company and the Indemnitee agree that the Third Party Indemnitors are express third party beneficiaries of the terms
of this Section 5.

 

		6.	EFFECTIVENESS.

 

The
Company represents and warrants that this Agreement is valid, binding and enforceable in accordance with its terms and was duly
adopted and approved by the Company, and shall be in full force and effect immediately upon its execution and shall continue to
be in full force for the duration of the Indemnification Period.

 

		7.	NOTIFICATION
                                         AND DEFENSE OF CLAIM.

 

Indemnitee
shall notify the Company of the commencement of any action, suit or proceeding, and of the receipt of any notice or threat that
any such legal proceeding has been or shall or may be initiated against Indemnitee (including any proceedings by or against the
Company and any subsidiary thereof), promptly upon Indemnitee first becoming so aware; but the omission to so notify the Company
will not relieve the Company from any liability which it may have to Indemnitee under this Agreement unless and to the extent
that such failure to provide notice materially and adversely impacts the Company’s ability to defend such action. Notice
to the Company shall be directed to the Chief Executive Officer or Chief Financial Officer of the Company at the address shown
in the preamble to this Agreement (or such other address as the Company shall designate in writing to Indemnitee). With respect
to any such action, suit or proceeding as to which Indemnitee notifies the Company of the commencement thereof and without derogating
from Sections 1.1 and 2:

 

		7.1.	The
                                         Company will be entitled to participate therein at its own expense.

 

		7.2.	Except
                                         as otherwise provided below, the Company, alone or jointly with any other indemnifying
                                         party similarly notified, will be entitled to assume the defense thereof, with counsel
                                         selected by the Company. Indemnitee shall have the right to employ his or her own counsel
                                         in such action, suit or proceeding, but the fees and expenses of such counsel incurred
                                         after notice from the Company of its assumption of the defense thereof shall be at the
                                         expense of Indemnitee, unless: (i) the employment of counsel by Indemnitee has been authorized
                                         in writing by the Company; (ii) the Company shall have, in good faith, reasonably concluded
                                         that there may be a conflict of interest under the law and rules of attorney professional
                                         conduct applicable to such claim between the Company and Indemnitee in the conduct of
                                         the defense of such action; or (iii) the Company has not in fact employed counsel to
                                         assume the defense of such action within reasonable time, in which cases the reasonable
                                         fees and expenses of Indemnitee’s counsel shall be at the expense of the Company.
                                         The Company shall not be entitled to assume the defense of any action, suit or proceeding
                                         brought by or on behalf of the Company or as to which the Company shall have reached
                                         the conclusion specified in (ii) above.

 

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		7.3.	The
                                         Company shall not be liable to indemnify Indemnitee under this Agreement for any amounts
                                         or expenses paid in connection with a settlement of any action, claim or otherwise, effected
                                         without the Company’s prior written consent.

 

		7.4.	The
                                         Company shall have the right to conduct the defense as it sees fit in its sole discretion
                                         (provided that the Company shall conduct the defense in good faith and in a diligent
                                         manner and that the Company and its counsel shall keep the Indemnitee reasonably notified
                                         on a regular basis of all events in the action), including the right to settle or compromise
                                         any claim or to consent to the entry of any judgment against Indemnitee without the consent
                                         of the Indemnitee, provided that, the amount of such settlement, compromise or judgment
                                         does not exceed the Limit Amount (if applicable) and is fully indemnifiable pursuant
                                         to this Agreement (subject to Section 1.2 of this Agreement) and/or applicable law, and
                                         any such settlement, compromise or judgment does not impose any penalty or limitation
                                         on Indemnitee without the Indemnitee’s prior written consent. The Indemnitee’s
                                         consent shall not be required if the settlement includes a complete release of Indemnitee,
                                         does not contain any admission of wrong-doing by Indemnitee, and includes monetary sanctions
                                         only as provided above. In the case of criminal proceedings, the Company and/or its legal
                                         counsel will not have the right to plead guilty or agree to a plea-bargain in the Indemnitee’s
                                         name without the Indemnitee’s prior written consent. Neither the Company nor Indemnitee
                                         will unreasonably withhold or delay its consent to any proposed settlement.

		7.5.	Indemnitee
                                         shall fully cooperate with the Company and shall give the Company all information and
                                         access to documents, files and to his or her advisors and representatives as shall be
                                         within Indemnitee’s power, in every reasonable way as may be required by the Company
                                         with respect to any claim that is the subject matter of this Agreement and in the defense
                                         of other claims asserted against the Company (other than claims asserted by Indemnitee),
                                         provided that the Company shall cover all expenses, costs and fees incidental thereto
                                         such that the Indemnitee will not be required to pay or bear such expenses, costs and
                                         fees.

 

		8.	EXCULPATION.

 

Subject
to the provisions of the Companies Law, the Company hereby releases, in advance, the Office Holder from liability to the Company
for any damage that arises from the breach of the Office Holder’s duty of care to the Company (within the meaning of such
terms under Sections 252 and 253 of the Companies Law), other than breach of the duty of care towards the Company in a distribution
(as such term is defined in the Companies Law).

 

		9.	NON-EXCLUSIVITY.

 

The
rights of the Indemnitee hereunder shall not be deemed exclusive of any other rights Indemnitee may have under the Articles, applicable
law or otherwise, and to the extent that during the Indemnification Period the indemnification rights of the then serving Indemnitees
are more favorable to such Indemnitees than the indemnification rights provided under this Agreement, Indemnitee shall be entitled
to the full benefits of such more favorable indemnification rights to the extent permitted by law.

 

		10.	PARTIAL
                                         INDEMNIFICATION.

 

If
Indemnitee is entitled under any provision of this Agreement to indemnification by the Company for some or a portion of the Expenses,
judgments, fines or penalties actually or reasonably incurred by Indemnitee in connection with any proceedings, but not, however,
for the total amount thereof, the Company shall nevertheless indemnify Indemnitee for the portion of such Expenses, judgments,
fines or penalties to which Indemnitee is entitled under any provision of this Agreement. Subject to the provisions of Section
5 above, any amount received by Indemnitee (under any insurance policy or otherwise) shall not reduce the Limit Amount hereunder
and shall not derogate from the Company’s obligation to indemnify the Indemnitee in accordance with the provisions of this
Agreement up to the Limit Amount, as set forth in Section 1.2.

 

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		11.	BINDING
                                         EFFECT.

 

This
Agreement shall be binding upon and inure to the benefit of and be enforceable by the parties hereto and their respective successors
and permitted assigns and their respective heirs, personal representatives, executors and administrators. In the event of a merger
or consolidation of the Company or a transfer or disposition of all or substantially all of the business or assets of the Company,
the Indemnitee shall be entitled to the same indemnification and insurance provisions as the most favorable indemnification and
insurance provisions afforded to the then-serving Office Holders of the Company. In the event that in connection with such transaction
the Company purchases a directors and officers’ “tail” or “run-off” policy for the benefit of its
then serving Office Holders, then such policy shall cover Indemnitee and such coverage shall be deemed to be in satisfaction of
the insurance requirements under this Agreement. This Agreement shall continue in effect during the Indemnification Period regardless
of whether Indemnitee continues to serve in a Corporate Capacity.

 

Any
amendment to the Companies Law, the Israeli Securities Law, the RTP Law or other applicable law adversely affecting the right
of the Indemnitee to be indemnified, insured or released pursuant hereto shall be prospective in effect, and shall not affect
the Company’s obligation or ability to indemnify or insure the Indemnitee for any act or omission occurring prior to such
amendment, unless otherwise provided by applicable law.

 

		12.	SEVERABILITY.

 

The
provisions of this Agreement shall be deemed severable and the invalidity or unenforceability of any provision shall not affect
the validity or enforceability of the other provisions hereof. If any provision of this Agreement, or the application thereof
or any circumstance, is invalid or unenforceable, (i) a suitable and equitable provision shall be substituted therefor in order
to carry out, so far as may be valid and enforceable, the intent and purpose of such invalid or unenforceable provision and (ii)
the remainder of this Agreement and the application of such provision or circumstances shall not be affected by such invalidity
or unenforceability, nor shall such invalidity or unenforceability affect the validity or enforceability of such provision, or
the application thereof, in any other jurisdiction.

 

		13.	NOTICE.

 

All
notices and other communications pursuant to this Agreement shall be in writing and shall be deemed provided if delivered personally,
telecopied, sent by electronic facsimile, email, reputable overnight courier or mailed by registered or certified mail (return
receipt requested), postage prepaid, to the parties at the addresses shown in the preamble to this Agreement, or to such other
address as the party to whom notice is to be given may have furnished to the other party hereto in writing in accordance herewith.
Any such notice or communication shall be deemed to have been delivered and received (i) in the case of personal delivery, on
the date of such delivery, (ii) in the case of telecopier or an electronic facsimile or email, one business day after the date
of transmission if confirmation of receipt is received, (iii) in the case of a reputable overnight courier, three business days
after deposit with such reputable overnight courier service, and (iv) in the case of mailing, on the seventh business day following
that on which the mail containing such communication is posted.

