Document:

SUBSCRIPTION
      AGREEMENT

    

    This
      Subscription Agreement (this “Agreement”)
      is
      entered into as of August 30, 2006 by and among Patient Safety Technologies,
      Inc., a Delaware corporation (together with its successors and permitted
      assigns, the “Issuer”),
      and
      the undersigned investors (each, together with its successors and permitted
      assigns, the “Investor”
and
      collectively, together with their successors and permitted assigns, the
“Investors”).
      

    

    RECITALS

    

    Subject
      to the terms and conditions of this Agreement, the Investors desire to subscribe
      for and purchase, and the Issuer desires to issue and sell to the Investors,
      certain shares of the Issuer’s common stock, par value $.33 per share (the
“Common
      Stock”),
      to
      purchase shares of Common Stock. The Issuer is offering One Hundred Twenty
      Five
      Thousand ($125,000) in shares of Common Stock, in a private placement to
      the Investors at a purchase price of One Dollar and Twenty-Five ($1.25) per
      share and on the other terms and conditions contained in this Agreement (the
      “Offering”)
      and
      the terms of the Company’s 10-K’s and 10-Q’s incorporated by reference,
provided
      that the
      Issuer reserves the right to issue and sell a lesser or greater number of
      shares.

    

    TERMS
      OF AGREEMENT

    

    In
      consideration of the mutual representations and warranties, covenants and
      agreements contained herein, the parties hereto agree as follows:

    

    
      	1.	
              SUBSCRIPTION
                AND ISSUANCE OF COMMON STOCK.

            

    

    

    1.1    Subscription
      and Issuance of Common Stock.
      Subject
      to the terms and conditions of this Agreement, the Issuer shall issue and sell
      to each Investor, and each Investor subscribes for and shall purchase from
      the
      Issuer, that number of shares of Common Stock set forth on such Investor’s
      counterpart signature page hereof (the “Shares”
or
      “Securities”)
      for
      the aggregate purchase price set forth on such counterpart signature page,
      which
      aggregate purchase price shall be equal to the product of the number of Shares
      subscribed for by such Investor multiplied by the per share purchase price
      specified in the above Recitals to this Agreement (the “Purchase
      Price”).
      

    

    1.2    Legends.
      

    

    (a) Any
      certificate or certificates representing the Shares shall bear the following
      legend, in addition to any legend that may be required by any Requirements
      of
      Law:

    

    THE
      SHARES REPRESENTED BY THIS CERTIFICATE ARE BEING ISSUED TO PURCHASE ADDITIONAL
      SHARES OF COMMON STOCK OF THE ISSUER PURSUANT TO A SUBSCRIPTION AGREEMENT WITH
      THE ISSUER DATED AS OF AUGUST 30, 2006, A COPY OF WHICH IS ON FILE WITH THE
      ISSUER. THE SHARES REPRESENTED BY THIS CERTIFICATE ISSUED HEREWITH UNDER SUCH
      SUBSCRIPTION AGREEMENT WILL NOT BE SEPARATELY TRANSFERABLE.

    

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

       

    

    IN
      ADDITION, THE SHARES REPRESENTED BY THIS CERTIFICATE MAY NOT BE SOLD,
      TRANSFERRED, OR OTHERWISE DISPOSED OF BY THE HOLDER EXCEPT PURSUANT TO AN
      EFFECTIVE REGISTRATION STATEMENT FILED UNDER THE SECURITIES ACT OF 1933, AS
      AMENDED, AND IN COMPLIANCE WITH APPLICABLE SECURITIES LAWS OF ANY STATE WITH
      RESPECT THERETO OR IN ACCORDANCE WITH AN OPINION OF COUNSEL IN FORM AND
      SUBSTANCE SATISFACTORY TO THE ISSUER THAT AN EXEMPTION FROM SUCH REGISTRATION
      IS
      AVAILABLE AND ALSO MAY NOT BE SOLD, TRANSFERRED OR OTHERWISE DISPOSED OF EXCEPT
      IN COMPLIANCE WITH ANY APPLICABLE RULES OF THE SECURITIES AND EXCHANGE
      COMMISSION.

    

    
      	2.	
              CLOSING.

            

    

    

    2.1    Closing.
      The
      closing of the transactions contemplated herein (the “Closing”)
      shall
      take place simultaneously upon execution of this Agreement at the offices of
      Issuer located 1800 Century Park East, Suite 200, Los Angeles, CA 90067. At
      the
      Closing: (i) each Investor participating in such Closing shall pay to the
      Issuer, by wire transfer of immediately available funds to an account designated
      in writing by the Issuer, the Purchase Price for the Shares being purchased
      by
      such Investor hereunder; (ii) the Issuer shall issue to each such Investor
      the
      Shares being purchased by the Investor hereunder and shall deliver or cause
      to
      be delivered to such Investor a certificate or certificates representing such
      Shares duly registered in the name of such Investor, as specified on the
      signature pages hereto; and (iii) all other actions referred to in this
      Agreement which are required to be taken at such Closing shall be taken and
      all
      other agreements and documents referred to in this Agreement that are required
      for such Closing shall be executed and delivered.

    

    
      	3.	
              REPRESENTATIONS
                AND WARRANTIES OF THE INVESTORS.

            

    

    

    As
      a
      material inducement to the Issuer to enter into this Agreement and issue the
      Securities, each Investor represents, warrants, and covenants to the Issuer
      as
      follows:

    

    3.1    Power
      and Authority.
      Such
      Investor, if other than a natural person, is an entity duly organized, validly
      existing and in good standing under the laws of the state of its incorporation
      or formation. Such Investor has the corporate, partnership or other power (or,
      in the case of a natural person, legal capacity) and authority under applicable
      law to execute and deliver this Agreement and consummate the transactions
      contemplated hereby, and has all necessary authority to execute, deliver and
      perform its obligations under this Agreement and to consummate the transactions
      contemplated hereby. Such Investor has taken all necessary action to authorize
      the execution, delivery and performance of this Agreement and the transactions
      contemplated hereby.

