Document:

Exhibit 10.66

 

Great Basin Scientific, Inc.

2441 South 3850 West

Salt Lake City, Utah 84120

 

Gentlemen:

 

The undersigned (the “Investor”)
hereby confirms its agreement with Great Basin Scientific, Inc., a Delaware corporation (the “Company”) as follows:

 

1.       This
Subscription Agreement, including the Terms and Conditions For Purchase of Securities attached hereto as Annex I (collectively,
(this “Agreement”) is made as of the date set forth below between the Company and the Investor.

 

2.       The
Company has authorized the sale and issuance to certain investors of up to an aggregate of _______ Units (the “Units”)
consisting of (i) ________ authorized but unissued shares of Series G Mandatorily Convertible Preferred Stock, par value $0.001
per share (the “Preferred Stock”), of the Company (the “Shares”) and (ii) _________ Series
I Warrants (the “Warrants”) to purchase an aggregate
of up to _______ authorized but unissued shares of common stock, par value $0.0001 per share (the “Common Stock”),
and the shares of Common Stock issuable upon exercise of the Warrants (the “Warrant
Shares”). Each Unit will consist of one Share and one Warrant. The Units, the Shares and the Warrants are collectively
referred to as the “Securities.” The purchase price per Unit shall be $____ (the “Unit Purchase Price”).
The Units will not be separately issued or certificated and the Securities shall be immediately separable and transferable upon
issuance. The form of the Warrant is attached hereto as Exhibit B.

 

3.       The
offering and sale of the Securities (the “Offering”) are being made pursuant to (1) an effective Registration
Statement on Form S-1, File No. 333-213144 (including any additional registration statement filed with respect thereto pursuant
to Rule 462(b) under the Securities Act (as defined below) the “Registration Statement”) filed by the Company
with the Securities and Exchange Commission (the “Commission”) (including the prospectus contained therein (the
“Prospectus”) and (2) if applicable, certain “free writing prospectuses” (as that term is defined
in Rule 405 under the Securities Act of 1933, as amended (the “Securities Act”)), that have been or will
be filed with the Commission and delivered to the Investor on or prior to the date hereof (the “Issuer Free Writing Prospectus”),
containing certain supplemental information regarding the Securities, the terms of the Offering and the Company.

 

4.       The
Company and the Investor agree that the Investor will purchase from the Company and the Company will issue and sell to the Investor
the Securities set forth below for the aggregate Purchase Price set forth below. The Securities shall be purchased pursuant to
the Terms and Conditions for Purchase of Securities attached hereto as Annex I and incorporated herein by this reference
as if fully set forth herein. The Investor acknowledges that the Offering is not being underwritten by the placement agent
(the “Placement Agent”) named in the Prospectus and that there is no minimum offering amount.

 

     

     

    

 

5.       The
manner of settlement of the Securities purchased by the Investor shall be as follows: (i) each Investor shall deliver to ___________
(the “Escrow Agent”), via wire transfer, immediately available funds equal to such Investor’s aggregate Purchase
Price for the Securities as set forth on the Signature Page hereto executed by such Investor on or prior to the Closing Date, and
(ii) the Company shall deliver the executed Shares and Warrants to the Investor by mail, registered in such names and sent to such
address as specified by the Investor below.

 

IT IS THE INVESTOR’S RESPONSIBILITY
TO MAKE THE NECESSARY WIRE TRANSFER TO THE ESCROW AGENT. IF THE INVESTOR DOES NOT DELIVER THE AGGREGATE PURCHASE PRICE FOR THE
SECURITIES, THE SECURITIES MAY NOT BE DELIVERED AT CLOSING TO THE INVESTOR OR THE INVESTOR MAY BE EXCLUDED FROM THE CLOSING
ALTOGETHER.

 

6.       The
Investor represents that, except as set forth below, (a) it has had no position, office or other material relationship within the
past three years with the Company or persons known to it to be affiliates of the Company, (b) it is not a member of the Financial
Industry Regulatory Authority, Inc. (“FINRA”) or an Associated Person (as such term is defined under the FINRA’s
NASD Membership and Registration Rules Section 1011) as of the Closing, and (c) neither the Investor nor any group of Investors
(as identified in a public filing made with the Commission) of which the Investor is a part in connection with the Offering, acquired,
or obtained the right to acquire, 20% or more of the Common Stock (or securities convertible into or exercisable for Common Stock)
or the voting power of the Company on a post-transaction basis. Exceptions: 

 

 

(If no exceptions,
write “none.” If left blank, response will be deemed to be “none.”)

 

7.       The
Investor represents that it has received (or otherwise had made available to it by the filing by the Company of an electronic version
thereof with the Commission) the Prospectus, dated ________ __, 2017, which is a part of the Company’s Registration Statement,
the documents incorporated by reference therein and any free writing prospectus (collectively, the “Disclosure Package”),
prior to or in connection with the receipt of this Agreement. The Investor acknowledges that, prior to the delivery of this
Agreement to the Company, the Investor will receive certain additional information regarding the Offering, including pricing information
(the “Offering Information”). Such information may be provided to the Investor by any means permitted
under the Securities Act, including a free writing prospectus and oral communications.

 

8.       No
offer by the Investor to buy Securities will be accepted and no part of the Purchase Price will be delivered to the Company until
the Investor has received the Offering Information and the Company has accepted such offer by countersigning a copy of this Agreement,
and any such offer may be withdrawn or revoked, without obligation or commitment of any kind, at any time prior to the Company
(or Roth on behalf of the Company) sending (orally, in writing or by electronic mail) notice of its acceptance of such offer. An
indication of interest will involve no obligation or commitment of any kind until the Investor has been delivered the Offering Information
and this Agreement is accepted and countersigned by or on behalf of the Company.

 

9.       The
Company acknowledges that the only material, non-public information relating to the Company or its subsidiaries that the Company,
its employees or agents has provided to the Investor in connection with the Offering prior to the date hereof are the material
pricing terms of the Offering.

 

     

     

    

 

Number of Units: ___________________

 

Purchase Price per Unit: $______

 

Aggregate Purchase Price: $______________________

 

Please confirm that the foregoing correctly
sets forth the agreement between us by signing in the space provided below for that purpose.

 

	 	Dated as of:  ________ ___, 2017
	 	 	 
	 	INVESTOR
	 	 	 
	 	By:	 
	 	Print Name:	 
	 	Title:	 
	 	Address:	 
	 	 

 

Agreed and Accepted

this ___ day of January, 2017:

 

	GREAT BASIN SCIENTIFIC, INC.	 
	 	 
	By:	                        	 
	Name:       	 
	Title:       	 
	 	 	 

 

     

     

    

 

annex
I

 

TERMS AND CONDITIONS FOR PURCHASE OF SECURITIES

 

1.              Authorization
and Sale of the Securities. Subject to the terms and conditions of this Agreement, the Company has authorized the sale of the
Securities.

 

2.              Agreement
to Sell and Purchase the Securities; Placement Agent.

 

2.1       At
the Closing (as defined in Section 3.1), the Company will sell to the Investor, and the Investor will purchase from the
Company, upon the terms and conditions set forth herein, the number of Securities set forth on the last page of the Agreement
to which these Terms and Conditions for Purchase of Securities are attached as Annex I (the “Signature Page”)
for the aggregate purchase price therefor set forth on the Signature Page.

 

2.2       The
Company proposes to enter into substantially this same form of Subscription Agreement with certain other investors (or, alternatively,
sell Securities pursuant to the Prospectus without any Subscription Agreement) (the “Other Investors”) and expects
to complete sales of Securities to them. The Investor and the Other Investors are hereinafter sometimes collectively referred
to as the “Investors,” and this Agreement and the Subscription Agreements executed by the Other Investors
are hereinafter sometimes collectively referred to as the “Agreements.”

 

2.3       Investor
acknowledges that the Company has agreed to pay Roth Capital Partners, LLC (the “Placement Agent” or “Roth”)
a fee (the “Placement Fee”) and to reimburse the Placement Agent for certain expenses in respect of the
sale of the Securities to the Investor.

 

2.4       The
Company has entered into a Placement Agent Agreement, dated the date hereof, (the “Placement Agreement”),
with the Placement Agent that contains representations, warranties, covenants and agreements of the Company that may be relied
upon by the Investor, which shall be a third party beneficiary thereof. The Company confirms that neither it nor any other
person acting on its behalf has provided the Investor or their agents or counsel with any information that constitutes or could
reasonably be expected to constitute material, nonpublic information, except as will be disclosed in the Prospectus and/or in the
Company’s Form 8-K to be filed with the Commission in connection with the Offering. The Company understands and confirms
that the Investor will rely on the foregoing representations in effecting transactions in securities of the Company.

 

3.              Closings
and Delivery of the Securities and Funds.

 

3.1       Closing.
The completion of the purchase and sale of the Securities (the “Closing”)
shall occur at a place and time (the “Closing Date”) to be specified by the Company and the Placement Agent,
and of which the Investors will be notified in advance by the Placement Agent, in accordance with Rule 15c6-l promulgated
under the Securities Exchange Act of 1934, as amended (the “Exchange Act”). At the Closing, (a) the Company
shall cause to be delivered to the Investor a number of Shares of Preferred Stock and a Warrant for the number of Warrant Shares
included in the Units set forth on the Signature Page registered in the name of the Investor or, if so indicated on the Investor
Questionnaire attached hereto as Exhibit A, in the name of a nominee designated by the Investor, and (b) the aggregate purchase
price for the Securities being purchased by the Investor will be delivered by or on behalf of the Investor to the Escrow Agent.

 

     

     

    

 

3.2       Conditions
to the Obligations of the Parties. 

 

3.3 (a)       Conditions
to the Company’s Obligations. The Company’s obligation to issue and sell the Securities to the Investor
shall be subject to: (i) the receipt by the Company of the purchase price for the Securities being purchased hereunder
as set forth on the Signature Page and (ii) the accuracy of the representations and warranties made by the Investor
and the fulfillment of those undertakings of the Investor to be fulfilled prior to the Closing Date.

