NMT MEDICAL, INC. NONSTATUTORY STOCK OPTION LETTER AGREEMENTNonstatutory Stock Option Letter Agreement • November 10th, 2004 • NMT Medical Inc • Surgical & medical instruments & apparatus
NMT Medical, Inc., a Delaware corporation (the “Company”), hereby grants to you a nonstatutory stock option to purchase <<Number>> shares of the Company’s common stock, $.001 par value, at an exercise price of <<Price>> per share (the “Option”) pursuant to the 1996 Stock Option Plan for Non-Employee Directors, as amended (the “Plan”). The date of grant of the option is <<Grant Date>>. This Option is not intended to constitute an incentive stock option as defined in Section 422A of the Internal Revenue Code of 1986, as amended, and is subject to the terms and conditions of the Plan, which are incorporated into this Agreement by reference.
