SEC Contract Filing

Filing Date: 2021-10-28

Document Content:
<DOCUMENT>
<TYPE>EX-10.3
<SEQUENCE>5
<FILENAME>ex10-3.htm
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<P STYLE="text-align: right; font: 10pt Times New Roman, Times, Serif; margin: 0pt"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Exhibit
10.3</B></FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt; text-align: justify"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">NEITHER
THIS SECURITY NOR THE SECURITIES FOR WHICH THIS SECURITY IS EXERCISABLE 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 EXERCISE
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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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt; text-align: center"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>COMMON
STOCK PURCHASE WARRANT</B></FONT></P>

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

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

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="font: 10pt Times New Roman, Times, Serif; width: 100%; border-collapse: collapse">
 <TR STYLE="font: 10pt Times New Roman, Times, Serif; vertical-align: top">
 <TD STYLE="font: 10pt Times New Roman, Times, Serif; width: 60%"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">Warrant
 Shares: _______</FONT></TD>
 <TD STYLE="font: 10pt Times New Roman, Times, Serif; width: 40%"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">Issue
 Date:______, 2021</FONT></TD></TR>
 <TR STYLE="font: 10pt Times New Roman, Times, Serif; vertical-align: top">
 <TD STYLE="font: 10pt Times New Roman, Times, Serif"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">&nbsp;</FONT></TD>
 <TD STYLE="font: 10pt Times New Roman, Times, Serif"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">Initial
 Exercise Date: _______, 2021</FONT></TD></TR>
 </TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt; text-align: justify"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt; text-transform: uppercase">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt; text-align: justify; text-indent: 1in"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">THIS
COMMON STOCK PURCHASE WARRANT (the &ldquo;<U>Warrant</U>&rdquo;) certifies that, for value received, _____________ or its assigns (the
&ldquo;<U>Holder</U>&rdquo;) is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter set
forth, at any time on or after the date set forth above (the &ldquo;<U>Initial Exercise Date</U>&rdquo;) and on or prior to 5:00 p.m.
(New York City time) on ______________<SUP>1</SUP> (the &ldquo;<U>Termination Date</U>&rdquo;) but not thereafter, to subscribe for and
purchase from My Size, Inc., a Delaware corporation (the &ldquo;<U>Company</U>&rdquo;), up to ______ shares (as subject to adjustment
hereunder, the &ldquo;<U>Warrant Shares</U>&rdquo;) of the Company&rsquo;s Common Stock. The purchase price of one share of Common Stock
under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b).</FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt; text-align: justify; text-indent: 0.5in"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><U>Section
1</U>. <U>Definitions</U>. Capitalized terms used and not otherwise defined herein shall have the meanings set forth in that certain
Securities Purchase Agreement (the &ldquo;<U>Purchase Agreement</U>&rdquo;), dated October 26, 2021, among the Company and the purchasers
signatory thereto.</FONT></P>

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