2021 Equity Incentive Plan Form of Restricted Stock Award Agreement
CLEARSIGN TECHNOLOGIES CORPORATION
2021 EQUITY INCENTIVE PLAN
NOTICE OF RESTRICTED STOCK AWARD
Participant’s Name and Address:
In accordance with the approval of the Compensation Committee of the Board of Directors of ClearSign Technologies Corporation (the “Company”) on November 18, 2021, you (the “Participant”) have been granted a stock bonus in the form of a restricted stock award (the “Award”) consisting of shares of Common Stock of the Company as set forth below. The Award is subject to the terms and conditions of this Notice of Restricted Stock Award (the “Notice”), the ClearSign Technologies Corporation 2021 Equity Incentive Plan, as amended from time to time (the “Plan”), and the Restricted Stock Award Agreement (the “Agreement”) attached hereto. Capitalized terms not defined herein shall have the meanings ascribed to them in the Plan.
Award Number [INSERT]
Date of Grant [INSERT]
Fair Market Value Price per Share $[INSERT]
as of the Date of Grant
Total Number of Shares
of Common Stock Awarded [INSERT]
Total Fair Market Value[INSERT]
Total Number of Share Withheld for [INSERT]
Tax Purposes
Net Number of Shares[INSERT]
Vesting Schedule[INSERT]
In the event of the Participant’s change in status from Employee, Director or Consultant to any other status of Employee, Director or Consultant, the Shares shall continue to be subject to the terms of this Notice, the Plan and the Agreement.
IN WITNESS WHEREOF, the Company and the Participant have executed this Notice and agree that the Award is to be governed by the terms and conditions of this Notice, the Plan, and the Agreement.
CLEARSIGN TECHNOLOGIES CORPORATION
a Washington corporation
By:
Name:
Title:
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THE PARTICIPANT ACKNOWLEDGES AND AGREES THAT NOTHING IN THIS NOTICE, THE AGREEMENT OR THE PLAN, SHALL CONFER UPON THE PARTICIPANT ANY RIGHT WITH RESPECT TO CONTINUATION OF THE PARTICIPANT’S CONTINUOUS SERVICE, NOR SHALL IT INTERFERE IN ANY WAY WITH THE PARTICIPANT’S RIGHT OR THE COMPANY’S RIGHT TO TERMINATE THE PARTICIPANT’S CONTINUOUS SERVICE AT ANY TIME, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE. THE PARTICIPANT ACKNOWLEDGES THAT UNLESS THE PARTICIPANT HAS A WRITTEN EMPLOYMENT AGREEMENT WITH THE COMPANY TO THE CONTRARY, THE PARTICIPANT’S STATUS IS AT WILL.
The Participant acknowledges receipt of a copy of the Plan and the Agreement and represents that he or she is familiar with the terms and provisions thereof, and hereby accepts the Award subject to all of the terms and provisions hereof and thereof. The Participant has reviewed this Notice, the Agreement and the Plan in their entirety, has had an opportunity to obtain the advice of counsel prior to executing this Notice and fully understands all provisions of this Notice, the Agreement and the Plan. The Participant hereby agrees that all questions of interpretation and administration relating to this Notice, the Plan and the Agreement shall be resolved by the Administrator in accordance with Section 14 of the Agreement. The Participant further agrees to the venue selection and waiver of a jury trial in accordance with Section 15 of the Agreement. The Participant further agrees to notify the Company upon any change in the residence address indicated in this Notice.
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Award Number: S-14
CLEARSIGN TECHNOLOGIES CORPORATION
2011 EQUITY INCENTIVE PLAN
RESTRICTED STOCK AWARD AGREEMENT
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