 

3.4 (b)       Conditions
to the Investor’s Obligations. The Investor’s obligation to purchase the Securities will be subject
to the accuracy of the representations and warranties made by the Company and the fulfillment of those undertakings of the
Company to be fulfilled prior to the Closing Date, including without limitation, those contained in the Placement Agreement,
and to the condition that the Placement Agent shall not have: (a) terminated the Placement Agreement pursuant to the
terms thereof or (b) determined that the conditions to the closing in the Placement Agreement have not been satisfied.
The Investor’s obligations are expressly not conditioned on the purchase by any or all of the Other Investors of the
Securities that they have agreed to purchase from the Company. The Investor understands and agrees that, in the event that
the Placement Agent in its sole discretion determines that the conditions to closing in the Placement Agreement have not been
satisfied or if the Placement Agreement may be terminated for any other reason permitted by such Placement Agreement, then
the Placement Agent may, but shall not be obligated to, terminate such Agreement, which shall have the effect of terminating
this Subscription Agreement pursuant to Section 14 below. 

 

3.5             Delivery
of Funds. The aggregate Purchase Price shall be delivered by each Investor on or prior to the Closing Date to the Escrow
Agent.

 

3.6             Delivery
of Shares. The Company shall cause the Shares of Preferred Stock and a Warrant for the number of Warrant Shares included
in the Units set forth on the Signature Page to be delivered to the address specified in each Investor’s Signature Page.

 

4.              Representations,
Warranties and Covenants of the Investor.

 

The Investor acknowledges,
represents and warrants to, and agrees with, the Company and the Placement Agent that:

 

4.1       The
Investor (a) is an entity that qualifies for an exemption from the requirements of the Company to qualify or register the offer
and sale of the Securities to the Investor under any applicable state “blue-sky” or securities laws in the jurisdiction
in which the Investor is deemed to reside (b) is knowledgeable, sophisticated and experienced in making, and is qualified to make
decisions with respect to, investments in securities presenting an investment decision like that involved in the purchase
of the Securities, including investments in securities issued by the Company and investments in comparable companies, (c) has answered
all questions on the Signature Page and the Investor Questionnaire and the answers thereto are true and correct as of the
date hereof and will be true and correct as of the Closing Date and (d) in connection with its decision to purchase the Securities
set forth on the Signature Page, has received and is relying only upon the Disclosure Package and the documents incorporated by
reference therein and the Offering Information.

 

     

     

    

 

4.2       
(a) No action has been or will be taken in any jurisdiction outside the United States by the Company or
the Placement Agent that would permit an offering of the Securities, or possession or distribution of offering materials in
connection with the issue of the Securities in any jurisdiction outside the United States where action for that purpose is
required, (b) if the Investor is outside the United States, it will comply with all applicable laws and regulations in each
foreign jurisdiction in which it purchases, offers, sells or delivers Securities or has in its possession or distributes any
offering material, in all cases at its own expense and (c) the Placement Agent is not authorized to make and has not made any representation,
disclosure or use of any information in connection with the issue, placement, purchase and sale of the Securities, except as set
forth or incorporated by reference in the Registration Statement, Prospectus or any free writing prospectus.

 

4.3       (a)
The Investor has full right, power, authority and capacity to enter into this Agreement and to consummate the transactions contemplated
hereby and has taken all necessary action to authorize the execution, delivery and performance of this Agreement, and (b)
this Agreement constitutes a valid and binding obligation of the Investor enforceable against the Investor in accordance with
its terms, except as enforceability may be limited by applicable bankruptcy, insolvency, reorganization, moratorium or similar laws
affecting creditors’ and contracting parties’ rights generally and except as enforceability may be subject to general
principles of equity (regardless of whether such enforceability is considered in a proceeding in equity or at law) and except
as to the enforceability of any rights to indemnification or contribution that may be violative of the public policy underlying
any law, rule or regulation (including any federal or state securities law, rule or regulation).

 

4.4       The
Investor understands that nothing in this Agreement, the Prospectus, the Disclosure Package, the Offering Information or any other
materials presented to the Investor in connection with the purchase and sale of the Units constitutes legal, tax or investment
advice. The Investor has consulted such legal, tax and investment advisors and made such investigation as it, in its sole discretion,
has deemed necessary or appropriate in connection with its purchase of Units. The Investor also understands that there is no established
public trading market for the Warrants, and that the Company does not expect such a market to develop. In addition, the Company
does not intend to apply for listing of the Warrants on any securities exchange. The Investor understands that without an active
trading market, the liquidity of the Warrants will be limited. 

 

4.5       The
Investor will maintain the confidentiality of all information acquired as a result of the transactions contemplated hereby prior
to the public disclosure of that information by the Company in accordance with Section 13 of this Annex.

 

     

     

    

 

4.6       Since
the time at which the Placement Agent first provided the material pricing terms of the Offering, the Investor has not disclosed
any material pricing information regarding the Offering to any third parties (other than its legal, accounting and other advisors)
and has not engaged in any purchases or sales of the securities of the Company (including, without limitation, any Short Sales
(as defined herein) involving the Company’s securities). The Investor covenants that it will not engage in any purchases
or sales of the securities of the Company (including Short Sales) from the time the Investor received material pricing information
regarding the offering until the time that the transactions contemplated by this Agreement are publicly disclosed. The Investor
agrees that it will not use any of the Securities acquired pursuant to this Agreement to cover any short position in the Common
Stock if doing so would be in violation of applicable securities laws. For purposes hereof, “Short Sales” include,
without limitation, all “short sales” as defined in Rule 200 promulgated under Regulation SHO under the Exchange
Act, whether or not against the box, and all types of direct and indirect stock pledges, forward sales contracts, options,
puts, calls, short sales, swaps, “put equivalent positions” (as defined in Rule 16a-1(h) under the Exchange Act)
and similar arrangements (including on a total return basis), and sales and other transactions through non-U.S. broker dealers or
foreign regulated brokers.

 

4.7       The
Investor has been afforded, (i) the opportunity to ask such questions as it has deemed necessary of, and to receive answers from,
representatives of the Company concerning the terms and conditions of the Offering and the merits and risks of investing in the
Securities; (ii) access to information about the Company and its financial condition, results of operations, business, properties,
management and prospects sufficient to enable it to evaluate its investment; and (iii) the opportunity to obtain such additional
information that the Company possesses or can acquire without unreasonable effort or expense that is necessary to make an informed
investment decision with respect to the investment.  The Investor acknowledges and agrees that neither Roth nor any affiliate
of Roth has provided such Investor with any information or advice with respect to the Securities nor is such information or advice
necessary or desired.  Neither Roth nor any of its affiliates has made or makes any representation as to the Company or the
quality of the Securities and Roth and any of its affiliate may have acquired non-public information with respect to the Company
which such Investor agrees need not be provided to it.  In connection with the issuance of the Securities to such Investor,
neither Roth nor any of its affiliates has acted as a financial advisor or fiduciary to such Investor.

 

5.              Survival
of Representations, Warranties and Agreements; Third Party Beneficiary. Notwithstanding any investigation made by any
party to this Agreement or by the Placement Agent, all covenants, agreements, representations and warranties made by the Company
and the Investor herein will survive the execution of this Agreement, the delivery to the Investor of the Securities being purchased
and the payment therefor. The Placement Agent shall be a third party beneficiary with respect to the representations, warranties
and agreements of the Investor in Section 4 hereof.

 

6.              Notices.
All notices, requests, consents and other communications hereunder will be in writing, will be delivered (a) if within the
domestic United States by first-class registered or certified airmail, or nationally recognized overnight express courier, postage
prepaid, or by facsimile or (b) if delivered from outside the United States, by International Federal Express or facsimile, and
will be deemed given (i) if delivered by first-class registered or certified mail domestic, three business days after so mailed,
(ii) if delivered by nationally recognized overnight carrier, one business day after so mailed, (iii) if delivered by International
Federal Express, two business days after so mailed, and (iv) if delivered by email attachment or facsimile number, upon the
date of transmission, and will be delivered and addressed as follows:

 

     

     

    

 

(a)       if
to the Company, to:

 

Great Basin Scientific, Inc.

2441 South 3850 West

Salt Lake City, Utah 84120

Attention: Chief Financial Officer

Facsimile: (801) 990-1051

E-mail: jrona@gbscience.com

with a copy (which shall not
constitute notice) to:

 

Dorsey & Whitney LLP

1400 Wewatta Street, Suite 400

Denver, Colorado 80202

Attention: Jason Brenkert

Fax: (303) 629-3450

 

(b)       if
to the Investor, at its address on the Signature Page hereto, or at such other address or addresses as may have been furnished
to the Company in writing.

 

7.              Changes.
This Agreement may not be modified or amended except pursuant to an instrument in writing signed by the Company and Investors
holding at least 67% in interest of the Securities at such time.

 

8.              Headings.
The headings of the various sections of this Agreement have been inserted for convenience of reference only and will not
be deemed to be part of this Agreement.

 

9.              Severability.
In case any provision contained in this Agreement should be invalid, illegal or unenforceable in any respect, the validity,
legality and enforceability of the remaining provisions contained herein will not in any way be affected or impaired thereby.

 

10.              Governing
Law. This Agreement will be governed by, and construed in accordance with, the internal laws of the State of New
York, without giving effect to the principles of conflicts of law that would require the application of the laws of any other
jurisdiction.

 

11.              Counterparts.
This Agreement may be executed in two or more counterparts, each of which will constitute an original, but all of which, when
taken together, will constitute but one instrument, and will become effective when one or more counterparts have been signed by
each party hereto and delivered to the other parties. The Company and the Investor acknowledge and agree that the Company shall
deliver its counterpart to the Investor along with the Prospectus (or the filing by the Company of an electronic version thereof
with the Commission).

 

12.              Confirmation
of Sale. The Investor acknowledges and agrees that such Investor’s receipt of the Company’s signed counterpart
to this Agreement, together with the Prospectus (or the filing by the Company of an electronic version thereof with the Commission),
shall constitute written confirmation of the Company’s sale of the Securities to such Investor.

 

     

     

    

 

13.              Press
Release; Disclosure. The Company and the Investor agree that the Company shall (a) prior to the opening of the financial markets
in New York City on _________ __, 2017 issue a press release announcing the Offering and disclosing all material information, including,
without limitation, the material terms, regarding the Offering, not previously disclosed, permitted under existing SEC rules applicable
to press releases, and (b) as promptly as practicable on _______ __, 2017 file a current report on Form 8-K with the Securities
and Exchange Commission. From and after the issuance of such press release, the Company represents to the Investor that it shall
have publicly disclosed all material, non-public information delivered to the Investor by the Company or any of its subsidiaries,
or any of their respective officers, directors, employees or agents in connection with the transactions contemplated by this Agreement.
In addition, effective upon the issuance of such press release, the Company acknowledges and agrees that any and all confidentiality
or similar obligations under any agreement, whether written or oral, between the Company, any of its subsidiaries or any of their
respective officers, directors, agents, employees or affiliates on the one hand, and the Investor or any of their affiliates on
the other hand, shall terminate. Except with respect to the material terms and conditions of the transactions contemplated by this
Agreement, which shall be disclosed pursuant to the press release required above, the Company covenants and agrees that neither
it, nor any other person acting on its behalf will provide Investor or its agents or counsel with any information that constitutes,
or the Company reasonably believes constitutes, material non-public information, unless prior thereto the Investor shall have consented
to the receipt of such information and agreed with the Company to keep such information confidential. To the extent that the Company
delivers any material, non-public information to an Investor without the Investor’s consent, the Company hereby covenants
and agrees that the Investor shall not have any duty of confidentiality to the Company, any of its subsidiaries, or any of their
respective officers, directors, agents, employees or affiliates, or a duty to the Company, any of its subsidiaries or any of their
respective officers, directors, agents, employees or Affiliates not to trade on the basis of, such material, non-public information,
provided that the Investor shall remain subject to applicable law. To the extent that any notice provided pursuant to this Agreement
or the Warrant constitutes, or contains, material, non-public information regarding the Company or any subsidiaries, the Company
shall simultaneously file such notice with the SEC pursuant to a Current Report on Form 8-K. The Company understands and confirms
that the Investor shall be relying on the provisions of this Section 13 in effecting transactions in securities of the Company.

 

14.              Termination.
In the event that the Placement Agreement is terminated by the Placement Agent pursuant to the terms thereof, this Agreement
shall terminate without any further action on the part of the parties hereto.

 

15.              Representations
and Warranties of the Company. The Company hereby represents and warrants to the Investor that:

 

     

     

    

 

15.1       The
Registration Statement and any prospectus included therein, including the Prospectus and any supplement thereto, complies in all
material respects with the requirements of the Exchange Act and the rules and regulations of the Securities and Exchange Commission
(the “Commission”) promulgated thereunder and all other applicable laws and regulations. At the time the Registration
Statement and any amendments thereto becomes effective (or became effective, as applicable), at the date of this Agreement and
at each deemed effective date thereof pursuant to Rule 430B(f)(2) of the Securities Act, the Registration Statement and any amendments
thereto complied and will comply in all material respects with the requirements of the Securities Act and did not and will not
contain any untrue statement of a material fact or omit to state any material fact required to be stated therein or necessary to
make the statements therein not misleading. The Prospectus and any amendments or supplements thereto, at the time the Prospectus
or any amendment or supplement thereto was issued and at the Closing Date, complied, and will comply, in all material respects
with the requirements of the Securities Act and did not, and will not, contain any untrue statement of a material fact or omit
to state a material fact necessary in order to make the statements therein, in light of the circumstances under which they were
made, not misleading.

 

15.2       As
of their respective dates, all reports, schedules, forms, statements and other documents filed by the Company with the Commission
pursuant to the reporting requirements of the Exchange Act during the two (2) years prior to the date hereof (all of the foregoing
filed prior to the date hereof and all exhibits included therein and financial statements, notes and schedules thereto and documents
incorporated by reference therein being hereinafter referred to as the “SEC Documents”) complied in all material
respects with the requirements of the Exchange Act and the rules and regulations of the Commission promulgated thereunder applicable
to the SEC Documents, and none of the SEC Documents, at the time they were filed with the Commission, contained any untrue statement
of a material fact or omitted to state a material fact required to be stated therein or necessary in order to make the statements
therein, in the light of the circumstances under which they were made, not misleading. As of their respective dates, the financial
statements of the Company included in the SEC Documents complied as to form in all material respects with applicable accounting
requirements and the published rules and regulations of the SEC with respect thereto as in effect as of the time of filing. The
Company is not currently contemplating to amend or restate any of the financial statements (including without limitation, any notes
or any letter of the independent accountants of the Company with respect thereto) included in the SEC Documents (the “Financial
Statements”), nor is the Company currently aware of facts or circumstances which would require the Company to amend or
restate any of the Financial Statements, in each case, in order for any of the Financials Statements to be in compliance with generally
accepted accounting principles and the rules and regulations of the Commission. The Company has not been informed by its independent
accountants that they recommend that the Company amend or restate any of the Financial Statements or that there is any need for
the Company to amend or restate any of the Financial Statements.

 

16.              Equal
Treatment of Purchasers. No consideration (including any modification of any subscription agreement executed pursuant to the
Offering or any Warrants issued pursuant to the Offering (each a “Transaction Document”)) shall be offered or
paid to any person to amend or consent to a waiver or modification of any provision of any Transaction Document unless the same
consideration is also offered to the each investor party to the Offering pursuant to this Agreement or other Subscription Agreements,
including the Investor. For clarification purposes, this provision constitutes a separate right granted to the Investor by the
Company and negotiated separately by the Investor, and is intended for the Company to treat the investors party to the Offering
as a class and shall not in any way be construed as any of the investors party to the Offering acting in concert or as a group
with respect to the purchase, disposition or voting of Securities or otherwise.

 

     

     

    

 

17.              Lock-Up.
For a period of ninety (90) days from the date hereof, the Company shall not, without the prior written consent of the Required
Investors, directly or indirectly offer, sell, assign, transfer, pledge, contract to sell, or otherwise dispose of, any shares
of Common Stock or any securities convertible into or exercisable or exchangeable for Common Stock, other than Exempt Issuance
as defined in the Warrants and any shares of Common Stock issuable pursuant to the convertible notes as described in clause (b)
of Exempt Issuance as defined in the Warrants. The provisions of this Section 17 may be amended or waived only in a writing signed
by investors which purchased 67% of the shares of Common Stock purchased in the Offering pursuant to this Agreement and other Subscription
Agreements (the “Required Investors”).

 

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

 

     

     

    

 

EXHIBIT A

GREAT BASIN SCIENTIFIC, INC.

INVESTOR QUESTIONNAIRE

 

Pursuant to Section 3 of Annex I to the Agreement,
please provide us with the following information:

 

	1.	 	The exact name that your Securities are to be registered in.  You may use a nominee name if appropriate:	 	 
	 	 	 	 	 
	2.	 	The relationship between the Investor and the registered holder listed in response to item 1 above:	 	 
	 	 	 	 	 
	3.	 	The mailing address of the registered holder listed in response to item 1 above:	 	 
	 	 	 	 	 
	4.	 	The Social Security Number or Tax Identification Number of the registered holder listed in the response to item 1 above:	 	 

 

     

     

    

 

EXHIBIT B

FORM OF SERIES I WARRANTExhibit 10.67

 

great
basin scientific, inc.

FORM
OF SERIES I Warrant To Purchase Common Stock

 

Warrant No.: I-___

Number of Shares of Common Stock: ___

Date of Issuance: ___, 2017 (“Issuance
Date”)

 

Great Basin Scientific, Inc., a Delaware
corporation (the “Company”), hereby certifies that, for good and valuable consideration, the receipt and sufficiency
of which are hereby acknowledged, [PURCHASER], the registered holder hereof or its permitted assigns (the “Holder”),
is entitled, subject to the terms set forth below, to purchase from the Company, at the Exercise Price (as defined below) then
in effect, at any time or times on or after the date hereof  (the “Initial Exercisability Date”), but
not after 11:59 p.m., New York time, on the Expiration Date (as defined below), up to such number of fully paid and nonassessable
shares of common stock of the Company (“Common Stock”) equal to ___, subject to adjustment as provided herein
(the “Warrant Shares”). Except as otherwise defined herein, capitalized terms in this Warrant to Purchase Common
Stock (including any warrants to Purchase Common Stock issued in exchange, transfer or replacement hereof, this “Warrant”),
shall have the meanings set forth in Section 17. This Warrant is one of the Series I Warrants to purchase Common Stock (the “Series
I Warrants”) originally issued pursuant to certain Subscription Agreements (the “Subscription Agreement”),
each dated as of ______, 2017(the “Subscription Date”), by and among the Company and the purchasers named therein
(the "Buyers”). Capitalized terms used herein and not otherwise defined shall have the definitions ascribed to
such terms in the Subscription Agreement.

 

1.   EXERCISE OF WARRANT.

 

(a) Mechanics of Exercise.   Subject
to the terms and conditions hereof  (including, without limitation, the limitations set forth in Section 1(f)), this Warrant
may be exercised by the Holder at any time or times on or after the Initial Exercisability Date, in whole or in part, by (i) delivery
of a written notice, in the form attached hereto as Exhibit A (the “Exercise Notice”), of the Holder’s
election to exercise this Warrant and (ii) (A) payment to the Company of an amount equal to the applicable Exercise Price (as defined
in Section 1(b)) multiplied by the number of Warrant Shares as to which this Warrant is being exercised (the “Aggregate
Exercise Price”) in cash by wire transfer of immediately available funds or (B) if the provisions of Section 1(d) are
applicable, by notifying the Company that this Warrant is being exercised pursuant to a Cashless Exercise (as defined in Section
1(d)). The Holder shall not be required to deliver the original Warrant in order to effect an exercise hereunder. Execution and
delivery of the Exercise Notice with respect to less than all of the Warrant Shares shall have the same effect as cancellation
of the original Warrant and issuance of a new Warrant evidencing the right to purchase the remaining number of Warrant Shares.
Execution and delivery of an Exercise Notice for all of the then remaining Warrant Shares shall have the same effect as cancellation
of the original of this Warrant after delivery of the Warrant Shares in accordance with the terms hereof. On or before the first
(1st) Trading Day following the date on which the Company has received the Exercise Notice, the Company shall transmit by facsimile
an acknowledgment of confirmation of receipt of the Exercise Notice to the Holder and the Company’s transfer agent (the “Transfer
Agent”). On or before the earlier of: (i) the third (3rd) Trading Day and (ii) the number of Trading Days comprising
the Standard Settlement Period, following the date on which the Company has received the Exercise Notice, so long as the Holder
delivers the Aggregate Exercise Price (or notice of a Cashless Exercise) on or prior to the second (2nd) Trading Day following
the date on which the Company has received the Exercise Notice (the “Share Delivery Date”) (provided that if
the Aggregate Exercise Price has not been delivered by such date, the Share Delivery Date shall be one (1) Trading Day after the
Aggregate Exercise Price (or notice of a Cashless Exercise) is delivered), the Company shall (X) provided that the Transfer Agent
is participating in The Depository Trust Company (“DTC”) Fast Automated Securities Transfer Program, credit
such aggregate number of Warrant Shares to which the Holder is entitled pursuant to such exercise to the Holder’s or its
designee’s balance account with DTC through its Deposit/​Withdrawal At Custodian system, or (Y) if the Transfer Agent
is not participating in the DTC Fast Automated Securities Transfer Program, issue and dispatch by overnight courier to the address
as specified in the Exercise Notice, 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. The Company agrees
to maintain a transfer agent that is a participant in the DTC Fast Automated Securities Transfer Program so long as this Warrant
remains outstanding and exercisable. The Company shall be responsible for all fees and expenses of the Transfer Agent and all fees
and expenses with respect to the issuance of Warrant Shares via DTC, if any. Upon delivery of the Exercise Notice, 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 such Warrant Shares are credited to the Holder’s DTC account or the date of
delivery of the certificates evidencing such Warrant Shares, as the case may be. If this Warrant is submitted in connection with
any exercise pursuant to this Section 1(a) and the number of Warrant Shares represented by this Warrant submitted for exercise
is greater than the number of Warrant Shares being acquired upon an exercise, then the Company shall as soon as practicable and
in no event later than three (3) Trading Days after any exercise and at its own expense, issue a new Warrant (in accordance with
Section 7(d)) representing the right to purchase the number of Warrant Shares issuable immediately prior to such exercise under
this Warrant, less the number of Warrant Shares with respect to which this Warrant is exercised. No fractional Warrant Shares are
to be issued upon the exercise of this Warrant, but rather the number of Warrant Shares to be issued shall be rounded up to the
nearest whole number. The Company shall pay any and all taxes (other than the Holder’s income taxes) which may be payable
with respect to the issuance and delivery of Warrant Shares upon exercise of this Warrant. The Company’s obligations to issue
and deliver Warrant Shares in accordance with the terms and subject to the conditions hereof are absolute and unconditional, irrespective
of any action or inaction by the Holder to enforce the same, any waiver or consent with respect to any provision hereof, the recovery
of any judgment against any Person or any action to enforce the same, or any setoff, counterclaim, recoupment, limitation or termination.

 

    	 	1	 

     

    

  

(b) Exercise Price.   For
purposes of this Warrant, “Exercise Price” means $___, subject to adjustment as provided herein.

 

(c) Company’s Failure to Timely
Deliver Securities.   If the Company shall fail for any reason or for no reason to issue to the Holder on or
prior to the Share Delivery Date either (I) if the Transfer Agent is not participating in the DTC Fast Automated Securities Transfer
Program, a certificate for the number of shares of Common Stock to which the Holder is entitled and register such shares of Common
Stock on the Company’s share register or if the Transfer Agent is participating in the DTC Fast Automated Securities Transfer
Program, to credit the Holder’s balance account with DTC, for such number of shares of Common Stock to which the Holder is
entitled upon the Holder’s exercise of this Warrant, (II) if the Registration Statement (as defined in Section 1(d)) covering
the issuance of all of the Warrant Shares that are the subject of the Exercise Notice (the “Unavailable Warrant Shares”)
is not available for the issuance of such Unavailable Warrant Shares and the Company fails to promptly, but in no event later than
one (1) Trading Day thereafter, (x) so notify the Holder and (y) deliver the Warrant Shares electronically without any restrictive
legend by crediting such aggregate number of Warrant Shares to which the Holder is entitled pursuant to such exercise to the Holder’s
or its designee’s balance account with DTC through its Deposit/​Withdrawal At Custodian system (the event described
in the immediately foregoing clause (II) is hereinafter referred as a “Notice Failure” and together with the
event described in clause (I) above, an “Exercise Failure”) or (III) if the Transfer Agent is not participating
in the DTC Fast Automated Securities Transfer Program, the Company shall fail for any reason or for no reason to issue and deliver
a certificate to the Holder and register such shares of Common Stock on the Company’s share register or, if the Transfer
Agent is participating in the DTC Fast Automated Securities Transfer Program, credit the Holder’s balance account with DTC,
as required pursuant to the terms of Section 1(a), for the number of shares of Common Stock to which the Holder is entitled upon
the Holder’s exercise hereunder or pursuant to the Company’s obligation pursuant to clause (ii) below, and if on or
after such Trading Day the Holder (or any other Person in respect, or on behalf, of the Holder) purchases (in an open market transaction
or otherwise) shares of Common Stock to deliver in satisfaction of a sale by the Holder of all or any portion of the number of
shares of Common Stock equal to or any portion of the number of shares of Common Stock issuable upon such exercise that the Holder
anticipated receiving from the Company (a “Buy-In”), then, in addition to all other remedies available to the
Holder, the Company shall, within three (3) Trading Days after the Holder’s request and in the Holder’s discretion,
either (i) pay cash to the Holder in an amount equal to the Holder’s total purchase price (including brokerage commissions
and other out-of-pocket expenses, if any) for the shares of Common Stock so purchased (the “Buy-In Price”),
at which point the Company’s obligation to deliver such certificate (and to issue such shares of Common Stock) or credit
such Holder’s balance account with DTC for such shares of Common Stock shall terminate, or (ii) promptly honor its obligation
to deliver to the Holder a certificate or certificates representing such shares of Common Stock or credit such Holder’s balance
account with DTC, as applicable, and pay cash to the Holder in an amount equal to the excess (if any) of the Buy-In Price over
the product of  (A) such number of shares of Common Stock, times (B) any trading price of the Common Stock selected by the
Holder in writing as in effect at any time during the period beginning on the date of the applicable Exercise Notice and ending
on the date of such issuance and payment under this Section 1(c). Nothing shall limit the 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 certificates representing shares of Common Stock
(or to electronically deliver such shares of Common Stock) upon the exercise of this Warrant as required pursuant to the terms
hereof.

 

    	 	2	 

     

    

  

(d) Cashless Exercise.   Notwithstanding
anything contained herein to the contrary, if the Registration Statement on Form S-1 (File number 333-213144) or other applicable
registration statement under the 1933 Act (the “Registration Statement”), covering the issuance of the Unavailable
Warrant Shares is not available for the issuance of such Unavailable Warrant Shares the Holder may, in its sole discretion, exercise
this Warrant in whole or in part and, in lieu of making the cash payment otherwise contemplated to be made to the Company upon
such exercise in payment of the Aggregate Exercise Price, elect instead to receive upon such exercise the “Net Number”
of shares of Common Stock determined according to the following formula (a “Cashless Exercise”):

 

Net Number = (A x B) - (A x C)

D

For purposes of the foregoing formula:

 

A= the total number
of shares with respect to which this Warrant is then being exercised.

B= the arithmetic average of the Closing
Sale Prices of the Common Stock for the five (5) consecutiveTrading Days ending on the date immediately preceding the date
of the Exercise Notice.

C= the Exercise Price
then in effect for the applicable Warrant Shares at the time of such exercise.

D= the Closing Sale
Price of the Common Stock on the date of the Exercise Notice.

 

If Warrant Shares are issued in a Cashless
Exercise, the parties acknowledge and agree that in accordance with Section 3(a)(9) of the 1933 Act, the Warrant Shares shall take
on the registered 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 1(d).

 

(e) Disputes.   In
the case of a dispute as to the determination of the Exercise Price or the arithmetic calculation of the Warrant Shares, the Company
shall promptly issue to the Holder the number of Warrant Shares that are not disputed and resolve such dispute in accordance with
Section 12.

 

    	 	3	 

     

    

  

(f) Beneficial Ownership Limitation
on Exercises.   Notwithstanding anything to the contrary contained herein, the Company shall not effect the
exercise of any portion of this Warrant, and the Holder shall not have the right to exercise any portion of this Warrant, pursuant
to the terms and conditions of this Warrant and any such exercise shall be null and void and treated as if never made, to the extent
that after giving effect to such exercise, the Holder together with the other Attribution Parties collectively would beneficially
own in excess of 9.99% (the “Maximum Percentage”) of the number of shares of Common Stock outstanding immediately
after giving effect to such exercise. For purposes of the foregoing sentence, the aggregate number of shares of Common Stock beneficially
owned by the Holder and the other Attribution Parties shall include the number of shares of Common Stock held by the Holder and
all other Attribution Parties plus the number of shares of Common Stock issuable upon exercise of this Warrant with respect to
which the determination of such sentence is being made, but shall exclude the number of shares of Common Stock which would be issuable
upon (A) exercise of the remaining, unexercised portion of this Warrant beneficially owned by the Holder or any of the other Attribution
Parties and (B) exercise or conversion of the unexercised or unconverted portion of any other securities of the Company (including,
without limitation, any convertible notes or convertible preferred stock or warrants) beneficially owned by the Holder or any other
Attribution Party subject to a limitation on conversion or exercise analogous to the limitation contained in this Section 1(f).
For purposes of this Section 1(f), beneficial ownership shall be calculated in accordance with Section 13(d) of the Securities
Exchange Act of 1934, as amended (the “1934 Act”). For purposes of this Warrant, in determining the number of
outstanding shares of Common Stock the Holder may acquire upon the exercise of this Warrant without exceeding the Maximum Percentage,
the Holder may rely on the number of outstanding shares of Common Stock as reflected in (x) the Company’s most recent Annual
Report on Form 10-K, Quarterly Report on Form 10-Q, Current Report on Form 8-K or other public filing with the Securities and Exchange
Commission (the “SEC”), as the case may be, (y) a more recent public announcement by the Company or (3) any
other written notice by the Company or the Transfer Agent setting forth the number of shares of Common Stock outstanding (the “Reported
Outstanding Share Number”). If the Company receives an Exercise Notice from the Holder at a time when the actual number
of outstanding shares of Common Stock is less than the Reported Outstanding Share Number, the Company shall (i) notify the Holder
in writing of the number of shares of Common Stock then outstanding and, to the extent that such Exercise Notice would otherwise
cause the Holder’s beneficial ownership, as determined pursuant to this Section 1(f), to exceed the Maximum Percentage, the
Holder must notify the Company of a reduced number of Warrant Shares to be purchased pursuant to such Exercise Notice (the number
of shares by which such purchase is reduced, the “Reduction Shares”) and (ii) as soon as reasonably practicable,
the Company shall return to the Holder any exercise price paid by the Holder for the Reduction Shares. For any reason at any time,
upon the written or oral request of the Holder, the Company shall within one (1) Business Day confirm orally and in writing or
by electronic mail to the Holder the number of shares of Common Stock then outstanding. In any case, the number of outstanding
shares of Common Stock shall be determined after giving effect to the conversion or exercise of securities of the Company, including
this Warrant, by the Holder and any other Attribution Party since the date as of which the Reported Outstanding Share Number was
reported. In the event that the issuance of shares of Common Stock to the Holder upon exercise of this Warrant results in the Holder
and the other Attribution Parties being deemed to beneficially own, in the aggregate, more than the Maximum Percentage of the number
of outstanding shares of Common Stock (as determined under Section 13(d) of the 1934 Act), the number of shares so issued by which
the Holder’s and the other Attribution Parties’ aggregate beneficial ownership exceeds the Maximum Percentage (the
“Excess Shares”) shall be deemed null and void and shall be cancelled ab initio, and the Holder shall not have
the power to vote or to transfer the Excess Shares. As soon as reasonably practicable after the issuance of the Excess Shares has
been deemed null and void, the Company shall return to the Holder the exercise price paid by the Holder for the Excess Shares.
Upon delivery of a written notice to the Company, the Holder may from time to time increase or decrease the Maximum Percentage
to any other percentage not in excess of 9.99% as specified in such notice; provided that (i) any such increase in the Maximum
Percentage will not be effective until the sixty-first (61st) day after such notice is delivered to the Company and (ii) any such
increase or decrease will apply only to the Holder and the other Attribution Parties and not to any other holder of Series I Warrants
that is not an Attribution Party of the Holder. For purposes of clarity, the shares of Common Stock issuable pursuant to the terms
of this Warrant in excess of the Maximum Percentage shall not be deemed to be beneficially owned by the Holder for any purpose
including for purposes of Section 13(d) or Rule 16a-1(a)(1) of the 1934 Act. The provisions of this paragraph shall be construed
and implemented in a manner otherwise than in strict conformity with the terms of this Section 1(f) to the extent necessary to
correct this paragraph or any portion of this paragraph which may be defective or inconsistent with the intended beneficial ownership
limitation contained in this Section 1(f) or to make changes or supplements necessary or desirable to properly give effect to such
limitation. The limitation contained in this paragraph may not be waived and shall apply to a successor holder of this Warrant.

