Document:

EX-10.17

 Exhibit 10.17 

OAK STREET HEALTH LLC 

EQUITY INCENTIVE PLAN 

INCENTIVE UNIT AWARD AND CONTRIBUTION AGREEMENT 

This Incentive Unit Award and Contribution Agreement (this “Agreement”), is made effective as of
                , 2019 (hereinafter referred to as the “Date of Grant”), among Oak Street Health, LLC, an Illinois limited liability company (the
“Company”), OSH Management Holdings, LLC (“Management LLC”) and                  (the “Participant”). 

R E C I T A L S: 

WHEREAS, the Company has adopted the Oak Street Health LLC Equity Incentive Plan (the “Incentive Plan”), which is
incorporated herein by reference and made a part of this Agreement (capitalized terms used and not otherwise defined in this Agreement shall have the meanings set forth for such terms in the Incentive Plan or the Fifth Amended and Restated Limited
Liability Company Operating Agreement of Oak Street Health LLC (as the same may be amended, modified or supplemented from time to time, the “LLC Agreement”)); 

WHEREAS, the Participant is employed by or otherwise provides services to the Company or an Affiliate thereof; 

WHEREAS, pursuant to the terms of the Incentive Plan, the Board is authorized to select the Participants to whom awards of Incentive Units
shall be made; 
 WHEREAS, the Board has determined that it would be in the best interests of the Company to award the Incentive Units
provided for herein to the Participant pursuant to the Incentive Plan and the terms and conditions set forth herein; 
 WHEREAS,
simultaneously with the award of the Incentive Units under this Agreement, Participant desires to contribute the Incentive Units to Management LLC in exchange for an identical number of “Incentive Units” of Management LLC (the
“Corresponding Incentive Units”) with the rights, preferences, and privileges as provided in the Limited Liability Company Operating Agreement of Management LLC dated December 12, 2016 (the “Management Operating
Agreement”); and 
 WHEREAS, Part I of this Agreement describes the terms and conditions of the award of Incentive Units to
Participant by the Company, Part II of this Agreement describes the terms and conditions of the contribution of the Incentive Units by Participant to Management LLC for Corresponding Units and Part III of this Agreement sets out other
terms and conditions and agreements among the parties. 
 NOW THEREFORE, in consideration of the mutual covenants hereinafter set forth, the
parties hereto agree as follows: 

 PART I - Award Agreement 

1. Award of Incentive Units. 

(a) Incentive Units. Subject to the terms and conditions of this Agreement and the Incentive Plan, the Company hereby grants to the
Participant an award of Incentive Units (collectively, the “Incentive Units”). 
 (b) Hurdle; Distributions. The
initial aggregate Hurdle Value with respect to the Incentive Units awarded hereby shall be $                , as shall be adjusted from time to time in accordance
with the Incentive Plan and the LLC Agreement. Distributions in respect of Incentive Units shall be made to the Participant in accordance with the provisions of the LLC Agreement. For the avoidance of doubt and notwithstanding anything to the
contrary herein, or otherwise in the LLC Agreement or in the Plan, in no event shall the Participant be eligible to receive any distributions in respect of the Incentive Units awarded hereby unless and until the aggregate adjusted Hurdle Value has
been achieved. 
 2. Vesting. All Incentive Units awarded hereby shall initially be unvested. Fifty percent (50%) of the Incentive
Units awarded hereby shall vest in accordance with Section 2(a) below (the “Service-Vesting Units”), and the balance of the Incentive Units awarded hereby shall vest in accordance with Section 2(b) below (the
“Performance-Vesting Units”). 
 (a) Service-Vesting Units. The Service-Vesting Units shall vest in installments
over four (4) years, with the first 25% vesting on the first anniversary of the Date of Grant and the remaining 75% vesting in equal quarterly installments thereafter (each such date, a “Vesting Date”), subject to the
Participant’s continuous employment with the Company or an Affiliate of the Company through the applicable Vesting Date. Upon or following the consummation of a Sponsors’ Exit (as defined in the Incentive Plan) prior to the final Vesting
Date, if the Participant’s employment is terminated by the Company or its Affiliates other than for Cause, all unvested Service-Vesting Units then outstanding shall become vested, subject to the Participant’s continuous employment with the
Company or an Affiliate of the Company through the date of such Sponsors’ Exit. 
 (b) Performance-Vesting Units. Upon the
consummation of a Sponsors’ Exit, the Performance-Vesting Units shall become 100% vested, subject to the Participant’s continuous employment with the Company or an Affiliate of the Company through the date of such Sponsors’ Exit. 

