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suance: , 2009 Subject to the terms and conditions of this Convertible Debenture (this "Debenture"), for good and valuable consideration received, LASERSCULPT, INC. (the "Payor"), a Delaware corporation, promises to pay to (the "Holder") the principal amount of AND 00/100 DOLLARS ($ .00) (the "Princ
TNESS WHEREOF, the Payor and the Holder have caused this Debenture to be executed as of the date first above written. LASERSCULPT, INC. By: Name: Steven A. Victor, M.D. Title: Chairman and Chief Executive Officer ACKNOWLEDGED, AGREED TO AND ACCEPTED by the Holder as of the day and year first above written:
VERSION #2 - 5/3/09 REviSIONS LASERSCULPT, INC. SUBSCRIPTION PACKAGE This Subscription Package relates to a private placement offering of certain units to be made by LaserSculpt, Inc. (the
d), together with payment for the units being subscribed for, to LASERSCULPT, INc., 30 East 76th Street, 6th Floor, New York, New York 10021, Attn: Steven A. Victor, Chairman and Chief Executive Officer Such documents and payment should be delivered by no later than 5:00 PM on June 30, 2009 (which date is subje
DGE OR HYPOTHECATION IS EXEMPT FROM THE REGISTRATION AND PROSPECTUS DELIVERY REQUIREMENTS OF THE ACT AND OF ANY APPLICABLE STATE SECURITIES LAWS. LASERSCULPT, INC. COMMON STOCK PURCHASE WARRANT Issuance Date: , 2009 THIS CERTIFIES THAT, for value received, (the "Holder") is entitled, upon the terms a
any and the Holder have caused this Common Stock Purchase Warrant to be executed as of the date first above written. LASERSCULPT, INC. By: Name: Steven A. Victor, M.D. Title: Chairman and Chief Executive Officer ACKNOWLEDGED, AGREED TO AND ACCEPTED by the Holder as of the day and year first above written:
Entities connected to both LASERSCULPT and Steven A. Victor
LaserSculpt, Inc.
ORGANIZATIONthe State of New York
LOCATIONHERETO
ORGANIZATIONthe City, County
LOCATIONthe "Holder's Representations
ORGANIZATIONRegistration of Ownership
ORGANIZATION
Eric Holder
PERSONINDIVDUAL
ORGANIZATION