 

(g) Insufficient Authorized Shares.   If
at any time while this Warrant remains outstanding the Company does not have a sufficient number of authorized and unreserved shares
of Common Stock to satisfy its obligation to reserve for issuance upon exercise of this Warrant at least a number of shares of
Common Stock equal to the maximum number of shares of Common Stock as shall from time to time be necessary to effect the exercise
of all of this Warrant then outstanding (the “Required Reserve Amount” and the failure to have such sufficient
number of authorized and unreserved shares of Common Stock, an “Authorized Share Failure”), then the Company
shall promptly take all action reasonably necessary to increase the Company’s authorized shares of Common Stock to an amount
sufficient to allow the Company to reserve the Required Reserve Amount for this Warrant and the other Series I Warrants then outstanding.
Without limiting the generality of the foregoing sentence, as soon as practicable after the date of the occurrence of an Authorized
Share Failure, but in no event later than seventy-five (75) days after the occurrence of such Authorized Share Failure, the Company
shall either (x) obtain the written consent of its shareholders for the approval of an increase in the number of authorized shares
of Common Stock and provide each shareholder with an information statement with respect thereto or (y) hold a meeting of its shareholders
for the approval of an increase in the number of authorized shares of Common Stock. In connection with such meeting, the Company
shall provide each shareholder with a proxy statement and shall use its reasonable best efforts to solicit its shareholders’
approval of such increase in authorized shares of Common Stock and to cause its board of directors to recommend to the shareholders
that they approve such proposal. Notwithstanding the foregoing, if any such time of an Authorized Share Failure, the Company is
able to obtain the written consent of a majority of the shares of its issued and outstanding Common Stock to approve the increase
in the number of authorized shares of Common Stock, the Company may satisfy this obligation by obtaining such consent and submitting
for filing with the SEC an Information Statement on Schedule 14C. The initial number of shares of Common Stock reserved for exercise
of this Warrant and the other Series I Warrants and each increase in the number of shares so reserved shall be allocated pro rata
among the Holder and the holders of the other Series I Warrants, based on the number of shares of Common Stock issuable upon exercise
of this Warrant (without regard to any limitations in exercise) issued to the Holder on the Issuance Date (the “Authorized
Share Allocation”). In the event that the Holder shall sell or otherwise transfer this Warrant, each transferee shall
be allocated a pro rata portion of such holder’s Authorized Share Allocation. Any shares of Common Stock reserved and allocated
to any Person which ceases to hold any Series I Warrants shall be allocated to the Holder and the remaining holders of Series I
Warrants, pro rata based on the shares of Common Stock issuable upon exercise of the Series I Warrants then held by such holders
(without regard to any limitations on the exercise of the Series I Warrants).

 

    	 	4	 

     

    

  

2.   ADJUSTMENT OF EXERCISE
PRICE AND NUMBER OF WARRANT SHARES.   The Exercise Price and the number of Warrant Shares shall be adjusted
from time to time as follows:

 

(a) Voluntary Adjustment By Company.   The
Company may at any time during the term of this Warrant, with the prior written consent of the Required Holders, reduce the then
current Exercise Price to any amount and for any period of time deemed appropriate by the Board of Directors of the Company.

 

(b) Adjustment Upon Subdivision or
Combination of Shares of Common Stock.   If the Company at any time on or after the Subscription Date subdivides
(by any stock split, stock dividend, recapitalization or otherwise) one or more classes of its outstanding shares of Common Stock
into a greater number of shares, the Exercise Price in effect immediately prior to such subdivision will be proportionately reduced
and the number of Warrant Shares will be proportionately increased. If the Company at any time on or after the Subscription Date
combines (by combination, reverse stock split or otherwise) one or more classes of its outstanding shares of Common Stock into
a smaller number of shares, the Exercise Price in effect immediately prior to such combination will be proportionately increased
and the number of Warrant Shares will be proportionately decreased. Any adjustment under this Section 2(b) shall become effective
at the close of business on the date the subdivision or combination becomes effective.

 

(c) Adjustment.   If
the Exercise Price on December 31, 2017 exceeds eighty-five percent (85%) of the lowest Weighted Average Price of the Common Stock
during the five (5) consecutive Trading Day period ending immediately prior to such date (the “Adjusted Exercise Price”),
the Exercise Price hereunder shall be reset to the Adjusted Exercise Price, subject to further adjustment hereunder.

 

(d) Other Events.   If
any event occurs of the type contemplated by the provisions of this Section 2, but not expressly provided for by such provisions
(including, without limitation, the granting of stock appreciation rights, phantom stock rights or other rights with equity features),
then the Company’s Board of Directors will make an appropriate adjustment in the Exercise Price and the number of Warrant
Shares, as mutually determined by the Company’s Board of Directors and the Required Holders, so as to protect the rights
of the Holder; provided that no such adjustment pursuant to this Section 2(d) will increase the Exercise Price or decrease
the number of Warrant Shares as otherwise determined pursuant to this Section 2.

 

    	 	5	 

     

    

  

3.   FUNDAMENTAL TRANSACTIONS.

 

