ACKNOWLEDGMENT AND STATEMENT OF DECISION REGARDING ELECTION
PURSUANT TO SECTION 83(b) OF THE INTERNAL REVENUE CODE
The undersigned, a grantee of restricted shares of common stock (the Restricted Stock) of Bright Horizons Family Solutions Inc., a Delaware corporation (the Company), [for cash] pursuant to a Restricted Stock Agreement, dated as of [●], between the undersigned and the Company (the Restricted Stock Agreement), hereby states, as of the date of grant of the Restricted Stock, as follows:
1. The undersigned acknowledges receipt of a copy of the Restricted Stock Agreement. The undersigned has carefully reviewed the Restricted Stock Agreement.
2. The undersigned either [check as applicable]:
(a) has consulted, and has been fully advised by, the undersigneds own tax advisor, , whose business address is , regarding the federal, state and local tax consequences of the grant of the Restricted Stock under the Restricted Stock Agreement, and particularly regarding the advisability of making elections pursuant to Section 83(b) of the Internal Revenue Code of 1986, as amended (the Code), and pursuant to the corresponding provisions, if any, of applicable state laws; or
(b) has knowingly chosen not to consult such tax advisor.
3. The undersigned hereby states that the undersigned has decided to make an election pursuant to Section 83(b) of the Code and is submitting to the Company together with the undersigneds executed Restricted Stock Agreement, a copy of an executed election form which is attached as Exhibit B to the Restricted Stock Agreement.
4. Neither the Company nor a representative of the Company has made any warranty or representation to the undersigned with respect to the tax consequences of the grant of the Restricted Stock pursuant to the Restricted Stock Agreement or of the making or failure to make an election pursuant to Section 83(b) of the Code or corresponding provisions, if any, of applicable state law.
5. The undersigned is also submitting to the Company, together with the undersigneds executed Restricted Stock Agreement, a copy of an executed election form, if an election is made, by the undersigned pursuant to provisions of state law corresponding to Section 83(b) of the Code, if any, that apply to the grant of the Restricted Stock to the undersigned.