SEC Contract Filing

Filing Date: 2022-06-15

Document Content:
<DOCUMENT>
<TYPE>EX-10.2
<SEQUENCE>3
<FILENAME>ea161592ex10-2_brainsci.htm
<DESCRIPTION>FORM DEBENTURE
<TEXT>
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: right; text-indent: 1in"><B>Exhibit 10.2</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: right; text-indent: 1in"><FONT STYLE="font-family: Times New Roman, Times, Serif"><B>&nbsp;</B></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: right; text-indent: 1in"><B>EXHIBIT A</B></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0in"><FONT STYLE="font-family: Times New Roman, Times, Serif">NEITHER
THIS SECURITY NOR THE SECURITIES INTO WHICH THIS SECURITY IS CONVERTIBLE HAVE BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION
OR THE SECURITIES COMMISSION OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED
(THE &ldquo;SECURITIES ACT&rdquo;), AND, ACCORDINGLY, MAY NOT BE OFFERED OR SOLD EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT
UNDER THE SECURITIES ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS
OF THE SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS. THIS SECURITY AND THE SECURITIES ISSUABLE UPON CONVERSION
OF THIS SECURITY MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT OR OTHER LOAN SECURED BY SUCH SECURITIES.</FONT></P>

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 <TD STYLE="width: 50%"><FONT STYLE="font-family: Times New Roman, Times, Serif">Original
Issue Date: <B>[DATE OF APPLICABLE CLOSING]</B></FONT></TD>
 <TD STYLE="text-align: right; width: 50%"><B></B>$_______________</TD></TR>
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"><FONT STYLE="font-family: Times New Roman, Times, Serif; text-transform: uppercase"><B>10.0%
ORIGINAL ISSUE DISCOUNT SENIOR SECURED </B></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"><FONT STYLE="font-family: Times New Roman, Times, Serif; text-transform: uppercase"><B>CONVERTIBLE
DEBENTURE</B></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"><FONT STYLE="font-family: Times New Roman, Times, Serif; text-transform: uppercase"><B>DUE
_________[___]<SUP>1</SUP>, 2023</B></FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in"><FONT STYLE="font-family: Times New Roman, Times, Serif">THIS
10.0% ORIGINAL ISSUE DISCOUNT SENIOR SECURED CONVERTIBLE DEBENTURE is one of a series of duly authorized and validly issued 10.0% Original
Issue Discount Senior Secured Convertible Debentures of Brain Scientific Inc., a Delaware corporation (the &ldquo;<U>Company</U>&rdquo;),
having a place of business at 6700 Professional Parkway, Lakewood Ranch, FL 34240, designated as its 10.0% Original Issue Discount Senior
Secured Convertible Debenture due ________ [__]<SUP>2</SUP>, 2023 (this debenture, the &ldquo;<U>Debenture</U>&rdquo; and, collectively
with the other debentures of such series, the &ldquo;<U>Debentures</U>&rdquo;).</FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in"><FONT STYLE="font-family: Times New Roman, Times, Serif">FOR
VALUE RECEIVED, the Company promises to pay to ________________________ or its registered assigns (the &ldquo;<U>Holder</U>&rdquo;),
or shall have paid pursuant to the terms hereunder, the principal sum of $_______________ on _________ [__], 2023<SUP>3</SUP> (subject
to extension as provided herein, the &ldquo;<U>Maturity Date</U>&rdquo;) or such earlier date as this Debenture is required or permitted
to be repaid as provided hereunder, and to pay interest to the Holder on the aggregate unconverted and then outstanding principal amount
of this Debenture in accordance with the provisions hereof. This Debenture is subject to the following additional provisions:</FONT></P>

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