Document:

Form of restricted stock unit award agreement for executive officers

 EXHIBIT 10.44 

AMERICAN EXPRESS COMPANY 
 2007 INCENTIVE COMPENSATION PLAN 
  

 

[            ] RESTRICTED STOCK UNIT AWARD AGREEMENT (BAND 99)

  
  

This [            ] Restricted Stock Unit Award Agreement (Band 99)
sets forth the terms and conditions of the Restricted Stock Units granted by American Express Company pursuant to the Company’s 2007 Incentive Compensation Plan, as amended and restated, to select employees in Band 99 during
[            ]. Capitalized terms used herein have the meanings given such terms herein or by Appendix A. 
 Additional specific terms of a Participant’s Award under this Agreement are set forth in the Participant’s Award Communication, which shall include the Date of Grant, the Number of Shares,
the Vesting Date, and any additional terms applicable to such Award. The terms of the performance vesting requirement applicable to a Participant’s Award under this Agreement are set forth on Schedule A, including the Performance Requirement
and the Performance Period. 
 For Awards granted in special situations (such as grants to newly hired or promoted
Participants), the vesting and/or performance requirements, if any, and references to the Date of Grant, the Vesting Date or the Performance Period applicable to the Participant’s Award may vary from the terms set forth in this Agreement, as
specified in the Participant’s Award Communication, which terms shall apply instead of the terms set forth in this Agreement. If a Participant’s Award Communication provides for vesting of the Number of Shares in installments, references
to the Vesting Date shall refer to the date an installment vests and references to Earned Shares shall refer to the portion of the Number of Shares that vest on a given Vesting Date, as applicable, and each installment will be treated separately
under this Agreement as necessary to give effect to the intent thereof. 
 Section 1. Vesting.

 (a) Vesting Date.    Subject to Section 1(b), Section 1(c) and the other
terms of this Agreement, a Participant’s Award shall vest for the number of Earned Shares on the Vesting Date. 

(b) Continued Employment Requirement.    Except as otherwise provided by Section 2,
Section 3 or Section 4, the vesting of a Participant’s Award is subject to and conditioned upon the Participant’s continued Employment at all times during the period beginning with the Date of Grant and ending on the Vesting
Date. 
 (c) Performance Requirement.    Except as otherwise provided by Section 2 or
Section 4, or by the Participant’s Award Communication for an Award granted in a special situation (such as a grant to a newly hired or promoted Participant), the vesting of a Participant’s Award is subject to and conditioned upon:
(i) the Company achieving at least the threshold level of performance under the Performance Requirement for the Performance Period, each as set forth on Schedule A, (ii) the Committee certifying the level of performance achieved under the
Performance Requirement for the Performance Period and determining the RSU Payout Percentage pursuant to Schedule A based on such certified level of performance achieved, (iii) the Committee determining the number of shares eligible for vesting
(the “Earned Shares”) based on the RSU Payout Percentage, and (iv) the Committee approving the vesting and payment of the Earned Shares. (For the avoidance of doubt, the number of Earned Shares under a Participant’s Award
may exceed the Award’s Number of Shares in the event of above-target performance.) This performance requirement is intended to qualify the Award for the “performance-based” compensation exception to Section 162(m) of the Code,
and it shall be administered, interpreted and applied consistent with such intent. Notwithstanding any other provision of this Agreement, if the requirements of this Section 1(c) are not satisfied, then except as otherwise provided by
Section 2 or Section 4, the Participant’s Award will be forfeited. 
 (d) Portion Which Does Not
Vest.    To the extent that a portion of a Participant’s Award does not vest pursuant to Section 1(a), Section 2, Section 3 or Section 4, such portion of the Award shall be forfeited and cancelled by
the Company. 

  
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 Section 2. Death or
Disability.    Notwithstanding anything in this Agreement to the contrary, if a Participant ceases Employment by reason of the Participant’s death or Disability before the Vesting Date, the Participant’s Award
shall immediately vest on the date of the Participant’s death or Disability, the RSU Payout Percentage for the Participant’s Award shall be 100% and the Participant’s Award shall no longer be subject to the vesting conditions set
forth in Section 1(b) or Section 1(c). 
 Section 3. Retirement. 

(a) Participants Outside European Union.    If a Participant’s home base country is outside
the European Union, then: (A) if the Participant ceases Employment by reason of the Participant’s Early Retirement before the Vesting Date, and the date of Early Retirement is more than one year after the Date of Grant, the
Participant’s Award shall continue and vest on the Vesting Date for the number of Earned Shares determined under Section 1(c); and (B) if the Participant ceases Employment by reason of the Participant’s Full Retirement before the
Vesting Date, the Participant’s Award shall continue and vest on the Vesting Date for the number of Earned Shares determined under Section 1(c); in each case, without regard to the vesting condition set forth in Section 1(b).

 (b) Participants Within European Union.    If a Participant’s home base country is
in the European Union, then if the Participant ceases Employment by reason of the Participant’s EU Retirement before the Vesting Date, and the date of EU Retirement is more than one year after the Date of Grant, the Participant’s Award
shall continue and vest on the Vesting Date for the number of Earned Shares determined under Section 1(c), without regard to the vesting condition set forth in Section 1(b). 

Section 4. Change in Control.    Notwithstanding anything in this Agreement to the contrary,
but subject to Appendix B, which could negate the treatment provided by this Section 4 as a result of Section 280G of the Code, in the event of a Defined Termination of a Participant before the Vesting Date, the Participant’s Award
shall immediately vest on the date of the Defined Termination, the RSU Payout Percentage shall be 100% and the Participant’s Award shall no longer be subject to the vesting conditions set forth in Section 1(b) or Section 1(c).

 Section 5. Other Termination.    Unless the Committee determines otherwise (but
in any case subject to and conditioned upon the satisfaction of Section 1(c)), then except as otherwise provided by Section 2, Section 3, Section 4 or a Participant’s Award Communication, in the event that a
Participant’s Employment terminates for any reason before the Vesting Date, the Participant’s Award shall be immediately forfeited and cancelled by the Company. 
 Section 6. Payment. 

(a) Generally.    Subject to Section 6(f), Section 6(h) and Section 6(i), and except
as otherwise provided by Section 6(b) or Section 6(d)(i), as soon as practical following the Vesting Date, but no later than the end of the calendar year in which the Vesting Date occurs, the Company shall issue to a Participant the number
of Earned Shares from the vesting of the Participant’s Award, less the number of any shares withheld or cancelled to cover the required tax withholding on such vesting and payment of such Earned Shares pursuant to Section 6(i). 

(b) Death or Disability.    Subject to Section 6(f), Section 6(h) and Section 6(i),
as soon as practical (but in no event later than 90 days) after the date of a Participant’s death or Disability, the Company shall issue to the Participant the number of Earned Shares from the vesting of the Participant’s Award pursuant to
Section 2, less the number of any shares withheld or cancelled to cover the required tax withholding on such vesting and payment of such Earned Shares pursuant to Section 6(i). In the case of death, the issuance of shares is subject to the
Company receiving required documentation from the legal representatives of the estate. 

(c) Retirement.    Subject to Section 6(f), Section 6(h) and Section 6(i), the
Company shall issue to a Participant the number of Earned Shares from the vesting of the Participant’s Award pursuant to Section 3, less the number of any shares withheld or cancelled to cover the required tax withholding on such vesting
and payment of such Earned Shares pursuant to Section 6(i), at the time specified by Section 6(a). 

  
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 (d) Change in Control.    Subject to
Section 6(f), Section 6(h) and Section 6(i), the Company shall issue to a Participant the number of Earned Shares from the vesting of the Participant’s Award pursuant to Section 4 and after the application of Appendix B,
less the number of any shares withheld or cancelled to cover the required tax withholding on such vesting and payment of such Earned Shares pursuant to Section 6(i), as follows: 

(i) if the Change in Control qualifies as a Section 409A Change Event, then the shares shall be issued to the Participant
immediately upon the occurrence of the Defined Termination, but in no event later than five days thereafter; or 

(ii) if the Change in Control does not qualify as a Section 409A Change Event, then the shares shall be issued to the
Participant at the time specified by Section 6(a). 
 (e) Issuance.    The issuance
of shares pursuant to this Section 6 may be made by crediting the shares to an account for the benefit of the Participant or by such other permissible manner chosen by the Company, in its sole discretion. As provided by Paragraph 17(e) of the
Plan, legal counsel for the Company must be satisfied at the time of the issuance of the shares that such issuance of shares will be in compliance with the Securities Act and applicable United States federal, state, local and foreign laws.

 (f) Documentation.    The Participant must provide the Company with any forms,
documents or other information reasonably required by the Company. 
 (g) No Shareholder
Rights.    Until the shares from the payment of an Award to a Participant have been issued to the Participant, the Participant shall have no rights as a shareholder of the Company with respect to such shares, and in
particular, shall not be entitled to vote such shares or to receive any dividend or other distribution paid or made in respect of such shares (other than the dividend equivalents provided by Section 7). 

(h) Compliance with Laws.    If the Company, in its sole discretion, determines that the listing
upon any securities exchange or registration or qualification under any United States federal, state, local or foreign law of any shares to be issued pursuant to an Award is necessary or desirable, issuance of such shares shall not be made in shares
until such listing, registration or qualification shall have been completed. 
 (i) Satisfaction of Tax
Withholding.    Unless the Committee determines otherwise or modifies this Section 6(i), in order for the Company to satisfy its obligation or the obligation of any of its Affiliates or other person, to withhold United
States federal, state, local or foreign income, employment or other taxes incurred by reason of the vesting, payment or taxability of the Participant’s Award, the Company shall automatically withhold or cancel a number of shares from the Award
with a Fair Market Value that is sufficient to satisfy the tax withholding obligation. Notwithstanding the foregoing, the provisions of this Section 6(i) will not apply or will be modified if, in the opinion of the Company’s legal counsel,
the application of this Section 6(i) to the Participant would jeopardize the Company’s deductibility of the Participant’s Award, or would cause a violation of Section 409A of the Code, in which event, the Participant will be
required to arrange for payment to the Company of the taxes required to be withheld. 
 Section 7. Dividend
Equivalents.    Prior to the vesting or forfeiture of the Participant’s Award, there shall be accrued on the Number of Shares an amount(s) equivalent to the regular cash dividends paid, if any, on the underlying
shares. In the event of the vesting and payment of the Award, the dividend equivalents accrued on the Earned Shares, less any applicable United States federal, state, local or foreign income, employment or other taxes that the Company determines are
required to be withheld therefrom, shall be paid at the time that the Earned Shares are issued to the Participant. In the event of the forfeiture or cancellation of all or a portion of the Number of Shares, the dividend equivalents accrued on the
portion of the Number of Shares that are forfeited shall also be forfeited. For an Award granted to a Participant in a special situation (such as a grant to a newly hired or promoted Participant), the Participant’s Award Communication may
provide for different terms, treatment and/or payment of any dividend equivalents on the Participant’s Award. 

Section 8. Additional Terms. 
 (a) No Assignment.    As provided by Paragraph 7(b) and Paragraph 17(d) of the Plan, except as otherwise determined by the Committee or permitted by the Plan, a
Participant may not sell, assign, transfer, pledge, hypothecate, encumber in whole or in part, or otherwise dispose of the Participant’s Award (or the shares underlying such Award) or the Participant’s rights and interest under the Award
(except by will or the laws of descent and 

  
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distribution in the event of the Participant’s death), including, but not limited to, by execution, levy, garnishment, attachment, pledge, bankruptcy or in any other manner. If a Participant
or anyone claiming under or through the Participant attempts to violate this Section 8(a), such attempted violation shall be null and void and without effect. 
 (b) No Assumption or Substitution Required.    In the event that the Company or any of its Affiliates is a participant in a corporate merger, consolidation or other
similar transaction, neither the Company nor such Affiliate shall be obligated to cause any other participant in such transaction to assume a Participant’s Award or to substitute a new award for the Award under this Agreement. 

(c) Detrimental Conduct.    A Participant’s Award is subject to the provisions of Appendix C
and the Consent to Detrimental Conduct Provisions executed by the Participant, which if violated, could result in the forfeiture and recoupment of the Award and the proceeds from the Award. 

(d) Dodd-Frank Clawback.    A Participant’s Award is subject to the Clawback Requirements and
the Consent to Dodd-Frank Clawback Provisions executed by the Participant, which could require the Participant to return to the Company, or forfeit if not yet paid, the Participant’s Award and the proceeds from the Award, in order to comply
with the Clawback Requirements and any policy adopted by the Committee pursuant to the Clawback Requirements. 