    

    
      
        
        

      

      
        2

        
          

        

      

      
        
        

      

       

    

    3.2    No
      Violation.
      The
      execution and delivery by such Investor of this Agreement, the consummation
      of
      the transactions contemplated hereby, and the compliance by such Investor with
      the terms and provisions hereof, will not: (i) result in a default under (or
      give any other party the right, with the giving of notice or the passage of
      time
      (or both), to declare a default or accelerate any obligation under) any Contract
      to which such Investor is a party or by which it or its properties or assets
      are
      bound (except to the extent such defaults or accelerations, individually or
      in
      the aggregate, would not reasonably be expected to have a Material Adverse
      Effect on such Investor); (ii) violate any Requirement of Law applicable to
      such
      Investor; or (iii) if such Investor is other than a natural person, violate
      any
      charter, bylaws or similar documents of such Investor. At or prior to the
      Closing, such Investor will have complied with all Requirements of Law
      applicable to it in connection with the Offering and at all times thereafter
      such Investor will comply with all Requirements of Law applicable to it in
      connection with any resale or transfer by such Investor of any Securities
      acquired by such Investor pursuant to this Agreement.

    

    3.3    Consents/Approvals.
      No
      consents, filings, authorizations or actions of any Governmental Authority
      are
      required for such Investor’s execution, delivery and performance of this
      Agreement. No consent, approval, waiver or other actions by any Person under
      any
      Contract to which such Investor is a party or by which such Investor or any
      of
      its properties or assets are bound is required or necessary for the execution,
      delivery and performance by such Investor of this Agreement and the consummation
      of the transactions contemplated hereby.

    

    3.4    Enforceability.
      This
      Agreement has been duly executed and delivered by such Investor and (assuming
      it
      has been duly authorized, executed, and delivered by the Issuer) constitutes
      a
      legal, valid and binding obligation of such Investor, enforceable against such
      Investor in accordance with its terms, except as such enforceability may be
      limited by applicable bankruptcy, insolvency, fraudulent conveyances,
      reorganization, moratorium or similar laws from time to time in effect affecting
      the enforcement of creditor’s rights generally, and general equitable
      principles, regardless of whether enforceability is considered in a proceeding
      at law or in equity, and except for the indemnity provisions of Article
      7 of
      this
      Agreement, which may not be enforceable based upon public policy
      considerations.

    

    3.5    Investment
      Intent.
      Buyer
      is
      acquiring the Shares for its own account, for investment purposes only and
      not
      with a view to resale or other distribution thereof, nor with the intention
      of
      selling, transferring or otherwise disposing of all or any part of such Shares,
      or any interest therein, for any particular price, or at any particular time,
      or
      upon the happening of any particular event or circumstances, except selling,
      transferring, or disposing of such Shares made in full compliance with all
      applicable provisions of the Securities Act of 1993 (the "Securities Act")
      and
      the Securities Exchange Act of 1934, and the Rules and Regulations promulgated
      by the Securities and Exchange Commission thereunder, all as
      amended.

    

    3.6    Accredited
      Investor.
      Such
      Investor is an “accredited investor” as such term is defined in Rule 501(a) of
      Regulation D under the Securities Act. Without limiting the foregoing
      representation, such Investor confirms that it has reviewed the partial
      definition of an “Accredited Investor” which is attached hereto as Exhibit
      A
      (which
      is not a complete definition of the term, but which includes the most likely
      categories of qualification) to confirm the accuracy of such representation,
      and
      such Investor has noted by paragraph number, on its signature page hereto,
      the
      category(ies) pursuant to which such Investor qualifies as an “Accredited
      Investor” according to the definition set forth in Exhibit
      A.
      Such
      Investor has not been formed for the purpose of acquiring the Securities. Such
      Investor is not an officer, director, employee, investment advisor, promoter,
      general partner, Affiliate or member of the advisory board of the
      Issuer.

    

    
      
        
        

      

      
        3

        
          

        

      

      
        
        

      

       

    

    3.7    Adequate
      Information.
      Such
      Investor has received from the Issuer, and has reviewed, such information as
      such Investor considers necessary or appropriate to evaluate the risks and
      merits of an investment in, and make an informed investment decision with
      respect to, the Securities, including, without limitation, the documents listed
      on Exhibit
      B,
      which
      have been received by such Investor as part of an informational packet of
      materials from the Issuer (the “Disclosure
      Documents”).
      Such
      Investor acknowledges that each of the SEC Reports, including the risk factors
      contained therein, are specifically incorporated herein by reference and form
      an
      integral part of this Agreement. Such Investor also acknowledges that the
      additional risk factors set forth and contained in the Disclosure Documents
      are
      specifically incorporated herein by reference and form an integral part of
      this
      Agreement.

    

    3.8    Opportunity
      to Question.
      Such
      Investor has had the opportunity to question, and has questioned, to the extent
      deemed necessary or appropriate, representatives of the Issuer so as to receive
      answers from the Issuer’s representatives regarding the terms and conditions of
      an investment in the Securities and to verify information obtained in such
      Investor’s examination of the Issuer, including, without limitation, the
      information that such Investor received and reviewed as referenced in
Section
      4.7
      in
      relation to its investment in the Securities.

    

    3.9    No
      Other Representations.
      No oral
      or written representations have been made to such Investor in connection with
      such Investor’s acquisition of the Securities which were in any way inconsistent
      with the information reviewed by such Investor. Such Investor acknowledges
      that,
      in deciding whether to enter into this Agreement and to acquire the Securities
      hereunder, it has not relied on any representations or warranties of any type
      or
      description made by the Issuer or any of its representatives with regard to
      the
      Issuer or its business, property or prospects of the investment contemplated
      herein, other than the representations and warranties of the Issuer set forth
      in
Article
      3
      hereof.

    

    3.10    Knowledge
      and Experience.
      Such
      Investor understands that an investment in the Securities involves substantial
      risk. Such Investor has such knowledge and experience in financial, tax and
      business matters, including substantial experience in evaluating and investing
      in common stock and other securities (including the common stock and other
      securities of speculative companies), so as to enable such Investor to utilize
      the information referred to in Section
      4.7
      hereof
      and any other information made available by the Issuer to such Investor in
      order
      to evaluate the merits and risks of an investment in the Securities and to
      make
      an informed investment decision with respect thereto.

    

    3.11    Independent
      Decision.
      Such
      Investor is not relying on the Issuer or on any legal or other opinion in the
      materials reviewed by such Investor with respect to the financial or tax
      considerations of such Investor relating to its investment in the Securities.
      Such Investor has relied solely on the representations and warranties, covenants
      and agreements of the Issuer in this Agreement (including the exhibits and
      schedules hereto) and on its examination and independent investigation in making
      its decision to acquire the Securities.

    

    
      
        
        

      

      
        4

        
          

        

      

      
        
        

      

       

    

    
      	
              4.

            	
              REGISTRATION
                RIGHTS.

            

    

    

    In
      the
      event the Issuer files a registration statement pursuant to the Securities
      Act
      of 1933, as amended, the Securities shall be included for resale in such
      registration statement; provided. 

