Document:

Exhibit
10.5

 

OptimizeRx
Corporation 

2021
Equity Incentive Plan

 

Notice of Restricted Stock Unit Grant

 

You (the “Grantee”)
have been granted the following award of Restricted Stock Units (“Restricted Stock Units” or “RSUs”)
with respect to shares of OptimizeRx Corporation (the “Company”) common stock, par value $0.001 per share (the “Shares”),
pursuant to the OptimizeRx Corporation 2021 Equity Incentive Plan (the “Plan”).

  

	 	Name of Grantee:	 	[NAME]
	 	 	 	 
	 	Number of Restricted Stock Units Granted:	 	[NUMBER]
	 	 	 	 
	 	Date of Grant:	 	[DATE]
	 	 	 	 
	 	Vesting and Period of Restriction:	 	See below

 

The vesting of the RSUs is contingent upon (i)
the Company’s achievement of the performance target(s) set forth on Exhibit A hereto (“Performance Goal(s)”)
during the Performance Period set forth on Exhibit A hereto, and (ii) the Grantee’s continued employment or service (as applicable)
with the Company through the end of the Performance Period1.
RSUs will vest and Shares will be delivered only after certification by the Committee of the achievement of the Performance Goals previously
established and approved by the Committee for the Performance Period.  

 

By your signature and the signature of the Company’s
representative below, you and the Company agree and acknowledge that this grant of Restricted Stock Units is granted under and governed
by the terms and conditions of the Plan and the attached Restricted Stock Unit Award Agreement, which are incorporated herein by reference,
and that you have been provided with a copy of the Plan and Restricted Stock Unit Agreement.

 

	Optionee:	 	OptimizeRx Corporation:
	 	 	 	 	 
	By:	        	 	By:	         
	 	 	 	 	 
	Name:		 	Name:	
	 	 	 	 	 
	 	 	 	Title:	 

 

 

		1	Note: This form assumes that the service-based vesting
condition matches Performance Period. If the service-based vesting condition does not match Performance Period, this paragraph will be
revised accordingly.

 

     

     

    

 

OptimizeRx
Corporation

2021
Equity Incentive Plan

 

Restricted Stock Unit Award Agreement

 

Section 1. Grant of Restricted Stock Unit

 

(a) Restricted
Stock Unit. On the terms and conditions set forth in the Notice of Restricted Stock Unit Grant (the “Grant Notice”)
and this Restricted Stock Unit Award Agreement (this “Agreement”), the Company grants to the Grantee on the Date of
Grant the right to receive the number of Restricted Stock Units set forth in the Grant Notice. Each RSU represents the right to receive
one Share to be issued and delivered at the end of the Period of Restriction, subject to the risk of forfeiture described herein.

 

(b) Plan
and Defined Terms. The RSUs are granted pursuant to the Plan. All terms, provisions, and conditions applicable to the RSUs set
forth in the Plan and not set forth herein are hereby incorporated by reference herein. To the extent any provision hereof is inconsistent
with a provision of the Plan, the provisions of the Plan will govern. All capitalized terms that are used in the Grant Notice or this
Agreement and not otherwise defined therein or herein shall have the meanings ascribed to them in the Plan.

 

Section 2. Forfeiture and Transfer Restrictions

 

(a) Forfeiture
Restrictions. Subject to Section 10(d) of the Plan, in the event of the Grantee’s Termination of Employment for any reason,
the Grantee shall, for no consideration, forfeit to the Company the RSUs to the extent such RSUs are subject to a Period of Restriction
at the time of such termination.

 

(b) Transfer
Restrictions. During the Period of Restriction, the RSUs may not be sold, assigned, pledged, exchanged, hypothecated or otherwise
transferred, encumbered or disposed of to the extent such RSUs are subject to a Period of Restriction.

 

(c) Lapse
of Restrictions; Delivery of Shares. The Period of Restriction shall lapse as to the RSUs in accordance with the Grant Notice.
Vested RSUs will be settled by delivery of Shares. As soon as practicable after the end of the Period of Restriction (but in no event
later than 75 days thereafter), the number of Shares of the vested RSUs (minus any withholding for taxes) shall be delivered to the Grantee.
The number of Shares that shall be delivered (less withholding for taxes) shall equal the number of vested RSUs. If the Grantee dies before
any payment due hereunder is made, such delivery shall be made to the Grantee’s beneficiary. If Shares are issued, they shall be
registered in the Grantee’s name in certificate or book entry form as soon as practicable following delivery of the Shares. Once
delivery of a Share has been made with respect to a RSU, the RSU shall be canceled.

 

Section 3. Change in Control.

 

Except as otherwise set forth
in an Individual Agreement between the Grantee and the Company or a Subsidiary or Affiliate, Section 10 of the Plan shall govern the treatment
of the RSUs in connection with a Change in Control.

 

Section 4. Miscellaneous Provisions

 

(a) Tax
Withholding. No later than the date as of which an amount first becomes includible in the gross income of the Grantee for federal,
state, local or foreign income or employment or other tax purposes with respect to the RSU, the Grantee shall pay to the Company, or make
arrangements satisfactory to the Company regarding the payment of, any federal, state, local or foreign taxes of any kind required by
law to be withheld with respect to such amount. Withholding obligations may be settled with Shares having a Fair Market Value on the date
of withholding equal to the minimum amount required to be withheld for tax purposes, all in accordance with such procedures as the Committee
establishes. The Committee may condition the delivery of Shares in respect of vested RSUs upon the Grantee’s satisfaction of such
withholding obligations.

 

    2

     

    

 

(b) Rights
as Stockholder. Neither Grantee nor any person claiming under or through Grantee shall have any of the rights or privileges of a stockholder
of the Company in respect of any Shares issuable hereunder unless and until certificates representing such Shares (which may be in uncertificated
form) have been issued and recorded on the books and records of the Company or its transfer agents or registrars, and delivered to Grantee
(including through electronic delivery to a brokerage account). After such issuance, recordation and delivery, Grantee shall have all
the rights of a stockholder of the Company, including with respect to the right to vote the Shares and the right to receive any cash or
share dividends or other distributions paid to or made with respect to the Shares. Cash dividends on Shares underlying RSUs shall accrue
in cash and be paid only to the extent the underlying RSU vests.

 

(c) Ratification
of Actions. By accepting this Agreement, the Grantee and each person claiming under or through the Grantee shall be conclusively
deemed to have indicated the Grantee’s acceptance and ratification of, and consent to, any action taken under the Plan or this Agreement
and Grant Notice by the Company, the Board, or the Committee.

 

(d) Choice
of Law. This Agreement and the Grant Notice shall be governed by, and construed in accordance with, the laws of the State of
Nevada, without regard to any conflicts of law or choice of law rule or principle that might otherwise cause the Plan, this Agreement
or the Grant Notice to be governed by or construed in accordance with the substantive law of another jurisdiction.

 

(e) Modification
or Amendment. This Agreement may only be modified or amended by written agreement executed by the parties hereto; provided, however,
that the adjustments permitted pursuant to Section 3(e) and Section 10 of the Plan may be made without such written agreement.

 

(f) Severability. In
the event any provision of this Agreement shall be held illegal or invalid for any reason, the illegality or invalidity shall not affect
the remaining provisions of this Agreement, and this Agreement shall be construed and enforced as if such illegal or invalid provision
had not been included.

 

(g) References
to Plan. All references to the Plan shall be deemed references to the Plan as it may be amended from time to time.

 

(h) Section 409A
Compliance. To the extent applicable, it is intended that the Plan and this Agreement comply with the requirements of Code Section 409A
and any related regulations or other guidance promulgated with respect to such Section by the U.S. Department of the Treasury or the Internal
Revenue Service and the Plan and the Award Agreement shall be interpreted accordingly.