 

		14.	GOVERNING
LAW; JURISDICTION.

 

This
Agreement shall be governed by and construed and enforced in accordance with the laws of the State of Israel, without giving effect
to the conflicts of law provisions of those laws. The Company and Indemnitee each hereby irrevocably consent to the exclusive
jurisdiction and venue of the courts of Tel Aviv, Israel for all purposes in connection with any action or proceeding which arises
out of or relates to this Agreement.

 

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		15.	ENTIRE
AGREEMENT AND TERMINATION.

 

This
Agreement represents the entire agreement between the parties and supersedes any other agreements, contracts or understandings
between the parties, whether written or oral, with respect to the subject matter of this Agreement. For the avoidance of doubt,
it is hereby clarified that nothing contained herein derogates from the Company’s right in its sole discretion, subject
to applicable law and the Articles, to indemnify Indemnitee post factum for any amounts the Indemnitee may be obligated to pay.

 

		16.	NO
MODIFICATION AND NO WAIVER.

 

No
supplement, modification or amendment, termination or cancellation of this Agreement shall be binding unless executed in writing
by both of the parties hereto. No waiver of any of the provisions of this Agreement shall be deemed or shall constitute a waiver
of any other provisions hereof (whether or not similar) nor shall such waiver constitute a continuing waiver. Any waiver shall
be in writing. The Company hereby undertakes not to amend its Articles in a manner that will adversely affect the provisions of
this Agreement.

 

		17.	ASSIGNMENTS;
NO THIRD PARTY RIGHTS.

 

Neither
party hereto may assign any of its rights or obligations hereunder except with the express prior written consent of the other
party. Nothing herein shall be deemed to create or imply an obligation for the benefit of a third party, except as set forth in
Section 5. Without limitation of the foregoing, nothing herein shall be deemed to create any right of any insurer that provides
directors’ and officers’ liability insurance, to claim, on behalf of Indemnitee, any rights hereunder.

 

		18.	INTERPRETATION;
DEFINITIONS.

 

The
obligations of the Company as provided hereunder shall be interpreted broadly and in a manner that shall facilitate its execution,
to the extent permitted by law, and for the purposes for which it was intended.

 

Unless
the context shall otherwise require: words in the singular shall also include the plural, and vice versa; any pronoun shall include
the corresponding masculine, feminine and neuter forms; the words “include”, “includes” and “including”
shall be deemed to be followed by the phrase “without limitation”; the words “herein”, “hereof”
and “hereunder” and words of similar import refer to this Agreement in its entirety and not to any part hereof; all
references herein to Sections or clauses shall be deemed references to Sections or clauses of this Agreement; any references to
any agreement or other instrument or law, statute or regulation are to it as amended, supplemented or restated, from time to time
(and, in the case of any law, to any successor provisions or re-enactment or modification thereof being in force at the time);
any reference to “law” shall include any supranational, national, federal, state, local, or foreign statute or law
and all rules and regulations promulgated thereunder; any reference to a “day” or a number of “days” (without
any explicit reference otherwise, such as to business days) shall be interpreted as a reference to a calendar day or number of
calendar days; reference to month or year means according to the Gregorian calendar; reference to a “company”, “corporate
body” or “entity” shall include a, partnership, firm, company, corporation, limited liability company, association,
joint venture, trust, unincorporated organization, estate, or a government municipality or any political, governmental, regulatory
or similar agency or body, and reference to a “person” shall mean any of the foregoing or a natural person.

 

		19.	COUNTERPARTS.

 

This
Agreement may be executed in any number of counterparts, each of which shall be deemed an original and enforceable against the
parties actually executing such counterpart, and all of which together shall constitute one and the same instrument; it being
understood that parties need not sign the same counterpart. The exchange of an executed Agreement (in counterparts or otherwise)
by facsimile or by electronic delivery in pdf format shall be sufficient to bind the parties to the terms and conditions of this
Agreement, as an original.

 

[SIGNATURE
PAGE TO FOLLOW]

 

    8

     

    

 

IN
WITNESS WHEREOF, the parties, each acting under due and proper authority, have executed this Agreement as of the date first
mentioned above, in one or more counterparts.

 

	PainReform
    Ltd.	 
	 	 
	By:	 	 
	 	 	 
	Name
    and title:	 	 

 

	Indemnitee:	 
	 	 
	Name:	 	 
	 	 	 
	Signature:	 	 
	 	 	 
	Address:	 	 

 

    9

     

    

 

EXHIBIT
A*

 

	 	 	CATEGORY
    OF INDEMNIFIABLE EVENT	 	LIMIT
    AMOUNT PER EACH

    SPECIFIC EVENT WITHIN

    THIS CATEGORY OF EVENTS
	 	 	 	 	 
	1.	 	Claims
    in connection with employment relationships with and/or by employees or consultants of the Company, and in connection with
    business relations between the Company and its employees, independent contractors, customers, suppliers, partners and various
    service providers.	 	the
    greater of (i) an amount equal to 25% of our shareholders’ equity on a consolidated basis, based on our most recent
    financial statements made publicly available before the date on which the indemnity payment is made, and (ii) $12.5 million
    (the “Maximum Amount”).
	 	 	 	 	 
	2.	 	Negotiations,
    execution, delivery and performance of agreements of any kind or nature, anti-competitive acts, acts of commercial wrongdoing,
    approval of corporate actions including the approval of and recommendation or information provided to shareholders with respect
    to corporate actions, the approval of the acts of the Company’s management, their guidance and their supervision, actions
    concerning the approval of transactions with Office Holders or shareholders, including controlling persons, actions pursuant
    to or in accordance with the policies and procedures of the Company (whether or not such policies and procedures are published)
    and claims of failure to exercise business judgment and a reasonable level of proficiency, expertise and care or any other
    applicable standard with respect to the Company’s business.	 	The
    Maximum Amount
	 	 	 	 	 
	3.	 	Violation,
    infringement, misappropriation, dilution and other misuse of copyrights, patents, designs, trade secrets and any other intellectual
    property rights, acts in connection with the registration, assertion or protection of rights to intellectual property and
    the defense of claims related to intellectual property, breach of confidentiality obligations, acts in regard of invasion
    of privacy including with respect to databases or personal information, acts in connection with slander and defamation, and
    claims in connection with publishing or providing any information, including any filings with any governmental authorities,
    whether or not required under any applicable laws.	 	The
    Maximum Amount
	 	 	 	 	 
	4.	 	Violations
    of securities laws of any jurisdiction, including without limitation, claims under the U.S. Securities Act of 1933, as amended
    from time to time, or the U.S. Exchange Act of 1934, as amended from time to time, or under the Israeli Securities Law, as
    amended from time to time, fraudulent disclosure claims, failure to comply with any securities authority or any stock exchange
    disclosure or other rules and any other claims relating to relationships with investors, debt holders, shareholders, holders
    of any other equity or debt instrument of the Company and the investment community and any claims related to the Sarbanes-Oxley
    Act of 2002, as amended from time to time; claims relating to or arising out of financing arrangements, any breach of financial
    covenants or other obligations towards lenders or debt holders of
    the Company, class actions, violations of laws requiring the Company to obtain regulatory and governmental licenses, permits
    and authorizations in any jurisdiction; actions taken in connection with the issuance, purchase, holding or disposition of
    any type of securities of Company, including, without limitation, the grant of options, warrants or other rights to purchase
    any of the same or any offering of the Company’s securities to private investors or to the public, and listing of such
    securities, or the offer by the Company to purchase securities from the public or from private investors or other holders,
    and any undertakings, representations, warranties and other obligations related to any such offering, listing or offer or
    to the Company’s status as a public company or as an issuer of securities.	 	The
    Maximum Amount

 

    10

     

    

 

	5.	 	Liabilities
    arising in connection with development of any products or services developed, distributed, rendered, sold, provided, licensed
    or marketed by the Company, and any actions or omission in connection with the distribution, provision, sale, marketing, license
    or use of such products or services, including without limitation in connection with professional liability and product liability
    claims.	 	The
    Maximum Amount
	 	 	 	 	 
	6.	 	The
    offering of securities by the Company to the public, including the offering of securities by a shareholder in connection with
    a secondary offering.	 	The
    Maximum Amount
	 	 	 	 	 
	7.	 	The
    offering of securities by the Company to private investors or the offer by the Company to purchase securities from the public
    and/or from private investors or other holders pursuant to a prospectus, agreements, notices, reports, tenders and/or other
    proceedings.	 	The
    Maximum Amount
	 	 	 	 	 
	8.	 	Events
    in connection with change in ownership or in the structure of the Company, its reorganization, dissolution, winding up, any
    other arrangements concerning creditors rights or any decision concerning any of the foregoing, including but not limited
    to, merger, sale or acquisition of assets, division, spin off, divestiture, change in capital.	 	The
    Maximum Amount
	 	 	 	 	 
	9.	 	Any
    claim or demand made in connection with any transaction not in the ordinary course of business of the Company, including the
    sale, lease or purchase of, or the receipt or any grant of any rights with respect to, any assets or business.	 	The
    Maximum Amount
	 	 	 	 	 