(e) FDIA Limitations.    Notwithstanding any other provision of the Plan, this Agreement or any
Award Communication, vesting and payment of Awards pursuant to this Agreement are subject to and conditioned upon their compliance with 12 USC Section 1828(k) and any regulations promulgated thereunder. 

Section 9. Miscellaneous. 
 (a) Incorporation of Plan and Award Communication.    The Award is subject to the Plan, the Award Communication and any interpretations by the Committee under the
Plan or the Award Communication, which are hereby incorporated into this Agreement by reference and made a part hereof. 

(b) Administration, Interpretation, Etc.    Any action taken or decision made by the Company, the
Board or the Committee arising out of or in connection with the construction, administration, interpretation or effect of any provision of the Plan, this Agreement or a Participant’s Award Communication shall lie within its sole and absolute
discretion, as the case may be, and shall be final, conclusive and binding on the Participant and all persons claiming under or through the Participant. By receipt of the Participant’s Award or other benefit under the Plan, the Participant and
each person claiming under or through the Participant shall be conclusively deemed to have indicated acceptance and ratification of, and consent to, any action taken under the Plan, this Agreement or the Participant’s Award Communication, by
the Company, the Board or the Committee. 
 (c) Correction.    The Committee may rescind,
without further notice to the Participant, any Award or portion thereof issued to the Participant in duplicate, or in error. 
 (d) Amendment. 
 (i) The terms of a
Participant’s Award (including terms under this Agreement or the Participant’s Award Communication) may be amended from time to time by the Committee, in its sole discretion, in any manner that the Committee deems appropriate; provided,
however, that (i) no such amendment shall adversely affect in a material manner any right of the Participant under the Award without the written consent of the Participant; (ii) the Committee shall not amend the Participant’s Award if
the amendment would disqualify the Award from the exception to Section 162(m) of the Code; and (iii) the Committee may not amend or delete Section 4 or Section A1(g) in a manner that is detrimental to the Participant without the
Participant’s written consent. 
 (ii) The Senior Vice President, Global Compensation may amend, revise or make
any changes to this Agreement to reflect any amendments, revisions, changes or other actions approved or taken by the Committee pursuant to Section 9(d)(i). 
 (e) Dilution and Other Adjustments.    As provided by Paragraph 9(c) of the Plan, to the extent permissible for purposes of Section 162(m) of the Code, in the
event of a change in the outstanding shares of the Company by reason of any change in corporate capitalization, such as a stock split or dividend, or a corporate transaction, such as any merger of the Company into another corporation, any
consolidation of two or more corporations into another 

  
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corporation, any separation of a corporation (including a spin-off or other distribution of stock or property by a corporation), any reorganization of a corporation, or any partial or complete
liquidation by the Company, the Committee shall make such adjustment in the class and the Number of Shares or other terms of the Award Communications of outstanding Awards as may be determined to be appropriate by the Committee, and such adjustments
shall be final, conclusive and binding for all purposes. 
 (f) Beneficiary
Designation.    As provided by Paragraph 16 of the Plan, a Participant may, by completing the form provided by the Company’s Global Business Services — LTIA Services for such purpose and returning it thereto, name a
beneficiary or beneficiaries to receive any payment to which such Participant may be entitled under the Participant’s Award in the event of such Participant’s death. The Committee reserves the right to review and approve beneficiary
designations by Participants. A Participant may change his or her beneficiary from time to time in the same manner, unless such Participant has made an irrevocable designation. A Participant’s beneficiary designation (to the extent it is valid
and enforceable under the applicable law) shall be controlling over any other disposition, testamentary, or otherwise, as determined by the Committee in its discretion. If a Participant does not designate a beneficiary, or if no designated
beneficiary is living on the date on which any amount becomes payable under the Participant’s Award, such payment will be made to the legal representatives of the Participant’s estate, which will be deemed to be the Participant’s
designated beneficiary under the Participant’s Award. If there is any question as to the legal right of a Participant’s beneficiary to receive a distribution under the Participant’s Award, the Committee in its discretion may determine
that the amount in question be paid to the legal representatives of the Participant’s estate, in which event the Company, the Board and the Committee will have no further liability to anyone with respect to such amount. 

(g) Governing Law.    As provided by Paragraph 17(o) of the Plan, the validity, construction,
interpretation, administration and effect of the Plan and of its rules and regulations, and rights relating to the Plan and to the Award issued under this Agreement, shall be governed by the substantive laws, but not the choice of law rules, of the
State of New York. 
 (h) Section 409A.    Restricted Stock Units and the dividend
equivalents payable thereon are intended to comply with the requirements of Section 409A, and the Plan, this Agreement and the Participant’s Award Communications shall be administered and interpreted consistent with such intent and the
409A Policy. Notwithstanding the foregoing, the Company makes no representations that the Awards or the vesting and payments provided by this Agreement comply with Section 409A of the Code, and in no event shall the Company or any Affiliate be
liable for all or any portion of any taxes, penalties, interest or other expenses that may be incurred by a Participant on account of non-compliance with Section 409A of the Code. References to a Participant’s “termination of
Employment” and similar terms used in this Agreement mean, to the extent necessary to comply with Section 409A of the Code, the date that the Participant first incurs a Separation from Service. Notwithstanding anything in this Agreement to
the contrary, if at the time of a Participant’s Separation from Service, the Participant is a “specified employee” for purposes of Section 409A of the Code, and the payment of the Award under this Agreement as a result of such
Separation from Service is required to be delayed by six months pursuant to Section 409A of the Code, then the Company will make such payment on the date that is the first day of the seventh month following the Participant’s Separation
from Service. 
 (i) Other Awards.    Notwithstanding any other provision of this
Agreement, the Company, in its sole discretion, may approve and grant Awards that are not governed by the provisions contained in this Agreement, which Awards shall be subject to the terms of such other agreement or writing specified by the Company
as applicable thereto. 

*        *        *     
   *        * 

  
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 AMERICAN EXPRESS COMPANY 

2007 INCENTIVE COMPENSATION PLAN 
  

 

[            ] RESTRICTED STOCK UNIT AWARD AGREEMENT (BAND 99)

  
  

APPENDIX A 
 DEFINITIONS 
 Section A1.
Definitions.    As used in the Agreement, the Appendices, Schedule A and the Award Communication, the following terms will have the respective meanings set forth below, and other capitalized terms used in the
Agreement, the Appendices, Schedule A or the Award Communication will have the respective meanings given such capitalized terms in the Agreement, the Appendices, Schedule A, the Award Communication or the Plan. 

(a) “409A Policy” means the Company’s Section 409A Compliance Policy, as amended and restated from
time to time, or any successor thereto. 
 (b) “Affiliate” has the meaning given such term by
Paragraph 3(b) of the Plan, which states that unless the Committee provides otherwise, “Affiliate” means any entity in which the Company has a direct or indirect equity interest of 50% or more, as determined by the Committee in its
discretion. 
 (c) “Agreement” means the
[            ] Restricted Stock Unit Award Agreement (Band 99). 
 (d) “Award” means the Restricted Stock Units granted by the Company to a Participant pursuant to the Plan, the Agreement and the Participant’s Award Communication.

 (e) “Award Communication” for a Participant and the Participant’s Award means, collectively,
the Participant’s year-end compensation statement for the year preceding the year that includes the Date of Grant (if applicable), and any other written or electronic communication by or on behalf of the Company to the Participant regarding the
particular terms of the Participant’s Award, and the LTIA Overview or similar document describing the terms of the Award generally. 
 (f) “Board” means the Board of Directors of the Company. 
 (g) “Change in Control” means the happening of any of the following: 
 (i) Any individual, entity or group (within the meaning of Section 13(d)(3) or 14(d)(2) of the Exchange Act (a “Person”) becomes the beneficial owner (within the meaning
of Rule 13d-3 promulgated under the Exchange Act) of 25% or more of either (i) the then outstanding common shares of the Company (the “Outstanding Company Common Shares”) or (ii) the combined voting power of the then
outstanding voting securities of the Company entitled to vote generally in the election of directors (the “Outstanding Company Voting Securities”); provided, however, that such beneficial ownership shall not constitute a Change in
Control if it occurs as a result of any of the following acquisitions of securities: (A) any acquisition directly from the Company; (B) any acquisition by the Company or any corporation, partnership, trust or other entity controlled by the
Company (a “Subsidiary”); (C) any acquisition by any employee benefit plan (or related trust) sponsored or maintained by the Company or any Subsidiary; (D) any acquisition by an underwriter temporarily holding Company
securities pursuant to an offering of such securities; (E) any acquisition by an individual, entity or group that is permitted to, and actually does, report its beneficial ownership on Schedule 13-G (or any successor schedule), provided that,
if any such individual, entity or group subsequently becomes required to or does report its beneficial ownership on Schedule 13D (or any successor schedule), then, for purposes of this subsection, such individual, entity or group shall be deemed to
have first acquired, on the first date on which such individual, entity or group becomes required to or does so report, beneficial ownership of all of the Outstanding Company Common Stock and Outstanding Company Voting Securities beneficially owned
by it on such date; or (F) any acquisition by any corporation pursuant to a reorganization, merger or consolidation if, following such reorganization, merger or consolidation, the conditions described in clauses (A), (B) and (C) of
Section A1(h)(iii) are 

  
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satisfied. Notwithstanding the foregoing, a Change in Control shall not be deemed to occur solely because any Person (the “Subject Person”) became the beneficial owner of 25% or
more of the Outstanding Company Common Shares or Outstanding Company Voting Securities as a result of the acquisition of Outstanding Company Common Shares or Outstanding Company Voting Securities by the Company which, by reducing the number of
Outstanding Company Common Shares or Outstanding Company Voting Securities, increases the proportional number of shares beneficially owned by the Subject Person; provided, that if a Change in Control would be deemed to have occurred (but for the
operation of this sentence) as a result of the acquisition of Outstanding Company Common Shares or Outstanding Company Voting Securities by the Company, and after such share acquisition by the Company, the Subject Person becomes the beneficial owner
of any additional Outstanding Company Common Shares or Outstanding Company Voting Securities which increases the percentage of the Outstanding Company Common Shares or Outstanding Company Voting Securities beneficially owned by the Subject Person,
then a Change in Control shall then be deemed to have occurred; or 
 (ii) Individuals who, as of the date hereof,
constitute the Board (the “Incumbent Board”) cease for any reason to constitute at least a majority of the Board; provided, however, that any individual becoming a director subsequent to the date hereof whose election, or nomination
for election by the Company’s shareholders, was approved by a vote of at least a majority of the directors then comprising the Incumbent Board shall be considered as though such individual were a member of the Incumbent Board, but excluding,
for this purpose, any such individual whose initial assumption of office occurs as a result of either an actual or threatened election contest or other actual or threatened solicitation of proxies or consents by or on behalf of a Person other than
the Board, including by reason of agreement intended to avoid or settle any such actual or threatened contest or solicitation; or 
 (iii) The consummation of a reorganization, merger, statutory share exchange, consolidation, or similar corporate transaction involving the Company or any of its direct or indirect Subsidiaries
(each a “Business Combination”), in each case, unless, following such Business Combination, (A) the Outstanding Company Common Shares and the Outstanding Company Voting Securities immediately prior to such Business Combination,
continue to represent (either by remaining outstanding or being converted into voting securities of the resulting or surviving entity or any parent thereof) more than 50% of the then-outstanding shares of common stock and the combined voting power
of the then-outstanding voting securities entitled to vote generally in the election of directors, as the case may be, of the corporation resulting from Business Combination (including, without limitation, a corporation that, as a result of such
transaction, owns the Company or all or substantially all of the Company’s assets either directly or through one or more subsidiaries), (B) no Person (excluding the Company, any employee benefit plan (or related trust) of the Company, a
Subsidiary or such corporation resulting from such Business Combination or any parent or subsidiary thereof, and any Person beneficially owning, immediately prior to such Business Combination, directly or indirectly, 25% or more of the Outstanding
Company Common Shares or Outstanding Company Voting Securities, as the case may be) beneficially owns, directly or indirectly, 25% or more of, respectively, the then outstanding shares of common stock of the corporation resulting from such Business
Combination (or any parent thereof) or the combined voting power of the then outstanding voting securities of such corporation entitled to vote generally in the election of directors, and (C) at least a majority of the members of the board of
directors of the corporation resulting from such Business Combination (or any parent thereof) were members of the Incumbent Board at the time of the execution of the initial agreement or action of the Board providing for such Business Combination;
or 
 (iv) The consummation of the sale, lease, exchange or other disposition of all or substantially all of the
assets of the Company, unless such assets have been sold, leased, exchanged or disposed of to a corporation with respect to which following such sale, lease, exchange or other disposition (A) more than 50% of, respectively, the then outstanding
shares of common stock of such corporation and the combined voting power of the then outstanding voting securities of such corporation (or any parent thereof) entitled to vote generally in the election of directors is then beneficially owned,
directly or indirectly, by all or substantially all of the individuals and entities who were the beneficial owners, respectively, of the Outstanding Company Common Shares and Outstanding Company Voting Securities immediately prior to such sale,
lease, exchange or other disposition in substantially the same proportions as their ownership immediately prior to such sale, lease, exchange or other disposition of such Outstanding Company Common Shares and Outstanding Company Voting Shares, as
the case may be, (B) no Person (excluding the Company and any employee benefit plan (or related trust)) of the Company or a Subsidiary or of such corporation or a subsidiary thereof and any Person beneficially owning, immediately prior to such
sale, lease, exchange or other disposition, directly or indirectly, 25% or more of the Outstanding Company Common Shares or Outstanding Company Voting Securities, as the case may be) beneficially owns, directly or indirectly, 25% or more of
respectively, the then outstanding shares of common stock of such corporation (or any parent thereof) and the combined voting power of the then outstanding voting securities of such corporation (or any parent thereof) entitled to vote generally in

