Exhibit 99.5
FORM OF BENEFICIAL OWNER ELECTION FORM
EKSO BIONICS HOLDINGS, INC.
The undersigned acknowledge(s) receipt of your letter and the enclosed materials referred to therein relating to the rights offering (the "Rights Offering") by Ekso Bionics Holdings, Inc., a Nevada corporation (the "Company"), of non-transferable subscription rights (the "Rights") to purchase common shares, par value $0.001 per share ("Common Shares"), of the Company.
This will instruct you whether to exercise the Rights to purchase Common Shares distributed with respect to the Common Shares held by you for the account of the undersigned, pursuant to the terms and subject to the conditions set forth in the Prospectus Supplement and the related "Instructions as to Use of Ekso Bionics Holdings, Inc. Rights Certificates."
I (we) hereby instruct you as follows:
(CHECK THE APPLICABLE BOXES AND PROVIDE ALL REQUIRED INFORMATION)
 
Box 1.
Please DO NOT EXERCISE RIGHTS for Common Shares.
 
Box 2.
Please EXERCISE RIGHTS for Common Shares as set forth below:

 
Number of Common Shares Subscribed For
 
Subscription Price per Common Share
 
Payment
 
           
Basic Subscription Right
 
x
$1.00
=
$_____________
 
Oversubscription Right
 
x
$1.00
=
$_____________
 
 
Total Payment Required
       
 
$_____________
 

 
Box 3.
Payment in the following amount is enclosed: $____________
 
Box 4.
Please deduct payment of $________ from the following account maintained by you as follows:
     
 
Type of Account: _________________________________
 
Account No.: _________________________________
(The total of Box 3 and Box 4 must equal the Total Payment specified above.)
I (we) on my (our) own behalf, or on behalf of any person(s) on whose behalf, or under whose directions, I am (we are) signing this form:
·
irrevocably elect to purchase the number of Common Shares indicated above upon the terms and conditions specified in the Prospectus Supplement; and
·
agree that if I (we) fail to pay for the Common Shares I (we) have elected to purchase, you may exercise any remedies available to you under law.
Name of beneficial owner(s):
   
Signature of beneficial owner(s):
   
     
If you are signing in your capacity as a trustee, executor, administrator, guardian, attorney-in-fact, agent, officer of a corporation or another acting in a fiduciary or representative capacity, please provide the following information:
     
Name:
   
Capacity:
   
Address (including Zip Code):
   
Telephone Number: