SEC Contract Filing

Filing Date: 2016-06-06

Document Content:
<DOCUMENT>
<TYPE>EX-10.1
<SEQUENCE>2
<FILENAME>exh_101.htm
<DESCRIPTION>EXHIBIT 10.1
<TEXT>
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<P STYLE="margin: 0; text-align: right"><B>Exhibit 10.1</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-weight: normal">THIS
NOTE AND ANY SECURITIES ISSUABLE UPON THE PAYMENT HEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED,
OR UNDER THE SECURITIES LAWS OF CERTAIN STATES. THESE SECURITIES MAY NOT BE OFFERED, SOLD OR OTHERWISE TRANSFERRED, PLEDGED OR
HYPOTHECATED EXCEPT AS PERMITTED UNDER THE ACT AND APPLICABLE STATE SECURITIES LAWS PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT
OR AN EXEMPTION THEREFROM. THE ISSUER OF THESE SECURITIES MAY REQUIRE AN OPINION OF COUNSEL REASONABLY SATISFACTORY TO THE ISSUER
THAT SUCH OFFER, SALE OR TRANSFER, PLEDGE OR HYPOTHECATION OTHERWISE COMPLIES WITH THE ACT AND ANY APPLICABLE STATE SECURITIES
LAWS.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: center; text-indent: 0in"><B>AMERICAN
CARESOURCE HOLDINGS, INC.</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: center; text-indent: 0in"><B>SECURED PROMISSORY
NOTE</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="font: 10pt Times New Roman, Times, Serif; width: 100%; border-collapse: collapse">
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 <TD STYLE="width: 60%; font-size: 10pt"><FONT STYLE="font-size: 10pt">Principal:&nbsp;&nbsp;$ [&bull;]</FONT></TD>
 <TD STYLE="width: 40%; font-size: 10pt; text-align: right"><FONT STYLE="font-size: 10pt">[&bull;], 2016</FONT></TD></TR>
</TABLE>

<P STYLE="font: bold 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: bold 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: bold 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in"><FONT STYLE="font-weight: normal">FOR
VALUE RECEIVED, American CareSource Holdings, Inc., a Delaware corporation (the &ldquo;</FONT>Company<FONT STYLE="font-weight: normal">&rdquo;),
promises to pay to [&bull;] (&ldquo;</FONT>Lender<FONT STYLE="font-weight: normal">&rdquo;), or Lender&rsquo;s registered assigns,
the principal sum set forth above, or such lesser amount as shall equal the outstanding principal amount of this Secured Promissory
Note (this &ldquo;</FONT>Note<FONT STYLE="font-weight: normal">&rdquo;), together with interest from the date of this Note on the
unpaid principal balance as set forth herein. </FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in"><FONT STYLE="font-weight: normal">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in"><FONT STYLE="font-weight: normal">The
following is a statement of the rights of Lender and the conditions to which this Note is subject, and to which Lender, by the
acceptance of this Note, agrees:</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">1.<FONT STYLE="font-family: Times New Roman, Times, Serif">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</FONT><B><I>Interest and Repayment</I></B><I>.</I></P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 1in">(a)<FONT STYLE="font-family: Times New Roman, Times, Serif">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</FONT><I>Interest</I>. Interest<I> </I>shall accrue at a rate equal to 6.0% per annum, computed on the basis of the actual number
of days elapsed and a year of 365 days.</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 1in">(b)<FONT STYLE="font-family: Times New Roman, Times, Serif">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</FONT><I>Repayment</I>. Payment on this Note shall be made in immediately available funds, and shall be applied first to accrued
interest and thereafter to the outstanding principal balance of this Note. Interest-only payments shall be due and payable on the
first day of each calendar month beginning the first full month after the date of this Note. All outstanding principal and interest
shall be due and payable on the date that is 18 months after the date of this Note (the &ldquo;<B>Maturity Date</B>&rdquo;). The
outstanding balance of this Note may be prepaid by the Company in full or in part at any time without penalty.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">2.<FONT STYLE="font-family: Times New Roman, Times, Serif">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</FONT><B><I>Events of Default</I></B>. The occurrence of any of the following shall constitute an &ldquo;<B>Event of Default</B>&rdquo;
under this Note:</P>

<P STYLE="font: 10pt Times New