MAY BE VIA A COMPANY ELECTRONIC MAIL SYSTEM OR BY REFERENCE
TO A LOCATION ON A COMPANY INTRANET TO WHICH PARTICIPANT HAS ACCESS.
PARTICIPANT HEREBY CONSENTS TO ANY AND ALL PROCEDURES THE COMPANY HAS
ESTABLISHED OR MAY ESTABLISH FOR AN ELECTRONIC SIGNATURE SYSTEM FOR DELIVERY AND
ACCEPTANCE OF ANY SUCH DOCUMENTS THAT THE COMPANY MAY BE REQUIRED TO DELIVER,
AND AGREES THAT HIS ELECTRONIC SIGNATURE IS THE SAME AS, AND SHALL HAVE THE SAME
FORCE AND EFFECT AS, HIS MANUAL SIGNATURE.
[signature blanks follow]
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Executed:
.
FIBERTOWER CORPORATION
By:
Kurt Van Wagenen
CEO
Accepted:
.
PARTICIPANT:
[PARTICIPANT NAME INSERT HERE]
Address:
[PARTICIPANT ADDRESS OF ]
RECORD INSERT HERE]
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EXHIBIT A
Assignment Separate from Certificate
FOR VALUE RECEIVED,
hereby sells, assigns and transfers unto FiberTower Corporation, a Delaware
corporation (the "Company"),
(
) shares of common stock of the Company
represented by Certificate No.
and does hereby irrevocably
constitute and appoint
, or his designee or
successor, as attorney to transfer the said stock on the books of the Company
with full power of substitution in the premises.
Dated:
, 20
.
Print Name
Signature
INSTRUCTIONS:
PLEASE DO NOT FILL IN ANY BLANKS OTHER THAN THE SIGNATURE LINE.
THE PURPOSE OF THIS ASSIGNMENT IS TO ENABLE THE COMPANY TO EXERCISE ITS
"REPURCHASE OPTION" SET FORTH IN THE AWARD AGREEMENT WITHOUT REQUIRING
ADDITIONAL SIGNATURES ON THE PART OF THE PURCHASER.
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