EX-99.3
Published on November 17, 2009
Exhibit 99.3
MINT SOFTWARE INC.
2006 STOCK PLAN
STOCK OPTION AGREEMENT
Unless otherwise defined herein, the terms defined in the 2006 Stock Plan (the Plan) shall
have the same defined meanings in this Stock Option Agreement (the Option Agreement).
I. | NOTICE OF STOCK OPTION GRANT | |
Name: | ||
Address: | ||
The undersigned Optionee has been granted an Option to purchase Common Stock of Mint Software
Inc. (the Company), subject to the terms and conditions of the Plan and this Option Agreement,
as follows:
Date of Grant
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Vesting Commencement Date |
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Exercise Price per Share |
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Total Number of Shares Granted |
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Total Exercise Price |
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Type of Option
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Incentive Stock Option | |||
Nonstatutory Stock Option |
Term/Expiration Date:
Vesting Schedule:
This Option shall be exercisable in whole or in part, according to the following vesting
schedule:
Twenty-five percent (25%) of the shares subject to this Option shall vest twelve (12) months
after the Vesting Commencement Date. Remaining shares shall vest over the next thirty-six (36)
months in equal monthly amounts subject to the terms and conditions of the Plan and Optionees
stock option agreement.
Termination Period:
This Option shall be exercisable for thirty (30) days after Optionee ceases to be a Service
Provider. Upon Optionees death or Disability, this Option may be exercised for six (6) months
after Optionee ceases to be Service Provider. In no event may Optionee exercise this Option after
the Term/Expiration Date as provided above.
II. AGREEMENT
A. Grant of Option. The Administrator of the Company hereby grants to the Optionee named in
the Notice of Grant in Part I of the Agreement (the Optionee), an option (the Option) to
purchase the number of Shares set forth in the Notice of Grant, at the exercise price per Share set
forth in the Notice of Grant (the Exercise Price), and subject to the terms and conditions of the
Plan, which is incorporated herein by reference. In the event of a conflict between the terms and
conditions of the Plan and this Option Agreement, the terms and conditions of the Plan shall
prevail.
If designated in the Notice of Grant as an Incentive Stock Option (ISO), this Option is
intended to qualify as an Incentive Stock Option as defined in Section 422 of the Code.
Nevertheless, to the extent that it exceeds the $100,000 rule of Code Section 422(d), this Option
shall be treated as a Nonstatutory Stock Option (NSO).
B. Exercise of Option.
1. Right to Exercise. This Option shall be exercisable during its term in accordance with the
Vesting Schedule set out in the Notice of Grant and with the applicable provisions of the Plan and
this Option Agreement.
2. Method of Exercise. This Option shall be exercisable by delivery of an exercise notice in
the form attached as Exhibit A (the Exercise Notice), which shall state the election to
exercise the Option, the number of Shares with respect to which the Option is being exercised, and
such other representations and agreements as may be required by the Company. The Exercise Notice
shall be accompanied by payment of the aggregate Exercise Price as to all Exercised Shares. This
Option shall be deemed to be exercised upon receipt by the Company of such fully executed Exercise
Notice accompanied by the aggregate Exercise Price.
No Shares shall be issued pursuant to the exercise of an Option unless such issuance and such
exercise comply with Applicable Laws. Assuming such compliance, for income tax purposes the Shares
shall be considered transferred to the Optionee on the date on which the Option is exercised with
respect to such Shares.
C. Optionees Representations. In the event the Shares have not been registered under the
Securities Act of 1933, as amended, at the time this Option is exercised, the Optionee shall, if
required by the Company, concurrently with the exercise of all or any portion of this Option,
deliver to the Company his or her Investment Representation Statement in the form attached hereto
as Exhibit B.
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D. Lock-Up Period. Optionee hereby agrees that Optionee shall not offer, pledge, sell,
contract to sell, sell any option or contract to purchase, purchase any option or contract to sell,
grant any option, right or warrant to purchase, lend, or otherwise transfer or dispose of, directly
or indirectly, any Common Stock (or other securities) of the Company or enter into any swap,
hedging or other arrangement that transfers to another, in whole or in part, any of the economic
consequences of ownership of any Common Stock (or other securities) of the Company held by Optionee
(other than those included in the registration) for a period specified by the representative of the
underwriters of Common Stock (or other securities) of the Company not to exceed one hundred eighty
(180) days following the effective date of any registration statement of the Company filed under
the Securities Act (or such other period as may be requested by the Company or the underwriters to
accommodate regulatory restrictions on (i) the publication or other distribution of research
reports and (ii) analyst recommendations and opinions, including, but not limited to, the
restrictions contained in NASD Rule 2711(f)(4) or NYSE Rule 472(f)(4), or any successor provisions
or amendments thereto).
Optionee agrees to execute and deliver such other agreements as may be reasonably requested by
the Company or the underwriter which are consistent with the foregoing or which are necessary to
give further effect thereto. In addition, if requested by the Company or the representative of the
underwriters of Common Stock (or other securities) of the Company, Optionee shall provide, within
ten (10) days of such request, such information as may be required by the Company or such
representative in connection with the completion of any public offering of the Companys securities
pursuant to a registration statement filed under the Securities Act. The obligations described in
this Section shall not apply to a registration relating solely to employee benefit plans on Form
S-1 or Form S-8 or similar forms that may be promulgated in the future, or a registration relating
solely to a Commission Rule 145 transaction on Form S-4 or similar forms that may be promulgated in
the future. The Company may impose stop-transfer instructions with respect to the shares of Common
Stock (or other securities) subject to the foregoing restriction until the end of said one hundred
eighty (180) day (or other) period. Optionee agrees that any transferee of the Option or shares
acquired pursuant to the Option shall be bound by this Section.
E. Method of Payment. Payment of the aggregate Exercise Price shall be by any of the
following, or a combination thereof, at the election of the Optionee:
1. cash;
2. check;
3. consideration received by the Company under a formal cashless exercise program adopted by
the Company in connection with the Plan; or
4. surrender of other Shares which, (i) in the case of Shares acquired from the Company,
either directly or indirectly, have been owned by the Optionee, and not subject to a substantial
risk of forfeiture, for more than six (6) months on the date of surrender, and (ii) have a Fair
Market Value on the date of surrender equal to the aggregate Exercise Price of the Exercised
Shares.
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F. Restrictions on Exercise. This Option may not be exercised until such time as the Plan has
been approved by the stockholders of the Company, or if the issuance of such Shares upon such
exercise or the method of payment of consideration for such shares would constitute a violation of
any Applicable Law.
G. Non-Transferability of Option. This Option may not be transferred in any manner otherwise
than by will or by the laws of descent or distribution and may be exercised during the lifetime of
Optionee only by Optionee. The terms of the Plan and this Option Agreement shall be binding upon
the executors, administrators, heirs, successors and assigns of the Optionee.
H. Term of Option. This Option may be exercised only within the term set out in the Notice of
Grant, and may be exercised during such term only in accordance with the Plan and the terms of this
Option.
I. Tax Obligations.
1. Withholding Taxes. Optionee agrees to make appropriate arrangements with the Company (or
the Parent or Subsidiary employing or retaining Optionee) for the satisfaction of all Federal,
state, local and foreign income and employment tax withholding requirements applicable to the
Option exercise. Optionee acknowledges and agrees that the Company may refuse to honor the
exercise and refuse to deliver the Shares if such withholding amounts are not delivered at the time
of exercise.
2. Notice of Disqualifying Disposition of ISO Shares. If the Option granted to Optionee
herein is an ISO, and if Optionee sells or otherwise disposes of any of the Shares acquired
pursuant to the ISO on or before the later of (1) the date two (2) years after the Date of Grant,
and (2) the date one (1) year after the date of exercise, the Optionee shall immediately notify the
Company in writing of such disposition. Optionee agrees that Optionee may be subject to income tax
withholding by the Company on the compensation income recognized by the Optionee.
3. Code Section 409 A. Under Code Section 409A, an Option that vests after December 31, 2004
that was granted with a per Share exercise price that is determined by the Internal Revenue Service
(the IRS) to be less than the Fair Market Value of a Share on the date of grant (a discount
option) may be considered deferred compensation. An Option that is a discount option may
result in (i) income recognition by the Optionee prior to the exercise of the Option, (ii) an
additional twenty percent (20%) tax, and (iii) potential penalty and interest charges. Optionee
acknowledges that the Company cannot and has not guaranteed that the IRS will agree that the per
Share exercise price of this Option equals or exceeds the Fair Market Value of a Share on the date
of grant in a later examination. Optionee agrees that if the IRS determines that the Option was
granted with a per Share exercise price that was less than the Fair Market Value of a Share on the
date of grant, Optionee shall be solely responsible for Optionees costs related to such a
determination.
J. Entire Agreement, Governing Law. The Plan is incorporated herein by reference. The Plan
and this Option Agreement constitute the entire agreement of the parties
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with respect to the subject matter hereof and supersede in their entirety all prior
undertakings and agreements of the Company and Optionee with respect to the subject matter hereof,
and may not be modified adversely to the Optionees interest except by means of a writing signed by
the Company and Optionee. This Agreement is governed by the internal substantive laws but not the
choice of law rules of California.
K. No Guarantee of Continued Service. OPTIONEE ACKNOWLEDGES AND AGREES THAT THE VESTING OF
SHARES PURSUANT TO THE VESTING SCHEDULE HEREOF IS EARNED ONLY BY CONTINUING AS A SERVICE PROVIDER
AT THE WILL OF THE COMPANY (OR THE PARENT OR SUBSIDIARY EMPLOYING OR RETAINING OPTIONEE) AND NOT
THROUGH THE ACT OF BEING HIRED, BEING GRANTED THIS OPTION OR ACQUIRING SHARES HEREUNDER. OPTIONEE
FURTHER ACKNOWLEDGES AND AGREES THAT THIS AGREEMENT, THE TRANSACTIONS CONTEMPLATED HEREUNDER AND
THE VESTING SCHEDULE SET FORTH HEREIN DO NOT CONSTITUTE AN EXPRESS OR IMPLIED PROMISE OF CONTINUED
ENGAGEMENT AS A SERVICE PROVIDER FOR THE VESTING PERIOD, FOR ANY PERIOD, OR AT ALL, AND SHALL NOT
INTERFERE IN ANY WAY WITH OPTIONEES RIGHT OR THE RIGHT OF THE COMPANY (OR THE PARENT OR SUBSIDIARY
EMPLOYING OR RETAINING OPTIONEE) TO TERMINATE OPTIONEES RELATIONSHIP AS A SERVICE PROVIDER AT ANY
TIME, WITH OR WITHOUT CAUSE.
Optionee acknowledges receipt of a copy of the Plan and represents that he or she is familiar
with the terms and provisions thereof, and hereby accepts this Option subject to all of the terms
and provisions thereof. Optionee has reviewed the Plan and this Option in their entirety, has had
an opportunity to obtain the advice of counsel prior to executing this Option and fully understands
all provisions of the Option. Optionee hereby agrees to accept as binding, conclusive and final
all decisions or interpretations of the Administrator upon any questions arising under the Plan or
this Option. Optionee further agrees to notify the Company upon any change in the residence
address indicated below.
[Remainder of Page Left Blank]
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OPTIONEE
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MINT SOFTWARE INC. | |||||
Signature
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Signature | |||||
Print Name
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Print Name | |||||
President and Chief Executive Officer | ||||||
Title | ||||||
Residence Address |
[Signature Page to 2006 Stock Plan Stock Option Agreement]
EXHIBIT A
2006 STOCK PLAN
EXERCISE NOTICE
Mint Software Inc.
280 Hope Street
Mountain View, CA 94041
280 Hope Street
Mountain View, CA 94041
Attention: President and Chief Executive Officer
1. Exercise of Option. Effective as of today,
,
, the undersigned
(Optionee) hereby elects to exercise Optionees option (the Option) to purchase
shares of the Common Stock (the Shares) of Mint Software Inc. (the Company) under and pursuant
to the 2006 Stock Plan (the Plan) and the Stock Option Agreement dated
(the Option Agreement).
2. Delivery of Payment. Optionee herewith delivers to the Company the full purchase price of
the Shares, as set forth in the Option Agreement, and any and all withholding taxes due in
connection with the exercise of the Option.
3. Representations of Optionee. Optionee acknowledges that Optionee has received, read and
understood the Plan and the Option Agreement and agrees to abide by and be bound by their terms and
conditions.
4. Rights as Stockholder. Until the issuance of the Shares (as evidenced by the appropriate
entry on the books of the Company or of a duly authorized transfer agent of the Company), no right
to vote or receive dividends or any other rights as a stockholder shall exist with respect to the
Optioned Stock, notwithstanding the exercise of the Option. The Shares shall be issued to the
Optionee as soon as practicable after the Option is exercised in accordance with the Option
Agreement. No adjustment shall be made for a dividend or other right for which the record date is
prior to the date of issuance except as provided in Section 13 of the Plan.
5. Companys Right of First Refusal. Before any Shares held by Optionee or any transferee
(either being sometimes referred to herein as the Holder) may be sold or otherwise transferred
(including transfer by gift or operation of law), the Company or its assignee(s) shall have a right
of first refusal to purchase the Shares on the terms and conditions set forth in this Section 5
(the Right of First Refusal).
(a) Notice of Proposed Transfer. The Holder of the Shares shall deliver to the Company a
written notice (the Notice) stating: (i) the Holders bona fide intention to sell or otherwise
transfer such Shares; (ii) the name of each proposed purchaser or other transferee (Proposed
Transferee); (iii) the number of Shares to be transferred to each Proposed Transferee; and (iv)
the bona fide cash price or other consideration for which the Holder proposes to transfer the
Shares (the Offered Price), and the Holder shall offer the Shares at the Offered Price to the
Company or its assignee(s).
(b) Exercise of Right of First Refusal. At any time within thirty (30) days after receipt of
the Notice, the Company and/or its assignee(s) may, by giving written notice to the Holder, elect
to purchase all, but not less than all, of the Shares proposed to be transferred to any one or more
of the Proposed Transferees, at the purchase price determined in accordance with subsection (c)
below.
(c) Purchase Price. The purchase price (Purchase Price) for the Shares purchased by the
Company or its assignee(s) under this Section 5 shall be the Offered Price. If the Offered Price
includes consideration other than cash, the cash equivalent value of the non-cash consideration
shall be determined by the Board of Directors of the Company in good faith.
(d) Payment. Payment of the Purchase Price shall be made, at the option of the Company or its
assignee(s), in cash (by check), by cancellation of all or a portion of any outstanding
indebtedness of the Holder to the Company (or, in the case of repurchase by an assignee, to the
assignee), or by any combination thereof within thirty (30) days after receipt of the Notice or in
the manner and at the times set forth in the Notice.
(e) Holders Right to Transfer. If all of the Shares proposed in the Notice to be transferred
to a given Proposed Transferee are not purchased by the Company and/or its assignee(s) as provided
in this Section 5, then the Holder may sell or otherwise transfer such Shares to that Proposed
Transferee at the Offered Price or at a higher price, provided that such sale or other transfer is
consummated within 120 days after the date of the Notice, that any such sale or other transfer is
effected in accordance with any applicable securities laws and that the Proposed Transferee agrees
in writing that the provisions of this Section 5 shall continue to apply to the Shares in the hands
of such Proposed Transferee. If the Shares described in the Notice are not transferred to the
Proposed Transferee within such period, a new Notice shall be given to the Company, and the Company
and/or its assignees shall again be offered the Right of First Refusal before any Shares held by
the Holder may be sold or otherwise transferred.
(f) Exception for Certain Family Transfers. Anything to the contrary contained in this
Section notwithstanding, the transfer of any or all of the Shares during the Optionees lifetime or
on the Optionees death by will or intestacy to the Optionees immediate family or a trust for the
benefit of the Optionees immediate family shall be exempt from the provisions of this Section 5.
Immediate Family as used herein shall mean spouse, lineal descendant or antecedent, father,
mother, brother or sister. In such case, the transferee or other recipient shall receive and hold
the Shares so transferred subject to the provisions of this Section 5, and there shall be no
further transfer of such Shares except in accordance with the terms of this Section 5.
(g) Termination of Right of First Refusal. The Right of First Refusal shall terminate as to
any Shares upon the earlier of (i) the first sale of Common Stock of the Company to the general
public, or (ii) a Change in Control in which the successor corporation has equity securities that
are publicly traded.
6. Tax Consultation. Optionee understands that Optionee may suffer adverse tax consequences
as a result of Optionees purchase or disposition of the Shares. Optionee represents that Optionee
has consulted with any tax consultants Optionee deems advisable in
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connection with the purchase or disposition of the Shares and that Optionee is not relying on
the Company for any tax advice.
7. Restrictive Legends and Stop-Transfer Orders.
(a) Legends. Optionee understands and agrees, that the Company shall cause the legends set
forth below or legends substantially equivalent thereto, to be placed upon any certificate(s)
evidencing ownership of the Shares together with any other legends that may be required by the
Company or by state or federal securities laws:
THE SECURITIES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE
SECURITIES ACT OF 1933 (THE ACT) AND MAY NOT BE OFFERED, SOLD OR OTHERWISE
TRANSFERRED, PLEDGED OR HYPOTHECATED UNLESS AND UNTIL REGISTERED UNDER THE
ACT OR, IN THE OPINION OF COUNSEL SATISFACTORY TO THE ISSUER OF THESE
SECURITIES, SUCH OFFER, SALE OR TRANSFER, PLEDGE OR HYPOTHECATION IS IN
COMPLIANCE THEREWITH.
THE SHARES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO CERTAIN
RESTRICTIONS ON TRANSFER AND A RIGHT OF FIRST REFUSAL HELD BY THE ISSUER OR
ITS ASSIGNEE(S) AS SET FORTH IN THE EXERCISE NOTICE BETWEEN THE ISSUER AND
THE ORIGINAL HOLDER OF THESE SHARES, A COPY OF WHICH MAY BE OBTAINED AT THE
PRINCIPAL OFFICE OF THE ISSUER. SUCH TRANSFER RESTRICTIONS AND RIGHT OF
FIRST REFUSAL ARE BINDING ON TRANSFEREES OF THESE SHARES.
THE SHARES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO RESTRICTIONS ON
TRANSFER FOR A PERIOD OF TIME FOLLOWING THE EFFECTIVE DATE OF THE
UNDERWRITTEN PUBLIC OFFERING OF THE COMPANYS SECURITIES SET FORTH IN AN
AGREEMENT BETWEEN THE ISSUER AND THE ORIGINAL HOLDER OF THESE SHARES AND MAY
NOT BE SOLD OR OTHERWISE DISPOSED OF BY THE HOLDER PRIOR TO THE EXPIRATION
OF SUCH PERIOD WITHOUT THE CONSENT OF THE COMPANY OR THE MANAGING
UNDERWRITER.
(b) Stop-Transfer Notices. Optionee agrees that, in order to ensure compliance with the
restrictions referred to herein, the Company may issue appropriate stop transfer instructions to
its transfer agent, if any, and that, if the Company transfers its own securities, it may make
appropriate notations to the same effect in its own records.
(c) Refusal to Transfer. The Company shall not be required (i) to transfer on its books any
Shares that have been sold or otherwise transferred in violation of any of the
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provisions of this Exercise Notice or (ii) to treat as owner, of such Shares or to accord the
right to vote or pay dividends to any purchaser or other transferee to whom such Shares shall have
been so transferred.
8. Successors and Assigns. The Company may assign any of its rights under this Exercise
Notice to single or multiple assignees, and this Exercise Notice shall inure to the benefit of the
successors and assigns of the Company. Subject to the restrictions on transfer herein set forth,
this Exercise Notice shall be binding upon Optionee and his or her heirs, executors,
administrators, successors and assigns.
9. Interpretation. Any dispute regarding the interpretation of this Exercise Notice shall be
submitted by Optionee or by the Company forthwith to the Administrator, which shall review such
dispute at its next regular meeting. The resolution of such a dispute by the Administrator shall
be final and binding on all parties.
10. Governing Law; Severability. This Exercise Notice is governed by the internal substantive
laws, but not the choice of law rules, of California. In the event that any provision hereof
becomes or is declared by a court of competent jurisdiction to be illegal, unenforceable or void,
this Exercise Notice shall continue in full force and effect.
11. Entire Agreement. The Plan and Option Agreement are incorporated herein by reference.
This Exercise Notice, the Plan, the Restricted Stock Purchase Agreement, the Option Agreement and
the Investment Representation Statement constitute the entire agreement of the parties with respect
to the subject matter hereof and supersede in their entirety all prior undertakings and agreements
of the Company and Optionee with respect to the subject matter hereof, and may not be modified
adversely to the Optionees interest except by means of a writing signed by the Company and
Optionee.
[Remainder of Page Left Blank]
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Submitted by:
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Accepted by : | |||||
OPTIONEE
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MINT SOFTWARE INC. | |||||
Signature |
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Print Name | ||||||
Print Name |
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President and Chief Executive Officer | ||||||
Title | ||||||
Address:
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Address: | |||||
280 Hope Street | ||||||
Mountain View, CA 94041 | ||||||
Date Received |
[Signature Page to 2006 Stock Plan Exercise Notice]
EXHIBIT B
INVESTMENT REPRESENTATION STATEMENT
INVESTMENT REPRESENTATION STATEMENT
OPTIONEE
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: | |
COMPANY
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: Mint Software Inc. | |
SECURITY
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: COMMON STOCK | |
AMOUNT
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: shares | |
DATE
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: |
In connection with the purchase of the above-listed Securities, the undersigned Optionee represents
to the Company the following:
1. Optionee is aware of the Companys business affairs and financial condition and has
acquired sufficient information about the Company to reach an informed and knowledgeable decision
to acquire the Securities. Optionee is acquiring these Securities for investment for Optionees
own account only and not with a view to, or for resale in connection with any distribution
thereof within the meaning of the Securities Act of 1933, as amended (the Securities Act).
2. Optionee acknowledges and understands that the Securities constitute restricted
securities under the Securities Act and have not been registered under the Securities Act in
reliance upon a specific exemption therefrom, which exemption depends upon, among other things, the
bona fide nature of Optionees investment intent as expressed herein. In this connection, Optionee
understands that, in the view of the Securities and Exchange Commission, the statutory basis for
such exemption may be unavailable if Optionees representation was predicated solely upon a present
intention to hold these Securities for the minimum capital gains period specified under tax
statutes, for a deferred sale, for or until an increase or decrease in the market price of the
Securities, or for a period of one year or any other fixed period in the future. Optionee further
understands that the Securities must be held indefinitely unless they are subsequently registered
under the Securities Act or an exemption from such registration is available. Optionee further
acknowledges and understands that the Company is under no obligation to register the Securities.
Optionee understands that the certificate evidencing the Securities shall be imprinted with any
legend required under applicable state securities laws.
3. Optionee is familiar with the provisions of Rule 701 and Rule 144, each promulgated under
the Securities Act, which, in substance, permit limited public resale of restricted securities
acquired, directly or indirectly from the issuer thereof, in a non-public offering subject to the
satisfaction of certain conditions. Rule 701 provides that if the issuer qualifies under Rule 701
at the time of the grant of the Option to the Optionee, the exercise shall be exempt from
registration under the Securities Act. In the event the Company becomes subject to the reporting
requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, ninety (90) days
thereafter (or such longer period as any market stand-off agreement may
require) the Securities exempt under Rule 701 may be resold, subject to the satisfaction of
certain of the conditions specified by Rule 144, including: (1) the resale being made through a
broker in an unsolicited brokers transaction or in transactions directly with a market maker (as
said term is defined under the Securities Exchange Act of 1934); and, in the case of an affiliate,
(2) the availability of certain public information about the Company, (3) the amount of Securities
being sold during any three (3) month period not exceeding the limitations specified in Rule
144(e), and (4) the timely filing of a Form 144, if applicable.
In the event that the Company does not qualify under Rule 701 at the time of grant of the
Option, then the Securities may be resold in certain limited circumstances subject to the
provisions of Rule 144, which requires the resale to occur not less than one (1) year after the
later of the date the Securities were sold by the Company or the date the Securities were sold by
an affiliate of the Company, within the meaning of Rule 144; and, in the case of acquisition of the
Securities by an affiliate, or by a non-affiliate who subsequently holds the Securities less than
two (2) years, the satisfaction of the conditions set forth in sections (1), (2), (3) and (4) of
the paragraph immediately above.
4. Optionee further understands that in the event all of the applicable requirements of Rule
701 or 144 are not satisfied, registration under the Securities Act, compliance with Regulation A,
or some other registration exemption shall be required; and that, notwithstanding the fact that
Rules 144 and 701 are not exclusive, the Staff of the Securities and Exchange Commission has
expressed its opinion that persons proposing to sell private placement securities other than in a
registered offering and otherwise than pursuant to Rules 144 or 701 shall have a substantial burden
of proof in establishing that an exemption from registration is available for such offers or sales,
and that such persons and their respective brokers who participate in such transactions do so at
their own risk. Optionee understands that no assurances can be given that any such other
registration exemption shall be available in such event.
OPTIONEE
Signature
Date
[Signature
Page to Investor Representation Statement]