	10.	 	Any
    claim or demand made by any third party suffering any personal injury and/or bodily injury or damage to business or personal
    property or any other type of damage through any act or omission attributed to the Company, or its employees, agents or other
    persons acting or allegedly acting on its behalf, including, without limitation, failure to make proper safety arrangements
    for the Company or its employees and liabilities arising from any accidental or continuous damage or harm to the Company’s
    employees, its contractors, its guests and visitors as a result of an accidental or continuous event, or employment conditions,
    permanent or temporary, in the Company’s offices.	 	The
    Maximum Amount
	 	 	 	 	 
	11.	 	Any
    claim or demand made directly or indirectly in connection with complete or partial failure, by the Company or its directors,
    officers and
    employees, to pay, report, keep applicable records or otherwise, of any foreign, federal, state, county, local, municipal
    or city taxes or other compulsory payments of any nature whatsoever, including, without limitation, income, sales, use, transfer,
    excise, value added, registration, severance, stamp, occupation, customs, duties, real property, personal property, capital
    stock, social security, unemployment, disability, payroll or employee withholding or other withholding, including any interest,
    penalty or addition thereto, whether disputed or not.	 	The
    Maximum Amount

 

    11

     

    

 

	12.	 	Any
    administrative, regulatory or judicial actions, orders, decrees, suits, demands, demand letters, directives, claims, liens,
    investigations, proceedings or notices of noncompliance or violation by any governmental entity or other person alleging the
    failure to comply with any statute, law, ordinance, rule, regulation, order or decree of any governmental entity applicable
    to the Company or any of its businesses, assets or operations, or the terms and conditions of any operating certificate or
    licensing agreement.	 	The
    Maximum Amount
	 	 	 	 	 
	13.	 	Participation
    and/or non-participation at the Company’s Board meetings, bona fide expression of opinion and/or voting and/or abstention
    from voting at the Company’s Board meetings, including, in each case, any committee thereof.	 	The
    Maximum Amount
	 	 	 	 	 
	14.	 	Review
    and approval of the Company’s financial statements and any specific items or matters within, including any action, consent
    or approval related to or arising from the foregoing, including, without limitations, execution of certificates for the benefit
    of third parties related to the financial statements.	 	The
    Maximum Amount
	 	 	 	 	 
	15.	 	Violation
    of laws, rules or regulations requiring the Company to obtain regulatory and governmental licenses, permits and authorizations
    (including without limitation relating to export, import, encryption, antitrust or competition authorities) or laws related
    to any governmental grants in any jurisdiction.	 	The
    Maximum Amount
	 	 	 	 	 
	16.	 	Resolutions
    and/or actions relating to investments in the Company and/or its subsidiaries and/or affiliated companies and/or the purchase
    and sale of assets, including the purchase or sale of companies and/or businesses, and/or investment in corporate or other
    entities and/or investments in traded securities and/or any other form of investment.	 	The
    Maximum Amount
	 	 	 	 	 
	17.	 	Liabilities
    arising out of advertising, including misrepresentations regarding the Company’s products or services and unlawful distribution
    of emails.	 	The
    Maximum Amount
	 	 	 	 	 
	18.	 	An
    announcement or statement, including a position taken or an opinion or representation made in good faith by the Office Holder
    in the course of his duties or in conjunction with his duties, whether in public or in private, including during a meeting
    of the Board of Directors of the Company or any of the committees thereof.	 	The
    Maximum Amount

 

    12

     

    

 

	19.	 	Management
    of the Company’s bank accounts, including money management, foreign currency deposits, securities, loans and credit
    facilities, credit cards, bank guarantees, letters of credit, consultation agreements concerning investments including with
    portfolio managers, hedging transactions, options, futures, and the like.	 	The
    Maximum Amount
	 	 	 	 	 
	20.	 	Any
    action or decision in relation to protection of work safety and/or working conditions, including with respect to provisions
    of the law, procedures or standards as applicable in or outside of Israel with relating to protection of work safety, pertaining,
    inter alia, to contamination, health protection, production processes, distribution, use, treatment, storage and transportation
    of certain materials, including in connection with corporal damage, property and environmental damages.	 	The
    Maximum Amount
	 	 	 	 	 
	21.	 	Any
    liability arising under any administrative, regulatory, judicial or civil actions orders, decrees, suits, demands, demand
    letters, directives, claims, liens, investigations, proceedings or notices of noncompliance or violation of Section 50P of
    the RTP Law.	 	The
    Maximum Amount
	 	 	 	 	 
	22.	 	All
    actions, consents and approvals relating to a distribution of dividends, in cash or otherwise, or to any other “distribution”
    as such term is defined under the Companies Law.	 	The
    Maximum Amount
	 	 	 	 	 
	23.	 	Any
    administrative, regulatory, judicial, civil or criminal, actions orders, decrees, suits, demands, demand letters, directives,
    claims, liens, investigations, proceedings or notices of noncompliance, violation or breaches alleging potential responsibility,
    liability, loss or damage (including potential responsibility or liability for costs of enforcement, investigation, cleanup,
    governmental response, removal or remediation, property damage or penalties, or for contribution, indemnification, cost recovery,
    compensation or injunctive relief), whether alleged or claimed by customers, consumers, regulators, shareholders or others,
    arising out of, based on or related to: (a) cyber security, cyber-attacks, data loss or breaches, unauthorized access to databases
    and use or disclosure of information contained therein, not preventing or detecting the breach or failing to otherwise disclose
    or respond to the breach; (b) circumstances forming the basis of any violation of any law, permit, license, registration or
    other authorization required under applicable law governing data security, data protection, network security, information
    systems, privacy or any cyber environment (including, users, networks, devices, software, processes, information systems,
    databases, information in storage or transit, applications, services, and systems that can be connected directly or indirectly
    to networks); (c) failure to implement a reporting system or control, or failure to monitor or oversee the operation of such
    a system; (d) data destruction, extortion, theft, hacking, and denial of service attacks; losses or liabilities to others
    caused by errors and omissions, failure to safeguard data or defamation; or (e) security-audit, post-incident public relations
    and investigative expenses, criminal reward funds, data breach/privacy crisis management (including, management of an incident,
    investigation, remediation, data subject notification, call management, credit checking for data subjects, legal costs, court
attendance
    and regulatory fines), extortion liability (including, losses due to a threat of extortion, professional fees related to dealing
    with the extortion), or network security liability (including, losses as a result of denial of access, costs related to data
    on third-parties and costs related to the theft of data on third-party systems).    	 	The
    Maximum Amount

 

	 	 	Aggregate
    Limit Amount for all events together.	 	The
    Maximum Amount

 

 

	*	Any
reference in this Exhibit A to the Company shall include the Company and any entity in which the Indemnitee serves
in a Corporate Capacity.

 

 

13Exhibit 10.5

 

THIS
WARRANT AND THE SECURITIES ISSUABLE UPON EXERCISE HEREOF MAY NOT BE SOLD, TRANSFERRED, ASSIGNED, PLEDGED, OR HYPOTHECATED, OR
BE THE SUBJECT OF ANY HEDGING, SHORT SALE, DERIVATIVE, PUT, OR CALL TRANSACTION THAT WOULD RESULT IN THE EFFECTIVE ECONOMIC DISPOSITION
OF SUCH SECURITIES BY ANY PERSON FOR A PERIOD OF ONE HUNDRED AND EIGHTY (180) DAYS IMMEDIATELY FOLLOWING THE DATE OF EFFECTIVENESS
OF THE PUBLIC OFFERING OF THE COMPANY’S SECURITIES PURSUANT TO REGISTRATION STATEMENT NO. 333-239576
AS FILED WITH THE SECURITIES AND EXCHANGE COMMISSION, EXCEPT IN ACCORDANCE WITH FINRA RULE
5110(G)(2).

 

REPRESENTATIVE
WARRANT

 

PAINREFORM LTD.

 

	Warrant Shares: [         ]1	Original Issuance Date: [        ], 2020

 

THIS
REPRESENTATIVE WARRANT (the “Warrant”) certifies that, for value received, [___] or its assigns (the “Holder”)
is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter set forth, at any time on
or after [      ], 20202 (the “Initial Exercise Date”) and on or prior to 5:00 p.m. (New York City
time) on [     ], 2025 (the “Termination Date”) 3 but not thereafter, to subscribe for and purchase
from PainReform Ltd., an Israeli company (the “Company”), up to [  ] Ordinary Shares (as subject to adjustment
hereunder, the “Warrant Shares”). The purchase price of one Ordinary Share under this Warrant shall be equal
to the Exercise Price, as defined in Section 2(b).

 

Section
1. Definitions. Capitalized terms used and not otherwise defined herein shall have the meanings set forth in that certain
Underwriting Agreement (the “Agreement”), dated [     ], 2020 by and among the Company, Maxim Group LLC and
Joseph Gunnar & Co., LLC, as representatives of the several underwriters.

 

Section
2. Exercise.

 

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

  

 

	1	5.0% of the Ordinary Shares sold in the offering.
	2	12 month anniversary of the Effective Date.
	3	Fifth anniversary of Effective Date.

 

    	 		 

     

    

 

b)
Exercise Price. The exercise price per Ordinary Share under this Warrant shall be $[ ] (which is 125% of the offering
price per Ordinary Share in the offering contemplated by the Agreement) (the “Exercise Price”).

 

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

 

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

 

    	 	2	 

     

    

 

(B)
= the Exercise Price of this Warrant, as adjusted hereunder; and

 

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

 

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

 

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

 

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

 

    	 	3	 

     

    

 

Notwithstanding
anything contained herein to the contrary, on the Termination Date, this Warrant shall be automatically exercised via cashless
exercise pursuant to this Section 2(c).

 

d)
Mechanics of Exercise.

 

i.
Delivery of Warrant Shares Upon Exercise. The Company shall cause the Warrant Shares purchased hereunder to be transmitted
by the Transfer Agent to the Holder by crediting the account of the Holder’s or its designee’s balance account with
The Depository Trust Company through its Deposit or Withdrawal at Custodian system (“DWAC”) if the Company
is then a participant in such system and either (A) there is an effective registration statement permitting the issuance of the
Warrant Shares to or resale of the Warrant Shares by Holder, or (B) if there is no effective registration statement and the Warrant
is exercised via cashless exercise at a time when such Warrant Shares would be eligible for resale under Rule 144 by a non-affiliate
of the Company, such Warrant Shares are delivered to Holder’s broker, and the Company receives a statement from Holder’s
broker that it has received instructions to sell the Warrant Shares or that it would take responsibility that the sales of the
Warrant Shares will only be made if the Warrant Shares are eligible to be sold under Rule 144, and otherwise by physical delivery
of a certificate, registered in the Company’s share register in the name of the Holder or its designee, for the number of
Warrant Shares to which the Holder is entitled pursuant to such exercise to the address specified by the Holder in the Notice
of Exercise by the date that is the earliest of (i) two (2) Trading Days after the delivery to the Company of the Notice of Exercise,
(ii) one (1) Trading Day after delivery of the aggregate Exercise Price to the Company and (iii) the number of Trading Days comprising
the Standard Settlement Period after the delivery to the Company of the Notice of Exercise (such date, the “Warrant Share
Delivery Date”). Upon delivery of the Notice of Exercise, the Holder shall be deemed for all corporate purposes to have
become the holder of record of the Warrant Shares with respect to which this Warrant has been exercised, irrespective of the date
of delivery of the Warrant Shares, provided that payment of the aggregate Exercise Price (other than in the case of a cashless
exercise) is received within the earlier of (i) two (2) Trading Days and (ii) the number of Trading Days comprising the Standard
Settlement Period following delivery of the Notice of Exercise. If the Company fails for any reason to deliver to the Holder the
Warrant Shares subject to a Notice of Exercise by the Warrant Share Delivery Date, the Company shall pay to the Holder, in cash,
as liquidated damages and not as a penalty, for each $1,000 of Warrant Shares subject to such exercise (based on the VWAP of the
Ordinary Shares on the date of the applicable Notice of Exercise), $10 per Trading Day (increasing to $20 per Trading Day on the
fifth Trading Day after such liquidated damages begin to accrue) for each Trading Day after such Warrant Share Delivery Date until
such Warrant Shares are delivered or Holder rescinds such exercise. The Company agrees to use commercially reasonable efforts
to maintain a transfer agent that is a participant in the FAST program so long as this Warrant remains outstanding and exercisable.
As used herein, “Standard Settlement Period” means the standard settlement period, expressed in a number of
Trading Days, on the Company’s primary Trading Market with respect to the Ordinary Shares as in effect on the date of delivery
of the Notice of Exercise.

 

    	 	4	 

     

    

 

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

 

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

 

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

 

    	 	5	 

     

    

 

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

 

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

 

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

 

    	 	6	 

     

    

 

e)
Holder’s Exercise Limitations. The Company shall not effect any exercise of this Warrant, and a Holder shall not
have the right to exercise any portion of this Warrant, pursuant to Section 2 or otherwise, to the extent that after giving effect
to such issuance after exercise as set forth on the applicable Notice of Exercise, the Holder (together with the Holder’s
Affiliates, and any other Persons acting as a group together with the Holder or any of the Holder’s Affiliates (such Persons,
“Attribution Parties”)), would beneficially own in excess of the Beneficial Ownership Limitation (as defined
below). For purposes of the foregoing sentence, the number of Ordinary Shares beneficially owned by the Holder and its Affiliates
and Attribution Parties shall include the number of Ordinary Shares issuable upon exercise of this Warrant with respect to which
such determination is being made, but shall exclude the number of Ordinary Shares which would be issuable upon (i) exercise of
the remaining, non-exercised portion of this Warrant beneficially owned by the Holder or any of its Affiliates or Attribution
Parties and (ii) exercise or conversion of the unexercised or non-converted portion of any other securities of the Company (including,
without limitation, any other Ordinary Shares Equivalents) subject to a limitation on conversion or exercise analogous to the
limitation contained herein beneficially owned by the Holder or any of its Affiliates or Attribution Parties. Except as set forth
in the preceding sentence, for purposes of this Section 2(e), beneficial ownership shall be calculated in accordance with Section
13(d) of the Exchange Act and the rules and regulations promulgated thereunder, it being acknowledged by the Holder that the Company
is not representing to the Holder that such calculation is in compliance with Section 13(d) of the Exchange Act and the Holder
is solely responsible for any schedules required to be filed in accordance therewith. To the extent that the limitation contained
in this Section 2(e) applies, the determination of whether this Warrant is exercisable (in relation to other securities owned
by the Holder together with any Affiliates and Attribution Parties) and of which portion of this Warrant is exercisable shall
be in the sole discretion of the Holder, and the submission of a Notice of Exercise shall be deemed to be the Holder’s determination
of whether this Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates and Attribution
Parties) and of which portion of this Warrant is exercisable, in each case subject to the Beneficial Ownership Limitation, and
the Company shall have no obligation to verify or confirm the accuracy of such determination. In addition, a determination as
to any group status as contemplated above shall be determined in accordance with Section 13(d) of the Exchange Act and the rules
and regulations promulgated thereunder. For purposes of this Section 2(e), in determining the number of outstanding Ordinary Shares,
a Holder may rely on the number of outstanding Ordinary Shares as reflected in (A) the Company’s most recent periodic or
annual report filed with the Commission, as the case may be, (B) a more recent public announcement by the Company or (C) a more
recent written notice by the Company or the Transfer Agent setting forth the number of Ordinary Shares outstanding. Upon the written
or oral request of a Holder, the Company shall within one Trading Day confirm orally and in writing to the Holder the number of
Ordinary Shares then outstanding. In any case, the number of outstanding Ordinary Shares shall be determined after giving effect
to the conversion or exercise of securities of the Company, including this Warrant, by the Holder or its Affiliates or Attribution
Parties since the date as of which such number of outstanding Ordinary Shares was reported. The “Beneficial Ownership
Limitation” shall be 4.99% of the number of shares of the Ordinary Shares outstanding immediately after giving effect
to the issuance of Ordinary Shares issuable upon exercise of this Warrant. The Holder, upon notice to the Company, may increase
or decrease the Beneficial Ownership Limitation provisions of this Section 2(e), provided that the Beneficial Ownership Limitation
in no event exceeds 9.99% of the number of shares of the Ordinary Shares outstanding immediately after giving effect to the issuance
of Ordinary Shares upon exercise of this Warrant held by the Holder and the provisions of this Section 2(e) shall continue to
apply. Any increase in the Beneficial Ownership Limitation will not be effective until the 61st day after such notice
is delivered to the Company. The provisions of this paragraph shall be construed and implemented in a manner otherwise than in
strict conformity with the terms of this Section 2(e) to correct this paragraph (or any portion hereof) which may be defective
or inconsistent with the intended Beneficial Ownership Limitation herein contained or to make changes or supplements necessary
or desirable to properly give effect to such limitation. The limitations contained in this paragraph shall apply to a successor
holder of this Warrant.

 

    	 	7	 

     

    

 

Section
3. Certain Adjustments.

 

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

 

b)
Subsequent Rights Offerings. In addition to any adjustments pursuant to Section 3(a) above, if at any time the Company
grants, issues or sells any Ordinary Shares Equivalents or rights to purchase stock, warrants, securities or other property pro
rata to the record holders of any class of Ordinary Shares (the “Purchase Rights”), then the Holder will be
entitled to acquire, upon the terms applicable to such Purchase Rights, the aggregate Purchase Rights which the Holder could have
acquired if the Holder had held the number of Ordinary Shares acquirable upon complete exercise of this Warrant (without regard
to any limitations on exercise hereof, including without limitation, the Beneficial Ownership Limitation) immediately before the
date on which a record is taken for the grant, issuance or sale of such Purchase Rights, or, if no such record is taken, the date
as of which the record holders of Ordinary Shares are to be determined for the grant, issue or sale of such Purchase Rights (provided,
however, to the extent that the Holder’s right to participate in any such Purchase Right would result in the Holder
exceeding the Beneficial Ownership Limitation, then the Holder shall not be entitled to participate in such Purchase Right to
such extent (or beneficial ownership of such Ordinary Shares as a result of such Purchase Right to such extent) and such Purchase
Right to such extent shall be held in abeyance for the Holder until such time, if ever, as its right thereto would not result
in the Holder exceeding the Beneficial Ownership Limitation).