  
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the election of directors, and (C) at least a majority of the members of the board of directors of such corporation (or any parent thereof) were members of the Incumbent Board at the time of
the execution of the initial agreement or action of the Board providing for such sale, lease, exchange or other disposition of assets of the Company; or 
 (v) Approval by the shareholders of the Company of a complete liquidation or dissolution of the Company. 
 (h) “Clawback Requirements” means Section 10D of the Exchange Act and any regulations promulgated, or national securities exchange listing conditions adopted, with respect
thereto. 
 (i) “Code” means the Internal Revenue Code of 1986, as amended and restated from time to
time, and includes the applicable Treasury Regulations promulgated and other official guidance issued thereunder. 

(j) “Committee” means the Compensation and Benefits Committee of the Board. To the extent that the Committee
has delegated its authority to certain officers and employees of the Company, references to the Committee with respect to a matter for which the Committee has delegated its authority shall include the officers and employees to whom such authority
has been delegated. 
 (k) “Company” means American Express Company. 

(l) “Consent to Detrimental Conduct Provisions” with respect to a Participant means the “Consent to the
Application of Forfeiture and Detrimental Conduct Provisions to Incentive Compensation Plan Awards” or similar document, and any successor thereto, executed by the Participant. 

(m) “Consent to Dodd-Frank Clawback Provisions” with respect to a Participant means the “Consent to the
Requirements of Section 954 of the Dodd-Frank Act” or similar document, and any successor thereto, executed by the Participant. 
 (n) “Constructive Termination” has the meaning given such term by the Senior Executive Severance Plan, which generally states that a “Constructive Termination” of a
Participant means any termination of the Participant’s Employment by the Participant as a result of Good Reason within two years after a Change in Control, and that “Good Reason” generally means the occurrence of any of the following
events without the Participant’s written consent: (i) a material reduction in the Participant’s base salary (except for similar across the board changes affecting all similarly situated employees) or any material reduction in the
aggregate of the Participant’s annual and long-term incentive opportunity, in each case from that in effect immediately prior to the Change in Control, (ii) the requirement that the Participant be based more than 50 miles from the location
at which the Participant was based immediately prior to the Change in Control and which location is more than 35 miles from the Participant’s residence, (iii) the assignment to the Participant of any duties that are materially inconsistent
with the Participant’s duties prior to the Change in Control, or (iv) a significant reduction in the Participant’s position, duties, or responsibilities from those in effect prior to the Change in Control; provided, however, in order
for any of the foregoing events to constitute Good Reason, the Participant must notify the Company within 30 days after the occurrence of the event giving rise to a Good Reason and the Company shall have 30 days to remedy the condition, and if
remedied by the Company within such 30-day period, no Good Reason shall exist on account of the remedied event. 

(o) “Date of Grant” for an Award means the date specified by the applicable Award Communication. 

(p) “Defined Termination” has the meaning given such term by the Senior Executive Severance Plan, which
states that “Defined Termination” means a Separation from Service within two years after a Change in Control that occurs as a result of either an Involuntary Termination or a Constructive Termination. 

(q) “Disability” has the meaning given such term by Section 409A of the Code, which generally provides
that “Disability” of a Participant means either (i) the Participant is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death
or can be expected to last for a continuous period of not less than 12 months, or (ii) the Participant is, by reason of any medically determinable physical or mental impairment that can be expected to result in death or can be expected to last
for a continuous period of not less than 12 months, receiving income replacement benefits for a period of not less than three months under an accident and health plan covering the employees of the Participant’s employer. 

  
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15 

 (r) “Early Retirement” with respect to a Participant means the
termination of the Participant’s Employment at a time that the Participant has attained 10 or more years of service (or deemed service under applicable retirement arrangements) with the Company or applicable Affiliates and the Participant is
age 55 or older, but younger than age 62. 
 (s) “Employment” means employment with the Company or
an Affiliate, or engagement in Related Employment. 
 (t) “EU Retirement” with respect to a
Participant means the termination of the Participant’s Employment at a time that the Participant has attained 15 or more years of service (or deemed service under applicable retirement arrangements) with the Company or applicable Affiliates.

 (u) “Exchange Act” means the Securities Exchange Act of 1934, as amended and restated from time
to time. 
 (v) “Fair Market Value” has the meaning given such term by Paragraph 5(b) of the Plan,
which generally states that “Fair Market Value” of a share on a given date is the fair market value of a share on such date, as determined in such reasonable manner as may be provided from time to time by the Committee or as may be
required in order to comply with the requirements of any applicable laws or regulation; and unless the Committee determines otherwise, the “Fair Market Value” of a Company share on a given date shall be the closing price of a Company share
as reported on the New York Stock Exchange composite tape on such date. 
 (w) “Full Retirement”
with respect to a Participant means the termination of the Participant’s Employment at a time that the Participant has attained 10 or more years of service (or deemed service under applicable retirement arrangements) with the Company or
applicable Affiliates and the Participant is age 62 or older. 
 (x) “Involuntary Termination” has
the meaning given such term by the Senior Executive Severance Plan, which generally states that an “Involuntary Termination” of a Participant means any involuntary termination of the Participant’s Employment for reasons other than
Good Cause within two years after a Change in Control, and that “Good Cause” generally means the occurrence of any of the following: (i) the Participant’s willful and continued failure to adequately perform substantially all of
the duties of the Participant’s Employment; (ii) the Participant’s willful engagement in conduct which is demonstrably and materially injurious to the Company and such of its subsidiaries and affiliated companies and other trades or
businesses, monetarily or otherwise; or (iii) the Participant’s conviction of a felony. 

(y) “LTIA Overview” for a Participant’s Award means the overview, program, summary, guide or similar
document provided by or on behalf of the Company describing certain terms of the Participant’s Award. Generally, new LTIA Overviews are provided each year describing the Awards granted to employees in specified Band levels as part of the
Company’s annual award process for that year. 
 (z) “Number of Shares” for an Award means the
number of shares subject to such Award, as specified in the applicable Award Communication. 

(aa) “Participant” means an employee to whom an Award has been granted pursuant to the Plan and the
Agreement, and following such employee’s death, the employee’s beneficiary or any person who acquires the right to receive payment of the employee’s Award by bequest or inheritance or by reason of the employee’s death.

 (bb) “Performance Period” for an Award means the performance period established by the Committee
and set forth in Schedule A. 
 (cc) “Performance Requirement” for an Award means the performance
objectives established by the Committee and set forth in Schedule A. 
 (dd) “Plan” means the
Company’s 2007 Incentive Compensation Plan, as amended and restated from time to time, or any successor thereto. 

(ee) “Related Employment” has the meaning given such term by Paragraph 14 of the Plan, which generally states
that “Related Employment” of an individual means the employment or performance of services by the individual for an employer that is neither the Company nor an Affiliate, provided that (a) such employment or performance of

  
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15 

 
services is undertaken by the individual at the request of the Company or an Affiliate; (b) immediately prior to undertaking such employment or performance of services, the individual was
engaged in Employment; and (c) such employment or performance of services is in the best interests of the Company and is recognized by the Committee, in its discretion, as Related Employment. 

(ff) “Restricted Stock Unit” means an Award that is a promise to issue shares to a Participant in the future
if the applicable vesting conditions are satisfied. 
 (gg) “Retirement” means Early Retirement,
Full Retirement or EU Retirement. 
 (hh) “RSU Payout Percentage” means the “RSU Payout
Percentage” determined pursuant to Schedule A. 
 (ii) “Section 409A Change Event” means a
“change in ownership,” a “change in effective control” or a “change in ownership of a substantial portion of the assets” of the Company, each as defined by Section 409A of the Code. Section 409A of the Code
generally states that (i) a “change in ownership” of a company means that any one person, or more than one person acting as a group, acquires ownership of stock of the company that, together with stock held by such person or group,
constitutes more than 50% of the total fair market value or total voting power of the stock of the company; (ii) a “change in effective control” of a company means (A) that any one person, or more than one person acting as a
group, acquires (or has acquired during the 12-month period ending on the date of the most recent acquisition by such person or persons) ownership of stock of the company possessing 30% or more of the total voting power of the stock of the company,
or (B) a majority of members of the company’s board of directors is replaced during any 12-month period by directors whose appointment or election is not endorsed by a majority of the members of the company’s board of directors before
the date of the appointment or election; and (iii) a “change in ownership of a substantial portion of the assets” of a company means that any one person, or more than one person acting as a group, acquires (or has acquired during the
12-month period ending on the date of the most recent acquisition by such person or persons) assets from the company that have a total gross fair market value equal to or more than 40% of the total gross fair market value of all of the assets of the
company immediately before such acquisition or acquisitions). 
 (jj) “Senior Executive Severance
Plan” means the Company’s Senior Executive Severance Plan, as amended and restated from time to time, or any successor thereto. 
 (kk) “Separation from Service” has the meaning given such term by Section 409A of the Code (and as determined in accordance with the 409A Policy), which generally states
that an employee has a “Separation from Service” with an employer if the employee dies, retires, or otherwise has a termination of his or her employment with such employer. Whether a Separation from Service has occurred is determined based
on whether the facts and circumstances indicate that the employer and employee reasonably anticipated that no further services would be performed after a certain date or that the level of bona fide services the employee would perform after such date
would permanently decrease to no more than 20% of the average level of bona fide services performed over the immediately preceding 36-month period. 
 (ll) “shares” refers to the shares of the Company’s common stock, par value of $.20 per share, or the shares of any other stock of any other class into which such shares
may thereafter be changed. 
 (mm) “Vesting Date” of an Award means the vesting date specified in
the Award Communication for such Award. (For the avoidance of doubt, the Vesting Date of an Award may differ from the last day of the Award’s Performance Period.) 
 *        *        *        *        *

  
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 AMERICAN EXPRESS COMPANY 

2007 INCENTIVE COMPENSATION PLAN 
  

 

[            ] RESTRICTED STOCK UNIT AWARD AGREEMENT (BAND 99)

  
  

APPENDIX B 
 SECTION 280G TERMS & PROCEDURES 
 Section
B1. “Best Net” Limitation.    In the event that any payment or benefit received or to be received by a Participant under the Agreement in connection with a Change in Control or termination of the
Participant’s employment (collectively, the “Payments”), will be subject to the excise tax referred to in Section 4999 of the Code (the “Excise Tax”), then the Payments shall be reduced to the extent
necessary so that no portion of the Payments is subject to the Excise Tax but only if (A) the net amount of all payments and benefits received or to be received by a Participant in connection with the applicable Change in Control or the
termination of the Participant’s employment, whether pursuant to the terms of the Agreement or any other plan, arrangement or agreement with the Company, any Person whose actions result in such Change in Control or any Person affiliated with
the Company or such Person (the “Total Payments”), as so reduced (and after subtracting the net amount of federal, state and local income and employment taxes on such reduced Total Payments), is greater than or equal to (B) the
net amount of such Total Payments without any such reduction (but after subtracting the net amount of federal, state and local income and employment taxes on such Total Payments and the amount of Excise Tax to which the Participant would be subject
in respect of such unreduced Total Payments); provided, however, that the Participant may elect in writing to have other components of his or her Total Payments reduced prior to any reduction in the Payments hereunder. 

Section B2. Calculations.    For purposes of determining whether the Payments will be subject to
the Excise Tax, the amount of such Excise Tax and whether any Payments are to be reduced hereunder: (i) the Total Payments shall be treated as “parachute payments” (within the meaning of Section 280G(b)(2) of the Code) unless, in
the opinion of the accounting firm which was, immediately prior to the Change in Control, the Company’s independent auditor, or if that firm refuses to serve, by another qualified firm, whether or not serving as independent auditors, designated
by the Committee (the “Firm”), such payments or benefits (in whole or in part) do not constitute parachute payments, including by reason of Section 280G(b)(2)(A) or Section 280G(b)(4)(A) of the Code; (ii) no portion
of the Total Payments the receipt or enjoyment of which the Participant shall have waived at such time and in such manner as not to constitute a “payment” within the meaning of Section 280G(b) of the Code shall be taken into account;
(iii) all “excess parachute payments” within the meaning of Section 280G(b)(1) of the Code shall be treated as subject to the Excise Tax unless, in the opinion of the Firm, such excess parachute payments (in whole or in part)
represent reasonable compensation for services actually rendered (within the meaning of Section 280G(b)(4)(B) of the Code) in excess of the Base Amount (within the meaning of Section 280G(b)(3) of the Code) allocable to such reasonable
compensation, or are otherwise not subject to the Excise Tax; and (iv) the value of any noncash benefits or any deferred payment or benefit shall be determined by the Firm in accordance with the principles of Section 280G(d)(3) and
Section 280G(d)(4) of the Code. For purposes of determining whether any Payments in respect of a Participant shall be reduced, a Participant shall be deemed to pay federal income tax at the highest marginal rate of federal income taxation (and
state and local income taxes at the highest marginal rate of taxation in the state and locality of such Participant’s residence, net of the maximum reduction in federal income taxes which could be obtained from deduction of such state and local
taxes) in the calendar year in which the Payments are made. The Firm will be paid reasonable compensation by the Company for its services. 
 Section B3. Notice of Adjustment.    As soon as practicable following a Change in Control, but in no event later than 30 days thereafter, the Company shall provide
to each Participant with respect to whom it is proposed that Payments be reduced, a written statement setting forth the manner in which the Total Payments in respect of such Participant were calculated and the basis for such calculations, including,
without limitation, any opinions or other advice the Company has received from the Firm or other advisors or consultants (and any such opinions or advice which are in writing shall be attached to the statement). 

*        *        *     
   *        * 

  
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 AMERICAN EXPRESS COMPANY 

2007 INCENTIVE COMPENSATION PLAN 
  

 

[            ] RESTRICTED STOCK UNIT AWARD AGREEMENT (BAND 99)

  
  

APPENDIX C 
 DETRIMENTAL CONDUCT PROVISIONS 
 Section C1.
Detrimental Conduct.    If a current or former employee of, or other individual that provides or has provided services for, the Company or its Affiliates (the “Employee”) engages in Detrimental
Conduct, Awards (as defined in Section C7(b) below) previously issued to such Employee may be canceled, rescinded or otherwise restricted and the Company can recover any payments received by and stock delivered to the Employee in accordance with the
terms of Section C2. For purposes of this Appendix C, “Detrimental Conduct” means the prohibited conduct described in Section C1(a) through Section C1(g). 
 (a) Noncompete.    For a one-year period after the last day of active employment if the Employee is a Band 70 or above employee or for a six-month period after the
last day of active employment if the Employee is a Band 50 or 60 employee, and during the Employee’s employment with the Company or its Affiliates, the Employee shall not be employed by, provide advice to or act as a consultant for any
Competitor. The Company has defined “Competitor” for certain lines of business, departments or job functions by establishing a specific standard and/or by name as set forth in the Company’s Competitor List(s). An
Employee’s personal list of Competitors will be the sum of: 
 (i) either (1) all Competitors derived from
the column titled “Standard” on the Competitor List for the lines of business and departments (as listed on the Competitor List under the “Line of Business” column) that the Employee provided services to or managed during the
two-year period preceding the date the Employee’s active employment with the Company or its Affiliates terminates, or (2) if the job function the Employee is employed in at the time his or her active employment with the Company or its
Affiliates terminates is listed on the Competitor List under the “Line of Business” column, the Competitors cited for that job function under the “Standard” column of the Competitor List; and 

(ii) the Entities (as defined in Section C7(c) below) listed on the Competitor List under the column titled “Business
Unit Wide Competitors” for the business units the Employee provided services to or managed during the two-year period preceding the date his or her active employment with the Company or its Affiliates terminates. If any line(s) of business the
Employee provided services to or managed during the two-year period preceding the date his or her active employment with the Company or its Affiliates terminates is not listed on the Competitor List then, with respect to such line(s) of business,
the Employee shall not be employed by, provide advice to or act as a consultant for (1) an Entity’s line of business that competes with those line(s) of business and (2) the Entities listed on the Competitor List under the column
titled “Business Unit Wide Competitors” for the business units the Employee provided services to or managed during the two-year period preceding the date the Employee’s active employment with the Company or its Affiliates terminates.
Except for Business Unit Wide Competitors, the prohibition against being employed by, providing advice to or acting as a consultant for a Competitor is limited to the line(s) of business of the Competitor that compete with the line(s) of business of
the Company or its Affiliates that the Employee provided services to or managed. With respect to Business Unit Wide Competitors, the Employee agrees not to be employed by, provide advice to or act as a consultant for such Entities in any line of
business because these Entities compete with several of the Company’s or its Affiliates’ lines of business. The Company can revise the Competitor List at its discretion at any time and from time to time and as revised will become part of
this Appendix C; a copy of the current Competitor List will be available through the Corporate Secretary’s Office. Notwithstanding anything in this Appendix C to the contrary, the Company shall not make any addition to the Competitor List for a
period of two years following the date of a Change in Control. 

(b) Nondenigration.    For a one-year period after an Employee’s last day of active employment
(the “Restricted Period”) and during his or her employment with the Company or its Affiliates, an Employee or anyone acting at his or her direction may not denigrate the Company or its Affiliates or the Company’s or its
Affiliates’ 

  
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of 15 

 
employees to the media or financial analysts. During the Restricted Period, an Employee may not (i) provide information considered proprietary by the Company to the media or financial
analysts or (ii) discuss the Company or its Affiliates with the media or financial analysts, without the explicit written permission of the Executive Vice President of Corporate Affairs and Communications. This Section C1(b) shall not be
applicable to any truthful statement required by any legal proceeding. 
 (c) Nonsolicitation of
Employees.    During the Restricted Period, an Employee may not employ or solicit for employment any employee of the Company or its Affiliates. In addition, during the Restricted Period an Employee may not advise or recommend
to any other person that he or she employ or solicit for employment, any person employed by the Company or its Affiliates for the purpose of employing that person at an Entity at which the Employee is or intends to be (i) employed, (ii) a
member of the board of directors, or (iii) providing consulting services. 
 (d) Nonsolicitation of
Customers.    During the Restricted Period, an Employee may not directly or indirectly solicit or enter into any arrangement with any Entity which is, at the time of such solicitation, a significant customer of the Company or
its Affiliates for the purpose of engaging in any business transactions of the nature performed or contemplated by the Company or its Affiliates. This Section C1(d) shall apply only to customers whom the Employee personally serviced while employed
by the Company or its Affiliates or customers the Employee acquired material information about while employed by the Company or its Affiliates. 
 (e) Misconduct.    During his or her employment with the Company or its Affiliates, an Employee may not engage in any conduct that results in termination of his or
her employment for Misconduct. For purposes of this Section C1(e), “Misconduct” is (i) material violation of the American Express Company Code of Conduct, (ii) criminal activity, (iii) gross insubordination, or
(iv) gross negligence in the performance of duties. 
 (f) Confidential
Information.    During the Restricted Period and during his or her employment with the Company or its Affiliates, an Employee may not misappropriate or improperly disclose confidential information or trade secrets of the
Company, its Affiliates and their businesses, including but not limited to information about marketing or business plans, possible acquisitions or divestitures, potential new products or markets and other data not available to the public.

 (g) Other Detrimental Conduct.    During the Restricted Period, an Employee may not
take any actions that the Company reasonably deems detrimental to its interests or those of its Affiliates. To the extent practicable, the Company will request an Employee to cease and desist or rectify the conduct prior to seeking any legal
remedies under this Appendix C and will only seek legal remedies if the Employee does not comply with such request. This Section C1(g) shall not be applied to conduct that is otherwise permitted by Section C1(a) through Section C1(f). For example,
if an Employee leaves the Company’s employment to work for an Entity that is not a Competitor under Section C1(a), the Company will not claim that employment with that Entity violates Section C1(g). Notwithstanding anything in this Appendix C
to the contrary, the prohibition on conduct described in this Section C1(g) shall not be applicable to an Employee from and after his or her last day of active employment, if his or her active employment terminates for any reason (other than for
Misconduct) within two years following a Change in Control. 
 Section C2. Remedies.

(a) Repayment of Financial Gain. 
 (i) If an Employee fails to comply with the requirements of Section C1(a) through Section C1(g), the Company may cancel any outstanding Awards and recover from the Employee (1) the Amount
(as that term is defined in Section C7(a) below) of any gain realized on Stock Options that the Employee exercised, as of the date exercised, (2) the Amount of any payments received by the Employee for Portfolio Grant Awards, Performance Grant
Awards or other Awards granted under the Plan and (3) the Number (as that term is defined in Section C7(d) below) of shares of stock whose restrictions lapsed (or the value of the Number of such shares of stock at the time the restrictions
lapsed) pursuant to an award of Restricted Stock or Restricted Stock Units or other Award, during the 24-month period preceding the Employee’s last day of active employment. 

(ii) If an Employee fails to comply with the requirements of Section C1(a) through Section C1(g), the Employee must and
agrees to repay the Company, upon demand by the Company, in accordance with the terms of this Section C2, and the Company shall be entitled, to the extent and in the manner permitted by the 409A Policy, to set-off against the amount of any such
repayment obligation against any amount owed, from any source, to the Employee by the Company or its Affiliates. 

  
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 (b) Other Remedies.    The remedy provided pursuant to
Section C2(a) shall be without prejudice to the Company’s right to recover any losses resulting from a violation of this Appendix C and shall be in addition to whatever other remedies the Company may have, at law or equity, for violation of the
terms of this Appendix C. 
 Section C3. Compensation Band Changes.    If the Company
changes its current system of classifying employees in compensation bands and management tiers, the references to Bands 50, 60 and 70, and Executive Officers in this Appendix C will be construed to mean the compensation level(s) and management tiers
in the new or revised system that, in the Company’s discretion, most closely approximates these bands and management tiers under the current system. 
 Section C4. Involuntary Terminations.    This Appendix C will not apply to employees of the Company or its Affiliates who enter into a severance agreement with the
Company or its Affiliates or other involuntary terminations as determined by the Company (excluding terminations covered by Section C1(e)). 
 Section C5. Court Modification.    If any term of this Appendix C is determined by a court of competent jurisdiction not to be enforceable in the manner set forth
in this Appendix C, such term shall be enforceable to the maximum extent possible under applicable law and such court shall reform such term to make it enforceable. 
 Section C6. Waivers.    The failure of the Company to enforce at any time any term of this Appendix C shall not be construed to be a waiver of such term or of any
other term. Any waiver or modification of the terms of this Appendix C will only be effective if reduced to writing and signed by both the Employee and the President or Chief Executive Officer of the Company. 

Section C7. Definitions.    As used in this Appendix C, the following terms will have the
respective meanings set forth below. 
 (a) “Amount” means the gross amount, before deduction of
applicable taxes or other amounts, and includes the gross amount of any dividends or dividend equivalents paid to the Employee on awards of Restricted Stock or Restricted Stock Units. 

(b) “Award” means a Performance Grant Award, Portfolio Grant Award, Restricted Stock, Restricted Stock Unit,
Stock Option or other award issued under the Plan. 
 (c) “Entity” or “Entities”
mean any corporation, partnership, association, joint venture, trust, government, governmental agency or authority, person or other organization or entity. 
 (d) “Number” means the total number of shares of stock, before reduction for the payment of applicable taxes or other amounts, and includes the total number of any shares of
stock paid to the Employee on awards of Restricted Stock or Restricted Stock Units. 
 (e) “Performance Grant
Award” means a performance grant award issued under the Plan, and includes the annual bonus provided to Executive Officers. 
 (f) “Portfolio Grant Award” means a portfolio grant award issued under the Plan. 
 (g) “Restricted Stock,” “Restricted Stock Unit” and “Stock Option” have the respective meanings given such terms in the Plan. 

*        *        *     
   *        * 

  
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 AMERICAN EXPRESS COMPANY 

2007 INCENTIVE COMPENSATION PLAN 
  

 

[            ] RESTRICTED STOCK UNIT AWARD AGREEMENT (BAND 99)

  
  

SCHEDULE A 
 PERFORMANCE REQUIREMENT 
 Performance Requirement:

 [    ] 
 Performance Period: 
 [    ]

 Earned Shares: 
 [    ] 
 RSU Payout Percentage: 

[    ] 
 Definitions: 
 [    ]

*        *        *     
   *        * 

  
 Page 15
of 15EX-10.12

 Exhibit 10.12 

ZYNGA INC. 

CHANGE IN CONTROL SEVERANCE BENEFIT PLAN1 
 1. INTRODUCTION. The Zynga Inc. Change in
Control Severance Benefit Plan (the “Plan”) is established effective September 14, 2011 (the “Effective Date”). The Plan provides for the payment of accelerated vesting severance benefits to
certain employees of Zynga Inc. (the “Company”) in the event of a Change in Control. This document constitutes the Summary Plan Description for the Plan. 

2. DEFINITIONS. For purposes of the Plan, the following terms are defined as follows:  

(a) “Board” means the Board of Directors of the Company.  

(b) “Cause” means, with respect to a Participant: (i) any willful, material
violation of any law or regulation applicable to the business of the Company, conviction for, or guilty plea to, a felony or a crime involving moral turpitude, or any willful perpetration of a common law fraud; (ii) commission of an act of
personal dishonesty that involves personal profit in connection with the Company or any other entity having a business relationship with the Company; (iii) any material breach of any provision of any agreement or understanding between the
Company and the Participant regarding the terms of service as an employee, officer, director, or consultant to the Company, including without limitation, the willful and continued failure or refusal to perform the material duties required an
employee, officer, director or consultant of the Company, other than as a result of having a disability that prevents the Participant from performing the material duties required of a person holding the Participant’s position with the Company
for a period of at least 120 days, or a breach of any applicable invention assignment and confidentiality agreement or similar agreement between the Company and the Participant; (iv) disregard of the policies of the Company so as to cause loss,
damage, or injury to the property, reputation, or employees of the Company; or (v) any other misconduct that is materially injurious to the financial condition or business reputation of, or is otherwise materially injurious to, the
Company. 
 (c) “Change in Control” means the occurrence, in a
single transaction or in a series of related transactions, of any one or more of the following events: 
 (i) any
person, entity or group (within the meaning of Section 13(2)(3) or 14(d)(2) of the Securities Exchange Act of 1934, as amended) acquires beneficial ownership of securities of the Company representing more than 50% of the combined voting power
of the Company’s then outstanding securities other than by virtue of a merger, consolidation or similar transaction. Notwithstanding the foregoing, a Change in Control will not be deemed to occur (A) on account of the acquisition of
securities of the Company directly from the Company, (B) on account of the acquisition of securities of the Company by an investor, any affiliate thereof or any other person, entity or group that acquires the Company’s securities in a
transaction or series 
  

	1 	 As amended and restated by the Compensation Committee of the Board of Directors of Zynga Inc. on November 22, 2011.

  
 1 

 
of related transactions the primary purpose of which is to obtain financing for the Company through the issuance of equity securities, (C) on account of the acquisition of securities of the
Company by Mark Pincus and/or any entity in which Mark Pincus has a direct or indirect interest (whether in the form of voting rights or participation in profits or capital contributions) of more than 50% (collectively, the “Pincus
Entities” ) or on account of the Pincus Entities continuing to hold shares that come to represent more than 50% of the combined voting power of the Company’s then outstanding securities as a result of the conversion of any class of
the Company’s securities into another class of the Company’s securities having a different number of votes per share pursuant to the conversion provisions set forth in the Company’s Amended and Restated Certificate of Incorporation;
or (D) solely because the level of beneficial ownership held by any such person, entity or group (the “Subject Person”) exceeds the designated percentage threshold of the outstanding voting securities as a result of a
repurchase or other acquisition of voting securities by the Company reducing the number of shares outstanding, provided that if a Change in Control would occur (but for the operation of this sentence) as a result of the acquisition of voting
securities by the Company, and after such share acquisition, the Subject Person becomes the beneficial owner of any additional voting securities that, assuming the repurchase or other acquisition had not occurred, increases the percentage of the
then outstanding voting securities beneficially owned by the Subject Person over the designated percentage threshold, then a Change in Control will be deemed to occur; 

(ii) there is consummated a merger, consolidation or similar transaction involving (directly or indirectly) the Company and,
immediately after the consummation of such merger, consolidation or similar transaction, the stockholders of the Company immediately prior thereto do not beneficially own, either (A) outstanding voting securities representing more than 50% of
the combined outstanding voting power of the surviving entity in such merger, consolidation or similar transaction, or (B) more than 50% of the combined outstanding voting power of the parent of the surviving entity in such merger,
consolidation or similar transaction, in each case in substantially the same proportions as their beneficial ownership of the outstanding voting securities of the Company immediately prior to such transaction; provided, however, that a
merger, consolidation or similar transaction will not constitute a Change in Control under this prong of the definition if the outstanding voting securities representing more than 50% of the combined voting power of the surviving entity or its
parent are owned by the Pincus Entities; 
 (iii) there is consummated a sale, lease, exclusive license or other disposition of all
or substantially all of the consolidated assets of the Company and its subsidiaries, other than a sale, lease, license or other disposition of all or substantially all of the consolidated assets of the Company and its subsidiaries to an entity, more
than 50% of the combined voting power of the voting securities of which are beneficially owned by stockholders of the Company in substantially the same proportions as their beneficial ownership of the outstanding voting securities of the Company
immediately prior to such sale, lease, license or other disposition; provided, however, that a sale, lease, exclusive license or other disposition of all or substantially all of the consolidated assets of the Company and its subsidiaries will
not constitute a Change in Control under this prong of the definition if the outstanding voting securities representing more than 50% of the combined voting power of the acquiring entity or its parent are owned by the Pincus Entities; or 

(iv) individuals who, on the date the Plan is adopted by the Board, are members of the Board (the “Incumbent
Board”) cease for any reason to constitute at least a majority of the members of the Board; provided, however, that if the appointment or election (or nomination for election) of any new Board member was approved or
recommended by a majority vote of the members of the Incumbent Board then still in office, such new member will, for purposes of the Plan, be considered as a member of the Incumbent Board. 

  
 2 

 For purposes of determining voting power under the term Change in Control, voting power shall be calculated by
assuming the conversion of all equity securities convertible (immediately or at some future time) into shares entitled to vote, but not assuming the exercise of any warrant or right to subscribe to or purchase those shares. In addition, the term
Change in Control will not include a sale of assets, merger or other transaction effected exclusively for the purpose of changing the domicile of the Company. In addition, the term Change in Control will not include a change in the voting power of
any one or more stockholders as a result of the conversion of any class of the Company’s securities into another class of the Company’s securities having a different number of votes per share pursuant to the conversion provisions set forth
in the Company’s Amended and Restated Certificate of Incorporation. To the extent required for compliance with Section 409A of the Code, in no event will a Change in Control be deemed to have occurred if such transaction is not also a
“change in the ownership or effective control of” the Company or “a change in the ownership of a substantial portion of the assets of” the Company as determined under Treasury Regulations Section 1.409A-3(i)(5) (without
regard to any alternative definition thereunder). 
 (d) “Code” means the
Internal Revenue Code of 1986, as amended. 
 (e) “Constructive
Termination” means the voluntary termination of employment with the Company by the Participant resulting in a Separation from Service after one of the following is undertaken without the Participant’s written consent: (i) the
assignment to the Participant of any duties or responsibilities that results in a material diminution in the Participant’s employment role in the Company as in effect immediately prior to the date of such actions; (ii) a greater than 10%
aggregate reduction by the Company in the Participant’s annual base salary (that is, a material reduction), as in effect immediately prior to the date of such actions; provided, however, that if there are
across-the-board proportionate reductions for all similarly situated employees of the Company, as determined by the Plan Administrator, by the same percentage amount as part of a general salary reduction, the reduction as to the Participant shall
not constitute a basis for a Constructive Termination or (iii) a non-temporary relocation of the Participant’s business office to a location that increases the Participant’s one way commute by more than 35 miles from the primary
location at which the Participant performs duties as of immediately prior to the date of such action. An event or action by the Company will not give the Participant grounds to voluntarily terminate employment as a Constructive Termination unless
(A) the Participant gives the Company written notice within 30 days after the initial existence of such event or action that the event or action by the Company would give the Participant such grounds to so terminate employment, (B) such
event or action is not reversed, 

  
 3 

 
remedied or cured, as the case may be, by the Company as soon as possible but in no event later than within 30 days of receiving such written notice from the Participant, and (C) the
Participant terminates employment within 90 days following the end of the cure period. 
 (f)
“ERISA” means the Employee Retirement Income Security Act of 1974, as amended. 

(g) “Involuntary Termination Without Cause” means a Participant’s involuntary
termination of employment by the Company resulting in a Separation from Service for a reason other than death, disability or Cause.  

(h) “Participant” means an individual (i) who is employed by the Company who
holds a title of Vice President of the Company or above, and (ii) who has received a Participation Notice from and executed and returned such Participation Notice to the Company.  

(i) “Participation Notice” means the latest notice delivered by the Company to a
Participant informing the employee that the employee is eligible to participate in the Plan, substantially in the form of EXHIBIT A hereto. 

(j) “Plan Administrator” means the Board or any committee thereof duly authorized
by the Board to administer the Plan. The Plan Administrator may, but is not required to be, the Compensation Committee of the Board. The Board may at any time administer the Plan, in whole or in part, notwithstanding that the Board has previously
appointed a committee to act as the Plan Administrator.  
 (k) “Qualifying
Termination” means either (i) an Involuntary Termination Without Cause, or (ii) a Constructive Termination, in either case that occurs during the 30 day period immediately preceding a Change in Control or the 18 month period
immediately following a Change in Control. Termination of employment of a Participant due to death or disability will not constitute a Qualifying Termination. 

(l) “Separation from Service” means a “separation from service” within
the meaning of Treasury Regulations Section 1.409A-1(h), without regard to any permissible alternative definition of “termination of employment” thereunder. 

3. ELIGIBILITY FOR BENEFITS. 

(a) Eligibility; Exceptions to Benefits. Subject to the terms and conditions of this Plan, the Company will provide the benefits
described in Section 4 to the affected Participant. A Participant will not receive benefits under the Plan (or will receive reduced benefits under the Plan) in the following circumstances, as determined by the Plan Administrator, in its sole
discretion: 
 (i) The Participant is a party to an employment agreement or equity award agreement with the Company, or is an
eligible participant in another benefit plan, in each case providing for accelerated vesting of equity awards in the event of a Change in Control and/or a  

  
 4 

 
Qualifying Termination, and which agreement or plan is in effect at the time of the Change in Control and/or the Qualifying Termination, and which agreement or plan provides benefits in an amount
that is greater than the amount provided for in this Plan, in which case such Participant’s applicable benefit will be governed by the terms of such agreement or plan. This Plan does not provide for duplication of benefits with any such other
agreement or plan. 
 (ii) The Participant’s employment terminates or is terminated for any reason other than a Qualifying
Termination, or is terminated for any reason more than 30 days prior to a Change in Control. 
 (iii)
The Participant has not entered into the Company’s standard form of Employee Invention Assignment and Confidentiality Agreement or any similar or successor document (the “Proprietary Agreement”). 

 (iv) The Participant has failed to execute, or has revoked, the Release (as defined and described in Section 6(a)
below) within 60 days following his or her Separation from Service. 
 (v) The Participant has
failed to return all Company Property. For this purpose, “Company Property” means all paper and electronic Company documents (and all copies thereof) created and/or received by the Participant during his or her period of
employment with the Company and other Company materials and property that the Participant has in his or her possession or control, including, without limitation, Company files, notes, drawings records, plans, forecasts, reports, studies, analyses,
proposals, agreements, financial information, research and development information, sales and marketing information, operational and personnel information, specifications, code, software, databases, computer-recorded information, tangible property
and equipment (including, without limitation, leased vehicles, computers, computer equipment, software programs, facsimile machines, mobile telephones, servers), credit and calling cards, entry cards, identification badges and keys, and any
materials of any kind that contain or embody any proprietary or confidential information of the Company (and all reproductions thereof, in whole or in part). As a condition to receiving benefits under the Plan, a Participant must not make or retain
copies, reproductions or summaries of any such Company documents, materials or property. However, a Participant is not required to return his or her personal copies of documents evidencing the Participant’s hire, termination, compensation,
benefits and stock options and any other documentation received as a stockholder of the Company. 
 (b) Termination of
Benefits. A Participant’s right to receive benefits under the Plan will terminate immediately if, at any time prior to or during the period for which the Participant is receiving benefits under the Plan, the Participant, without the prior
written approval of the Plan Administrator: 
 (i) willfully breaches a material provision of the Proprietary Agreement;

  
 5 

 (ii) encourages or solicits any of the Company’s then current employees to leave the
Company’s employ for any reason or interferes in any other manner with employment relationships at the time existing between the Company and its then current employees; or 

(iii) induces any of the Company’s then current clients, customers, suppliers, vendors, distributors, licensors, licensees or
other third party to terminate their existing business relationship with the Company or interferes in any other manner with any existing business relationship between the Company and any then current client, customer, supplier, vendor, distributor,
licensor, licensee or other third party. 
 4. AMOUNT OF BENEFITS. 

(a) Single Trigger Vesting. Subject to a Participant’s continued service and eligibility under this Plan through the time
immediately prior to a Change in Control, or in the event of a Qualifying Termination in the 30 day period immediately preceding a Change in Control, and except as may otherwise be provided in the Participant’s Participation Notice, 25% of the
total number of shares (or such lesser number as remain unvested) subject to each of the Participant’s compensatory equity awards that are outstanding as of immediately prior to the Change in Control (or, in the case of a Qualifying
Termination, as of the Qualifying Termination and after giving effect to the accelerated vesting in Section 4(b) below), including, without limitation, stock options and restricted stock units, will immediately vest, and, as applicable, become
exercisable. 
 (b) Double Trigger Vesting. In the event of the Qualifying Termination of a Participant who is serving at or
above the level of Senior Vice President at the time of the Qualifying Termination, and except as may otherwise be provided in the Participant’s Participation Notice, an additional 25% of the total number of shares (or such lesser number as
remain unvested) subject to each of the Participant’s then-outstanding compensatory equity awards, including, without limitation, stock options and restricted stock units, will vest, and, as applicable, become exercisable, effective as of the
date of the Qualifying Termination This vesting is in addition to any vesting benefit for which the Participant is eligible under Section 4(a) above, such that a Participant serving at or above the level of Senior Vice President at the time of
the Qualifying Termination may be eligible for acceleration of up to 50% of the total number of shares subject to each then-outstanding compensatory equity award. 

5. ADDITIONAL BENEFITS. The Plan Administrator may, in its sole discretion, provide additional or enhanced benefits to
the Participants and may also provide the benefits of this Plan to employees who are not Participants (“Non-Participants”) but who are chosen by the Plan Administrator, in its sole discretion, to receive
benefits under this Plan. The provision of any such benefits to a Participant or a Non-Participant will in no way obligate the Company to provide such benefits to any other Participant or to any other Non-Participant, even if similarly situated. If
benefits under the Plan are provided to a Non-Participant, references in the Plan to “Participant” will be deemed to refer to such Non-Participants. 

  
 6 

 6. LIMITATIONS ON BENEFITS. 

(a) Release. To be eligible to receive any benefits under the Plan that are triggered by a Qualifying
Termination, a Participant must execute, in connection with the Participant’s Qualifying Termination, a general waiver and release in substantially the form attached hereto as EXHIBIT B,
EXHIBIT C, or EXHIBIT D, as appropriate (the “Release”), and such release must become effective in accordance with its terms
within 60 days following the Separation from Service (the “Release Date”). With respect to any outstanding stock option held by the Participant that is subject to acceleration under this Plan, such option may not be exercised
as to any shares as to which the vesting was accelerated until the Release Date, and only if the Release becomes effective. The Plan Administrator, in its sole discretion, may modify the form of the required Release to comply with applicable law,
and any such Release may be incorporated into a termination agreement or other agreement with the Participant.  
 (b)
Prior Agreements; Certain Reductions. The Plan Administrator will reduce a Participant’s benefits under this Plan by any other statutory severance obligations or contractual severance benefits, obligations for pay in lieu of notice, and any
other similar benefits payable to the Participant by the Company (or any successor thereto) that are due in connection with the Participant’s Qualifying Termination and that are in the same form as the benefits provided under this Plan (that
is, equity award vesting credit). Without limitation, this reduction includes a reduction for any benefits required pursuant to (i) any applicable legal requirement, including, without limitation, the Worker Adjustment and Retraining
Notification Act (the “WARN Act”), (ii) a written employment or severance agreement with the Company, (iii) any Company policy or practice providing for the Participant to remain on the payroll for a
limited period of time after being given notice of the termination of the Participant’s employment, and (iv) any required salary continuation, notice pay, statutory severance payment, or other payments either required by local law, or owed
pursuant to a collective labor agreement, as a result of the termination of the Participant’s employment. The benefits provided under the Plan are intended to satisfy, to the greatest extent possible, and not to provide benefits duplicative of,
any and all statutory, contractual and collective agreement obligations of the Company in respect of the form of benefits provided under this Plan that may arise out of a Qualifying Termination, and the Plan Administrator will so construe and
implement the terms of the Plan. Reductions may be applied on a retroactive basis, with benefits previously provided being recharacterized as benefits pursuant to the Company’s statutory or other contractual obligations. The payments pursuant
to the Plan are in addition to, and not in lieu of, any unpaid salary, bonuses or employee welfare benefits to which a Participant may be entitled for the period ending with the Participant’s Qualifying Termination. 

(c) Mitigation. Except as otherwise specifically provided in the Plan, a Participant will not be required to mitigate damages or the
amount of any payment provided under the Plan by seeking other employment or otherwise, nor will the amount of any payment provided for under the Plan be reduced by any compensation earned by a Participant as a result of employment by another
employer or any retirement benefits received by such Participant after the date of the Participant’s termination of employment with the Company. 

(d) Indebtedness of Participants. If a Participant is indebted to the Company on the effective date of his or her Qualifying
Termination, the Company reserves the right to offset the 

  
 7 

 
payment of any severance benefits under the Plan by the amount of such indebtedness. Such offset shall be made in accordance with all applicable laws. The Participant’s execution
of the Participant Notice constitutes knowing written consent to the foregoing. 
 (e) Parachute Payments. Except as otherwise
expressly provided in an agreement between a Participant and the Company, if any payment or benefit the Participant would receive in connection with a Change in Control from the Company or otherwise (a
“Payment”) would (i) constitute a “parachute payment” within the meaning of Section 280G of the Code, and (ii) but for this sentence, be subject to the excise tax imposed by
Section 4999 of the Code (the “Excise Tax”), then such Payment will be equal to the Reduced Amount. The “Reduced Amount” will be either (A) the largest portion of
the Payment that would result in no portion of the Payment being subject to the Excise Tax, or (B) the largest portion, up to and including the total, of the Payment, whichever amount, after taking into account all applicable federal, state,
provincial, foreign and local employment taxes, income taxes, and the Excise Tax (all computed at the highest applicable marginal rate), results in the Participant’s receipt, on an after-tax basis, of the greatest economic benefit
notwithstanding that all or some portion of the Payment may be subject to the Excise Tax. If a reduction in payments or benefits constituting “parachute payments” is necessary so that the Payment equals the Reduced Amount, reduction will
occur in the following order: (1) reduction of cash payments; (2) cancellation of accelerated vesting of stock awards other than stock options; (3) cancellation of accelerated vesting of stock options; and (4) reduction of other
benefits paid to the Participant. Within any such category of Payments (that is, (1), (2), (3) or (4)), a reduction will occur first with respect to amounts that are not “deferred compensation” within the meaning of Section 409A
of the Code and then with respect to amounts that are. In the event that acceleration of vesting of stock award compensation is to be reduced, such acceleration of vesting will be cancelled in the reverse order of the date of grant of the
Participant’s applicable type of stock award (i.e., earliest granted stock awards are cancelled last). If Section 409A is not applicable by law to a Participant, the Company shall determine whether any similar law in
the Participant’s jurisdiction applies and should be taken into account. 
 7. TAX MATTERS. 

(a) Application of Code Section 409A. It is intended that all of the benefits provided under the Plan satisfy, to the greatest
extent possible, the exemptions from the application of Section 409A of the Code and the regulations and other guidance thereunder and any state law of similar effect (collectively, “Section 409A”) provided under
Treasury Regulations Sections 1.409A-1(b)(4), 1.409A-1(b)(5) and 1.409A-1(b)(9), and the Plan will be construed to the greatest extent possible as consistent with those provisions. To the extent not so exempt, the Plan (and any definitions under the
Plan) will be construed in a manner that complies with Section 409A, and incorporates by reference all required definitions and payment terms. For purposes of Section 409A (including, without limitation, for purposes of Treasury
Regulations Section 1.409A-2(b)(2)(iii)), a Participant’s right to receive any installment payments under the Plan will be treated as a right to receive a series of separate payments and, accordingly, each installment payment under the
Plan will at all times be considered a separate and distinct payment. If the Plan Administrator determines that any of the payments upon a Separation from Service provided under the Plan constitute “deferred compensation” under
Section 409A and if the 

  
 8 

 
Participant is a “specified employee” of the Company, as such term is defined in Section 409A(a)(2)(B)(i), at the time of his or her Separation from Service, then, solely to the
extent necessary to avoid the incurrence of the adverse personal tax consequences under Section 409A, the timing of the payments upon a Separation from Service will be delayed as follows: on the earlier to occur of (i) the date that is six
months and one day after the effective date of the Participant’s Separation from Service, and (ii) the date of the Participant’s death (such earlier date, the “Delayed Initial Payment Date”), the Company will
(A) pay to the Participant a lump sum amount equal to the sum of the payments upon Separation from Service that the Participant would otherwise have received through the Delayed Initial Payment Date if the commencement of the payments had not
been delayed pursuant to this Section 7(a), and (B) commence paying the balance of the payments in accordance with the applicable payment schedules set forth in above. No interest will be due on any amounts so deferred. If
Section 409A is not applicable by law to a Participant, the Company shall determine whether any similar law in the Participant’s jurisdiction applies and should be taken into account. 

(b) Withholding. All payments under the Plan will be subject to all applicable withholding obligations of the Company, including,
without limitation, obligations to withhold for federal, state, provincial, foreign and local income and employment taxes.  
 (c)
Tax Advice. By becoming a Participant in the Plan, Participant agrees to review with Participant’s own tax advisors the federal, state, provincial, local and foreign tax consequences of participation in this Plan. Participant shall rely
solely on such advisors and not on any statements or representations of the Company or any of its agents. Participant understands that Participant (and not the Company) shall be responsible for his or her own tax liability that may arise as a result
of becoming a Participant in the Plan.  
 8. REEMPLOYMENT. In the event of a Participant’s reemployment by the Company
during the period of time in respect of which severance benefits have been provided (that is, benefits as a result of a Qualifying Termination), the Company, in its sole and absolute discretion, may require such Participant to repay to the Company
all or a portion of such severance benefits as a condition of reemployment. 
 9. RIGHT TO INTERPRET
PLAN; AMENDMENT AND TERMINATION. 
 (a) Exclusive Discretion. The
Plan Administrator will have the exclusive discretion and authority to establish rules, forms, and procedures for the administration of the Plan and to construe and interpret the Plan and to decide any and all questions of fact, interpretation,
definition, computation or administration arising in connection with the operation of the Plan, including, without limitation, the eligibility to participate in the Plan, the amount of benefits paid under the Plan and any adjustments that need to be
made in accordance with the laws applicable to a Participant. The rules, interpretations, computations and other actions of the Plan Administrator will be binding and conclusive on all persons. 

(b) Amendment or Termination. The Company reserves the right to amend or terminate the Plan, any Participation Notice issued pursuant
to the Plan or the benefits provided hereunder at any time; provided, however, that no such amendment or termination will apply to 

  
 9 

 
any Participant who would be adversely affected by such amendment or termination unless such Participant consents in writing to such amendment or termination. Any action amending or terminating
the Plan or any Participation Notice will be in writing and executed by a duly authorized officer of the Company. 
 10. NO
IMPLIED EMPLOYMENT CONTRACT. The Plan will not be deemed (i) to give any employee or other person any right to be retained in the employ of the Company, or (ii) to interfere with the right
of the Company to discharge any employee or other person at any time, with or without cause, which right is hereby reserved. 
 11.
LEGAL CONSTRUCTION. The Plan will be governed by and construed under the laws of the State of California (without regard to principles of conflict of laws), except to the extent preempted by ERISA. 

12. CLAIMS, INQUIRIES AND APPEALS. 

(a) Applications for Benefits and Inquiries. Any application for benefits, inquiries about the Plan or inquiries about present or
future rights under the Plan must be submitted to the Plan Administrator in writing by an applicant (or his or her authorized representative). The Plan Administrator is set forth in Section 14(d). 

(b) Denial of Claims. In the event that any application for benefits is denied in whole or in part, the Plan Administrator must provide
the applicant with written or electronic notice of the denial of the application, and of the applicant’s right to review the denial. Any electronic notice will comply with the regulations of the U.S. Department of Labor. The notice of denial
will be set forth in a manner designed to be understood by the applicant and will include the following: 
 (1) the specific
reason or reasons for the denial; 
 (2) references to the specific Plan provisions upon which the denial is based;

 (3) a description of any additional information or material that the Plan Administrator needs to complete the review and an
explanation of why such information or material is necessary; and 
 (4) an explanation of the Plan’s review procedures
and the time limits applicable to such procedures, including a statement of the applicant’s right to bring a civil action under Section 502(a) of ERISA following a denial on review of the claim, as described in Section 12(d). 

The notice of denial will be given to the applicant within 90 days after the Plan Administrator receives the application, unless special circumstances require
an extension of time, in which case, the Plan Administrator has up to an additional 90 days for processing the application. If an extension of time for processing is required, written notice of the extension will be furnished to the applicant before
the end of the initial 90 day period. 

  
 10 

 The notice of extension will describe the special circumstances necessitating the additional time and the date by
which the Plan Administrator is to render its decision on the application. 
 (c) Request for a Review. Any person (or that
person’s authorized representative) for whom an application for benefits is denied, in whole or in part, may appeal the denial by submitting a request for a review to the Plan Administrator within 60 days after the application is denied. A
request for a review will be in writing and will be addressed to: 
 Zynga Inc. 

Attn: General Counsel 
 699 8th Street 
 San Francisco, CA 94103 

A request for review must set forth all of the grounds on which it is based, all facts in support of the request and any other matters that the applicant
feels are pertinent. The applicant (or his or her representative) will have the opportunity to submit (or the Plan Administrator may require the applicant to submit) written comments, documents, records, and other information relating to his or her
claim. The applicant (or his or her representative) will be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to his or her claim. The review will take into account
all comments, documents, records and other information submitted by the applicant (or his or her representative) relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. 

(d) Decision on Review. The Plan Administrator will act on each request for review within 60 days after receipt of the request, unless
special circumstances require an extension of time (not to exceed an additional 60 days), for processing the request for a review. If an extension for review is required, written notice of the extension will be furnished to the applicant within the
initial 60 day period. This notice of extension will describe the special circumstances necessitating the additional time and the date by which the Plan Administrator is to render its decision on the review. The Plan Administrator will give prompt,
written or electronic notice of its decision to the applicant. Any electronic notice will comply with the regulations of the U.S. Department of Labor. In the event that the Plan Administrator confirms the denial of the application for benefits, in
whole or in part, the notice will set forth, in a manner designed to be understood by the applicant, the following: 
 (1)
the specific reason or reasons for the denial; 
 (2) references to the specific Plan provisions upon which the denial is
based; 

  
 11 

 (3) a statement that the applicant is entitled to receive, upon request and free of
charge, reasonable access to, and copies of, all documents, records and other information relevant to his or her claim; and 

(4) a statement of the applicant’s right to bring a civil action under Section 502(a) of ERISA.  

(e) Rules and Procedures. The Plan Administrator will establish rules and procedures, consistent with the Plan and with ERISA, as
necessary and appropriate in carrying out its responsibilities in reviewing benefit claims. The Plan Administrator may require an applicant who wishes to submit additional information in connection with an appeal from the denial of benefits to do so
at the applicant’s own expense. 
 (f) Exhaustion of Remedies. No legal action for benefits under the Plan may be brought
until the applicant (i) has submitted a written application for benefits in accordance with the procedures described by Section 12(a), (ii) has been notified by the Plan Administrator that the application is denied, (iii) has
filed a written request for a review of the application in accordance with the appeal procedure described in Section 12(c), and (iv) has been notified that the Plan Administrator has denied the appeal. Notwithstanding the foregoing, if the
Plan Administrator does not respond to an applicant’s claim or appeal within the relevant time limits specified in this Section 12, the applicant may bring legal action for benefits under the Plan pursuant to Section 502(a) of ERISA.
 
 13. BASIS OF PAYMENTS TO AND FROM
PLAN. All benefits under the Plan will be paid by the Company. The Plan will be unfunded, and benefits hereunder will be paid only from the general assets of the Company. 

14. OTHER PLAN INFORMATION. 

(a) Employer and Plan Identification Numbers. The Employer Identification Number assigned to the Company (which is the “Plan
Sponsor” as that term is used in ERISA) by the Internal Revenue Service is 42-1733483. The Plan Number assigned to the Plan by the Plan Sponsor pursuant to the instructions of the Internal Revenue Service is 525. 

(b) Ending Date for Plan’s Fiscal Year. The date of the end of the fiscal year for the purpose of maintaining the Plan’s
records is December 31. 
 (c) Agent for the Service of Legal Process. The agent for the service of legal process with respect
to the Plan is: 
 Zynga Inc. 

Attn: General Counsel 
 699 8th Street 
 San Francisco, CA 94103 

  
 12 

 (d) Plan Sponsor and Administrator. The “Plan Sponsor” and the “Plan
Administrator” of the Plan is: 
 Zynga Inc. 

Attn: General Counsel 
 699 8th Street 
 San Francisco, CA 94103 

The Plan Sponsor’s and Plan Administrator’s telephone number is (800) 762-2530. The Plan Administrator is the named fiduciary charged with the
responsibility for administering the Plan. 
 15. STATEMENT OF ERISA RIGHTs. 

Participants in the Plan (which is a welfare benefit plan sponsored by Zynga Inc.) are entitled to certain rights and protections under ERISA.
If you are a Participant, you are considered a participant in the Plan for the purposes of this Section 15 and, under ERISA, you are entitled to: 

Receive Information About Your Plan and Benefits 

(a) Examine, without charge, at the Plan Administrator’s office and at other specified locations, such as worksites, all documents
governing the Plan and a copy of the latest annual report (Form 5500 Series), if applicable, filed by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration;

 (b) Obtain, upon written request to the Plan Administrator, copies of documents governing the operation of the Plan and copies
of the latest annual report (Form 5500 Series), if applicable, and an updated (as necessary) Summary Plan Description. The Plan Administrator may make a reasonable charge for the copies; and 

(c) Receive a summary of the Plan’s annual financial report, if applicable. The Plan Administrator is required by law to furnish
each participant with a copy of this summary annual report. 
 Prudent Actions By Plan Fiduciaries 

In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan.
The people who operate the Plan, called “fiduciaries” of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your employer, your union or any other person,
may fire you or otherwise discriminate against you in any way to prevent you from obtaining a Plan benefit or exercising your rights under ERISA. 

  
 13 

 Enforce Your Rights 

If your claim for a Plan benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating
to the decision without charge, and to appeal any denial, all within certain time schedules. 
 Under ERISA, there are steps you can take to enforce the
above rights. For instance, if you request a copy of Plan documents or the latest annual report from the Plan, if applicable, and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the
Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Plan Administrator. 

If you have a claim for benefits that is denied or ignored, in whole or in part, you may file suit in a state or federal court. 

If you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal
court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example,
if it finds your claim is frivolous. 
 Assistance With Your Questions 

If you have any questions about the Plan, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under
ERISA, or if you need assistance in obtaining documents from the Plan Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division
of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under
ERISA by calling the publications hotline of the Employee Benefits Security Administration. 
 16. GENERAL PROVISIONS.

 (a) Notices. Any notice, demand or request required or permitted to be given by either the Company or a Participant pursuant to
the terms of the Plan will be in writing and will be deemed given when delivered personally, when received electronically (including email addressed to the Participant’s Company email account and to the Company email account of the
Company’s General Counsel), or deposited in the U.S. mail, First Class with postage prepaid, and addressed to the parties, in the case of the Company, at the address set forth in Section 14(d), in the case of a Participant, at the address
as set forth in the Company’s employment file maintained for the Participant as previously furnished by the Participant or such other address as a party may request by notifying the other in writing. 

  
 14 

 (b) Transfer and Assignment. The rights and obligations of a Participant under the Plan
may not be transferred or assigned without the prior written consent of the Company. The Plan will be binding upon any surviving entity resulting from a Change in Control and upon any other person who is a successor by merger, acquisition,
consolidation or otherwise to the business formerly carried on by the Company without regard to whether or not such person or entity actively assumes the obligations hereunder. 

 
 (c) Waiver. Any party’s failure to enforce any provision or
provisions of the Plan will not in any way be construed as a waiver of any such provision or provisions, nor prevent any party from thereafter enforcing each and every other provision of the Plan. The rights granted to the parties herein are
cumulative and will not constitute a waiver of any party’s right to assert all other legal remedies available to it under the circumstances.  

(d) Severability. Should any provision of the Plan be declared or determined to be invalid, illegal or unenforceable, the validity,
legality and enforceability of the remaining provisions will not in any way be affected or impaired. 
  

(e) Section Headings. Section headings in the Plan are included only for convenience of reference and will not be considered part of the
Plan for any other purpose. 
  
 17. EXECUTION. To record
the adoption of the Plan as set forth herein, Zynga Inc. has caused its duly authorized officer to execute the same as of the Effective Date. 
  

			
	ZYNGA INC.:
	
	  

		 	(Signature)
		
	By:	 	  

		
	Title:	 	  

  

  
 15 

 EXHIBIT A 

ZYNGA INC. 

CHANGE IN CONTROL SEVERANCE BENEFIT PLAN 

PARTICIPATION NOTICE 
  

			
	To:	 	  

		
	Date:	 	  

 Zynga Inc. (the “Company”) has adopted the Zynga Inc. Change in Control
Severance Benefit Plan (the “Plan”). The Company is providing you this Participation Notice to inform you that you have been designated as a Participant in the Plan. A copy of the Plan document is attached to this
Participation Notice. The terms and conditions of your participation in the Plan are as set forth in the Plan and this Participation Notice, which together constitute the Summary Plan Description for the Plan. 

You understand that by accepting your status as a Participant in the Plan, your stock options that have been considered to be “incentive
stock options” prior to the date hereof may cease to qualify as “incentive stock options” as a result of the vesting acceleration benefit provided in the Plan. By accepting participation, you represent that you have either consulted
your personal tax or financial planning advisor about the tax consequences of your participation in the Plan, or you have knowingly declined to do so. 

Notwithstanding the terms of the Plan: 
  

			
	  

	
	  

 Please return to the Company’s General Counsel a copy of this Participation Notice signed by you and
retain a copy of this Participation Notice, along with the Plan document, for your records. 
  

			
	ZYNGA INC.:
	
	  

	(Signature)
		
	By:	 	  

		
	Title:	 	  

 EXHIBIT B 

RELEASE AGREEMENT 

[EMPLOYEES AGE 40 OR OVER; INDIVIDUAL TERMINATION]

 I understand and agree completely to the terms set forth in the Zynga Inc. Change in Control Severance Benefit Plan (the
“Plan”). 
 I understand that this Release, together with the Plan, constitutes the complete, final and
exclusive embodiment of the entire agreement between the Company, affiliates of the Company and me with regard to the subject matter hereof. I am not relying on any promise or representation by the Company or an affiliate of the Company that is not
expressly stated therein. Certain capitalized terms used in this Release are defined in the Plan. 
 I hereby confirm my obligations under
my Proprietary Agreement. 
 Except as otherwise set forth in this Release, I hereby generally and completely release the
Company and its affiliates, and their parents, subsidiaries, successors, predecessors and affiliates, and their partners, members, directors, officers, employees, stockholders, shareholders, agents, attorneys, predecessors, insurers, affiliates and
assigns, from any and all claims, liabilities and obligations, both known and unknown, that arise out of or are in any way related to events, acts, conduct, or omissions occurring at any time prior to and including the date I sign this Release. This
general release includes, but is not limited to: (a) all claims arising out of or in any way related to my employment with the Company and its affiliates, or their affiliates, or the termination of that employment; (b) all claims related
to my compensation or benefits, including salary, bonuses, commissions, vacation pay, expense reimbursements, severance pay, fringe benefits, stock, stock options, or any other ownership interests in the Company and its affiliates, or their
affiliates; (c) all claims for breach of contract, wrongful termination, and breach of the implied covenant of good faith and fair dealing; (d) all tort claims, including claims for fraud, defamation, emotional distress, and discharge in
violation of public policy; and (e) all federal, state, provincial and local statutory claims, including claims for discrimination, harassment, retaliation, attorneys’ fees, or other claims arising under the federal Civil Rights Act of
1964 (as amended), the federal Americans with Disabilities Act of 1990 (as amended), the federal Age Discrimination in Employment Act (as amended) (“ADEA”), the federal Employee Retirement Income Security Act of 1974 (as
amended), and the California Fair Employment and Housing Act (as amended). 
 Notwithstanding the foregoing, I understand that
the following rights or claims are not included in my Release: (a) any rights or claims for indemnification I may have pursuant to any written indemnification agreement with the Company or its affiliate to which I am a party; the charter,
bylaws, or operating agreements of the Company or its affiliate; or under applicable law; or (b) any rights which cannot be waived as a matter of law. In addition, I understand that nothing in this Release prevents me from filing, cooperating
with, or participating in any proceeding before the Equal Employment Opportunity Commission, the Department of Labor, or the California Department of Fair Employment and Housing, except that I hereby waive my right to any monetary benefits in
connection with any such claim, charge or proceeding. I hereby represent and warrant that, other than the claims identified in this paragraph, I am not aware of any claims I have or might have that are not included in the Release. 

  
 ii 

 I acknowledge that I am knowingly and voluntarily waiving and releasing any rights I may have
under the ADEA, and that the consideration given under the Plan for the waiver and release in the preceding paragraph hereof is in addition to anything of value to which I was already entitled. I further acknowledge that I have been advised by this
writing, as required by the ADEA, that: (a) my waiver and release do not apply to any rights or claims that may arise after the date I sign this Release; (b) I should consult with an attorney prior to signing this Release (although I may
choose voluntarily not do so); (c) I have 21 days to consider this Release (although I may choose voluntarily to sign this Release earlier); (d) I have seven days following the date I sign this Release to revoke the Release by providing
written notice to an officer of the Company; and (e) this Release will not be effective until the date upon which the revocation period has expired, which will be the eighth day after I sign this Release. 

I acknowledge that I have read and understand Section 1542 of the California Civil Code which reads as follows: “A general
release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release, which if known by him or her must have materially affected his or her settlement with the
debtor.” I hereby expressly waive and relinquish all rights and benefits under that section and any law of any jurisdiction of similar effect with respect to my release of any claims hereunder. 

I hereby represent that I have been paid all compensation owed and for all hours worked; I have received all the leave and leave benefits and
protections for which I am eligible pursuant to the Family and Medical Leave Act, the California Family Rights Act, or otherwise; and I have not suffered any on-the-job injury for which I have not already filed a workers’ compensation claim.

 I acknowledge that to become effective, I must sign and return this Release to the Company so that it is received not later than 21 days
following the date it is provided to me. 
  

			
	PARTICIPANT:
	
	  

	(Signature)
		
	By:	 	  

		
	Date:	 	  

  
 iii 

 EXHIBIT C 

RELEASE AGREEMENT 

[EMPLOYEES AGE 40 OR OVER; GROUP TERMINATION]

 I understand and agree completely to the terms set forth in the Zynga Inc. Change in Control Severance Benefit Plan (the
“Plan”). 
 I understand that this Release, together with the Plan, constitutes the complete, final and
exclusive embodiment of the entire agreement between the Company, affiliates of the Company and me with regard to the subject matter hereof. I am not relying on any promise or representation by the Company or an affiliate of the Company that is not
expressly stated therein. Certain capitalized terms used in this Release are defined in the Plan. 
 I hereby confirm my obligations under
my Proprietary Agreement. 
 Except as otherwise set forth in this Release, I hereby generally and completely release the
Company and its affiliates, and their parents, subsidiaries, successors, predecessors and affiliates, and its and their partners, members, directors, officers, employees, stockholders, shareholders, agents, attorneys, predecessors, insurers,
affiliates and assigns, from any and all claims, liabilities and obligations, both known and unknown, that arise out of or are in any way related to events, acts, conduct, or omissions occurring at any time prior to and including the date I sign
this Release. This general release includes, but is not limited to: (a) all claims arising out of or in any way related to my employment with the Company and its affiliates, or their affiliates, or the termination of that employment;
(b) all claims related to my compensation or benefits, including salary, bonuses, commissions, vacation pay, expense reimbursements, severance pay, fringe benefits, stock, stock options, or any other ownership interests in the Company and its
affiliates, or their affiliates; (c) all claims for breach of contract, wrongful termination, and breach of the implied covenant of good faith and fair dealing; (d) all tort claims, including claims for fraud, defamation, emotional
distress, and discharge in violation of public policy; and (e) all federal, state, provincial and local statutory claims, including claims for discrimination, harassment, retaliation, attorneys’ fees, or other claims arising under the
federal Civil Rights Act of 1964 (as amended), the federal Americans with Disabilities Act of 1990 (as amended), the federal Age Discrimination in Employment Act (as amended) (“ADEA”), the federal Employee Retirement Income
Security Act of 1974 (as amended), and the California Fair Employment and Housing Act (as amended).  
 Notwithstanding the
foregoing, I understand that the following rights or claims are not included in my Release: (a) any rights or claims for indemnification I may have pursuant to any written indemnification agreement with the Company or its affiliate to which I
am a party; the charter, bylaws, or operating agreements of the Company or its affiliate; or under applicable law; or (b) any rights which cannot be waived as a matter of law. In addition, I understand that nothing in this Release prevents me
from filing, cooperating with, or participating in any proceeding before the Equal Employment Opportunity Commission, the Department of Labor, or the California Department of Fair Employment and Housing, except that I hereby waive my right to any
monetary benefits in connection with any such claim, charge or proceeding. I hereby represent and warrant that, other than the claims identified in this paragraph, I am not aware of any claims I have or might have that are not included in the
Release. 

 I acknowledge that I am knowingly and voluntarily waiving and releasing any rights I may have
under the ADEA, and that the consideration given under the Plan for the waiver and release in the preceding paragraph hereof is in addition to anything of value to which I was already entitled. I further acknowledge that I have been advised by this
writing, as required by the ADEA, that: (a) my waiver and release do not apply to any rights or claims that may arise after the date I sign this Release; (b) I should consult with an attorney prior to signing this Release (although I may
choose voluntarily not to do so); (c) I have 45 days to consider this Release (although I may choose voluntarily to sign this Release earlier); (d) I have seven days following the date I sign this Release to revoke the Release by providing
written notice to an office of the Company; (e) this Release will not be effective until the date upon which the revocation period has expired, which will be the eighth day after I sign this Release; and (f) I have received with this
Release a detailed list of the job titles and ages of all employees who were terminated in this group termination and the ages of all employees of the Company in the same job classification or organizational unit who were not terminated. 

I acknowledge that I have read and understand Section 1542 of the California Civil Code which reads as follows: “A general
release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release, which if known by him or her must have materially affected his or her settlement with the
debtor.” I hereby expressly waive and relinquish all rights and benefits under that section and any law of any jurisdiction of similar effect with respect to my release of any claims hereunder. 

I hereby represent that I have been paid all compensation owed and for all hours worked; I have received all the leave and leave benefits and
protections for which I am eligible pursuant to the Family and Medical Leave Act, the California Family Rights Act, or otherwise; and I have not suffered any on-the-job injury for which I have not already filed a workers’ compensation claim.

 I acknowledge that to become effective, I must sign and return this Release to the Company so that it is received not later than 45 days
following the date it is provided to me. 
  

			
	PARTICIPANT:
	
	  

	(Signature)
		
	By:	 	  

		
	Date:	 	  

  
 ii 

 EXHIBIT D 

RELEASE AGREEMENT 

[EMPLOYEES UNDER AGE 40] 

I understand and agree completely to the terms set forth in the Zynga Inc. Change in Control Severance Benefit Plan (the
“Plan”). 
 I understand that this Release, together with the Plan, constitutes the complete, final and
exclusive embodiment of the entire agreement between the Company, affiliates of the Company and me with regard to the subject matter hereof. I am not relying on any promise or representation by the Company or an affiliate of the Company that is not
expressly stated therein. Certain capitalized terms used in this Release are defined in the Plan. 
 I hereby confirm my obligations under
my Employee Proprietary Agreement. 
 Except as otherwise set forth in this Release, I hereby generally and completely release the Company
and its affiliates, and their parents, subsidiaries, successors, predecessors and affiliates, and its and their partners, members, directors, officers, employees, stockholders, shareholders, agents, attorneys, predecessors, insurers, affiliates and
assigns, from any and all claims, liabilities and obligations, both known and unknown, that arise out of or are in any way related to events, acts, conduct, or omissions occurring at any time prior to and including the date I sign this Release. This
general release includes, but is not limited to: (a) all claims arising out of or in any way related to my employment with the Company and its affiliates, or their affiliates, or the termination of that employment; (b) all claims related
to my compensation or benefits, including salary, bonuses, commissions, vacation pay, expense reimbursements, severance pay, fringe benefits, stock, stock options, or any other ownership interests in the Company and its affiliates, or their
affiliates; (c) all claims for breach of contract, wrongful termination, and breach of the implied covenant of good faith and fair dealing; (d) all tort claims, including claims for fraud, defamation, emotional distress, and discharge in
violation of public policy; and (e) all federal, state, provincial and local statutory claims, including claims for discrimination, harassment, retaliation, attorneys’ fees, or other claims arising under the federal Civil Rights Act of
1964 (as amended), the federal Americans with Disabilities Act of 1990 (as amended), the federal Employee Retirement Income Security Act of 1974 (as amended), and the California Fair Employment and Housing Act (as amended). 

Notwithstanding the foregoing, I understand that the following rights or claims are not included in my Release: (a) any rights or claims
for indemnification I may have pursuant to any written indemnification agreement with the Company or its affiliate to which I am a party; the charter, bylaws, or operating agreements of the Company or its affiliate; or under applicable law; or
(b) any rights which cannot be waived as a matter of law. In addition, I understand that nothing in this Release prevents me from filing, cooperating with, or participating in any proceeding before the Equal Employment Opportunity Commission,
the Department of Labor, or the California Department of Fair Employment and Housing, except that I hereby waive my right to any monetary benefits in connection with any such claim, charge or proceeding. I hereby represent and warrant that, other
than the claims identified in this paragraph, I am not aware of any claims I have or might have that are not included in the Release. 

 I acknowledge that I have read and understand Section 1542 of the California Civil
Code which reads as follows: “A general release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release, which if known by him or her must have materially
affected his or her settlement with the debtor.” I hereby expressly waive and relinquish all rights and benefits under that section and any law of any jurisdiction of similar effect with respect to my release of any claims hereunder.

 I hereby represent that I have been paid all compensation owed and for all hours worked; I have received all the leave and leave
benefits and protections for which I am eligible pursuant to the Family and Medical Leave Act, the California Family Rights Act, or otherwise; and I have not suffered any on-the-job injury for which I have not already filed a workers’
compensation claim. 
 I acknowledge that to become effective, I must sign and return this Release to the Company so that it is received not
later than 14 days following the date it is provided to me. 
  

			
	PARTICIPANT:
	
	  

	(Signature)
		
	By:	 	  

		
	Date:	 	  

  
 ii

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