    

    
      	5.	
              INDEMNIFICATION.

            

    

    

    5.1    Indemnification
      by the Issuer.
      The
      Issuer will indemnify and hold harmless each Holder or Selling Stockholder
      of
      Shares covered by a Registration Statement pursuant to the provisions of
Article
      6,
      any
      Person who controls such Holder or Selling Stockholder within the meaning of
      the
      Securities Act, and any officer, director, investment adviser, employee, agent,
      partner, member or Affiliate of such Holder or Selling Stockholder (each, a
      “Holder/Selling
      Stockholder Indemnified Party”),
      from
      and against, and will reimburse each such Holder/Selling Stockholder Indemnified
      Party with respect to, any and all claims, actions, demands, losses, damages,
      liabilities, costs and expenses to which such Holder/Selling Stockholder or
      any
      such Holder/Selling Stockholder Indemnified Party may become subject under
      the
      Securities Act or otherwise, insofar as such claims, actions, demands, losses,
      damages, liabilities, costs or expenses arise out of or are based upon: (a)
      any
      untrue statement or alleged untrue statement of any material fact contained
      in
      such registration statement, any prospectus contained therein or any amendment
      or supplement thereto; (b) the omission or alleged omission to state therein
      a
      material fact required to be stated therein or necessary to make the statements
      therein (in the case of any preliminary prospectus or prospectus, in light
      of
      the circumstances under which they were made) not misleading; or (c) any
      materially inaccurate representation or breach of any material warranty,
      agreement or covenant of the Issuer contained herein; provided
      that the
      Issuer will not be liable in any such case to the extent that any such claim,
      action, demand, loss, damage, liability, cost or expense arises out of or is
      based upon an untrue statement or alleged untrue statement or omission or
      alleged omission (i) made in reliance on and conformity with information
      furnished by any Holder/Selling Stockholder in writing specifically for use
      in
      the preparation thereof or (ii) which was cured in an amendment or supplement
      to
      the prospectus (or any amendment or supplement thereto) delivered to the
      Holder/Selling Stockholder on a timely basis to permit proper delivery thereof
      prior to the date on which any Shares were transferred or sold.

    

    5.2    Indemnification
      by the Holder or Selling Stockholder.
      Each
      Holder and each Selling Stockholder of Shares covered by a Registration
      Statement pursuant to the provisions of Article
      6
      will
      indemnify and hold harmless the Issuer, any Person who controls the Issuer
      within the meaning of the Securities Act, and any officer, director, employee,
      agent, partner, member or Affiliate of the Issuer (each, an “Issuer
      Indemnified Party”)
      from
      and against, and will reimburse the Issuer Indemnified Parties with respect
      to,
      any and all claims, actions, demands, losses, damages, liabilities, costs or
      expenses to which such Issuer Indemnified Parties may become subject under
      the
      Securities Act or otherwise, insofar as such losses, damages, liabilities,
      costs
      or expenses arise out of or are based upon: (a) any untrue or alleged untrue
      statement of any material fact contained in such Registration Statement, any
      prospectus contained therein or any amendment or supplement thereto; or (b)
      the
      omission or the alleged omission to state therein a material fact required
      to be
      stated therein or necessary to make the statements therein, (in the case of
      any
      preliminary prospectus or prospectus, in light of the circumstances under which
      they were made) not misleading, in each case to the extent, but only to the
      extent, that such untrue statement or alleged untrue statement or omission
      or
      alleged omission was so made in reliance on and conformity with written
      information furnished by such Holder or Selling Stockholder specifically for
      use
      in the preparation thereof; provided
      that the
      liability of any Holder or Selling Stockholder pursuant to this Section
      7.2
      shall be
      limited to an amount not to exceed the net proceeds received by such Holder
      or
      Selling Stockholder from the sale of Registrable Securities pursuant to the
      Registration Statement which gives rise to such obligation to
      indemnify.

    

    
      
        
        

      

      
        5

        
          

        

      

      
        
        

      

       

    

    5.3    Procedures.
      Promptly after receipt by a party indemnified pursuant to the provisions of
      Section
      5.1
      or
Section
      5.2
      of
      notice of the commencement of any action involving the subject matter of the
      foregoing indemnity provisions, such indemnified party will, if a claim thereof
      is to be made against the indemnifying party pursuant to the provisions of
      Section
      5.1
      or
Section
      5.2,
      notify
      the indemnifying party of the commencement thereof; provided
      the
      omission to so notify the indemnifying party will not relieve it from any
      liability which it may have to an indemnified party otherwise than under this
      Article
      7,
      and
      shall not relieve the indemnifying party from liability under this Article
      7,
      except
      to the extent that such indemnifying party is materially prejudiced by such
      omission. In case such action is brought against any indemnified party and
      it
      notifies the indemnifying party of the commencement thereof, the indemnifying
      party shall have the right to participate in, and, to the extent that it may
      wish, jointly with any other indemnifying party similarly notified, to assume
      the defense thereof, with counsel reasonably satisfactory to such indemnified
      party, and after notice from the indemnifying party to such indemnified party
      of
      its election to assume the defense thereof, the indemnifying party will not
      be
      liable to such indemnified party pursuant to the provisions of Section
      5.1
      or
Section
      5.2
      for any
      legal or other expense subsequently incurred by such indemnified party in
      connection with the defense thereof. No indemnifying party shall be liable
      to an
      indemnified party for any settlement of any action or claim without the consent
      of the indemnifying party. No indemnifying party will consent to entry of any
      judgment or enter into any settlement which does not include as an unconditional
      term thereof the giving by the claimant or plaintiff to such indemnified party
      of an unconditional release from all liability in respect to such action, claim
      or litigation.

    

    
      	6.	
              MISCELLANEOUS.

            

    

    

    6.1    Defined
      Terms.
      As used
      herein the following terms shall have the following meanings:

    

    (a) “Affiliate”
has
      the
      meaning ascribed to it in Rule 12b-2 of the General Rules and Regulations under
      the Exchange Act, as in effect on the date hereof.

    

    (b) “Agreement”
has
      the
      meaning specified in the preamble to this Agreement.

    

    (c) “AMEX”
has
      the
      meaning specified in Section
      3.5
      of this
      Agreement.

    

    (d) “Business
      Day”
means
      any day except Saturday, Sunday and any day which shall be a federal legal
      holiday or a day on which either (i) the SEC or (ii) banking institutions in
      the
      State of New York are authorized or required by law or other governmental action
      to close.