3. Effect of Termination of Employment; Company’s Rights to Repurchase Units. 

(a) If the Participant’s employment with the Company and its Affiliates is terminated by either party and for any reason, all then
unvested Incentive Units held by the Participant shall be cancelled and forfeited without consideration. 
 (b) If the Participant’s
employment is terminated by the Company or an Affiliate for Cause, then all Incentive Units held by the Participant, whether vested or unvested, shall be cancelled and forfeited without consideration. 

  
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 (c) If the Participant’s employment with the Company and its Affiliates is terminated
for any reason, the vested Incentive Units then held by the Participant shall be subject to cancellation and repurchase by the Company pursuant to this Section 3(c). 

(i) Upon any termination of Participant’s employment, the Company shall have the right, but not the obligation (the “Company Call
Right”), within 180 days following such termination (the “Call Period”), to make a payment to the Participant in consideration for the cancellation of any one or more of the vested Incentive Units then held by the
Participant (the “Called Units”), such payment to equal the Fair Market Value of such Incentive Units taking into account the applicable Hurdle Value for such Incentive Units (the “Call Price”). 

(ii) The Company Call Right may be exercised by the Company or any assignee(s) or designee(s) of the Company, as applicable, by delivery of
written notice (the “Call Notice”) to the Participant within the Call Period. At the closing of the transactions contemplated by the Company Call Right, (i) the Participant shall deliver certificates, if any, representing the
Called Units, duly endorsed for transfer and accompanied by all requisite transfer taxes, if any; (ii) the Called Units shall be free and clear of any Liens (other than those arising hereunder, the LLC Agreement, securities laws and those
attributable to actions by the purchasers thereof) and the Participant shall so represent and warrant; (iii) the Participant shall further represent and warrant that it is the sole beneficial and record owner of the Called Units; and
(iv) the Participant shall provide a limited release of claims with respect to any claims arising out of or related to the Called Units and the Participant’s capacity as an equity holder. For the avoidance of doubt, all of the
Participant’s rights, title and interest in such Incentive Unit shall terminate automatically without any further action required by any Person upon payment of the Call Price for any Incentive Unit. 

(iii) Notwithstanding the foregoing, if exercise of the Call Right would constitute (or with notice or lapse of time or both would constitute)
an event of default (which remains uncured) under, or would otherwise violate or breach, any financing arrangement of the Company or any of its subsidiaries (a “Financing Restriction”), or if the Company does not have funds
available to effect such repurchase of Incentive Units, the Call Period shall be extended until the earliest date on which such Financing Restriction or unavailability of funds has ceased and no such event would result from exercise of the Call
Right. 
 4. Rights as Holder of Incentive Units. The Participant shall be the record owner of the Incentive Units granted hereunder
unless and until such Units are forfeited or repurchased pursuant to Section 3, or transferred in accordance with Section 6, and as record owner shall be entitled to all rights of a holder of Incentive Units of the Company; provided, that
the Incentive Units shall be subject to the limitations on Transfer set forth in this Agreement, the Incentive Plan and the LLC Agreement. 

5. Participant Representations, Warranties and Acknowledgments. 

(a) No Reliance on the Company. In determining to accept the Incentive Units, the Participant has not relied upon the Company or any of
its Affiliates, or any 

  
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 representative thereof for any advice of any sort, including, but not limited to securities or investment
advice, or advice regarding the federal, state or local tax consequences arising from the grant, vesting, holding or disposition of the Incentive Units (the “Tax Matters”). 

(b) Acknowledgments. The Participant acknowledges and agrees that: 

(i) The Incentive Units cannot be transferred except in very limited circumstances in accordance with the provisions of the LLC Agreement, the
Incentive Plan and this Agreement and at present no market for the Incentive Units exists and it is not anticipated that a market for the Incentive Units will develop in the future. 

(ii) The Incentive Units may be worthless. 

(iii) The Company is treated as a “partnership” for federal and state income tax purposes and, as a result of receiving and holding
the Incentive Units, the Participant will be treated as a “partner” of the Company for federal and state income tax purposes. Further, the Participant acknowledges that the Participant’s status may have adverse consequences to the
Participant with respect to matters in which employees may be treated more favorably than partners, such as entitlement to and the tax treatment of fringe benefits, employee benefit plans, payroll taxes, and possible self-employment tax liability.

 (iv) The Participant will receive an annual Schedule K-l from the Company requiring that the
Participant report on the Participant’s tax return the Participant’s distributive share of the income, gain, loss, deductions and credits of the Company attributable to the Incentive Units (including any unvested Incentive Units). 

(v) The distributions made to the Participant will not be subject to FIC A or other tax withholding. 

(vi) Ownership of the Incentive Units may result in taxable income to the Participant without a corresponding cash or in-kind distribution. 
 (vii) The Participant has been advised to seek and has had an opportunity to seek
independent advice regarding the Tax Matters, including the 83(b) Election required by Section 8 hereof. 
 (viii) The Company will
have no obligation to indemnify or hold the Participants harmless for any claims or liabilities arising from the Tax Matters. 
 (ix) The
Incentive Units will not be registered under the Securities Act of 1933, as amended (the “Securities Act”) or any applicable state securities laws (collectively, the “Securities Laws”), and they are being issued in
reliance upon certain exemptions contained in Securities Laws, including Rule 701 promulgated under the Securities Act and corresponding state law exemptions, if any, and the representations and warranties of the Participant contained herein are
essential to any claim of exemption by the Company under the Securities Laws. 
 (x) The Incentive Units are “restricted
securities” as that term is defined in Rule 144 promulgated under the Securities Act. 

  
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 (xi) The Participant is aware that there is no assurance of an Initial Offering and even in
the event of an Initial Offering, any capital stock which may be distributed by the Company to the Participant cannot be transferred without registration under the Securities Laws unless the Company receives an opinion of counsel acceptable to it
(as to both counsel and the opinion) that such registration is not required. 
 6. Transferability. Except for Transfers to the
Company or as may otherwise be permitted in the LLC Agreement or the Incentive Plan, the Participant may Transfer, directly or indirectly, any Incentive Unit or any interest in any Incentive Unit only with the prior written consent of the Board,
which consent shall be withheld or granted in the sole discretion of the Board. In addition to the restrictions on Transfer under the LLC Agreement, the Incentive Plan or this Agreement, the Participant acknowledges that the Incentive Units are
“restricted securities” and may only be transferred in compliance with the registration requirements of the Securities Laws or an opinion of counsel acceptable to the Company to the effect that such registration is not required. Any
purported assignment, transfer or grant by the Participant, directly or indirectly, of any Incentive Unit or any interest in any Incentive Unit in contravention of the LLC Agreement, the Incentive Plan or this Agreement shall be entirely null and
void. 
 PART II - Contribution Agreement 

7. Contribution. The Participant hereby contributes, sells, assigns, conveys, transfers and delivers to Management LLC, and Management
LLC accepts from the Participant all of the Incentive Units identified in Section 1(a) in exchange for the issuance by Management LLC to the Participant of an identical number of Corresponding Incentive Units. The Participant irrevocably
constitutes and appoints the Company as the Participant’s true and lawful agent and attorney-in-fact with respect to the Incentive Units, with full power of
substitution (such power of attorney being deemed to be an irrevocable power coupled with an interest), to transfer ownership of the Incentive Units to Management LLC on the Company’s books and records. 

