Exhibit 10.4

      

      

      

      CUE HEALTH, INC.

    RESTRICTED STOCK UNIT AGREEMENT

    

    

    Cue Health, Inc. (the “Company”) hereby grants the following restricted stock units pursuant to its Amended and Restated 2014 Equity Incentive Plan.  The terms and conditions attached hereto are also a part
      hereof.

    

    

    Notice of Grant

     

      

    	
            Name of recipient (the “Participant”):

          	 
	
            Grant Date:

          	 
	
            Number of restricted stock units (“RSUs”) granted:

          	 
	
            Number, if any, of RSUs that vest immediately on the grant date:

          	 
	
            RSUs that are subject to vesting schedule:

          	 
	
            Vesting Start Date:

          	 


    

    

    Vesting Schedule:

     

    

    	
            Vesting Date:

          	
            Number of RSUs that Vest:

          
	
            [On the first anniversary of the Grant Date and on each of the three subsequent annual anniversaries thereof until the fourth anniversary of the Grant Date]

          	 
	 	 
	
            All vesting is dependent on the Participant remaining an Eligible Participant, as provided herein.

          


    

    

    This grant of RSUs satisfies in full all commitments that the Company has to the Participant with respect to the issuance of stock, stock options or other equity securities.

     

    

    	 	 	
            CUE HEALTH, INC.

          
	
            Signature of Participant

             

            

          	 	 
	
            Street Address

          	 	
            By:  

            

          	 	 
	
             

            

          	 	
            Name of Officer

            Title:

          
	
            City/State/Zip Code

          


    

    

    
      
        


    

    Cue Health, Inc.

    

    

    Restricted Stock Unit Agreement

    Incorporated Terms and Conditions

    

    

    1.          Award of Restricted Stock Units. In consideration of services rendered and to be rendered to the Company by the Participant, the Company has granted to the Participant, subject to the terms and
      conditions set forth in this Restricted Stock Unit Agreement (this “Agreement”) and in the Company’s Amended and Restated 2014 Equity Incentive Plan (the “Plan”), an award with respect to the number of restricted stock units (the “RSUs”)
      set forth in the Notice of Grant that forms part of this Agreement (the “Notice of Grant”).  Each RSU represents the right to receive one share of common stock, no par value per share, of the Company (the “Common Stock”) upon vesting of
      the RSU, subject to the terms and conditions set forth herein.

    

    

    2.          Vesting.  The RSUs shall vest in accordance with the Vesting Schedule set forth in the Notice of Grant (the “Vesting Schedule”).  Any fractional shares resulting from the application of any
      percentages used in the Vesting Schedule shall be rounded down to the nearest whole number of RSUs.  Upon the vesting of the RSU, the Company will deliver to the Participant, for each RSU that becomes vested, one share of Common Stock, subject to the
      payment of any taxes pursuant to Section 7.  The Common Stock will be delivered to the Participant as soon as practicable following each vesting date, but in any event within 30 days of such date.

    

    

    3.          Forfeiture of Unvested RSUs Upon Cessation of Service.  In the event that the Participant ceases to be an Eligible Participant (as defined below) for any reason or no reason, with or without cause, all
      of the RSUs that are unvested as of the time of such cessation shall be forfeited immediately and automatically to the Company, without the payment of any consideration to the Participant, effective as of such cessation.  The Participant shall have
      no further rights with respect to the unvested RSUs or any Common Stock that may have been issuable with respect thereto.  The Participant shall be an “Eligible Participant” if he or she is an employee of the Company or any other entity the
      employees of which are eligible to receive awards of RSUs under the Plan.

    

    

    4.          Restrictions on Transfer.  The Participant shall not sell, assign, transfer, pledge, hypothecate, encumber or otherwise dispose of, by operation of law or otherwise (collectively “transfer”) any RSUs,
      or any interest therein. The Company shall not be required to treat as the owner of any RSUs or issue any Common Stock to any transferee to whom such RSUs have been transferred in violation of any of the provisions of this Agreement.

    

    

    5.          Rights as a Stockholder.  The Participant shall have no rights as a stockholder of the Company with respect to any shares of Common Stock that may be issuable with respect to the RSUs until the
      issuance of the shares of Common Stock to the Participant following the vesting of the RSUs.

    

    

    6.          Provisions of the Plan.  This Agreement is subject to the provisions of the Plan, a copy of which is furnished to the Participant with this Agreement.

    
      
        


    

    7.          Right of First Refusal.  The shares of Common Stock issued pursuant to this Agreement are subject to the right of first refusal set forth in Section 6.11, Restrictions on Transfer and Ownership of
      Common Stock of the Company, set forth in the Company’s Bylaws.