(a)  Fundamental Transactions.   The
Company shall not enter into or be party to a Fundamental Transaction unless the Successor Entity assumes 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(a) pursuant to written agreements in form and substance reasonably satisfactory to the Required Holders and approved by the Required
Holders, such approval not to be unreasonably withheld or delayed, prior to such Fundamental Transaction, including agreements,
if so requested by the Holder, to deliver to each holder of the Series I Warrants in exchange for such Series I Warrants a security
of the Successor Entity evidenced by a written instrument substantially similar in form and substance to this Warrant, including,
without limitation, an adjusted exercise price equal to the value for the shares of Common Stock reflected by the terms of such
Fundamental Transaction, and exercisable for a corresponding number of shares of capital stock equivalent to the shares of Common
Stock 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 satisfactory to the Required Holders, 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 shares of Common Stock pursuant
to such Fundamental Transaction and the value of such shares of capital stock, such adjustments to the 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 occurrence
or consummation of such Fundamental Transaction). Upon the occurrence or consummation of any Fundamental Transaction, and it shall
be a required condition to the occurrence or consummation of any Fundamental Transaction that, the Company and the Successor Entity
or Successor Entities, jointly and severally, shall succeed to, and the Company shall cause any Successor Entity or Successor Entities
to jointly and severally succeed to, and be added to the term “Company” under this Warrant (so that from and after
the date of such Fundamental Transaction, and the provisions of this Warrant referring to the “Company” shall refer
instead to each of the Company and the Successor Entity or Successor Entities, jointly and severally), and the Company and the
Successor Entity or Successor Entities, jointly and severally, may exercise every right and power of the Company prior thereto
and shall assume all of the obligations of the Company prior thereto under this Warrant with the same effect as if the Company
and such Successor Entity or Successor Entities, jointly and severally, had been named as the Company in this Warrant, and, solely
at the request of the Holder, if the Successor Entity and/or Successor Entities is a publicly traded corporation whose common stock
is quoted on or listed for trading on an Eligible Market, shall deliver (in addition to and without limiting any right under this
Warrant) to the Holder in exchange for this Warrant a security of the Successor Entity and/or Successor Entities evidenced by a
written instrument substantially similar in form and substance to this Warrant and exercisable for a corresponding number of shares
of capital stock of the Successor Entity and/or Successor Entities (the “Successor Capital Stock”) equivalent
to the shares of Common Stock acquirable and receivable upon exercise of this Warrant (without regard to any limitations on the
exercise of this Warrant) prior to such Fundamental Transaction (such corresponding number of shares of Successor Capital Stock
to be delivered to the Holder shall be equal to the greater of  (A) the quotient of  (i) the aggregate dollar value
of all consideration (including cash consideration and any consideration other than cash (“Non-Cash Consideration”),
in such Fundamental Transaction, as such values are set forth in any definitive agreement for the Fundamental Transaction that
has been executed at the time of the first public announcement of the Fundamental Transaction or, if no such value is determinable
from such definitive agreement, as determined in accordance with Section 12 with the term “Non-Cash Consideration”
being substituted for the term “Exercise Price”) that the Holder would have been entitled to receive upon the happening
of such Fundamental Transaction or the record, eligibility or other determination date for the event resulting in such Fundamental
Transaction, had this Warrant been exercised immediately prior to such Fundamental Transaction or the record, eligibility or other
determination date for the event resulting in such Fundamental Transaction (without regard to any limitations on the exercise of
this Warrant) (the “Aggregate Consideration”) divided by (ii) the per share Closing Sale Price of such Successor
Capital Stock on the Trading Day immediately prior to the consummation or occurrence of the Fundamental Transaction and (B) the
product of  (i) the Aggregate Consideration and (ii) the highest exchange ratio pursuant to which any shareholder of the
Company may exchange Common Stock for Successor Capital Stock) (provided, however, to the extent that the Holder’s right
to receive any such shares of publicly traded common stock (or their equivalent) of the Successor Entity would result in the Holder
and its other Attribution Parties exceeding the Maximum Percentage, if applicable, then the Holder shall not be entitled to receive
such shares to such extent (and shall not be entitled to beneficial ownership of such shares of publicly traded common stock (or
their equivalent) of the Successor Entity as a result of such consideration to such extent) and the portion of such shares shall
be held in abeyance for the Holder until such time or times, as its right thereto would not result in the Holder and its other
Attribution Parties exceeding the Maximum Percentage, at which time or times the Holder shall be delivered such shares to the extent
as if there had been no such limitation), and such security shall be reasonably satisfactory to the Holder, and with an identical
exercise price to the Exercise Price hereunder (such adjustments to the number of shares of capital stock and such exercise price
being for the purpose of protecting after the consummation or occurrence of such Fundamental Transaction the economic value of
this Warrant that was in effect immediately prior to the consummation or occurrence of such Fundamental Transaction, as elected
by the Holder solely at its option). Upon occurrence or consummation of the Fundamental Transaction, and it shall be a required
condition to the occurrence or consummation of such Fundamental Transaction that, the Company and the Successor Entity or Successor
Entities shall deliver to the Holder confirmation that there shall be issued upon exercise of this Warrant at any time after the
occurrence or consummation of the Fundamental Transaction, as elected by the Holder solely at its option, shares of Common Stock,
Successor Capital Stock or, in lieu of the shares of Common Stock or Successor Capital Stock (or other securities, cash, assets
or other property purchasable upon the exercise of this Warrant prior to such Fundamental Transaction), such shares of stock, securities,
cash, assets or any other property whatsoever (including warrants or other purchase or subscription rights), which for purposes
of clarification may continue to be shares of Common Stock, if any, that the Holder would have been entitled to receive upon the
happening of such Fundamental Transaction or the record, eligibility or other determination date for the event resulting in such
Fundamental Transaction, had this Warrant been exercised immediately prior to such Fundamental Transaction or the record, eligibility
or other determination date for the event resulting in such Fundamental Transaction (without regard to any limitations on the exercise
of this Warrant), as adjusted in accordance with the provisions of this Warrant. In addition to and not in substitution for any
other rights hereunder, prior to the occurrence or consummation of any Fundamental Transaction pursuant to which holders of shares
of Common Stock are entitled to receive securities, cash, assets or other property with respect to or in exchange for shares of
Common Stock (a “Corporate Event”), the Company shall make appropriate provision to ensure that, and any applicable
Successor Entity or Successor Entities shall ensure that, and it shall be a required condition to the occurrence or consummation
of such Corporate Event that, the Holder will thereafter have the right to receive upon exercise of this Warrant at any time after
the occurrence or consummation of the Corporate Event, shares of Common Stock or Successor Capital Stock or, if so elected by the
Holder, in lieu of the shares of Common Stock (or other securities, cash, assets or other property) purchasable upon the exercise
of this Warrant prior to such Corporate Event, such shares of stock, securities, cash, assets or any other property whatsoever
(including warrants or other purchase or subscription rights and any shares of Common Stock) which the Holder would have been entitled
to receive upon the occurrence or consummation of such Corporate Event or the record, eligibility or other determination date for
the event resulting in such Corporate Event, had this Warrant been exercised immediately prior to such Corporate Event or the record,
eligibility or other determination date for the event resulting in such Corporate Event (without regard to any limitations on exercise
of this Warrant). Provision made pursuant to the preceding sentence shall be in a form and substance reasonably satisfactory to
the Holder. The provisions of this Section 3(a) shall apply similarly and equally to successive Fundamental Transactions and Corporate
Events. Notwithstanding the foregoing, the Holder may elect, in its sole discretion, by delivery of written notice to the Company,
to waive this Section 3(a) and allow the Company to enter into or be a party to a Fundamental Transaction without the assumption
of this Warrant pursuant to the provisions of this Section 3(a), provided, however, that any such waiver shall only
bind the Holder with respect to this Warrant and not the Holder with respect to any other warrant or other securities of the Company
or any holder of other Series I Warrants.

 

    	 	6	 

     

    

  

(c)  Notwithstanding anything herein
to the contrary, the Company shall be required to obtain the prior written consent of the Required Holders to enter into, allow
and/or consummate a Fundamental Transaction other than one in which a Successor Entity that is a publicly traded corporation whose
stock is quoted or listed for trading on an Eligible Market assumes this Warrant such that the Warrant shall be exercisable for
the publicly traded Common Stock of such Successor Entity.

 

4.   NONCIRCUMVENTION.   The
Company hereby covenants and agrees that the Company will not, by amendment of its Articles of Incorporation or Bylaws, or through
any reorganization, transfer of assets, consolidation, merger, scheme of arrangement, 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, and will
at all times in good faith carry out all of the provisions of this Warrant and take all action as may be required to protect the
rights of the Holder. Without limiting the generality of the foregoing, the Company (i) shall not increase the par value of any
shares of Common Stock receivable upon the exercise of this Warrant above the Exercise Price then in effect, (ii) shall take all
such actions as may be necessary or appropriate in order that the Company may validly and legally issue fully paid and nonassessable
shares of Common Stock upon the exercise of this Warrant, and (iii) shall, so long as any of the Series I Warrants are outstanding,
take all action necessary to reserve and keep available out of its authorized and unissued shares of Common Stock, solely for the
purpose of effecting the exercise of the Series I Warrants, the Required Reserve Amount to effect the exercise of the Series I
Warrants then outstanding (without regard to any limitations on exercise).

 

    	 	7	 

     

    

  

5.   WARRANT HOLDER NOT
DEEMED A SHAREHOLDER.   Except as otherwise specifically provided herein, the Holder, solely in such Person’s
capacity as a holder of this Warrant, shall not be entitled to vote or receive dividends or be deemed the holder of share capital
of the Company for any purpose, nor shall anything contained in this Warrant be construed to confer upon the Holder, solely in
such Person’s capacity as the Holder of this Warrant, any of the rights of a shareholder of the Company or any right to vote,
give or withhold consent to any corporate action (whether any reorganization, issue of stock, reclassification of stock, consolidation,
merger, conveyance or otherwise), receive notice of meetings, receive dividends or subscription rights, or otherwise, prior to
the issuance to the Holder of the Warrant Shares which such Person is then entitled to receive upon the due exercise of this Warrant.
In addition, nothing contained in this Warrant shall be construed as imposing any liabilities on the Holder to purchase any securities
(upon exercise of this Warrant or otherwise) or as a shareholder of the Company, whether such liabilities are asserted by the Company
or by creditors of the Company. Notwithstanding this Section 6, the Company shall provide the Holder with copies of the same notices
and other information given to the shareholders of the Company generally, contemporaneously with the giving thereof to the shareholders.

 

6.   REISSUANCE OF WARRANTS.

 

(a) Transfer of Warrant.   If
this Warrant is to be transferred, the Holder shall surrender this Warrant to the Company, whereupon the Company will forthwith
issue and deliver upon the order of the Holder a new Warrant (in accordance with Section 6(d)), registered as the Holder may request,
representing the right to purchase the number of Warrant Shares being transferred by the Holder and, if less than the total number
of Warrant Shares then underlying this Warrant is being transferred, a new Warrant (in accordance with Section 6(d)) to the Holder
representing the right to purchase the number of Warrant Shares not being transferred.

 

(b) Lost, Stolen or Mutilated Warrant.   Upon
receipt by the Company of evidence reasonably satisfactory to the Company of the loss, theft, destruction or mutilation of this
Warrant, and, in the case of loss, theft or destruction, of any indemnification undertaking by the Holder to the Company in customary
form and, in the case of mutilation, upon surrender and cancellation of this Warrant, the Company shall execute and deliver to
the Holder a new Warrant (in accordance with Section 6(d)) representing the right to purchase the Warrant Shares then underlying
this Warrant.

 

(c) Exchangeable for Multiple Warrants.   This
Warrant is exchangeable, upon the surrender hereof by the Holder at the principal office of the Company, for a new warrant or warrants
(in accordance with Section 6(d)) representing in the aggregate the right to purchase the number of Warrant Shares then underlying
this Warrant, and each such new Warrant will represent the right to purchase such portion of such Warrant Shares as is designated
by the Holder at the time of such surrender; provided, however, that no Series I Warrants for fractional Warrant
Shares shall be given.

 

(d) Issuance of New Warrants.   Whenever
the Company is required to issue a new Warrant pursuant to the terms of this Warrant, such new Warrant (i) shall be of like tenor
with this Warrant, (ii) shall represent, as indicated on the face of such new Warrant, the right to purchase the Warrant Shares
then underlying this Warrant (or in the case of a new Warrant being issued pursuant to Section 6(a) or Section 6(c), the Warrant
Shares designated by the Holder which, when added to the number of shares of Common Stock underlying the other new warrants issued
in connection with such issuance, does not exceed the number of Warrant Shares then underlying this Warrant), (iii) shall have
an issuance date, as indicated on the face of such new Warrant which is the same as the Issuance Date, and (iv) shall have the
same rights and conditions as this Warrant.

 

7.   NOTICES.   Whenever
notice is required to be given under this Warrant, unless otherwise provided herein, with respect to a notice to the Company or
to a Holder that is a party to a Subscription Agreement, such notice shall be given in accordance with Section [●] of the
Subscription Agreement, and, with respect to a notice to a Holder that is not a party to a Subscription Agreement, such notice
shall be given in the manner set forth in and pursuant to the terms of Section [●] of the Subscription Agreement to Holder’s
address, facsimile number or e-mail address in the Company’s records. The Company shall provide the Holder with prompt written
notice of all actions taken pursuant to this Warrant, including in reasonable detail a description of such action and the reason
therefor. Without limiting the generality of the foregoing, the Company will give written notice to the Holder (i) immediately
upon any adjustment of the Exercise Price, setting forth in reasonable detail, and certifying, the calculation of such adjustment
and (ii) at least fifteen (15) days prior to the date on which the Company closes its books or takes a record for determining rights
to vote with respect to any Fundamental Transaction, dissolution or liquidation; provided in each case that such information
shall be made known to the public prior to or in conjunction with such notice being provided to the Holder. It is expressly understood
and agreed that the time of exercise specified by the Holder in each Exercise Notice shall be definitive and may not be disputed
or challenged by the Company.

 

    	 	8	 

     

    

  

8.   AMENDMENT AND WAIVER.   Except
as otherwise provided herein, the provisions of this Warrant may be amended or waived and the Company may take any action herein
prohibited, or omit to perform any act herein required to be performed by it, only if the Company has obtained the written consent
of the Required Holders.

 

9.   GOVERNING LAW; JURISDICTION;
JURY TRIAL.   This Warrant shall be governed by and construed and enforced in accordance with, and all questions
concerning the construction, validity, interpretation and performance of this Warrant shall be governed by, the internal laws of
the State of New York, without giving effect to any choice of law or conflict of law provision or rule (whether of the State of
New York or any other jurisdictions) that would cause the application of the laws of any jurisdictions other than the State of
New York. The Company hereby irrevocably submits to the exclusive jurisdiction of the state and federal courts sitting in The City
of New York, Borough of Manhattan, for the adjudication of any dispute hereunder or in connection herewith or with any transaction
contemplated hereby or discussed herein, and hereby irrevocably waives, and agrees not to assert in any suit, action or proceeding,
any claim that it is not personally subject to the jurisdiction of any such court, that such suit, action or proceeding is brought
in an inconvenient forum or that the venue of such suit, action or proceeding is improper. The Company hereby irrevocably waives
personal service of process and consents to process being served in any such suit, action or proceeding by mailing a copy thereof
to the Company at the address set forth in Section 11 of the Underwriting Agreement and agrees that such service shall constitute
good and sufficient service of process and notice thereof. Nothing contained herein shall be deemed to limit in any way any right
to serve process in any manner permitted by law. Nothing contained herein shall be deemed or operate to preclude the Holder from
bringing suit or taking other legal action against the Company in any other jurisdiction to collect on the Company’s obligations
to the Holder, to realize on any collateral or any other security for such obligations, or to enforce a judgment or other court
ruling in favor of the Holder. THE COMPANY HEREBY IRREVOCABLY WAIVES ANY RIGHT IT MAY HAVE, AND AGREES NOT TO REQUEST, A JURY
TRIAL FOR THE ADJUDICATION OF ANY DISPUTE HEREUNDER OR IN CONNECTION WITH OR ARISING OUT OF THIS WARRANT OR ANY TRANSACTION CONTEMPLATED
HEREBY.

 

10.   CONSTRUCTION; HEADINGS.   This
Warrant shall be deemed to be jointly drafted by the Company and all the Buyers and shall not be construed against any Person as
the drafter hereof. The headings of this Warrant are for convenience of reference and shall not form part of, or affect the interpretation
of, this Warrant.

 

11.   DISPUTE RESOLUTION.   In
the case of a dispute as to the determination of the Exercise Price or the arithmetic calculation of the Warrant Shares, the Company
shall submit the disputed determinations or arithmetic calculations via facsimile or electronic mail within two (2) Business Days
after receipt of the Exercise Notice giving rise to such dispute, as the case may be, to the Holder. If the Holder and the Company
are unable to agree upon such determination or calculation of the Exercise Price or the Warrant Shares within three (3) Business
Days after such disputed determination or arithmetic calculation being submitted to the Holder, then the Company shall, within
two (2) Business Days submit via facsimile (a) the disputed determination of the Exercise Price to an independent, reputable investment
bank selected by the Holder and approved by the Company, such approval not to be unreasonably withheld or delayed or (b) the disputed
arithmetic calculation of the Warrant Shares to the Company’s independent, outside accountant, approved by the Holder, such
approval not to be unreasonably withheld or delayed. The Company shall cause at its expense the investment bank or the accountant,
as the case may be, to perform the determinations or calculations and notify the Company and the Holder of the results no later
than ten (10) Business Days from the time it receives the disputed determinations or calculations. Such investment bank’s
or accountant’s determination or calculation, as the case may be, shall be binding upon all parties absent demonstrable error.

 

    	 	9	 

     

    

  

12.   REMEDIES, OTHER OBLIGATIONS,
BREACHES AND INJUNCTIVE RELIEF.   The remedies provided in this Warrant shall be cumulative and in addition
to all other remedies available under this Warrant and the other Transaction Documents, at law or in equity (including a decree
of specific performance and/or other injunctive relief), and nothing herein shall limit the right of the Holder to pursue actual
damages for any failure by the Company to comply with the terms of this Warrant. The Company acknowledges that a breach by it of
its obligations hereunder will cause irreparable harm to the Holder and that the remedy at law for any such breach may be inadequate.
The Company therefore agrees that, in the event of any such breach or threatened breach, the holder of this Warrant shall be entitled,
in addition to all other available remedies, to an injunction restraining any breach, without the necessity of showing economic
loss and without any bond or other security being required.

 

13.   TRANSFER.   This
Warrant and the Warrant Shares may be offered for sale, sold, transferred, pledged or assigned without the consent of the Company.

 

14.   SEVERABILITY.   If
any provision of this Warrant is prohibited by law or otherwise determined to be invalid or unenforceable by a court of competent
jurisdiction, the provision that would otherwise be prohibited, invalid or unenforceable shall be deemed amended to apply to the
broadest extent that it would be valid and enforceable, and the invalidity or unenforceability of such provision shall not affect
the validity of the remaining provisions of this Warrant so long as this Warrant as so modified continues to express, without material
change, the original intentions of the parties as to the subject matter hereof and the prohibited nature, invalidity or unenforceability
of the provision(s) in question does not substantially impair the respective expectations or reciprocal obligations of the parties
or the practical realization of the benefits that would otherwise be conferred upon the parties. The parties will endeavor in good
faith negotiations to replace the prohibited, invalid or unenforceable provision(s) with a valid provision(s), the effect of which
comes as close as possible to that of the prohibited, invalid or unenforceable provision(s).

 

15.   DISCLOSURE.   Upon
receipt or delivery by the Company of any notice in accordance with the terms of this Warrant, unless the Company has in good faith
determined that the matters relating to such notice do not constitute material, nonpublic information relating to the Company or
its subsidiaries, the Company shall within one (1) Business Day after any such receipt or delivery publicly disclose such material,
nonpublic information on a Current Report on Form 8-K or otherwise. In the event that the Company believes that a notice contains
material, nonpublic information relating to the Company or its subsidiaries, the Company so shall indicate to such Holder contemporaneously
with delivery of such notice, and in the absence of any such indication, the Holder shall be allowed to presume that all matters
relating to such notice do not constitute material, nonpublic information relating to the Company or its subsidiaries.

 

16.   CERTAIN DEFINITIONS.   For
purposes of this Warrant, the following terms shall have the following meanings:

 

(a) “1933 Act” means
the Securities Act of 1933, as amended.

 

(b) “Affiliate” means,
with respect to any Person, any other Person that directly or indirectly controls, is controlled by, or is under common control
with, such Person, it being understood for purposes of this definition that “control” of a Person means the power directly
or indirectly either to vote 10% or more of the stock having ordinary voting power for the election of directors of such Person
or direct or cause the direction of the management and policies of such Person whether by contract or otherwise.

 

(c) “Attribution Parties”
means, collectively, the following Persons and entities:

 

(i) any investment vehicle, including, any
funds, feeder funds or managed accounts, currently, or from time to time after the Issuance Date, directly or indirectly managed
or advised by the Holder’s investment manager or any of its Affiliates or principals,

 

(ii) any direct or indirect Affiliates of
the Holder or any of the foregoing,

 

(iii) any Person acting or who could be
deemed to be acting as a Group together with the Holder or any of the foregoing and

 

    	 	10	 

     

    

  

(iv) any other Persons whose beneficial
ownership of the Company’s Common Stock would or could be aggregated with the Holder’s and the other Attribution Parties
for purposes of Section 13(d) of the 1934 Act. For clarity, the purpose of the foregoing is to subject collectively the Holder
and all other Attribution Parties to the Maximum Percentage.

 

(d) “Bloomberg” means
Bloomberg Financial Markets.

 

(e) “Business Day”
means any day other than Saturday, Sunday or other day on which commercial banks in The City of New York are authorized or required
by law to remain closed.

 

(f) “Closing Bid Price”
and “Closing Sale Price” means, for any security as of any date, the last closing bid price and last closing
trade price, respectively, for such security on the Principal Market, as reported by Bloomberg, or, if the Principal Market begins
to operate on an extended hours basis and does not designate the closing bid price or the closing trade price, as the case may
be, then the last bid price or the last trade price, respectively, of such security prior to 4:00:00 p.m., New York time, as reported
by Bloomberg, or, if the Principal Market is not the principal securities exchange or trading market for such security, the last
closing bid price or last trade price, respectively, of such security on the principal securities exchange or trading market where
such security is listed or traded as reported by Bloomberg, or if the foregoing do not apply, the last closing bid price or last
trade price, respectively, of such security in the over-the-counter market on the electronic bulletin board for such security as
reported by Bloomberg, or, if no closing bid price or last trade price, respectively, is reported for such security by Bloomberg,
the average of the bid prices, or the ask prices, respectively, of any market makers for such security as reported in the OTC Link
or “pink sheets” by OTC Markets Group Inc. (formerly Pink OTC Markets Inc.). If the Closing Bid Price or the Closing
Sale Price cannot be calculated for a security on a particular date on any of the foregoing bases, the Closing Bid Price or the
Closing Sale Price, as the case may be, of such security on such date shall be the fair market value as mutually determined by
the Company and the Holder. If the Company and the Holder are unable to agree upon the fair market value of such security, then
such dispute shall be resolved pursuant to Section 12. All such determinations to be appropriately adjusted for any stock dividend,
stock split, stock combination, reclassification or other similar transaction during the applicable calculation period.

