EX-4.3
from S-4/A
9 pages
This Note and the Securities Issuable Upon Conversion of This Note Have Been Acquired for Investment and Have Not Been Registered Under the Securities Act (As Defined Below), or Under the Securities Laws of Applicable States. This Note and Such Securities Are Subject to Restrictions on Transferability and Resale and May Not Be Sold, Pledged or Transferred Except as Permitted Under the Securities Act and the Applicable State Securities Laws, Pursuant to Registration Under Such Laws or a Valid Exemption From Such Registration Requirements. the Securities Represented Hereby May Be Transferred Only in Accordance With the Terms of the Purchase Agreement (As Defined Below), a Copy of Which Is on File With the Secretary of the Company. Holder (As Defined Below) Should Be Aware That It, He or She May Be Required to Bear the Financial Risks of This Investment for an Indefinite Period of Time. This Note Is Subordinated to Certain Other Indebtedness of the Company as Set Forth in the Purchase Agreement (As Defined Below). Allurion Technologies, Inc. Convertible Unsecured Promissory Note $[ ] 2023 Cpn#[ ] Made as of [ ], 2023
12/34/56