8. Terms and Conditions of Award Continue. The Participant hereby acknowledges and agrees that (i) the Corresponding Incentive
Units shall be subject to the terms and conditions of Part I of this Agreement and of the Incentive Plan and in particular, the Hurdle Value set forth Section 1(b) of this Agreements will continue to apply to the Corresponding Incentive Units;
and (ii) Part I of this Agreements shall be read as if the “Incentive Units” refers to the Corresponding Incentive Units and as if the “LLC Agreement” refers to the Management Operating Agreement. Either Management LLC or
the Company, acting through this Agreement, the LLC Agreement and the Management Operating Agreement, shall be entitled to enforce any right or remedy of Part I against the Participant. 

9. Member of the Company; Joinder. The Participant hereby (i) agrees and acknowledges that Participant has received and read a
copy of the LLC Agreement and the Management Operating Agreement and (ii) agrees that, if Participant was not a Member of the Management LLC prior to the issuance of the Corresponding Incentive Units hereunder, then by execution of this
Agreement, Participant shall become, effective as of the Date of Grant, a party to the Management Operating Agreement and shall be fully bound by, and subject to, all of the covenants, terms and conditions of the Management Operating Agreement as
though an original party thereto and shall be deemed, and is hereby admitted as, a Member, for all purposes thereof and entitled to all the rights incidental thereto. 

  
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 PART III - Other Agreements 

10. Profits Interest. The Incentive Units and the Corresponding Incentive Units are intended to constitute a “profits
interest” for all U.S. federal income tax purposes. A profits interest is granted in connection with the performance of services and is a right to receive distributions funded solely by the profits of the Company and Management LLC,
respectively, which are generated after the grant. As such, the Board of Management LLC shall, if necessary, limit distributions and allocations of profits to the Participant so that such distributions and allocations do not exceed the available
profits in respect of such Participant’s related profits interest. 
 11. Spousal Consent. If married, the Participant has
caused the Participant’s spouse to execute and deliver to the Company and Management LLC the Consent of Spouse in the form attached hereto as Exhibit A. If no Consent of Spouse has been executed and delivered to the Company and Management LLC
on the Date of Grant, the Participant represents and warrants that the Participant is not married and no person has or will have a marital or community property interest in the Incentive Units. If the Participant marries after the Date of Grant, the
Participant will cause the Participant’s spouse to execute and deliver to the Company and Management LLC a Consent of Spouse in the form attached hereto as Exhibit A. 

12. LLC Agreement; Management Operating Agreement. Neither the adoption of the Incentive Plan nor the grant of any Incentive Units or
issuance of Corresponding Incentive Units pursuant to this Agreement shall restrict in any way the adoption of any amendment to the LLC Agreement or Management Operating Agreement in accordance with its terms. 

13. Section 83(b) Election. As a condition subsequent to the issuance of the Incentive Units and Corresponding Incentive Units pursuant
to this Agreement, the Participant shall execute and deliver to the Company and the Internal Revenue Service (the “IRS”) a timely, valid election under Section 83(b) of the Code (the “83(b) Election”) as to
each of the Incentive Units and Corresponding Incentive Units. The Participant understands that under Section 83 of the Code, regulations promulgated thereunder, and certain IRS administrative announcements in the absence of an effective
election under Section 83(b) of the Code, the excess of the fair market value of the Incentive Units or Corresponding Incentive Units on the date on which any forfeiture restrictions applicable to such the Incentive Units or Corresponding
Incentive Units lapse over the respective price paid for the Incentive Units or Corresponding Incentive Units (which price is $0) may be reportable as ordinary income at that time. For this purpose, the term “forfeiture restrictions” means
the restrictions on transferability and the vesting conditions imposed under this Agreement. The Participant understands that (i) in making the 83(b) Election as to each of the Incentive Units and Corresponding Incentive Units, the Participant
may be taxed at the time the Incentive Units and Corresponding Incentive Units are acquired hereunder to the extent the fair market value of the Incentive Units and Corresponding Incentive Units exceeds the purchase price for such Units and
(ii) in order to be effective, the 83(b) Election as to each of the Incentive Units and Corresponding Incentive Units must be filed with the IRS within thirty (30) days after the Date of Grant. The Participant hereby acknowledges that
(x) the 

  
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 foregoing description of the tax consequences of the 83(b) Election is not intended to be complete and,
among other things, does not describe state, local or non-U.S. income and other tax consequences or all tax considerations that might be relevant to the Participant in light of the Participant’s
circumstances or if the Participant is subject to special tax rules, (y) neither the Company or Management LLC has provided, and is not hereby providing, the Participant with legal or tax advice regarding the Incentive Units or the
Corresponding Incentive Units or the 83(b) Election and has urged the Participant to consult the Participant’s own tax advisor with respect to the taxation consequences thereof, and (z) neither the Company or Management LUC has advised the
Participant to rely on any determination by it or its representatives as to the fair market value specified in the 83(b) Election and will have no liability to the Participant if the actual fair market value of the Incentive Units or the
Corresponding Incentive Units on the Date of Grant exceeds the amount specified in the 83(b) Election. 
 14. Notices. Any notice
necessary under this Agreement shall be addressed to the Company or Management LLC at the principal executive office of the Company and to the Participant at the address appearing in the personnel records of the Company or one of its Affiliates or
to any party at such other address as such party may hereafter designate in writing to the other parties. Any such notice shall be deemed effective upon receipt thereof by the addressee. 

15. Incorporation of Incentive Plan and LLC Agreement. By entering into this Agreement, the Participant agrees and acknowledges that
(i) the Participant has received and read a copy of the Incentive Plan, the LLC Agreement and the Management Operating Agreement, (ii) the Incentive Units are subject to this Agreement, the Incentive Plan and the LLC Agreement, and
(iii) the Corresponding Incentive Units are subject to this Agreement, the Incentive Plan and the Management Operating Agreement, the terms and provisions of all of which are hereby incorporated herein by reference. In the event of a conflict
between any term or provision contained herein and a term or provision of the Incentive Plan, the applicable terms and provisions of the Incentive Plan will govern and prevail. In the event of a conflict between any term or provision contained
herein or the Incentive Plan and a term or provision of the Management Operating Agreement, the applicable terms and provisions of the Management Operating Agreement will govern and prevail. 

16. Certain Specific Acknowledgements; Entire Agreement. This Agreement (together with the Incentive Plan, the LLC Agreement and the
Management Operating Agreement) embody the complete agreement and understanding among the parties to this Agreement with respect to the subject matter of this Agreement and supersede and preempt any prior understandings, agreements or
representations by or among the parties, written or oral, which may have related to the subject matter of this Agreement in any way. Without limiting the provisions of Section 15, the Participant acknowledges that the Corresponding Incentive
Units are subject to Incentive Plan, LLC Agreement and Management Operating Agreement provisions under which (a) in certain circumstances an adjustment may be made to the number of Corresponding Incentive Units and/or the applicable Hurdle
Value of the Corresponding Incentive Units; (b) the Board has full discretion to interpret and administer the Incentive Plan and this Agreement and its judgments are final, conclusive and binding; and (c) the Participant may be required to
sell the Participant’s Corresponding Incentive Units or otherwise participate in a transaction where other equity holders of the Company are selling (a “drag-along”). 

  
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 17. No Right to Continued Service. Neither the Incentive Plan nor this Agreement
shall be construed as giving the Participant the right to be retained in the employ of, or in any other continuing relationship with, the Company or any of its Affiliates. 