 

c)
Pro Rata Distributions. During such time as this Warrant is outstanding, if the Company shall declare or make any dividend
or other distribution of its assets (or rights to acquire its assets) to holders of Ordinary Shares, by way of return of capital
or otherwise, other than cash (including, without limitation, any distribution of stock or other securities, property or options
by way of a dividend, spin off, reclassification, corporate rearrangement, scheme of arrangement or other similar transaction)
(a “Distribution”), at any time after the issuance of this Warrant, then, in each such case, the Holder shall
be entitled to participate in such Distribution to the same extent that the Holder would have participated therein if the Holder
had held the number of Ordinary Shares acquirable upon complete exercise of this Warrant (without regard to any limitations on
exercise hereof, including without limitation, the Beneficial Ownership Limitation) immediately before the date of which a record
is taken for such Distribution, or, if no such record is taken, the date as of which the record holders of Ordinary Shares are
to be determined for the participation in such Distribution (provided, however, to the extent that the Holder's
right to participate in any such Distribution would result in the Holder exceeding the Beneficial Ownership Limitation, then the
Holder shall not be entitled to participate in such Distribution to such extent (or in the beneficial ownership of any Ordinary
Shares as a result of such Distribution to such extent) and the portion of such Distribution shall be held in abeyance for the
benefit of the Holder until such time, if ever, as its right thereto would not result in the Holder exceeding the Beneficial Ownership
Limitation).

 

    	 	8	 

     

    

 

d)
Fundamental Transaction. If, at any time while this Warrant is outstanding, (i) the Company, directly or indirectly, in
one or more related transactions effects any merger or consolidation of the Company with or into another Person, (ii) the Company,
directly or indirectly, effects any sale, lease, license, assignment, transfer, conveyance or other disposition of all or substantially
all of its assets in one or a series of related transactions, (iii) any, direct or indirect, purchase offer, tender offer or exchange
offer (whether by the Company or another Person) is completed pursuant to which holders of Ordinary Shares are permitted to sell,
tender or exchange their shares for other securities, cash or property and has been accepted by the holders of 50% or more of
the outstanding Ordinary Shares, (iv) the Company, directly or indirectly, in one or more related transactions effects any reclassification,
reorganization or recapitalization of the Ordinary Shares or any compulsory share exchange pursuant to which the Ordinary Shares
are effectively converted into or exchanged for other securities, cash or property, or (v) the Company, directly or indirectly,
in one or more related transactions consummates a stock or share purchase agreement or other business combination (including,
without limitation, a reorganization, recapitalization, spin-off or scheme of arrangement) with another Person or group of Persons
whereby such other Person or group acquires more than 50% of the outstanding Ordinary Shares (not including any Ordinary Shares
held by the other Person or other Persons making or party to, or associated or affiliated with the other Persons making or party
to, such stock or share purchase agreement or other business combination) (each a “Fundamental Transaction”),
then, upon any subsequent exercise of this Warrant, the Holder shall have the right to receive, for each Warrant Share that would
have been issuable upon such exercise immediately prior to the occurrence of such Fundamental Transaction, at the option of the
Holder (without regard to any limitation in Section 2(e) on the exercise of this Warrant), the number of Ordinary Shares of the
successor or acquiring corporation or of the Company, if it is the surviving corporation, and any additional consideration (the
“Alternate Consideration”) receivable as a result of such Fundamental Transaction by a holder of the number
of Ordinary Shares for which this Warrant is exercisable immediately prior to such Fundamental Transaction (without regard to
any limitation in Section 2(e) on the exercise of this Warrant). For purposes of any such exercise, the determination of the Exercise
Price shall be appropriately adjusted to apply to such Alternate Consideration based on the amount of Alternate Consideration
issuable in respect of one share of Ordinary Shares in such Fundamental Transaction, and the Company shall apportion the Exercise
Price among the Alternate Consideration in a reasonable manner reflecting the relative value of any different components of the
Alternate Consideration. If holders of Ordinary Shares are given any choice as to the securities, cash or property to be received
in a Fundamental Transaction, then the Holder shall be given the same choice as to the Alternate Consideration it receives upon
any exercise of this Warrant following such Fundamental Transaction. Notwithstanding anything to the contrary, in the event of
a Fundamental Transaction, the Company or any Successor Entity (as defined below) shall, at the Holder’s option, exercisable
at any time concurrently with, or within 30 days after, the consummation of the Fundamental Transaction (or, if later, the date
of the public announcement of the applicable Fundamental Transaction), purchase this Warrant from the Holder by paying to the
Holder an amount of cash equal to the Black Scholes Value of the remaining unexercised portion of this Warrant on the date of
the consummation of such Fundamental Transaction; provided, however, if the Fundamental Transaction is not within
the Company's control, including not approved by the Company's Board of Directors or the consideration is not in all stock of
the Successor Entity, Holder shall only be entitled to receive from the Company or any Successor Entity, as of the date of consummation
of such Fundamental Transaction, the same type or form of consideration (and in the same proportion), at the Black Scholes Value
(as defined below) of the unexercised portion of this Warrant, that is being offered and paid to the holders of Ordinary Shares
of the Company in connection with the Fundamental Transaction, whether that consideration be in the form of cash, stock or any
combination thereof, or whether the holders of Ordinary Shares are given the choice to receive from among alternative forms of
consideration in connection with the Fundamental Transaction. “Black Scholes Value” means the value of this
Warrant based on the Black and Scholes Option Pricing Model obtained from the “OV” function on Bloomberg, L.P. (“Bloomberg”)
determined as of the day of consummation of the applicable Fundamental Transaction for pricing purposes and reflecting (A) a risk-free
interest rate corresponding to the U.S. Treasury rate as of the Trading Day immediately following the public announcement of the
applicable Fundamental Transaction, (B) an expected volatility equal to the greater of 100% and the 100 day volatility obtained
from the HVT function on Bloomberg as of the Trading Day immediately following the public announcement of the applicable Fundamental
Transaction, (C) the underlying price per share used in such calculation shall be the greater of (i) the sum of the price per
share being offered in cash, if any, plus the value of any non-cash consideration, if any, being offered in such Fundamental Transaction
and (ii) the greater of (x) the last VWAP immediately prior to the public announcement of such Fundamental Transaction and (y)
the last VWAP immediately prior to the consummation of such Fundamental Transaction and (D) a remaining option time equal to the
time between the date of the public announcement of the applicable Fundamental Transaction and the Termination Date. The payment
of the Black Scholes Value will be made by wire transfer of immediately available funds within five Business Days of the Holder’s
election (or, if later, on the effective date of the Fundamental Transaction). The Company shall cause any successor entity in
a Fundamental Transaction in which the Company is not the survivor (the “Successor Entity”) to assume in writing
all of the obligations of the Company under this Warrant and the other Transaction Documents in accordance with the provisions
of this Section 3(e) pursuant to written agreements in form and substance reasonably satisfactory to the Holder and approved by
the Holder (without unreasonable delay) prior to such Fundamental Transaction and shall, at the option of the Holder, deliver
to the Holder in exchange for this Warrant a security of the Successor Entity evidenced by a written instrument substantially
similar in form and substance to this Warrant which is exercisable for a corresponding number of shares of capital stock of such
Successor Entity (or its parent entity) equivalent to the Ordinary Shares acquirable and receivable upon exercise of this Warrant
(without regard to any limitations on the exercise of this Warrant) prior to such Fundamental Transaction, and with an exercise
price which applies the exercise price hereunder to such shares of capital stock (but taking into account the relative value of
the Ordinary Shares pursuant to such Fundamental Transaction and the value of such shares of capital stock, such number of shares
of capital stock and such exercise price being for the purpose of protecting the economic value of this Warrant immediately prior
to the consummation of such Fundamental Transaction), and which is reasonably satisfactory in form and substance to the Holder.
Upon the occurrence of any such Fundamental Transaction, the Successor Entity shall succeed to, and be substituted for (so that
from and after the date of such Fundamental Transaction, the provisions of this Warrant and the other Transaction Documents referring
to the “Company” shall refer instead to the Successor Entity), and may exercise every right and power of the Company
and shall assume all of the obligations of the Company under this Warrant and the other Transaction Documents with the same effect
as if such Successor Entity had been named as the Company herein.

 

    	 	9	 

     

    

 

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

 

f)
Notice to Holder.

 

i.
Adjustment to Exercise Price. Whenever the Exercise Price is adjusted pursuant to any provision of this Section 3, the
Company shall promptly deliver to the Holder by facsimile or email a notice setting forth the Exercise Price after such adjustment
and any resulting adjustment to the number of Warrant Shares and setting forth a brief statement of the facts requiring such adjustment.

 

ii.
Notice to Allow Exercise by Holder. If (A) the Company shall declare a dividend (or any other distribution in whatever
form) on the Ordinary Shares, (B) the Company shall declare a special nonrecurring cash dividend on or a redemption of the Ordinary
Shares, (C) the Company shall authorize the granting to all holders of the Ordinary Shares rights or warrants to subscribe for
or purchase any shares of capital stock of any class or of any rights, (D) the approval of any stockholders of the Company shall
be required in connection with any reclassification of the Ordinary Shares, any consolidation or merger to which the Company is
a party, any sale or transfer of all or substantially all of the assets of the Company, or any compulsory share exchange whereby
the Ordinary Shares are converted into other securities, cash or property, or (E) the Company shall authorize the voluntary or
involuntary dissolution, liquidation or winding up of the affairs of the Company, then, in each case, the Company shall cause
to be delivered by facsimile or email to the Holder at its last facsimile number or email address as it shall appear upon the
Warrant Register of the Company, at least 20 calendar days prior to the applicable record or effective date hereinafter specified,
a notice stating (x) the date on which a record is to be taken for the purpose of such dividend, distribution, redemption, rights
or warrants, or if a record is not to be taken, the date as of which the holders of the Ordinary Shares of record to be entitled
to such dividend, distributions, redemption, rights or warrants are to be determined or (y) the date on which such reclassification,
consolidation, merger, sale, transfer or share exchange is expected to become effective or close, and the date as of which it
is expected that holders of the Ordinary Shares of record shall be entitled to exchange their shares of the Ordinary Shares for
securities, cash or other property deliverable upon such reclassification, consolidation, merger, sale, transfer or share exchange;
provided that the failure to deliver such notice or any defect therein or in the delivery thereof shall not affect the validity
of the corporate action required to be specified in such notice. To the extent that any notice provided in this Warrant constitutes,
or contains, material, non-public information regarding the Company or any of the Subsidiaries, the Company shall simultaneously
file such notice with the Commission pursuant to a Current Report on Form 8-K. The Holder shall remain entitled to exercise this
Warrant during the period commencing on the date of such notice to the effective date of the event triggering such notice except
as may otherwise be expressly set forth herein.

 

    	 	10	 

     

    

 

Section
4. Transfer of Warrant.

 

a)
Transferability. Pursuant to FINRA Rule 5110(g)(1) and the Agreement, neither this Warrant nor any Warrant Shares issued
upon exercise of this Warrant shall be sold, transferred, assigned, pledged or hypothecated, or be the subject of any hedging,
short sale, derivative, put or call transaction that would result in the effective economic disposition of the securities by any
person for a period of one hundred eighty (180) days immediately following the date of effectiveness or commencement of sales
of the offering pursuant to which this Warrant is being issued, except the transfer of any security:

 

(i)
by operation of law or by reason of reorganization of the Company;

 

(ii)
to any FINRA member firm participating in the offering and the officers and partners thereof, if all securities so transferred
remain subject to the lock-up restriction in this Section 4(a) for the remainder of the time period;

 

(iii)
if the aggregate amount of securities of the Company held by the Holder or related person do not exceed 1% of the securities being
offered;

 

(iv)
that is beneficially owned on a pro-rata basis by all equity owners of an investment fund, provided that no participating member
manages or otherwise directs investments by the fund, and participating members in the aggregate do not own more than 10% of the
equity in the fund; or

 

(v)
the exercise or conversion of any security, if all securities received remain subject to the lock-up restriction in this Section
4(a) for the remainder of the time period.

 

Subject
to the foregoing restrictions, compliance with any applicable securities laws, and the conditions set forth in Section 4(d) hereof,
this Warrant and all rights hereunder (including, without limitation, any registration rights) are transferable, in whole or in
part, upon surrender of this Warrant at the principal office of the Company or its designated agent, together with a written assignment
of this Warrant substantially in the form attached hereto duly executed by the Holder or its agent or attorney and funds sufficient
to pay any transfer taxes payable upon the making of such transfer. Upon such surrender and, if required, such payment, the Company
shall execute and deliver a new Warrant or Warrants in the name of the assignee or assignees, as applicable, and in the denomination
or denominations specified in such instrument of assignment, and shall issue to the assignor a new Warrant evidencing the portion
of this Warrant not so assigned, and this Warrant shall promptly be cancelled. Notwithstanding anything herein to the contrary,
the Holder shall not be required to physically surrender this Warrant to the Company unless the Holder has assigned this Warrant
in full, in which case, the Holder shall surrender this Warrant to the Company within three (3) Trading Days of the date the Holder
delivers an assignment form to the Company assigning this Warrant in full. The Warrant, if properly assigned in accordance herewith,
may be exercised by a new holder for the purchase of Warrant Shares without having a new Warrant issued.

 

    	 	11	 

     

    

 

b)
New Warrants. This Warrant may be divided or combined with other Warrants upon presentation hereof at the aforesaid office
of the Company, together with a written notice specifying the names and denominations in which new Warrants are to be issued,
signed by the Holder or its agent or attorney. Subject to compliance with Section 4(a), as to any transfer which may be involved
in such division or combination, the Company shall execute and deliver a new Warrant or Warrants in exchange for the Warrant or
Warrants to be divided or combined in accordance with such notice. All Warrants issued on transfers or exchanges shall be dated
the Original Issuance Date of this Warrant and shall be identical with this Warrant except as to the number of Warrant Shares
issuable pursuant thereto.

 

c)
Warrant Register. The Company shall register this Warrant, upon records to be maintained by the Company for that purpose
(the “Warrant Register”), in the name of the record Holder hereof from time to time. The Company may deem and
treat the registered Holder of this Warrant as the absolute owner hereof for the purpose of any exercise hereof or any distribution
to the Holder, and for all other purposes, absent actual notice to the contrary.

 

d)
Representation by the Holder. The Holder, by the acceptance hereof, represents and warrants that it is acquiring this Warrant
and, upon any exercise hereof, will acquire the Warrant Shares issuable upon such exercise, for its own account and not with a
view to or for distributing or reselling such Warrant or Warrant Shares or any part thereof in violation of the Securities Act
or any applicable state securities law, except pursuant to sales registered or exempted under the Securities Act.

 

Section
5. Registration Rights.

 

a)
Piggy-Back Registration.

 

i.
Piggy-Back Rights. If at any time prior to the Termination Date, the registration statement is no longer effective and
the Company proposes to file a registration statement under the Securities Act with respect to an offering of equity securities,
or securities or other obligations exercisable or exchangeable for, or convertible into, equity securities, by the Company for
its own account or for shareholders of the Company for their account (or by the Company and by shareholders of the Company), other
than a registration statement (i) filed in connection with any employee share option or other benefit plan, (ii) for an exchange
offer or offering of securities solely to the Company’s existing shareholders, or (iii) for a dividend reinvestment plan,
then the Company shall (x) give written notice of such proposed filing to the holders of Registrable Securities as soon as practicable
but in no event less than ten days before the anticipated filing date, which notice shall describe the amount and type of securities
to be included in such offering, the intended method(s) of distribution, and the name of the proposed managing underwriter or
underwriters, if any, of the offering, and (y) offer to the holders of Registrable Securities in such notice the opportunity to
register the sale of such number of Warrant Shares held by such holder (the “Piggy-Back Registrable Securities”),
as such holders may request in writing within five days following receipt of such notice (a “Piggy-Back Registration”).
The Company shall cause such Piggy-Back Registrable Securities to be included in such registration and shall use its commercially
reasonable efforts to cause the managing underwriter or underwriters of a proposed underwritten offering to permit the Piggy-Back
Registrable Securities requested to be included in a Piggy-Back Registration on the same terms and conditions as any similar securities
of the Company and to permit the sale or other disposition of such Piggy-Back Registrable Securities in accordance with the intended
method(s) of distribution thereof. All holders of Piggy-Back Registrable Securities proposing to distribute their securities through
a Piggy-Back Registration that involves an underwriter or underwriters shall enter into an underwriting agreement in customary
form with the underwriter or underwriters selected for such Piggy-Back Registration.

 

ii.
Reduction of Offering. If the managing underwriter or underwriters for a Piggy-Back Registration that is to be an underwritten
offering advises the Company and the holders of Registrable Securities in writing that the dollar amount or number of Ordinary
Shares which the Company desires to sell, taken together with Ordinary Shares, if any, as to which registration has been requested
pursuant to written contractual arrangements with persons other than the holders of Piggy-Back Registrable Securities hereunder,
the Piggy-Back Registrable Securities as to which registration has been requested under this Section 5(a), and the Ordinary Shares,
if any, as to which registration has been requested pursuant to the written contractual piggy-back registration rights of other
shareholders of the Company, exceeds the maximum dollar amount or maximum number of shares that can be sold in such offering without
adversely affecting the proposed offering price, the timing, the distribution method, or the probability of success of such offering
(such maximum dollar amount or maximum number of shares, as applicable, the “Maximum Number of Shares”), then
the Company shall include in any such registration:

 

    	 	12	 

     

    

 

(x)
If the registration is undertaken for the Company’s account: (A) first, the Ordinary Shares or other securities that the
Company desires to sell that can be sold without exceeding the Maximum Number of Shares; and (B) second, subject to the requirements
of registration rights granted by the Company prior to the date hereof, to the extent that the Maximum Number of Shares has not
been reached under the foregoing clause (A), up to the amount of Ordinary Shares or other securities that can be sold without
exceeding the Maximum Number of Shares, on a pro rata basis, from (i) Piggy-Back Registrable Securities as to which registration
has been requested and (ii) the Ordinary Shares or other securities for the account of other persons that the Company is obligated
to register pursuant to written contractual piggy-back registration rights with such persons;

 

(y)
If the registration is a Demand Registration undertaken at the demand of holders of Registrable Securities, subject to the requirements
of registration rights granted by the Company prior to the date hereof, (A) first, the Ordinary Shares or other securities for
the account of the demanding persons that can be sold without exceeding the Maximum Number of Shares; (B) second, to the extent
that the Maximum Number of Shares has not been reached under the foregoing clause (A), the Ordinary Shares or other securities
comprised of Piggy-Back Registrable Securities, pro rata, as to which registration has been requested pursuant to the terms hereof
that can be sold without exceeding the Maximum Number of Shares; and (C) third, to the extent that the Maximum Number of Shares
has not been reached under the foregoing clauses (A) and (B), the Ordinary Shares or other securities for the account of other
persons that the Company is obligated to register pursuant to written contractual arrangements with such persons, that can be
sold without exceeding the Maximum Number of Shares.

 

iii.
Withdrawal. Any holder of Piggy-Back Registrable Securities may elect to withdraw such holder’s request for inclusion
of such Piggy-Back Registrable Securities in any Piggy-Back Registration by giving written notice to the Company of such request
to withdraw prior to the effectiveness of the registration statement. The Company (whether on its own determination or as the
result of a withdrawal by persons making a demand pursuant to written contractual obligations) may withdraw a registration statement
at any time prior to the effectiveness of the registration statement. Notwithstanding any such withdrawal, the Company shall pay
all expenses incurred by the holders of Piggy-Back Registrable Securities in connection with such Piggy-Back Registration as provided
in Section 5(a)(iv).

 

iv.
Terms. The Company shall bear all fees and expenses attendant to registering the Piggy-Back Registrable Securities, including
the expenses of one legal counsel selected by the Holders to represent them in connection with the sale of the Piggy-Back Registrable
Securities but the Holders shall pay any and all underwriting commissions related to the Piggy-Back Registrable Securities. In
the event of such a proposed registration, the Company shall furnish the then Holders of outstanding Piggy-Back Registrable Securities
with not less than fifteen days written notice prior to the proposed date of filing of such registration statement. Such notice
to the Holders shall continue to be given for each applicable registration statement filed (during the period in which the Warrant
is exercisable) by the Company until such time as all of the Piggy-Back Registrable Securities have been registered and sold.
The Holders of the Piggy-Back Registrable Securities shall exercise the “piggy-back” rights provided for herein by
giving written notice, within ten days of the receipt of the Company’s notice of its intention to file a registration statement.
The Company shall cause any registration statement filed pursuant to the above “piggyback” rights to remain effective
for at least nine (9) months from the date that the Holders of the Piggy-Back Registrable Securities are first given the opportunity
to sell all of such securities.

 

    	 	13	 

     

    

 

b)
General Terms. These additional terms shall relate to registration under Section 5(a) above:

 

i.
Indemnification.

 

(w)
The Company shall, to the fullest extent permitted by applicable law, indemnify the Holder(s) of the Registrable Securities to
be sold pursuant to any registration statement hereunder and each person, if any, who controls such Holders within the meaning
of Section 15 of the Act or Section 20(a) of the Exchange Act against all loss, claim, damage, expense or liability (including
all reasonable attorneys’ fees and other expenses reasonably incurred in investigating, preparing or defending against litigation,
commenced or threatened, or any claim whatsoever whether arising out of any action between the underwriter and the Company or
between the underwriter and any third party or otherwise) to which any of them may become subject under the Act, the Exchange
Act or otherwise, arising from such registration statement; provided, however, that, with respect to any Holder
of Registrable Securities, this indemnity shall not apply to any loss, liability, claim, damage or expense to the extent arising
out of an untrue statement or omission or alleged untrue statement or omission made in reliance upon and in conformity with written
information furnished to the Company by such Holder expressly for use in the registration statement (or any amendment thereto),
or any preliminary prospectus or the prospectus (or any amendment or supplement thereto).

 

(x)
The Holder(s) of the Registrable Securities to be sold pursuant to such registration statement, and their successors and assigns,
shall severally, and not jointly, indemnify the Company, its officers and directors and each person, if any, who controls the
Company within the meaning of Section 15 of the Act or Section 20(a) of the Exchange Act, against all loss, claim, damage, expense
or liability (including all reasonable attorneys’ fees and other expenses reasonably incurred in investigating, preparing
or defending against any claim whatsoever) to which they may become subject under the Act, the Exchange Act or otherwise, arising
from information furnished by or on behalf of such Holders, or their successors or assigns, in writing, for specific inclusion
in such registration statement(or any amendment thereto), or any preliminary prospectus or the prospectus (or any amendment or
supplement thereto).

 

    	 	14	 

     

    

 

(y)
Each indemnified party shall give prompt notice to each indemnifying party of any action commenced against it in respect of which
indemnity may be sought hereunder, but failure to so notify an indemnifying party shall not relieve the indemnifying party from
any liability it may have under this Agreement, except to the extent that the indemnifying party is prejudiced thereby. If it
so elects, after receipt of such notice, an indemnifying party, jointly with any other indemnifying parties receiving such notice,
may assume the defense of such action with counsel chosen by it; provided, however, that the indemnified party shall
be entitled to participate in (but not control) the defense of such action with counsel chosen by it, the reasonable fees and
expenses of which shall be paid by such indemnified party, unless a conflict would arise if one counsel were to represent both
the indemnified party and the indemnifying party, in which case the reasonable fees and expenses of counsel to the indemnified
party shall be paid by the indemnifying party or parties. In no event shall the indemnifying party or parties be liable for a
settlement of an action with respect to which they have assumed the defense if such settlement is effected without the written
consent of such indemnifying party, or for the reasonable fees and expenses of more than one counsel for (i) the Company, its
officers, directors and controlling persons as a group, and (ii) the selling Holders and their controlling persons as a group,
in each case, in connection with any one action or separate but similar or related actions in the same jurisdiction arising out
of the same general allegations or circumstances; provided, however, that if, in the reasonable judgment of an indemnified
party, a conflict of interest may exist between such indemnified party and the Company or any other of such indemnified parties
with respect to such claim, the indemnifying party shall be obligated to pay the reasonable fees and expenses of such additional
counsel.

 

(z)
If the indemnification provided for in or pursuant to Section 5(b)(i) is due in accordance with the terms hereof, but held by
a court of competent jurisdiction to be unavailable or unenforceable in respect of any losses, claims, damages, liabilities or
expenses referred to therein, then each applicable indemnifying party, in lieu of indemnifying such indemnified party, shall contribute
to the amount paid or payable by such indemnified party as a result of such losses, claims, damages, liabilities or expenses in
such proportion as is appropriate to reflect the relative fault of the indemnifying party on the one hand and of the indemnified
party on the other in connection with the statements or omissions which result in such losses, claims, damages, liabilities or
expenses as well as any other relevant equitable considerations. The relative fault of the indemnifying party on the one hand
and of the indemnified party on the other shall be determined by reference to, among other things, whether the untrue or alleged
untrue statement of a material fact or the omission or alleged omission to state a material fact relates to information supplied
by the indemnifying party or by the indemnified party, and by such party’s relative intent, knowledge, access to information
and opportunity to correct or prevent such statement or omission.

 

ii.
Documents Delivered to Holders. The Company shall furnish the initial Holder a signed counterpart, addressed to the initial
Holder, of (i) an opinion of counsel to the Company, dated the effective date of such registration statement (or, if such registration
includes an underwritten public offering, an opinion dated the date of the closing under any underwriting agreement related thereto),
and (ii) if such registration statement is filed in connection of an underwritten public offering, a “cold comfort”
letter dated the effective date of such registration statement (or, if such registration includes an underwritten public offering,
a letter dated the date of the closing under the underwriting agreement) signed by the independent public accountants who have
issued a report on the Company’s financial statements included in such registration statement, in each case covering substantially
the same matters with respect to such registration statement (and the prospectus included therein) and, in the case of such accountants’
letter, with respect to events subsequent to the date of such financial statements, as are customarily covered in opinions of
issuer’s counsel and in accountants’ letters delivered to underwriters in underwritten public offerings of securities.

 

    	 	15	 

     

    

 

iii.
Supplemental Prospectus. Each Holder agrees, that upon receipt of any notice from the Company of the happening of any event
as a result of which the prospectus included in the registration statement, as then in effect, includes an untrue statement of
a material fact or omits to state a material fact required to be stated therein or necessary to make the statements therein not
misleading in light of the circumstances then existing, such Holder will immediately discontinue disposition of Registrable Securities
pursuant to the registration statement covering such Registrable Securities until such Holder’s receipt of the copies of
a supplemental or amended prospectus, and, if so desired by the Company, such Holder shall deliver to the Company (at the expense
of the Company) or destroy (and deliver to the Company a certificate of such destruction) all copies, other than permanent file
copies then in such Holder’s possession, of the prospectus covering such Registrable Securities current at the time of receipt
of such notice. Immediately after discovering of such an event which causes the prospectus included in the registration statement,
as then in effect, includes an untrue statement of a material fact or omits to state a material fact required to be stated therein
or necessary to make the statements therein not misleading in light of the circumstances then existing, the Company shall prepare
and file, as soon as practicable, a supplement or amendment to the prospectus so that such registration statement does not include
any untrue statement of a material fact or omits to state a material fact required to be stated therein or necessary to make the
statements therein not misleading in light of the circumstances then existing and distribute such supplement or amendment to each
Holder.