    

    
      
        
        

      

      
        6

        
          

        

      

      
        
        

      

       

    

    (e) “Bylaws”
means
      the Bylaws of the Issuer, as the same may be supplemented, amended, or restated
      from time to time.

    

    (f) “Certificate
      of Incorporation”
means
      the Issuer’s Certificate of Incorporation, as the same may be supplemented,
      amended or restated from time to time.

    

    (g) “Closing”
has
      the
      meaning specified in Section
      2.1 of
      this
      Agreement.

    

    (h) “Common
      Stock”
has
      the
      meaning specified in the Recitals to this Agreement.

    

    (i) “Confidential
      Information”
has
      the
      meaning specified in Section
      6.13
      of this
      Agreement.

    

    (j) “Contract”
means
      any indenture, lease, sublease, loan agreement, mortgage, note, restriction,
      commitment, obligation or other contract, agreement or instrument.

    

    (k) “Disclosure
      Documents”
has
      the
      meaning specified in Section
      3.7
      of this
      Agreement and in Exhibit C.

    

    (l) “Exchange
      Act”
means
      the Securities Exchange Act of 1934, as amended.

    

    (m) “GAAP”
means
      generally accepted accounting principles in effect in the United States of
      America.

    

    (n) “Governmental
      Authority”
means
      any nation or government, any state or other political subdivision thereof,
      and
      any entity or official exercising executive, legislative, judicial, regulatory
      or administrative functions of or pertaining to government.

    

    (o) “Holder/Selling
      Stockholder Indemnified Party”
has
      the
      meaning specified in Section
      5.1
      of this
      Agreement.

    

    (p) “Investor”
has
      the
      meaning specified in the preamble to this Agreement.

    

    (q) “Issuer”
means
      Patient Safety Technologies, Inc., a Delaware corporation.

    

    (r) “Issuer
      Indemnified Party”
has
      the
      meaning specified in Section
      5.2
      of this
      Agreement.

    

    (s) “Knowledge”
means,
      with respect to the Issuer, the actual knowledge of Milton “Todd” Ault
      III.

    

    (t) “Material
      Adverse Effect”
means
      a
      material and adverse change in, or effect on, the financial condition,
      properties, assets, liabilities, rights, obligations, operations or business,
      of
      a Person.

    

    
      
        
        

      

      
        7

        
          

        

      

      
        
        

      

       

    

    (u) “Notice
      and Questionnaire”
has
      the
      meaning specified in Exhibit
      D
      of this
      Agreement. 

    

    (v) “Offering”
has
      the
      meaning specified in the Recitals to this Agreement.

    

    (w) “Permit”
means
      any permit, certificate, consent, approval, authorization, order, license,
      variance, franchise or other similar indicia of authority issued or granted
      by
      any Governmental Authority.

    

    (x) “Person”
means
      a
      natural person, partnership, corporation, limited liability company, business
      trust, joint stock company, estate, trust, unincorporated association, joint
      venture, Governmental Authority or other entity, of whatever
      nature.

    

    (y) “Purchase
      Price”
has
      the
      meaning specified in Section
      1.1 of
      this
      Agreement.

    

    (z) “Rule
      144”
means
      Rule 144 promulgated under the Securities Act, or any successor
      thereto.

    

    (aa) “SEC”
means
      the Securities and Exchange Commission.

    

    (bb) “Securities”
has
      the
      meaning specified in Section
      1.2
      of this
      Agreement.

    

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

    

    (dd) “Shares”
has
      the
      meaning specified in Section
      1.1
      of this
      Agreement.

    

    6.2    Other
      Definitional Provisions.

    

    (a) All
      terms
      defined in this Agreement shall have the defined meanings when used in any
      certificates, reports or other documents made or delivered pursuant hereto
      or
      thereto, unless the context otherwise requires.

    

    (b) Terms
      defined in the singular shall have a comparable meaning when used in the plural,
      and vice versa.

    

    (c) All
      accounting terms shall have a meaning determined in accordance with
      GAAP.

    

    (d) The
      words
“hereof,” “herein” and “hereunder,” and words of similar import, when used in
      this Agreement shall refer to this Agreement as a whole (including any exhibits
      and schedules hereto) and not to any particular provision of this
      Agreement.

    

    6.3    Notices.
      All
      notices, requests, demands, claims, and other communications hereunder shall
      be
      in writing and shall be delivered by certified or registered mail (first class
      postage pre-paid), guaranteed overnight delivery, or facsimile transmission if
      such transmission is confirmed by delivery by certified or registered mail
      (first class postage pre-paid) or guaranteed overnight delivery, to the
      following addresses and telecopy numbers (or to such other addresses or telecopy
      numbers which such party shall subsequently designate in writing to the other
      party):

    

    
      
        
        

      

      
        8

        
          

        

      

      
        
        

      

       

    

    
      	
            	
              (a)

            	
              if
                to the Issuer to:

            

    

    

    Patient
      Safety Technologies, Inc.

    c/o
      Milton “Todd” Ault III

    1800
      Century Park East, Suite 200

    Suite
      200

    Los
      Angeles, CA 90067

    Facsimile:
      (310) 895-7750

    

    (b)    if
      to an
      Investor, to the address set forth next to such Investor’s name on such
      Investor’s counterpart signature page hereto.

    

    Each
      such
      notice or other communication shall for all purposes of this Agreement be
      treated as effective or having been given when delivered if delivered by hand,
      by messenger or by courier, or if sent by facsimile, upon confirmation of
      receipt.

    

    6.4    Entire
      Agreement.
      This
      Agreement (including the exhibits and schedules attached hereto) and other
      documents delivered at the Closing pursuant hereto, contain the entire
      understanding of the parties in respect of its subject matter and supersede
      all
      prior agreements and understandings between the parties with respect to such
      subject matter. 

    

    6.5    Expenses;
      Taxes.
      Except
      as otherwise provided in this Agreement, the parties shall pay their own fees
      and expenses, including their own counsel fees, incurred in connection with
      this
      Agreement or any transaction contemplated hereby; provided
      that the
      Issuer shall pay at the Closing the reasonable legal fees (up to a maximum
      of
      $20,000) of a single special counsel to the Investors. Any sales tax, stamp
      duty, deed transfer or other tax (except taxes based on the income of the
      Investors) arising out of the issuance of the Securities (but not with respect
      to subsequent transfers) by the Issuer to the Investors and consummation of
      the
      transactions contemplated by this Agreement shall be paid by the
      Issuer.