 

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OptimizeRx
Corporation

 

RESTRICTED STOCK UNIT AWARD

 

EXHIBIT A

 

[insert vesting conditions based on achievement of Performance Goals]

 

For purposes of this Award:

 

		(a)	“Performance Goal” means [one or more of the following performance criteria, either individually, alternatively
or in any combination, applied either to the Company as a whole or on any one or more Subsidiaries or Affiliates or business units of
the Company or a Subsidiary or Affiliate and may be measured relative to a peer group, an index or a business plan and may be considered
as absolute measures or changes in measures, relative to a pre-established target or to a previous year’s results, in each case
as specified by the Committee in the agreement evidencing the award of restricted stock units: (a) income; (b) expense; (c) operating
cash flow; (d) capital spending; (e) total shareholder return, (f) gross margin, (g) growth in revenues, sales, market share, gross income,
net income, pre-tax income, stock price, and/or earnings per share, return on assets, net assets, and/or capital, working capital, free
cash flow and/or after tax cash flow, earnings before interest and taxes (EBIT), earnings before interest, taxes, depreciation, and amortization
(EBITDA); (h) EBITDA plus stock compensation; (i) return on shareholders’ equity, return on invested capital (j) economic or shareholder
value added, acquisition of assets, (k) acquisition of companies; (l) creation of new joint ventures; (m) growth in new products; (n)
lower product acquisition costs and/or improvements in costs and/or expenses; (o) stock price hurdles; and (p) other objective financial
or service-based standards relevant to the Company’s business as may be established by the Committee, subject to adjustment by the
Committee to eliminate the effects of the following items: (i) extraordinary, unusual, and/or nonrecurring items of gain or loss; (ii) gains
or losses on the disposition of a business; (iii) dividends declared on the Company’s stock; (iv) changes in tax or accounting
principles, regulations or laws; or (v) expenses incurred in connection with a merger, acquisition or similar transaction.]

 

		(b)	“Performance Period” means [_________________].

 

 

4Exhibit 4.1

 

	NUMBER	UNITS
	U-	 

SEE REVERSE FOR CERTAIN DEFINITIONS

 

CUSIP 53627A 208

 

Lionheart IV Corp

UNITS CONSISTING OF ONE SHARE OF CLASS A COMMON
STOCK AND ONE-HALF OF ONE WARRANT

 

THIS CERTIFIES THAT is the owner of Units.

 

Each Unit (“Unit”)
consists of one (1) share of Class A common stock, par value $0.0001 per share (“Common Stock”), of Lionheart
IV Corp, a Delaware corporation (the “Company”), and one-half of one redeemable warrant (the “Warrant”).
Each whole Warrant initially entitles the holder to purchase one (1) share of Common Stock for $11.50 per share (subject to adjustment).
Only whole Warrants are exercisable. Each whole Warrant will become exercisable on the later of (i) thirty (30) days after the Company’s
completion of a merger, capital stock exchange, asset acquisition, stock purchase, reorganization or other similar business combination
with one or more businesses (each a “Business Combination”), or (ii) twelve (12) months from the closing of
the Company’s initial public offering and unless exercised earlier, will expire at 5:00 p.m., New York City Time, on the date that
is five (5) years after the date on which the Company completes its initial Business Combination, or earlier upon redemption thereof or
the Company’s liquidation. The Common Stock and Warrants comprising the Units represented by this certificate are not transferable
separately prior to                                 ,
2021, unless Nomura Securities International, Inc. elects to allow separate trading earlier, subject to the Company’s filing of
a Current Report on Form 8-K with the Securities and Exchange Commission containing an audited balance sheet reflecting the Company’s
receipt of the gross proceeds of the Company’s initial public offering and the Company issuing a press release announcing when separate
trading will begin. The terms of the Warrants are governed by a Warrant Agreement, dated as of                                   ,
2021, between the Company and Continental Stock Transfer & Trust Company, as Warrant Agent, and are subject to the terms and provisions
contained therein, all of which terms and provisions the holder of this certificate consents to by acceptance hereof. Copies of the Warrant
Agreement are on file at the office of the Warrant Agent at 1 State Street, 30th Floor, New York, New York 10004, and are available
to any Warrant holder on written request and without cost.