 

Section
6. Miscellaneous.

 

a)
No Rights as Stockholder Until Exercise. This Warrant does not entitle the Holder to any voting rights, dividends or other
rights as a stockholder of the Company prior to the exercise hereof as set forth in Section 2(d)(i), except as expressly set forth
in Section 3.

 

b)
Loss, Theft, Destruction or Mutilation of Warrant. The Company covenants that upon receipt by the Company of evidence reasonably
satisfactory to it of the loss, theft, destruction or mutilation of this Warrant or any stock certificate relating to the Warrant
Shares, and in case of loss, theft or destruction, of indemnity or security reasonably satisfactory to it (which, in the case
of the Warrant, shall not include the posting of any bond), and upon surrender and cancellation of such Warrant or stock certificate,
if mutilated, the Company will make and deliver a new Warrant or stock certificate of like tenor and dated as of such cancellation,
in lieu of such Warrant or stock certificate.

 

c)
Saturdays, Sundays, Holidays, etc. If the last or appointed day for the taking of any action or the expiration of any right
required or granted herein shall not be a Business Day, then, such action may be taken or such right may be exercised on the next
succeeding Business Day.

 

    	 	16	 

     

    

 

d)
Authorized Shares. The Company covenants that, during the period the Warrant is outstanding, it will reserve from its authorized
and unissued Ordinary Shares a sufficient number of shares to provide for the issuance of the Warrant Shares upon the exercise
of any purchase rights under this Warrant. The Company further covenants that its issuance of this Warrant shall constitute full
authority to its officers who are charged with the duty of issuing the necessary Warrant Shares upon the exercise of the purchase
rights under this Warrant. The Company will take all such reasonable action as may be necessary to assure that such Warrant Shares
may be issued as provided herein without violation of any applicable law or regulation, or of any requirements of the Trading
Market upon which the Ordinary Shares may be listed. The Company covenants that all Warrant Shares which may be issued upon the
exercise of the purchase rights represented by this Warrant will, upon exercise of the purchase rights represented by this Warrant
and payment for such Warrant Shares in accordance herewith, be duly authorized, validly issued, fully paid and non-assessable
and free from all taxes, liens and charges created by the Company in respect of the issue thereof (other than taxes in respect
of any transfer occurring contemporaneously with such issue).

 

Except
and to the extent as waived or consented to by the Holder, the Company shall not by any action, including, without limitation,
amending its certificate of incorporation or through any reorganization, transfer of assets, consolidation, merger, dissolution,
issue or sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of the
terms of this Warrant, but will at all times in good faith assist in the carrying out of all such terms and in the taking of all
such actions as may be necessary or appropriate to protect the rights of Holder as set forth in this Warrant against impairment.
Without limiting the generality of the foregoing, the Company will (i) not increase the par value of any Warrant Shares above
the amount payable therefor upon such exercise immediately prior to such increase in par value, (ii) take all such action as may
be necessary or appropriate in order that the Company may validly and legally issue fully paid and non-assessable Warrant Shares
upon the exercise of this Warrant and (iii) use commercially reasonable efforts to obtain all such authorizations, exemptions
or consents from any public regulatory body having jurisdiction thereof, as may be, necessary to enable the Company to perform
its obligations under this Warrant.

 

Before
taking any action which would result in an adjustment in the number of Warrant Shares for which this Warrant is exercisable or
in the Exercise Price, the Company shall obtain all such authorizations or exemptions thereof, or consents thereto, as may be
necessary from any public regulatory body or bodies having jurisdiction thereof.

 

e)
Jurisdiction. All questions concerning the construction, validity, enforcement and interpretation of this Warrant shall
be determined in accordance with the provisions of the Agreement.

 

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

 

g)
Non-waiver and Expenses. No course of dealing or any delay or failure to exercise any right hereunder on the part of Holder
shall operate as a waiver of such right or otherwise prejudice the Holder’s rights, powers or remedies. Without limiting
any other provision of this Warrant or the Agreement, if the Company willfully and knowingly fails to comply with any provision
of this Warrant, which results in any material damages to the Holder, the Company shall pay to the Holder such amounts as shall
be sufficient to cover any costs and expenses including, but not limited to, reasonable attorneys’ fees, including those
of appellate proceedings, incurred by the Holder in collecting any amounts due pursuant hereto or in otherwise enforcing any of
its rights, powers or remedies hereunder.

 

    	 	17	 

     

    

 

h)
Notices. Any notice, request or other document required or permitted to be given or delivered to the Holder by the Company
shall be delivered in accordance with the notice provisions of the Agreement.

 

i)
Limitation of Liability. No provision hereof, in the absence of any affirmative action by the Holder to exercise this Warrant
to purchase Warrant Shares, and no enumeration herein of the rights or privileges of the Holder, shall give rise to any liability
of the Holder for the purchase price of any Ordinary Shares or as a stockholder of the Company, whether such liability is asserted
by the Company or by creditors of the Company.

 

j)
Remedies. The Holder, in addition to being entitled to exercise all rights granted by law, including recovery of damages,
will be entitled to specific performance of its rights under this Warrant. The Company agrees that monetary damages would not
be adequate compensation for any loss incurred by reason of a breach by it of the provisions of this Warrant and hereby agrees
to waive and not to assert the defense in any action for specific performance that a remedy at law would be adequate.

 

k)
Successors and Assigns. Subject to applicable securities laws, this Warrant and the rights and obligations evidenced hereby
shall inure to the benefit of and be binding upon the successors and permitted assigns of the Company and the successors and permitted
assigns of Holder. The provisions of this Warrant are intended to be for the benefit of any Holder from time to time of this Warrant
and shall be enforceable by the Holder or holder of Warrant Shares.

 

l)
Amendment. This Warrant may be modified or amended or the provisions hereof waived with the written consent of the Company
and the Holder.

 

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

 

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

 

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

 

(Signature
Page Follows)

 

    	 	18	 

     

    

 

IN
WITNESS WHEREOF, the Company has caused this Representative Warrant to be executed by its officer thereunto duly authorized as
of the date first above indicated.

 

	 	PainReform Ltd.
	 	 
	 	By:	                     
	 	Name:	 
	 	Title:	 

 

    	 	19	 

     

    

 

NOTICE
OF EXERCISE

 

TO:
PainReform Ltd.

 

(1)
The undersigned hereby elects to purchase ________ Warrant Shares of the Company pursuant to the terms of the attached Warrant
(only if exercised in full), and tenders herewith payment of the exercise price in full, together with all applicable transfer
taxes, if any.

 

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

 

[
] in lawful money of the United States; or

 

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

 

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

 

______________________

 

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

 

______________________

 

______________________

 

______________________

 

[SIGNATURE
OF HOLDER]

 

Name
of Investing Entity:_________________________________________________________

 

Signature
of Authorized Signatory of Investing Entity:___________________________________

 

Name
of Authorized Signatory:____________________________________________________

 

Title
of Authorized Signatory:_____________________________________________________

 

Date:_________________________________________________________________________

 

    	 	20	 

     

    

 

EXHIBIT
B

 

ASSIGNMENT
FORM

 

(To
assign the foregoing Warrant, execute this form and supply required information. Do not use this form to purchase shares.)

 

FOR
VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to

 

	Name:	 	 
	 	 	 
	Address:	 	(Please
    Print)
	 	 	 
	Phone
    Number:	 	 
	 	 	 
	Email
    Address:	 	(Please
    Print)
	 	 	 
	Dated:
    ___________ __, _____	 	 
	 	 	 
	Holder’s
    Signature:	 	 
	 	 	 
	Holder’s
    Address:	 	 

 

    	 	21	 

     

    

 

Warrant
Exercise Log

 

	

        Date
	 	Number
    of Warrant Shares Available to be Exercised	 	Number
    of Warrant Shares 

Exercised	 	Number
    of Warrant Shares Remaining to be Exercised	 
	 
	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 

 

    	 	22	 

     

    

 

PainReform
Ltd.

WARRANT DATED __________, 2020

 

WARRANT NO. [       ]

 

FORM
OF ASSIGNMENT

 

[To
be completed and signed only upon transfer of Warrant]

 

FOR
VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto ________________________________ the right represented
by the above-captioned Warrant to purchase ____________ share of Company Ordinary Shares and appoints ________________ attorney
to transfer said right on the books of the Company with full power of substitution in the premises.

 

Dated:_______________,
____

 

	 	 
	 	(Signature must conform in all respects to name of holder as specified on the face of the Warrant)
	 	 
	 	
	 	Address of Transferee
	 	 
	 	 
	 	 
	 	 

 

In
the presence of:

 

__________________________

 

 

23

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