18. Tax Withholding. The Participant shall be required to pay to the Company, Management LLC or any Affiliate, and the Company,
Management LLC and its Affiliates shall have the right and are hereby authorized to withhold from any payment due or transfer made under any Corresponding Incentive Unit, under the Incentive Plan or from any other amount owing to a Participant
(including in connection with any Transfers), the amount (in cash, securities or other property) of any applicable U.S. federal, state, local or non-U. S. withholding taxes in respect of an Incentive Unit or
any payment or transfer under an Corresponding Incentive Unit or the Incentive Plan and to take such other action as may be necessary in the opinion of the Board to satisfy all obligations for the payment of such taxes. The Company and Management
LLC acknowledge that, absent a change in applicable Law, the Participant intends to value the Incentive Units awarded hereby and Corresponding Incentive Units issued in exchange therefor using the “liquidation value” of such Incentive
Units and Corresponding Incentive Units, and that consistent with the intention of the Incentive Units and Corresponding Incentive Units to constitute a “profits interest,” the Participant intends the value of the Incentive Units and
Corresponding Incentive Units to be $0 upon grant. The Company, Management LLC and its Affiliates agree to withhold taxes in a manner consistent with this treatment unless otherwise required by applicable Law. 

19. Severability. If any provision of this Agreement is, becomes or is deemed to be invalid, illegal or unenforceable in any
jurisdiction or as to any Person, the Incentive Units or the Corresponding Incentive Units, or would disqualify the Incentive Units or Corresponding Incentive Units under any Law deemed applicable by the Board, such provision shall be construed or
deemed amended to conform to the applicable Laws, or if it cannot be construed or deemed amended without, in the determination of the Board, materially altering the intent of this Agreement, such provision shall be stricken as to such jurisdiction,
Person, the Incentive Units or Corresponding Incentive Units and the remainder of this Agreement, the Incentive Units and Corresponding Incentive Units shall remain in full force and effect. 

20. Choice of Law; Forum. This Agreement and all claims and controversies hereunder shall be governed by and construed in accordance
with the internal laws of the State of Illinois, without regard to the choice of law provisions thereof. The parties hereto hereby agree and consent to be subject to the jurisdiction of the U.S. District Court, Northern District of Illinois or the
State Court of Illinois, Cook County over any action, suit or proceeding (a “Legal Action”) arising out of or in connection with this Agreement. The parties hereto irrevocably waive the defense of an inconvenient forum to the
maintenance of any such Legal Action. Each of the parties hereto further irrevocably consents to the service of process out of any of the aforementioned courts in any such Legal Action by the mailing of copies thereof by registered mail, postage
prepaid, to such party at its address contained in the records of the Company, Management LLC and its Affiliates, such service of process to be effective upon acknowledgment of receipt of such registered mail. Nothing in this Section shall affect
the right of any party hereto to serve legal process in any other manner permitted by law. This provision may be filed with any court as written evidence of the knowing and voluntary irrevocable agreement between the parties to waive any objections
to venue or to convenience of forum. 

  
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 21. WAIVER OF JURY TRIAL. EACH PARTY HERETO HEREBY WAIVES, TO THE FULLEST EXTENT
PERMITTED BY APPLICABLE LAW, ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN ANY LEGAL PROCEEDING DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATING TO THIS AGREEMENT (WHETHER BASED ON CONTRACT, TORT OR ANY OTHER THEORY). EACH PARTY HERETO
(A) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY OTHER PARTY HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER PARTY WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVER, AND (B) ACKNOWLEDGES
THAT SUCH PARTY AND THE OTHER PARTIES HERETO HAVE BEEN INDUCED TO ENTER INTO THIS AGREEMENT BY, AMONG OTHER THINGS, THE MUTUAL WAIVERS AND CERTIFICATIONS IN THIS SECTION. 