    

    6.6    Amendment;
      Waiver.
      This
      Agreement may not be modified, amended, supplemented, canceled or discharged,
      except by written instrument executed by the parties to this Agreement. No
      failure to exercise, and no delay in exercising, any right, power or privilege
      under this Agreement shall operate as a waiver, nor shall any single or partial
      exercise of any right, power or privilege hereunder preclude the exercise of
      any
      other right, power or privilege. No waiver of any breach of any provision shall
      be deemed to be a waiver of any preceding or succeeding breach of the same
      or
      any other provision, nor shall any waiver be implied from any course of dealing
      between the parties. No extension of time for performance of any obligations
      or
      other acts hereunder or under any other agreement shall be deemed to be an
      extension of the time for performance of any other obligations or any other
      acts. The rights and remedies of the parties under this Agreement are in
      addition to all other rights and remedies, at law or equity, that they may
      have
      against each other.

    

    6.7    Binding
      Effect; Assignment.
      The
      rights and obligations of this Agreement shall bind and inure to the benefit
      of
      the parties and their respective successors and legal assigns. The rights and
      obligations of the Issuer pursuant to this Agreement may not be assigned to
      any
      third party without the prior written consent of the Holders of a majority
      of
      the Registrable Securities. 

    

    
      
        
        

      

      
        9

        
          

        

      

      
        
        

      

       

    

    6.8    Counterparts;
      Facsimile Signature.
      This
      Agreement may be executed by facsimile signature and in any number of
      counterparts, each of which shall be an original but all of which together
      shall
      constitute one and the same instrument.

    

    6.9    Headings.
      The
      headings contained in this Agreement are for convenience of reference only
      and
      are not to be given any legal effect and shall not affect the meaning or
      interpretation of this Agreement.

    

    6.10    Governing
      Law; Interpretation.
      This
      Agreement shall be construed in accordance with and governed for all purposes
      by
      the laws of the State of California applicable to contracts executed and to
      be
      wholly performed within such state.

    

    6.11    Severability.
      The
      parties stipulate that the terms and provisions of this Agreement are fair
      and
      reasonable as of the date of this Agreement. However, any provision of this
      Agreement shall be determined by a court of competent jurisdiction to be
      invalid, void or unenforceable, the remainder of the terms, provisions,
      covenants and restrictions of this Agreement shall remain in full force and
      effect and shall in no way be affected, impaired or invalidated. If, moreover,
      any of those provisions shall for any reason be determined by a court of
      competent jurisdiction to be unenforceable because excessively broad or vague
      as
      to duration, activity or subject, it shall be construed by limiting, reducing
      or
      defining it, so as to be enforceable.

    

    6.12    Further
      Assurances.
      Each of
      the parties hereto shall execute and deliver such additional instruments and
      other documents and shall take such further actions as may be reasonably
      necessary or appropriate to effectuate, carry out and comply with all of the
      terms of this Agreement and the transactions contemplated hereby. Each of the
      Investors and the Issuer shall make on a prompt and timely basis all
      governmental or regulatory notifications and filings required to be made by
      it
      with or to any Governmental Authority in connection with the consummation of
      the
      transactions contemplated hereby. The Issuer and the Investors agree to
      cooperate with one another in the preparation and filing of all forms,
      notifications, reports and information, if any, required or reasonably deemed
      advisable pursuant to any Requirement of Law or AMEX rules in connection with
      the transactions contemplated by this Agreement and to use their respective
      commercially reasonable efforts to agree jointly on a method to overcome any
      objections by any Governmental Authority to any such transactions. 

    

    
      
        
        

      

      
        10

        
          

        

      

      
        
        

      

       

    

    6.13    Confidential
      Information.
      Each
      Investor confirms that it has entered into a confidentiality agreement with
      the
      Issuer, pursuant to which such Investor has agreed to keep confidential certain
      information relating to the Issuer that has been disclosed by the Issuer to
      the
      Investor in connection with such Investor’s investment in the Securities, and
      that such Investor shall continue to be bound by such confidentiality agreement
      after the Closing. In addition, each Investor agrees that no portion of the
      Confidential Information (as defined below) shall be disclosed to third parties,
      except as may be required by law, without the prior express written consent
      of
      the Issuer; provided
      that
      each Investor may share such information with such of its officers and
      professional advisors as may need to know such information to assist such
      Investor in its evaluation thereof, on the condition that such parties agree
      to
      be bound by the terms of this Section
      5.4.
      “Confidential
      Information”
means
      the existence and terms of this Agreement, the transactions contemplated hereby,
      and the disclosures and other information contained herein, excluding any
      disclosures or other information that is publicly available.

    

    

    

    

    [REMAINDER
      OF PAGE INTENTIONALLY LEFT BLANK]

     

     

     

     

    
      
        
        

      

      
        11

        
          

        

      

      
        
        

      

    

    

    IN
      WITNESS WHEREOF, the parties hereto have caused this Subscription Agreement
      to
      be duly executed and delivered as of the date set forth below.

     

    
      	 	
              ISSUER:

               

              Patient
                Safety Technologies, Inc.

               

              By:_______________________     

               

              Name:_____________________     

               

              Title:______________________     

               

               

            

    

    

    

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    [INVESTOR
      COUNTERPART SIGNATURE PAGE]

    

    

    
      	
              NAME
                OF INVESTOR
                (please print)

               

              _________________________

            	
              ADDRESS
                FOR NOTICE
                (please print)

              
                _________________________

              

              
                _________________________

              

              
                _________________________

              

              Attention:_____________________     

              Tax
                Identification #:______________    

            
	
              SIGNATURE

               

              By:__________________________     

               

              Name:________________________     

               

              Title:_________________________     

               

              Date:_________________________     

            	 
	
               

               

              Exact
                name to appear on stock certificate:

               

              
                _________________________

              

            	
               

               

              Number
                of Shares subscribed for: 

               

              
                _________________________

              

            
	
               

               

              Aggregate
                Purchase Price (see Section 1.1):
                

               

               

              $__________________________

                 

            	
               

               

              Categories
                pursuant to which Investor qualifies as an Accredited Investor as
                defined
                in Exhibit B
                to
                this Agreement (please indicate the applicable section numbers noted
                on
                Exhibit
                B
                to
                this Agreement):

              __________________________

               

            

    

    

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    EXHIBIT
      A

    

    DEFINITION
      OF “ACCREDITED INVESTOR”

    

    “Accredited
      Investor”
shall
      mean any person who comes within any of the following categories, or who the
      Issuer reasonably believes comes within any of the following categories, at
      the
      time of the sale of the Securities to that person:

