LIBERTY GLOBAL, INC. DEFERRED COMPENSATION PLAN (Effective December 15, 2008; Amended and Restated as of November 20, 2009) 2012 DEFERRAL ELECTION FORM

Participant’s Name:    

This Deferral Election is subject to all of the terms of the Liberty Global, Inc. Deferred Compensation Plan (the “Plan”). I acknowledge that I have received a copy of the Plan and that my participation is subject to the terms and conditions of the Plan and this Deferral Election. I understand that capitalized terms in this Deferral Election have the meanings assigned to such terms in the Plan.

A.    Timing of Elective Distribution Event

I hereby elect the following distribution events (choose one option and complete as necessary):

1.    _____________________________________

2.    _____________________________________

3.    _____________________________________

o    The earlier to occur of (specify any or all of the following):

1.    _____________________________________

2.    _____________________________________

3.    _____________________________________

o    My Separation from Service.

o    A Change of Control.

o    A Section 409A Change of Control.

B.    Form of Payment

I hereby elect the following form of payment commencing on the applicable distribution event (check only one box and complete, if necessary):

o    A single lump sum payment; or

o    A series of ________ (specify five or fewer) substantially equal annual installments; or

1.    ________%

2.    ________%

3.    ________%

I understand that this Deferral Election will become irrevocable after December 31, 2011.

I further understand that the Company may take whatever steps the Company, in its sole discretion, deems appropriate or necessary to satisfy the Company’s state and federal income tax, social security, Medicare, and any other tax withholding obligations (including in jurisdictions other than the United States) arising in connection with any Compensation subject to this Deferral Election. I understand that social security and Medicare (FICA) tax will arise at the time the payments would otherwise have been made in the absence of this deferral election, and that the Company will withhold amounts necessary to satisfy that obligation from other compensation I am entitled to receive.

This Deferral Election shall be interpreted, and such amounts shall in all events be paid, in a manner consistent with Section 409A so as to avoid adverse tax consequences related to the deferrals.

I am aware that any elections I have hereby made may have significant tax consequences to me and, to the extent I deem necessary, I have received advice from my personal tax advisor before making this Deferral Election.

_____________________________________        Deliver by December 31, 2011 to:

Participant’s Signature

Liberty Global, Inc.

Attn: Senior Vice President, Global Human Resources

12300 Liberty Boulevard

____________________________________        Englewood, Colorado 80112

Date Signed