    

    

    8.          Tax Matters.

    

    

    (a)          Acknowledgments; No Section 83(b) Election.  The Participant acknowledges that he or she is responsible for obtaining the advice of the Participant’s own tax advisors with respect to the award of RSUs
      and the Participant is relying solely on such advisors and not on any statements or representations of the Company or any of its agents with respect to the tax consequences relating to the RSUs.  The Participant understands that the Participant (and
      not the Company) shall be responsible for the Participant’s tax liability that may arise in connection with the acquisition, vesting and/or disposition of the RSUs.  The Participant acknowledges that no election under Section 83(b) of the Internal
      Revenue Code of 1986, as amended, (the “Code”) is available with respect to RSUs.

    

    

    (b)          Withholding.  The Participant acknowledges and agrees that the Company has the right to deduct from payments of any kind otherwise due to the Participant any federal, state, local or other taxes of
      any kind required by law to be withheld with respect to the vesting of the RSUs. At such time as the Participant is not aware of any material nonpublic information about the Company or the Common Stock and is otherwise permitted to do so under the
      Company’s insider trading policy, the Participant shall execute the instructions set forth in Schedule A attached hereto (the “Automatic Sale Instructions”) as the means of satisfying such tax obligation.  If the Participant does not
      execute the Automatic Sale Instructions prior to an applicable vesting date, then the Participant agrees that if under applicable law the Participant will owe taxes at such vesting date on the portion of the award then vested the Company shall be
      entitled to immediate payment from the Participant of the amount of any tax required to be withheld by the Company.  The Company shall not deliver any shares of Common Stock to the Participant until it is satisfied that all required withholdings have
      been made.

    

    

    9.          Miscellaneous.

    

    

    (a)          Section 409A.  The RSUs awarded pursuant to this Agreement are intended to be exempt from or comply with the requirements of Section 409A of the Code and the Treasury Regulations issued thereunder (“Section
        409A”).  The delivery of shares of Common Stock on the vesting of the RSUs may not be accelerated or deferred unless permitted or required by Section 409A.  Notwithstanding the foregoing, the Company shall have no liability to the Participant
      nor to any other person if the RSUs awarded pursuant to this Agreement are not exempt from, or compliant with, Section 409A.

    

    

    (b)          Participant’s Acknowledgements.  The Participant acknowledges that he or she:  (i) has read this Agreement; (ii) has been represented in the preparation, negotiation and execution of this Agreement by
      legal counsel of the Participant’s own choice or has voluntarily declined to seek such counsel; (iii) understands the terms and consequences of this Agreement; (iv) is fully aware of the legal and binding effect of this Agreement; and (v) agrees that
      in accepting this award, he or she will be bound by any clawback policy that the Company may adopt in the future.

    
      
        


    

    Schedule A

    

    

    Automatic Sale Instructions

    

    

    The undersigned hereby consents and agrees that any taxes due on a vesting date as a result of the vesting of RSUs on such date shall be paid through an automatic sale of shares as follows:

    

    

    (a)          Upon any vesting of RSUs pursuant to Section 2 hereof, the Company shall arrange for the sale of such number of shares of Common Stock issuable with respect to the RSUs that vest pursuant to Section 2 as is
      sufficient to generate net proceeds sufficient to satisfy the Company’s minimum statutory withholding obligations with respect to the income recognized by the Participant upon the vesting of the RSUs (based on minimum statutory withholding rates for
      all tax purposes, including payroll and social security taxes, that are applicable to such income), and the net proceeds of such sale shall be delivered to the Company in satisfaction of such tax withholding obligations.

    

    

    (b)          The Participant hereby appoints the Chief Executive Officer or the designee of the Chief Executive Officer, and any of them acting alone and with full power of substitution, to serve as his or her attorneys
      in fact to arrange for the sale of the Participant’s Common Stock in accordance with this Schedule A.  The Participant agrees to execute and deliver such documents, instruments and certificates as may reasonably be required in connection with the
      sale of the shares pursuant to this Schedule A.

    

    

    (c)          The Participant represents to the Company that, as of the date hereof, he or she is not aware of any material nonpublic information about the Company or the Common Stock.  The Participant and the Company
      have structured this Agreement, including this Schedule A, to constitute a “binding contract” relating to the sale of Common Stock, consistent with the affirmative defense to liability under Section 10(b) of the Securities Exchange Act of 1934 under
      Rule 10b5-1(c) promulgated under such Act.

    

    

    The Company shall not deliver any shares of Common Stock to the Participant until it is satisfied that all required withholdings have been made.

    

    	
             

          	

          
	
             

          	Participant Name:	

          
	
             

          	Date: