EXHIBIT A NOTICE OF EXERCISE WARRANT
Exhibit 4.4
EXHIBIT A
NOTICE OF EXERCISE – WARRANT
TO: BIOLARGO, INC.
(1) The undersigned hereby elects to purchase _____________ common shares of the Company (maximum allowed: [________]) pursuant to the terms of the attached Warrant, and tenders herewith payment of the exercise price in full, together with all applicable transfer taxes, if any.
(2) Unless said Warrant Shares will be delivered electronically via DWAC, please issue the Warrant Shares in the name of the undersigned or in such other name as is specified below in “book entry” form at the Company’s transfer agent.
If the Warrant Shares will be delivered electronically via DWAC, please issue them to the following account:
Name of DTC Participant (broker-dealer at which the account of Holder to be
credited with the Warrant Shares is maintained): _______________________________________
DTC Participant Number: _______________________________________
Name of Account at DTC Participant to be credited with the Shares: _______________________
______________________________________________________________________________
Account Number at DTC Participant to be credited with the Shares: _______________________________
_______________________________________
[SIGNATURE OF HOLDER]
Name of Investing Entity: ________________________________________________________________________
Signature of Authorized Signatory of Investing Entity: _______________________________________
Name of Authorized Signatory: _________________________________________________________
Title of Authorized Signatory: __________________________________________________________
Date: ___________________________________________________
Address for delivery of shares (no PO boxes): ______________________________________________
____________________________________________
Social Security Number / Tax Identification Number: ________________________________________
EXHIBIT B
NOTICE OF TRANSFER –WARRANT
(To be signed only upon transfer of Warrant and subject to other conditions of this Warrant)
FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto ____________________________________________ the right represented by the attached Warrant to purchase __________ shares of the Common Stock of BIOLARGO, INC., to which the attached Warrant relates, and appoints _____________________ as Attorney-in-fact to transfer such right on the books of BIOLARGO, INC., with full power of substitution in the premises.
The undersigned understands that any transfer of the attached Warrant is subject to full compliance with Federal and applicable state securities laws and other requirements, which requirements shall be determined and which issues shall be decided by BIOLARGO, INC., in its sole and absolute discretion, prior to consenting to and recognizing such transfer.
Dated:
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Signed in the presence of: