The undersigned, the holder of a right to purchase shares of Common Stock of AzurRx BioPharma, Inc. (the “Company”) pursuant to that certain Warrant to Purchase Common Stock of AzurRx BioPharma, Inc. Number CSW- (the “Warrant”), dated as of , 2019 hereby irrevocably elects to exercise the purchase right represented by such Warrant for, and to purchase thereunder, shares of Common Stock of [[Organization A:Organization]] and herewith makes payment of therefor in cash.
The undersigned hereby acknowledges that as of the date hereof, shares of Common Stock remain subject to the right of purchase in favor of pursuant to that certain Warrant to Purchase Common Stock of AzurRx BioPharma, Inc., number CSW- dated as of , 2019.
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