    

    1. Any
      bank
      as defined in section 3(a)(2) of the Act, or any savings and loan association
      or
      other institution as defined in section 3(a)(5)(A) of the Act whether acting
      in
      its individual or fiduciary capacity; any broker or dealer registered pursuant
      to section 15 of the Securities Exchange Act of 1934; any insurance company
      as
      defined in section 2(13) of the Act; any investment company registered under
      the
      Investment Company Act of 1940 or a business development company as defined
      in
      section 2(a)(48) of that Act; any Small Business Investment Company licensed
      by
      the U.S. Small Business Administration under section 301(c) or (d) of the Small
      Business Investment Act of 1958; any plan established and maintained by a state,
      its political subdivisions, or any agency or instrumentality of a state or
      its
      political subdivisions, for the benefit of its employees, if such plan has
      total
      assets in excess of $5,000,000; any employee benefit plan within the meaning
      of
      the Employee Retirement Income Security Act of 1974 if the investment decision
      is made by a plan fiduciary, as defined in section 3(21) of such act, which
      is
      either a bank, savings and loan association, insurance company, or registered
      investment adviser, or if the employee benefit plan has total assets in excess
      of $5,000,000 or, if a self-directed plan, with investment decisions made solely
      by persons that are Accredited Investors;

    

    2. Any
      private business development company as defined in section 202(a)(22) of the
      Investment Advisers Act of 1940;

    

    3. Any
      organization described in section 501(c)(3) of the Internal Revenue Code,
      corporation, Massachusetts or similar business trust, or partnership, not formed
      for the specific purpose of acquiring the securities offered, with total assets
      in excess of $5,000,000;

    

    4. Any
      director, executive officer, or general partner of the Issuer, or any director,
      executive officer, or general partner of a general partner of the
      Issuer;

    

    5. Any
      natural person whose individual net worth, or joint net worth with that person’s
      spouse, at the time of his purchase exceeds $1,000,000;

    

    6. Any
      natural person who had an individual income in excess of $200,000 in each of
      the
      two most recent years or joint income with that person’s spouse in excess of
      $300,000 in each of those years and has a reasonable expectation of reaching
      the
      same income level in the current year;

    

    7. Any
      trust, with total assets in excess of $5,000,000, not formed for the specific
      purpose of acquiring the Securities, whose purchase is directed by a
      sophisticated person as described in 230.506(b)(2)(ii); and

    

    8. Any
      entity in which all of the equity owners are Accredited Investors.

    

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    EXHIBIT
      B

    

    NOTICE
      AND QUESTIONNAIRE

    

    The
      undersigned beneficial holder of Registrable Securities of Patient Safety
      Technologies, Inc. (the “Issuer”)
      understands that the Issuer has filed or intends to file with the Securities
      and
      Exchange Commission (the “SEC”)
      a
      Registration Statement under the Securities Act of 1933, as amended (the
“Securities
      Act”),
      for
      the registration and resale of the Registrable Securities in accordance with
      the
      terms of the Subscription Agreement, dated as of August __, 2006 (the
“Subscription
      Agreement”),
      by
      and among the Issuer and the purchasers of the Issuer’s securities thereunder.
      The Subscription Agreement is available from the Issuer upon request at the
      address set forth below. All capitalized terms used but not otherwise defined
      herein shall have the respective meanings given to them in the Subscription
      Agreement.

    

    Each
      beneficial owner of Registrable Securities that has agreed to be bound by
      certain provisions of the Subscription Agreement is entitled to the benefits
      of
      the Subscription Agreement under such provisions. In order to sell or otherwise
      dispose of any Registrable Securities pursuant to the Registration Statement,
      a
      beneficial owner of Registrable Securities generally will be required to be
      named as a selling securityholder in the related prospectus, deliver a
      prospectus to purchasers of Registrable Securities and be bound by those
      provisions of the Subscription Agreement applicable to such beneficial owner
      (including certain indemnification provisions as described below). Beneficial
      owners that do not complete this Notice and Questionnaire and deliver it to
      the
      Issuer as provided below will not be named as selling securityholders in the
      prospectus and therefore will not be permitted to sell any Registrable
      Securities pursuant to the Registration Statement. 

    

    Certain
      legal consequences may arise from being named as selling securityholders in
      the
      Registration Statement and the related prospectus. Accordingly, holders and
      beneficial owners of Registrable Securities are advised to consult their own
      securities law counsel regarding the consequences of being named or not being
      named as a selling securityholder in the Registration Statement and the related
      prospectus.

    

    Notice

    

    The
      undersigned beneficial owner (the “Selling
      Stockholder”)
      of
      Registrable Securities hereby requests that the Issuer include in the
      Registration Statement the Registrable Securities beneficially owned by it
      and
      listed below in Item 3 (unless otherwise specified under Item 3) pursuant to
      the
      Registration Statement. The undersigned Selling Stockholder, by signing and
      returning this Notice and Questionnaire, understands that it will be bound
      by
      the terms and conditions of this Notice and Questionnaire and the Subscription
      Agreement.

    

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    

    The
      undersigned Selling Stockholder hereby provides the following information to
      the
      Issuer and represents and warrants that such information is accurate and
      complete:

    

    Questionnaire

    

    
      	
            	1.
              (a)	
              Full
                Legal Name of Selling Stockholder:

            

    

    

    
      	 	
              (b)

            	
              Full
                legal name of registered holder (if not the same as (a) above) through
                which Registrable Securities listed in (3) below are
                held:

            

    

    

    
      	 	
              (c)

            	
              Full
                legal name of broker-dealer or other third party through which Registrable
                Securities listed in (3) below are
                held:

            

    

    

    
      	 	
              (d)

            	
              Full
                legal name of DTC participant (if applicable and if not the same
                as (b) or
                (c) above) through which Registrable Securities listed in (3) below
                are
                held:

            

    

    

    
      	
            	2.	
              Address
                for Notices to Selling Stockholder:

            

    

    

    
      	
              Telephone: 

            	 
	
              Fax: 

            	 
	
              Contact
                Person: 

            	 

    

     

    
      	
            	3.	
              Beneficial
                ownership of Registrable Securities:       

            

    

     

    
      	 	 
	 	 
	 	 

    

     

    Unless
      otherwise indicated in the space provided below, all shares of common stock
      listed in response to Item (3) above will be included in the Registration
      Statement. If the undersigned does not wish all such shares of common stock
      to
      be so included, please indicate below the principal amount or the number of
      shares to be included:

    
      	 	 

    

     

    
      	
            	4.	
              Beneficial
                Ownership of the Issuer’s securities owned by the
                Selling

            

    

    
      
        	
                Stockholder: 

              	 

      

    

          

    Except
      as set forth below in this Item (4), the undersigned is not the beneficial
      or
      registered owner of any securities of the Issuer other than the Registrable
      Securities listed above in Item (3).

