Common use of Notice of Exercise of Option Clause in Contracts

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBW, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBW, Inc. 2018 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 2 contracts

Samples: Non Qualified Stock Option Award Agreement (FFBW, Inc.), Incentive Stock Option Award Agreement (FFBW, Inc.)

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Notice of Exercise of Option. I I, , hereby exercise the stock option (the “Option”) granted to me by FFBWVWF Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Non-Qualified Stock Option Agreement (the “Agreement”) and the FFBWVWF Bancorp, Inc. 2018 2023 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $______ $ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______$ , in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ $ in full/partial payment of the purchase price.* ___ My check in the sum of $ and stock of the Company with a fair market value of $ , in full/partial payment of the purchase price.* ​ ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any minimum required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ _investment ___ _resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933, as amended (the “Securities Act”) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____20 . _________________________________________ ​ ​ Participant’s signature * If I elect to exercise by exchanging xxxxxxxxxx shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Non Qualified Stock Option Award Agreement (VWF Bancorp, Inc.)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBWWolverine Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBWWolverine Bancorp, Inc. 2018 2012 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $_______ per share. I elect to pay the exercise price by: Enclosed please find (check one): ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement My check in the sum of $_______ and stock of the OptionCompany with a fair market value of $______, using a portion of the shares obtained on exercise in full/partial payment of the exercise price of the Option (and, if applicable, any required tax withholding). purchase price.* ___ Selling Please sell ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. ____________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.signature

Appears in 1 contract

Samples: Stock Option Agreement (Wolverine Bancorp, Inc.)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBWSunshine Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBWSunshine Bancorp, Inc. 2018 2015 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $_______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any minimum required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Incentive Stock Option Agreement (Sunshine Bancorp, Inc.)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBWSunshine Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBWSunshine Bancorp, Inc. 2018 2015 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any minimum required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Non Qualified Stock Option Agreement (Sunshine Bancorp, Inc.)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBWHV Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBWHV Bancorp, Inc. 2018 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Non Qualified Stock Option Award Agreement (HV Bancorp, Inc.)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBWHV Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBWHV Bancorp, Inc. 2018 2021 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $_______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.signature

Appears in 1 contract

Samples: Incentive Stock Option Award Agreement (HV Bancorp, Inc.)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBW, Inc. Cincinnati Bancorp (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBW, Inc. 2018 Cincinnati Bancorp 2017 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.signature

Appears in 1 contract

Samples: Equity Incentive Plan (Cincinnati Bancorp)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBWThe Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBWThe Bancorp, Inc. 2018 Stock Option and Equity Incentive Plan of 2013 (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $_____________ per share. I elect to pay the exercise price by: Enclosed please find (check one): ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement My check in the sum of $_______ and stock of the OptionCompany with a fair market value of $______, using a portion of the shares obtained on exercise in full/partial payment of the exercise price of the Option (and, if applicable, any required tax withholding). purchase price.* ___ Selling Please sell ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares excxxxxxxx xxares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Stock Option (Bancorp, Inc.)

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Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBW, Inc. Riverview Financial Corporation (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBW, Inc. 2018 Riverview Financial Corporation 2019 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.signature

Appears in 1 contract

Samples: Equity Incentive Plan (Riverview Financial Corp)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBWHV Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBWHV Bancorp, Inc. 2018 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $_______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Incentive Stock Option Award Agreement (HV Bancorp, Inc.)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBW, Inc. Equitable Financial Corp. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBW, Inc. 2018 Equitable Financial Corp. 2016 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $_________ per share. I elect wish to pay the exercise purchase price by: ___ by (check one or more): [Any payment to be delivered must accompany this Notice of Exercise of Option] ☐Cash or personal, certified or cashier’s check in the sum of $_________, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ ____, in full/partial payment of the purchase price.* ☐A “net settlement” of the Option whereby I direct the Company to withhold a sufficient number of shares to satisfy the purchase price. ☐A check (personal, certified or cashier’s) in the sum of $_________ A net settlement and stock of the OptionCompany with a fair market value of $_________, using a portion of the shares obtained on exercise in full payment of the exercise price of the Option (and, if applicable, any required tax withholding). purchase price.* ☐Please sell ___ Selling _______________ shares from my Option shares through a broker in full/partial payment of the purchase price. If my broker requires additional forms in order to consummate this “broker cashless exercise,” I have included them with this election. I understand that after this exercise, _________________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Stock Option (Equitable Financial Corp.)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBW, Inc. Cincinnati Bancorp (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBW, Inc. 2018 Cincinnati Bancorp 2017 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $______ per share. I elect to pay the exercise price by: ___ Cash or personal, certified or cashier’s check in the sum of $_______, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ in full/partial payment of the purchase price.* ___ A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any required tax withholding). ___ Selling ______ shares from my Option shares through a broker in full/partial payment of the purchase price. I understand that after this exercise, ____________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Equity Incentive Plan (Cincinnati Bancorp)

Notice of Exercise of Option. I hereby exercise the stock option (the “Option”) granted to me by FFBW, Inc. Equitable Financial Corp. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the FFBW, Inc. 2018 Equitable Financial Corp. 2016 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase __________________ shares of common stock of the Company (“Common Stock”) for a purchase price of $_________ per share. I elect wish to pay the exercise purchase price by: ___ by (check one or more): [Any payment to be delivered must accompany this Notice of Exercise of Option] ☐ Cash or personal, certified or cashier’s check in the sum of $_________, in full/partial payment of the purchase price. ___ Stock of the Company with a fair market value of $______ ____, in full/partial payment of the purchase price.* ☐ A “net settlement” of the Option whereby I direct the Company to withhold a sufficient number of shares to satisfy the purchase price. ☐ A check (personal, certified or cashier’s) in the sum of $_________ A net settlement and stock of the OptionCompany with a fair market value of $_________, using a portion of the shares obtained on exercise in full payment of the exercise price of the Option (and, if applicable, any required tax withholding). purchase price.* ☐ Please sell ___ Selling _______________ shares from my Option shares through a broker in full/partial payment of the purchase price. If my broker requires additional forms in order to consummate this “broker cashless exercise,” I have included them with this election. I understand that after this exercise, _________________ shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan. I hereby represent that it is my intention to acquire these shares for the following purpose: ___ investment ___ resale or distribution Please note: if your intention is to resell (or distribute within the meaning of Section 2(11) of the Securities Act of 1933) the shares you acquire through this Option exercise, the Company or transfer agent may require an opinion of counsel that such resale or distribution would not violate the Securities Act of 1933 prior to your exercise of such Option. Date: ____________, _____. _________________________________________ Participant’s signature * If I elect to exercise by exchanging shares I already own, I will constructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a notarized statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire.

Appears in 1 contract

Samples: Stock Option (Equitable Financial Corp.)

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