Exhibit 10.5


 


MEDIFAST, INC.


 


AMENDED AND RESTATED 2012 SHARE INCENTIVE
PLAN


 


PERFORMANCE-BASED DEFERRED
SHARE AWARD AGREEMENT


 


Medifast, Inc. (the “Company”)
has determined to grant to you an award of deferred shares of common stock (“Award”) of the Company under the
Medifast, Inc. Amended and Restated 2012 Share Incentive Plan (the “Plan”). The terms of the grant are set forth
in the attached Performance-Based Deferred Share Award Agreement (the “Agreement”). The following provides a
summary of the key terms of the Agreement; however, you should read the entire Agreement along with the terms of the Plan, to fully
understand the Agreement.


 


SUMMARY OF PERFORMANCE-BASED DEFERRED
SHARE 

AWARD AGREEMENT


 


	Participant:	[                                              ]
	 	 
	Date of Grant:	[________],[_______]
	 	 
	Maximum Number of Deferred Shares 	 
	that may be Earned:	[_______]


 


The above is a summary
description of certain provisions of the Agreement and is not intended to be complete. In the event any aspect of this summary
conflicts with the terms of the Agreement, the terms of the Agreement shall govern.


 




     


     


    

 


PERFORMANCE-BASED
DEFERRED SHARE AWARD AGREEMENT


 


This PERFORMANCE-BASED
DEFERRED SHARE AWARD AGREEMENT (the “Agreement”), dated as of [_________],[_______] (the “Date of Grant”)
is delivered by Medifast, Inc. (the “Company”), to [______________] (the “Participant”).


 


The Company has determined
to provide the Participant a deferred share award under the Medifast, Inc. Amended and Restated 2012 Share Incentive Plan (the
“Plan”) and in accordance with the terms and conditions set forth in this Agreement. Capitalized terms that
are used but not defined herein shall have the respective meanings accorded to such terms in the Plan.


 


The Company and Participant,
intending to be legally bound hereby, agree as follows:


 


1.          Grant
of Deferred Share Award.


 


The Company grants
to Participant [_______] Deferred Shares (the “Award”), subject to certain restrictions, terms and conditions
as set forth in this Agreement. Each vested Deferred Share entitles the Participant to receive the one Share, such Share subject
to the transfer restrictions as described in Paragraph 3 until such Share is vested, as described in Paragraph 2 below.


 


2.          Vesting
of Award; Dividend Equivalents.


 


Deferred Shares shall
be earned in accordance with the performance goals set forth in Exhibit A attached hereto based on the Company’s performance
during the [_______] fiscal year. Immediately following the end of the [_______] fiscal year, the Board shall determine the extent
to which the performance goals have been satisfied and the number of Deferred Shares that the Participant has earned with respect
to the Award. To the extent the Deferred Shares are earned, the Deferred Shares will be deemed to vest on [_______],[_______] (the
“Initial Vesting Date”). Any Deferred Shares that the Board deems have not been earned shall be forfeited.


 


Any Shares required
to be delivered to you as a result of the vesting of Deferred Shares (the “Earned Shares”) shall be delivered
no later than [_______],[_______]. Such Earned Shares shall be subject to forfeiture and transfer restrictions and shall vest on
[_______],[_______] (the “Subsequent Vesting Date”), if the Participant continues to be employed by, or provide
service to, the Company from the Date of Grant until the Subsequent Vesting Date. The Participant will be entitled to exercise
voting rights with respect to the Earned Shares prior to the Subsequent Vesting Date.


 


Unless otherwise provided
in a Company-sponsored plan, policy or arrangement, or any agreement to which the Company is a party, the Participant shall forfeit
the Award or the Earned Shares in the event the Participant ceases to be employed by, or provide service to, the Company prior
to the Initial Vesting Date or the Subsequent Vesting Date, as applicable.


 




     


     


    

 


3.          Transferability.


 


The Deferred Shares
and Earned Shares issued pursuant to this Agreement may not be assigned, transferred, hypothecated, or encumbered, in whole or
in part, either directly or by operation of law or otherwise, including, but not limited to, by execution, levy, garnishment, attachment,
pledge, bankruptcy, or in any other manner, except transfer by will or by the laws of descent and distribution. All rights with
respect to this Award shall be exercisable during the Participant’s lifetime only by the Participant or the Participant’s
guardian or legal representative.


 


4.          Dividend
Equivalents.


 


On each dividend payment
date for each cash dividend on the Shares, the Company will credit the Participant with dividend equivalents in cash (the “Cash
Dividends”). The Cash Dividends shall be subject to the same vesting requirements applicable to the Deferred Shares or
Earned Shares, as applicable, in respect of which they were credited and shall be settled in accordance with, and at the time of,
settlement of the vested Earned Shares to which they are related. Cash Dividends applicable to Deferred Shares and/or Earned Shares
that are subsequently forfeited shall be forfeited. If the Participant’s vested Earned Shares have been settled after the
record date but prior to the dividend payment date, any Cash Dividends that would be credited pursuant to this Section 4 shall
be settled on or as soon as practicable after the dividend payment date.