     

    
      	
              (a) 

            	Type
              and
              amount of other securities beneficially owned by the Selling
              Stockholder: 	 
	 	 	 
	
              (b) 

            	CUSIP
              No(s). of such other securities beneficially owned: 	 
	 	 	 
	
              5. 

            	Relationship
              with the Issuer: 	 

    

    

    Except
      as set forth below, neither the undersigned nor any of its Affiliates, directors
      or principal equity holders (5% or more) has held any position or office or
      has
      had any other material relationship with the Issuer (or its predecessors or
      Affiliates) during the past three years.

    

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

       

       

      
        	State
                any exceptions to the foregoing here: 	 

      

    

       

    The
      undersigned Selling Stockholder acknowledges that it understands its obligation
      to comply with the provisions of the Exchange Act, and the rules thereunder
      relating to stock manipulation, particularly Regulation M thereunder (or any
      successor rules or regulations) and the provisions of the Securities Act
      relating to prospectus delivery, in connection with any offering of Registrable
      Securities pursuant to the Registration Statement. The undersigned Selling
      Stockholder agrees that neither it nor any person acting on its behalf will
      engage in any transaction in violation of such provisions.

    

    The
      Selling Stockholder hereby acknowledges its obligations under the Subscription
      Agreement to indemnify and hold harmless certain persons set forth therein.
      Pursuant to the Subscription Agreement, the Issuer has agreed under certain
      circumstances to indemnify the Selling Stockholders against certain
      liabilities.

    

    In
      accordance with the undersigned Selling Stockholder’s obligation under the
      Subscription Agreement to provide such information as maybe required by law
      for
      inclusion in the Registration Statement, the undersigned Selling Stockholder
      agrees to promptly notify the Issuer of any inaccuracies or changes in the
      information provided herein that may occur subsequent to the date hereof at
      any
      time while the Registration Statement remains effective. All notices hereunder
      and pursuant to the Subscription Agreement shall be made in writing at the
      address set forth below.

    

    In
      the
      event any Selling Stockholder transfers all or any portion of the Registrable
      Securities listed in Item (3) above after the date on which such information
      is
      provided to the Issuer, the Selling Stockholder will notify the transferees
      at
      the time of transfer of its rights and obligations under this Notice and
      Questionnaire and the Subscription Agreement.

    

    By
      signing below, the undersigned Selling Stockholder consents to the disclosure
      of
      the information contained herein in its answers to items (1) through (5) above
      and the inclusion of such information in the Registration Statement and any
      related prospectus. The undersigned Selling Stockholder understands that such
      information will be relied upon by the Issuer without independent investigation
      or inquiry in connection with the preparation or amendment of the Registration
      Statement and any related prospectus.

    

    

    

    [REMAINDER
      OF PAGE INTENTIONALLY LEFT BLANK]

    

    

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    

    IN
      WITNESS WHEREOF, the undersigned Selling Stockholder, by authority duly given,
      has caused this Notice and Questionnaire to be executed and delivered either
      in
      person or by its authorized agent.

    

    
      	 	 	Selling Stockholder: 	 
	 	 	 	 
	 	 	By: ________________	 
	 	 	
              Name: 

            	 
	 	 	
              Title: 

            	 
	 	 	 	 
	 	 	 	 
	Dated:________________ 	 	 	 

    

     

    

    

    PLEASE
      RETURN THE COMPLETED AND EXECUTED NOTICE AND QUESTIONNAIRE
      TO:

    

    Patient
      Safety Technologies, Inc.

    c/o
      Milton “Todd” Ault III

    1800
      Century Park East

    Suite
      200

    Los
      Angeles, CA 90067NUMBER  

            	 	
              (SEE
                REVERSE SIDE FOR LEGEND)

            	 	
              WARRANTS

            
	
               

            	
               

            	
               

            	
               

            	
               

            
	
              [SYMBOL]

            	 	
              THIS
                WARRANT WILL BE VOID IF NOT EXERCISED PRIOR TO

              5:00
                P.M. NEW YORK CITY TIME,
                           , 2010
                

              OR
                UPON EARLIER REDEMPTION

            	 	 

    

    

     

    DOUBLOON
      CORP.

    CUSIP
      ___________

    

    WARRANT

    

     

    THIS
      CERTIFIES THAT, for value received

     

    is
      the
      registered holder of a Warrant or Warrants expiring at 5:00 p.m., New York
      City
      Time, [_______], 2010, or upon earlier redemption (the “Warrant”), to purchase
      one fully paid and non-assessable share of Common Stock, par value $0.00001
      per
      share (“Shares”), of Doubloon Corp., a Delaware corporation (the “Company”), for
      each Warrant evidenced by this Warrant Certificate.  The Warrant entitles
      the holder thereof to purchase from the Company, commencing on the later of
      (i)
      [_______], 2007 or (ii) the consummation by the Company of an acquisition
      through merger, capital stock exchange, asset acquisition, stock purchase or
      other similar transaction, or a combination of any of the foregoing, of one
      or
      more operating businesses in the financial services industry or any other
      industry that is its initial business combination and which meets the size,
      timing and other criteria outlined in the Company's registration statement
      on
      Form S-1 initially filed with the Securities and Exchange Commission on July
      11,
      2006 (File No. 333-35711), as amended (“Business Combination”), such number of
      Shares of the Company at the price of $8.00 per share, upon surrender of this
      Warrant Certificate accompanied by the annexed duly executed subscription form
      and payment of the Warrant Price (as hereinafter defined) at the office or
      agency of the Warrant Agent, [_______] (such payment to be made by check made
      payable to the Warrant Agent), but only subject to the conditions set forth
      herein and in the Warrant Agreement between the Company and American
      Stock Transfer and Trust Company (the “Warrant Agreement”); provided, that, the
      Company shall not be obligated to deliver any securities pursuant to the
      exercise of a Warrant and shall have no obligation to settle a Warrant exercise
      unless a registration statement under the Securities Act of 1933, as amended
      (the “Act”), with respect to the Common Stock is effective and a current
      prospectus is available for delivery to the Warrant holders. In the event that
      a
      registration statement with respect to the Common Stock underlying a Warrant
      is
      not effective under the Act, or a current prospectus is not available, the
      holder of such Warrant shall not be entitled to exercise such Warrant and such
      Warrant may have no value and expire worthless. In no event will the Company
      be
      required to net cash settle the warrant exercise..  The Warrant Agreement
      provides that upon the occurrence of certain events the Warrant Price and the
      number of Warrant Shares purchasable hereunder, may, subject to certain
      conditions, be adjusted.  The term Warrant Price as used in this Warrant
      Certificate refers to the price per Share at which Shares may be purchased
      at
      the time the Warrant is exercised.