 

This certificate is not valid
unless countersigned by the Transfer Agent and Registrar of the Company.

 

This certificate shall be
governed by and construed in accordance with the internal laws of the State of New York.

 

Witness the facsimile signature
of a duly authorized signatory of the Company.

 

	 	 	 
	Authorized Signatory	 	Transfer Agent and Registrar

 

     

     

    

 

Lionheart IV Corp

 

The Company will furnish
without charge to each unitholder who so requests, a statement of the powers, designations, preferences and relative, participating, optional
or other special rights of each class of stock or series thereof of the Company and the qualifications, limitations, or restrictions of
such preferences and/or rights.

 

The following abbreviations,
when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to
applicable laws or regulations:

 

	TEN COM — as tenants in common	 	UNIF GIFT MIN 

ACT	 	—	 	 	 	Custodian	 	 
	TEN ENT — as tenants by the entireties	 	 	 	 	 	(Cust) 	 	 	 	(Minor) 
	JT TEN — as joint tenants with right of survivorship and not as tenants in common	 	 	 	 	 	under Uniform Gifts to Minors Act
	 	 	 	 	 	 	(State)

 

Additional abbreviations may also be used though
not in the above list.

 

For value received, hereby sell, assign and transfer unto 

 

(PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING
NUMBER OF ASSIGNEE)

 

(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING
ZIP CODE, OF ASSIGNEE)

 

Units represented by the within Certificate,
and do hereby irrevocably constitute and appoint

 

Attorney to transfer the said Units on the books of the within
named Company with full power of substitution in the premises.

 

Dated

	 	 
	 	Notice: The signature to this assignment must correspond with the name as written upon the face of the certificate in every particular, without alteration or enlargement or any change whatever.

 

	Signature(s) Guaranteed:	 
	THE SIGNATURE(S) MUST BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM, PURSUANT TO S.E.C. RULE 17Ad-15 (OR ANY SUCCESSOR RULE).	 

 

     

     

    

 

In each case, as more
fully described in the Company’s final prospectus dated [•], 2021, the holder(s) of this certificate shall be entitled to
receive a pro-rata portion of certain funds held in the trust account established in connection with the Company’s initial public
offering only in the event that (i) the Company redeems the shares of Common Stock sold in the Company’s initial public offering
and liquidates because it does not consummate an initial business combination by [•], 2023 (or such later date as the Company’s
amended and restated certificate of incorporation may be amended to provide for), (ii) the Company offers to redeem the shares of Common
Stock sold in its initial public offering in connection with a stockholder vote to amend the Company’s amended and restated certificate
of incorporation (A) to modify the substance or timing of the ability of holders of Common Stock sold in the Company’s initial public
offering to seek redemption in connection with the Company’s initial business combination or the Company’s obligation to redeem
100% of such Common Stock if it does not consummate an initial business combination by [•], 2023 or (B) with respect to any other
provision relating to stockholders’ rights or pre-initial business combination activity, and the holder(s) of this certificate elects
to have the shares of Common Stock held by him, her or it redeemed pursuant to that offer, or (iii) if the holder(s) seek(s) to redeem
for cash his, her or its respective shares of Class A common stock in connection with a tender offer (or proxy solicitation, solely in
the event the Company seeks stockholder approval of the proposed initial business combination) setting forth the details of a proposed
initial business combination. In no other circumstances shall the holder(s) have any right or interest of any kind in or to the trust
account.

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