Furnishing statement to employer. A copy of this statement has been furnished to the Company. Dated: _________________ ___, _____ [Name]
Furnishing statement to employer. A copy of this statement has been furnished to the Company. Dated: June __, 2003 _____________________________ Xxxxxx Xxxxxxxxxx This election must be filed with the Internal Revenue Service Center with which the Taxpayer files his or her Federal income tax returns and must be filed within thirty (30) days after the date of purchase. This filing should be made by registered or certified mail, return receipt requested. The taxpayer must retain two copies of the completed form for filing with his or her Federal and State tax returns for the current tax year and an additional copy for his or her records.
Furnishing statement to employer. A copy of this statement has been furnished to the Company. Dated: [●] This election must be filed with the Internal Revenue Service Center with which the Taxpayer files his Federal income tax returns and must be filed within thirty (30) days after the date of transfer. This filing should be made by registered or certified mail, return receipt requested.
Furnishing statement to employer. A copy of this statement has been furnished to the Company. Date: Signature Printed Name
Furnishing statement to employer. A copy of this statement has been furnished to Novation Companies, Inc. Dated: [ ] Name: EXHIBIT B JOINT ESCROW INSTRUCTIONS [Date] Xxxxxx X. Xxxxxxxxx c/o Novation Companies, Inc. 0000 Xxxxxxx Xxxxxx, Xxxxx 000 Xxxxxx Xxxx, XX 00000 Dear Sir: As Escrow Agent for the undersigned parties, Novation Companies, Inc., a Maryland corporation (the “Corporation”), and Xxxxxx X. Xxxxxx (“Director”), you are hereby authorized and directed to hold the Stock deposited with you pursuant to the terms of that certain Amended and Restated Restricted Stock Award Agreement (the “Agreement”) between the Corporation and the Director, to which a copy of these Joint Escrow Instructions is attached as Exhibit B, in accordance with the following instructions (capitalized terms used herein shall have the meanings set forth in the Agreement):
Furnishing statement to employer. A copy of this election has been furnished to the Company. Dated: , 2007 [Name] INSTRUCTIONS FOR COMPLETING THE SECTION 83(B) ELECTION THE SECTION 83(b) ELECTION MUST BE FILED NO LATER THAN THIRTY (30) DAYS AFTER THE DATE ON WHICH THE SHARES ARE ISSUED TO YOU. ASSUMING A JANUARY 1, 2007 ISSUANCE, THE ELECTION WILL BE DUE NO LATER THAN JANUARY 31, 2007 (“DUE DATE”). Execute four copies of the Election.
Furnishing statement to employer. A copy of this statement has been furnished to Valley Financial Corporation. Dated: ____________________
Furnishing statement to employer. A copy of this statement has been furnished to Iatros Health Network, Inc. Dated: --------------- Signature: --------------------------------- Name: --------------------------------- INSTRUCTIONS FOR SECTION 83(B) ELECTION FORM:
Furnishing statement to employer. A copy of this statement has been furnished to the Company. Dated: _________________ ___, _____ [Name] ADTHEORENT HOLDING COMPANY, LLC PARTICIPANT INTEREST AGREEMENT This PARTICIPANT INTEREST AGREEMENT (this “Agreement”) is made as of May 6, 2019, between AdTheorent Holding Company, LLC, a Delaware limited liability company (the “Company”), and the individual set forth on the signature page hereto (“Optionee”). Optionee is executing this Agreement in connection with Optionee’s receipt of Options (as defined below) pursuant to the AdTheorent Holding Company, LLC 2017 Interest Option Plan (the “Plan”), and employment with the Company and/or its Subsidiaries. Certain capitalized terms used herein are defined in Section 8 hereof. All capitalized terms not otherwise defined herein shall have the meanings set forth in the Plan, and to the extent not defined in the Plan, then as defined in the Operating Agreement. This Agreement provides for the issuance to Optionee of options (each an “Option” and collectively, the “Options”) to purchase that number of Non-Voting Class C Interests set forth on the signature page hereto (collectively, the “Participant Interests”) subject to the terms and conditions set forth herein and in the Operating Agreement. The parties hereto agree as follows:
Furnishing statement to employer. A copy of this statement has been furnished to Quidel Corporation. Date: Signature Printed Name This election must be filed with the Internal Revenue Service Center with which taxpayer files his or her Federal income tax returns and must be made within thirty (30) days after the date of the Grant Date of the Restricted Shares. This filing should be made by registered or certified mail, return receipt requested. The taxpayer must retain two (2) copies of the completed form for filing with his or her Federal and state tax returns for the current tax year and an additional copy for his or her records.