 

(g) “Common Stock”
means (i) the Company’s shares of Common Stock, par value $0.0001 per share, and (ii) any share capital into which such Common
Stock shall have been changed or any share capital resulting from a reclassification of such Common Stock.

 

(h) “Eligible Market”
means the Principal Market, the NYSE MKT LLC, The NASDAQ Global Market, The NASDAQ Global Select Market, The New York Stock Exchange,
Inc., the OTC Bulletin Board, the OTCQX or the OTCQB.

 

(i) “Expiration Date”
means the date that is sixty (60) months after the Initial Exercisability Date, or, if such date falls on a day other than a Business
Day or on which trading does not take place on the Principal Market (a “Holiday”), the next day that is not
a Holiday.

 

    	 	11	 

     

    

  

(j) “Fundamental Transaction”
means (A) that the Company shall, directly or indirectly, including through subsidiaries, Affiliates or otherwise, in one or more
related transactions, (i) consolidate or merge with or into (whether or not the Company is the surviving corporation) another Subject
Entity, or (ii) sell, assign, transfer, convey or otherwise dispose of all or substantially all of the properties or assets of
the Company or any of its “significant subsidiaries” (as defined in Rule 1-02 of Regulation S-X) to one or more Subject
Entities, or (iii) make, or allow one or more Subject Entities to make, or allow the Company to be subject to or have its Common
Stock be subject to or party to one or more Subject Entities making, a purchase, tender or exchange offer that is accepted by the
holders of at least either (x) 50% of the outstanding shares of Common Stock, (y) 50% of the outstanding shares of Common Stock
calculated as if any shares of Common Stock held by all Subject Entities making or party to, or Affiliated with any Subject Entities
making or party to, such purchase, tender or exchange offer were not outstanding; or (z) such number of shares of Common Stock
such that all Subject Entities making or party to, or Affiliated with any Subject Entity making or party to, such purchase, tender
or exchange offer, become collectively the beneficial owners (as defined in Rule 13d-3 under the 1934 Act) of at least 50% of the
outstanding shares of Common Stock, or (iv) consummate a share purchase agreement or other business combination (including, without
limitation, a reorganization, recapitalization, spin-off or scheme of arrangement) with one or more Subject Entities whereby such
Subject Entities, individually or in the aggregate, acquire, either (x) at least 50% of the outstanding shares of Common Stock,
(y) at least 50% of the outstanding shares of Common Stock calculated as if any shares of Common Stock held by all the Subject
Entities making or party to, or Affiliated with any Subject Entity making or party to, such stock purchase agreement or other business
combination were not outstanding; or (z) such number of shares of Common Stock such that the Subject Entities become collectively
the beneficial owners (as defined in Rule 13d-3 under the 1934 Act) of at least 50% of the outstanding shares of Common Stock,
or (v) reorganize, recapitalize or reclassify its Common Stock, (B) that the Company shall, directly or indirectly, including through
subsidiaries, Affiliates or otherwise, in one or more related transactions, allow any Subject Entity individually or the Subject
Entities in the aggregate to be or become the “beneficial owner” (as defined in Rule 13d-3 under the 1934 Act), directly
or indirectly, whether through acquisition, purchase, assignment, conveyance, tender, tender offer, exchange, reduction in outstanding
shares of Common Stock, merger, consolidation, business combination, reorganization, recapitalization, spin-off, scheme of arrangement,
reorganization, recapitalization or reclassification or otherwise in any manner whatsoever, of either (x) at least 50% of the aggregate
ordinary voting power represented by issued and outstanding Common Stock, (y) at least 50% of the aggregate ordinary voting power
represented by issued and outstanding Common Stock not held by all such Subject Entities as of the Subscription Date calculated
as if any shares of Common Stock held by all such Subject Entities were not outstanding, or (z) a percentage of the aggregate ordinary
voting power represented by issued and outstanding shares of Common Stock or other equity securities of the Company sufficient
to allow such Subject Entities to effect a statutory short form merger or other transaction requiring other shareholders of the
Company to surrender their shares of Common Stock without approval of the shareholders of the Company or (C) directly or indirectly,
including through subsidiaries, Affiliates or otherwise, in one or more related transactions, the issuance of or the entering into
any other instrument or transaction structured in a manner to circumvent, or that circumvents, the intent of this definition in
which case this definition shall be construed and implemented in a manner otherwise than in strict conformity with the terms of
this definition to the extent necessary to correct this definition or any portion of this definition which may be defective or
inconsistent with the intended treatment of such instrument or transaction.

 

(k) “Group” means
a “group” as that term is used in Section 13(d) of the 1934 Act and as defined in Rule 13d-5 thereunder.

 

(l) “Parent Entity”
of a Person means an entity that, directly or indirectly, controls the applicable Person, including such entity whose common shares
or common stock or equivalent equity security is quoted or listed on an Eligible Market (or, if so elected by the Required Holders,
any other market, exchange or quotation system), or, if there is more than one such Person or such entity, the Person or such entity
designated by the Required Holders or in the absence of such designation, such Person or entity with the largest public market
capitalization as of the date of consummation of the Fundamental Transaction.

 

(m) “Person” means
an individual, a limited liability company, a partnership, a joint venture, a corporation, a trust, an unincorporated organization,
any other entity and a government or any department or agency thereof.

 

(n) “Principal Market”
means the OTCQB.

 

(o) “Required Holders”
means the holders of the Series I Warrants representing at least a majority of the shares of Common Stock underlying the Series
I Warrants then outstanding.

 

(p) “Standard Settlement Period”
means the standard settlement period, expressed in number of Trading Days, on the Company’s primary trading market or quotation
system from time to time, with respect to trades of Common Stock as in effect on the date of delivery of the exercise notice.

 

(q) “Subject Entity”
means any Person, Persons or Group or any Affiliate or associate of any such Person, Persons or Group.

    	 	12	 

     

    

  

(r) “Successor Entity”
means one or more Person or Persons (or, if so elected by the Holder, the Company or Parent Entity) formed by, resulting from or
surviving any Fundamental Transaction or one or more Person or Persons (or, if so elected by the Holder, the Company or the Parent
Entity) with which such Fundamental Transaction shall have been entered into.

 

(s) “Trading Day”
means any day on which the Common Stock is traded on the Principal Market, or, if the Principal Market is not the principal trading
market for the Common Stock, then on the principal securities exchange or securities market on which the Common Stock is then traded;
provided that “Trading Day” shall not include any day on which the Common Stock is scheduled to trade on such
exchange or market for less than 4.5 hours or any day that the Common Stock is suspended from trading during the final hour of
trading on such exchange or market (or if such exchange or market does not designate in advance the closing time of trading on
such exchange or market, then during the hour ending at 4:00:00 p.m., New York time).

 

(t) “Weighted Average Price”
means, for any security as of any date, the dollar volume-weighted average price for such security on the Principal Market during
the period beginning at 9:30:01 a.m., New York time (or such other time as the Principal Market publicly announces is the official
open of trading), and ending at 4:00:00 p.m., New York time (or such other time as the Principal Market publicly announces is the
official close of trading), as reported by Bloomberg through its “Volume at Price” function or, if the foregoing does
not apply, the dollar volume-weighted average price of such security in the over-the-counter market on the electronic bulletin
board for such security during the period beginning at 9:30:01 a.m., New York time (or such other time as such market publicly
announces is the official open of trading), and ending at 4:00:00 p.m., New York time (or such other time as such market publicly
announces is the official close of trading), as reported by Bloomberg, or, if no dollar volume-weighted average price is reported
for such security by Bloomberg for such hours, the average of the highest closing bid price and the lowest closing ask price of
any of the market makers for such security as reported in the OTC Link or “pink sheets” by OTC Markets Group Inc. (formerly
Pink OTC Markets Inc.). If the Weighted Average Price cannot be calculated for a security on a particular date on any of the foregoing
bases, the Weighted Average Price of such security on such date shall be the fair market value as mutually determined by the Company
and the Holder. If the Company and the Holder are unable to agree upon the fair market value of such security, then such dispute
shall be resolved pursuant to Section 12 with the term “Weighted Average Price” being substituted for the term “Exercise
Price.” All such determinations shall be appropriately adjusted for any stock dividend, stock split, stock combination, reclassification
or other similar transaction during the applicable calculation period.

 

[Signature Page Follows]

 

    	 	13	 

     

    

  

IN WITNESS WHEREOF, the Company has
caused this Warrant to Purchase Common Stock to be duly executed as of the Issuance Date set out above.

 

	 	 	 	GREAT BASIN SCIENTIFIC, INC. 
	 	 	 	 	 
	 	 	 	By:	 
	 	 	 	 	 
	 	 	 	Name: 	 
	 	 	 	 	 
	 	 	 	Title: 	 

  

    	 	14	 

     

    

 

EXHIBIT A

EXERCISE NOTICE 

TO BE EXECUTED BY THE REGISTERED HOLDER
TO EXERCISE THIS 

 

WARRANT TO PURCHASE COMMON STOCK 

GREAT BASIN SCIENTIFIC, INC. 

 

The undersigned holder hereby exercises the
right to purchase _________________ of the shares of Common Stock, par value $0.0001 per share (the “Warrant Shares”)
of Great Basin Scientific, Inc., a Delaware corporation (the “Company”), evidenced by the attached Series I
Warrant to purchase Common Stock No. I-____ (the “Warrant”). Capitalized terms used herein and not otherwise
defined shall have the respective meanings set forth in the Warrant.

 

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

 

____________ a “Cash Exercise” with respect
to _________________ Warrant Shares; or

 

____________ a “Cashless Exercise” with respect
to _______________ Warrant Shares.

 

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

 

3.   Delivery of Warrant Shares.
The Company shall deliver to the holder __________ Warrant Shares in accordance with the terms of the Warrant.

 

Please issue the Warrant Shares in the following name and to
the following account:

Issue to:    

    

Facsimile Number and

Electronic Mail:

Authorization:

By:

Title:

Dated:

Broker Name:

Broker DTC #:

Broker Telephone #:

Account Number:

(if electronic book entry transfer)

Transaction Code Number:

(if electronic book entry transfer)

 

    	 	15

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