 


5.          No
Stockholder Rights Prior to Settlement; Issuance of Certificates.


 


(a)          The
Participant shall have no rights as a stockholder with respect to any Shares represented by the Deferred Shares until the date
of issuance of the Earned Shares (as evidenced by the appropriate entry on the books of the Company or of a duly authorized transfer
agent of the Company), if applicable. Unless otherwise required by the Plan or this Agreement, no adjustment shall be made for
dividends, distributions, or other rights for which the record date is prior to the date, if any, that Shares are issued.


 


(b)          Stock
certificates representing the Earned Shares may be issued by the Company and held in escrow by the Company until the Earned Shares
vest, or the Company may hold non-certificated shares until the Earned Shares vest.


 


(c)          When
the Participant obtains a vested right to the Earned Shares, a certificate representing the vested shares shall be issued to the
Participant, free of the restrictions under Section 3 of this Agreement.


 


(d)          The
obligation of the Company to deliver shares upon the vesting of the Award shall be subject to all applicable laws, rules, and regulations
and such approvals by governmental agencies as may be deemed appropriately to comply with relevant securities laws and regulations.


 


6.          Change
in Control.


 


The provisions of the
Plan applicable to a Change in Control or other corporate transaction (as described in Sections 8 and 9 of the Plan) shall apply
to the Award.


 




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7.          Withholding.



 


The Participant shall
be required to pay to the Company, or make other arrangements satisfactory to the Company to provide for the payment of, any federal,
state, local or other taxes that the Company is required to withhold with respect to the grant or vesting of the Award. Subject
to Committee approval, the Participant may elect to satisfy any tax withholding obligation of the Company with respect to the Award
by having shares withheld up to an amount that does not exceed the minimum applicable withholding tax rate for federal (including
FICA), state, local and other tax liabilities.


 


7.          Miscellaneous.


 


(a)          No
Right to Employment. The grant of the Award shall not be construed as giving the Participant the right to be retained by or
in the employ of the Company or any other employment right.


 


(b)          Award
Subject to Plan. By entering into this Agreement the Participant agrees and acknowledges that the Award is subject to the Plan.
The terms and provisions of the Plan, as they may be amended from time to time, are hereby incorporated herein by reference. In
the event of a conflict between any term or provision contained herein and a term or provision of the Plan, the applicable terms
and provisions of the Plan will govern and prevail.


 


(c)          Committee
Authority. By entering into this Agreement the Participant agrees and acknowledges that all decisions and determinations of
the Committee shall be final and binding on the Participant, his or her beneficiaries and any other person having or claiming an
interest in the Award.


 


(d)          Severability.
If any provision of this Agreement is or becomes or is deemed to be invalid, illegal or unenforceable in any jurisdiction or would
disqualify this Agreement or the Award under any applicable law, such provision shall be construed or deemed amended to conform
to applicable law (or if such provision cannot be so construed or deemed amended without materially altering the purpose or intent
of this Agreement and the grant of the Award hereunder, such provision shall be stricken as to such jurisdiction and the remainder
of this Agreement and the award shall remain in full force and effect).


 


(e)          Notices.
Any notice to be given to Company under the terms of this Agreement shall be addressed to the Company, at the attention of the
Committee, at its principal place of business, and any notice to be given to Participant may be sent to Participant’s address
as it appears in the payroll records of the Company, or at such other addresses as either party may designate in writing to the
other


 


(f)          Governing
Law. The validity, construction, interpretation and effect of this Agreement shall be governed by and construed in accordance
with the laws of the State of Delaware, without giving effect to the conflict of laws provisions thereof


 


(g)          Interpretation.
The Participant accepts the Award subject to all the terms and provisions of this Agreement and the terms and conditions of the
Plan.


 




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(g)          Headings.
Headings are given to the paragraphs and subparagraphs of this Agreement solely as a convenience to facilitate reference. Such
headings shall not be deemed in any way material or relevant to the construction or interpretation of this Agreement or any provision
thereof.


 


(h)          Counterparts.
This Agreement may be executed in one or more counterparts, each of which will be deemed to be an original copy of this Agreement
and all of which, when taken together, will be deemed to constitute one and the same agreement. Facsimile or other electronic transmission
of any signed original document or retransmission of any signed facsimile or other electronic transmission will be deemed the same
as delivery of an original.


 


(i)          Complete
Agreement. Except as otherwise provided for herein, this Agreement and those agreements and documents expressly referred to
herein embody the complete agreement and understanding among the parties and supersede and preempt any prior understandings, agreements
or representations by or among the parties, written or oral, which may have related to the subject matter hereof in any way. The
terms of this Agreement shall be binding upon the executors, administrators, heirs, successors and assigns of the Participant.


 


[Signature Page Follows]


 




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IN WITNESS WHEREOF,
the Company and Participant have executed this Agreement as of the grant date shown above.


 





	 	Medifast, Inc.
	 	 
	 	 
	 	By:	 
	 	 	Name:
	 	 	Title:  
	 	 
	 	GRANTEE:
	 	 
	 	 
	 	Name:  [Insert Name]




 


(Signature Page to
Performance-Based Deferred Share Award Agreement)


 




     


     


    

 


EXHIBIT A


 


[_______] Performance
Goals