     

    No
      fraction of a Share will be issued upon any exercise of a Warrant.  If the
      holder of a Warrant would be entitled to receive a fraction of a Share upon
      any
      exercise of a Warrant, the Company shall, upon such exercise, round up or down
      to the nearest whole number the number of Shares to be issued to such
      holder.

     

    Upon
      any
      exercise of the Warrant for less than the total number of full Shares provided
      for herein, there shall be issued to the registered holder hereof or his
      assignee a new Warrant Certificate covering the number of Shares for which
      the
      Warrant has not been exercised.

     

    Warrant
      Certificates, when surrendered at the office or agency of the Warrant Agent
      by
      the registered holder hereof in person or by attorney duly authorized in
      writing, may be exchanged in the manner and subject to the limitations provided
      in the Warrant Agreement, but without payment of any service charge, for another
      Warrant Certificate or Warrant Certificates of like tenor and evidencing in
      the
      aggregate a like number of Warrants.

     

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    Upon
      due
      presentment for registration of transfer of the Warrant Certificate at the
      office or agency of the Warrant Agent, a new Warrant Certificate or Warrant
      Certificates of like tenor and evidencing in the aggregate a like number of
      Warrants shall be issued to the transferee in exchange for this Warrant
      Certificate, subject to the limitations provided in the Warrant Agreement,
      without charge except for any applicable tax or other governmental
      charge.

     

    The
      Company and the Warrant Agent may deem and treat the registered holder as the
      absolute owner of this Warrant Certificate (notwithstanding any notation of
      ownership or other writing hereon made by anyone), for the purpose of any
      exercise hereof, of any distribution to the registered holder, and for all
      other
      purposes, and neither the Company nor the Warrant Agent shall be affected by
      any
      notice to the contrary.

     

    This
      Warrant does not entitle the registered holder to any of the rights of a
      stockholder of the Company.

     

    The
      Company reserves the right to redeem all (but not part) of the then outstanding
      Warrants, with a notice of redemption in writing to the holders of record of
      the
      Warrants then outstanding, giving 30 days' notice of such redemption at any
      time
      after such Warrants become exercisable if the last sale price of the Shares
      has
      been at least $14.25 per share on each of 20 trading days within a 30 trading
      day period ending on the third business day prior to the date on which notice
      of
      such redemption is given. The redemption price of the Warrants is to be $.01
      per
      Warrant. Any Warrant either not exercised or tendered back to the Company by
      the
      end of the date specified in the notice of redemption shall be cancelled on
      the
      books of the Company and have no further value except for the $.01 redemption
      price. 

    

    
      	
              By

            	
              Doubloon
                Corp.

            	 
	 	
              CORPORATE

            	 
	 	 
	
              THE
                STATE OF DELAWARE

            	 
	 
	
              Chief
                Executive Officer

            	
              SEAL

            	
              Secretary

            
	 	
              2006

            	 

    

    

    

    COUNTERSIGNED:

     

    
      AMERICAN
        STOCK TRANSFER AND 

    

    TRUST
      COMPANY,

    

    as
      Warrant Agent

       

     

    _________________________________

    Authorized
      Officer

     

     

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    

     

    

    SUBSCRIPTION
      FORM

    

    To
      Be
      Executed by the Registered Holder in Order to Exercise Warrants

     

    The
      undersigned Registered Holder irrevocably elects to exercise
                        Warrants
      represented by this Warrant Certificate, and to purchase the shares of Common
      Stock issuable upon the exercise of such Warrants, and requests that
      Certificates for such shares shall be issued in the name of

     

     

    
      	
               

            
	
              (PLEASE
                TYPE OR PRINT NAME AND ADDRESS)

            
	
               

            
	
               

            
	
              (SOCIAL
                SECURITY OR TAX IDENTIFICATION NUMBER)

            
	
               

            
	
              and
                be delivered to

            	 
	 	
              (PLEASE
                PRINT OR TYPE NAME AND ADDRESS)

            

    

    

     

     

    and,
      if
      such number of Warrants shall not be all the Warrants evidenced by this Warrant
      Certificate, that a new Warrant Certificate for the balance of such Warrants
      be
      registered in the name of, and delivered to, the Registered Holder at the
      address stated below:

     

    
      	
              Dated:

            	 
	 	 

	 	
              (SIGNATURE)

            
	
               

            	
               
                

            
	 	
              (ADDRESS)

            
	
               

            	
               

            
	
               

            	
               
                

            
	 	
              (TAX
                IDENTIFICATION NUMBER)

            

    

    

     

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    

    ASSIGNMENT

    To
      Be
      Executed by the Registered Holder in Order to Assign Warrants

     

    For
      Value
      Received,
                                     
hereby sells, assigns, and transfers unto

     

    
      	
               

            
	
              (PLEASE
                TYPE OR PRINT NAME AND ADDRESS)

            
	
               

            
	
               

            
	
              (SOCIAL
                SECURITY OR TAX IDENTIFICATION NUMBER)

            
	
               

            
	 	 
	 	 

    

    

     

                                                
      of the Warrants represented by this Warrant Certificate, and hereby irrevocably
      constitutes and appoints
                                                        
Attorney to transfer this Warrant Certificate on the books of the Company,
      with
      full power of substitution in the premises.

     

    
      	
              Dated:

            	 
	 	 
	 
	 	
              (SIGNATURE)

            

    

    

     

    THE
      SIGNATURE TO THE ASSIGNMENT OF THE SUBSCRIPTION FORM MUST CORRESPOND TO THE
      NAME
      WRITTEN UPON THE FACE OF THIS WARRANT CERTIFICATE IN EVERY PARTICULAR, WITHOUT
      ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER, AND MUST BE GUARANTEED
      BY A
      COMMERCIAL BANK OR TRUST COMPANY OR A MEMBER FIRM OF THE AMERICAN STOCK EXCHANGE
      OR THE NEW YORK STOCK EXCHANGE.

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00109-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00109-of-00352.parquet"}]]