22. Signature in Counterparts. This Agreement may be signed in counterparts, each of which shall be an original, with the same effect
as if the signatures thereto and hereto were upon the same instrument. 
 [signature page follows] 

  
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 IN WITNESS WHEREOF, the parties hereto have executed this Incentive Unit Award and
Contribution Agreement as of the date first written above. 
  

			
	OAK STREET HEALTH, LLC
		
	By:	 	 
	Name:	 	Mike Pykosz
	Title:	 	Chief Executive Officer
	
	OSH MANAGEMENT HOLDINGS, LLC
		
	By:	 	 
	Name:	 	Mike Pykosz
	Title:	 	Chief Executive Officer
	
	PARTICIPANT:
	
	 
	Print Name
	
	 
	Signature

 [Signature Page to Incentive Unit Award and Contribution Agreement] 

 EXHIBIT A 

Consent of Spouse 
 I,
                , the spouse of                 , hereby acknowledge that I
have read the foregoing Incentive Unit Award and Contribution Agreement and the Fifth Amended and Restated Limited Liability Operating Agreement of Oak Street Health, LLC, an Illinois limited liability company (the “Company”) and the
Limited Liability Company Operating Agreement dated December 12, 2016 of OSH Management Holdings, LLC, an Illinois limited liability company (“Management LLC”) (together, the “Agreements”) and that I understand their
contents. I am aware that the Agreements contain numerous provisions that affect my spouse, any Member, the Incentive Units and Corresponding Incentive Units (as defined in the Incentive Unit Award and Contribution Agreement) that may be granted to
my spouse, including, without limitation, provisions that provide for the forfeiture of such Incentive Units and Corresponding Incentive Units and repurchase of such Incentive Units and Corresponding Incentive Units under certain circumstances, and
impose other restrictions on the transfer of such Incentive Units and Corresponding Incentive Units. I hereby consent to the Agreements and agree to be bound by the provisions of the Agreements, and any other agreements now or hereafter entered into
by my spouse in connection with such Incentive Units and Corresponding Incentive Units as and to the same extent as if an initial named party thereto and as amended from time to time. Specifically, I agree that my spouse’s interest in the
Incentive Units and Corresponding Incentive Units is subject to the Agreements and any direct or indirect interest I may have in such Incentive Units and Corresponding Incentive Units will also be irrevocably bound by the Agreements and, further,
that my marital or community property interest in such Incentive Units and Corresponding Incentive Units will be similarly bound by the Agreements. This consent and agreement may be relied upon by my spouse, the Company, Management LLC and any other
Member or other equity holder of the Company or Management LLC, and is irrevocable. 
 I am aware that the legal, financial and other matters contained in
the Agreements are complex and I am encouraged to seek advice with respect thereto from independent legal and/or financial counsel. I have either sought such advice or determined after carefully reviewing the Agreements that I hereby waive such
right. 
 Acknowledged and agreed to this              day of
                , 20        . 

 

Name:EX-4.1

 Exhibit 4.1 

FORM OF PRE-FUNDED WARRANT TO PURCHASE COMMON STOCK 

Number of Shares: [                ] 

(subject to adjustment) 

Original Issue Date: [    ], 2020 

Otonomy, Inc. , a Delaware corporation (the “Company”), hereby certifies that, for good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, [    ] or its registered assigns (the “Holder”), is entitled, subject to the terms set forth below, to purchase from the Company up to a total of
[    ] shares of common stock, $0.001 par value per share (the “Common Stock”), of the Company (each such share, a “Warrant Share” and all such shares, the “Warrant Shares”) at
an exercise price per share equal to $0.001 per share (as adjusted from time to time as provided in Section 9 herein, the “Exercise Price”), upon surrender of this Warrant to Purchase Common Stock
(including any Warrants to Purchase Common Stock issued in exchange, transfer or replacement hereof, the “Warrant”) at any time and from time to time on or after the date hereof (the “Original Issue Date”),
subject to the following terms and conditions: 
 1. Definitions. For purposes of this Warrant, the following terms shall have the following meanings:

 (a) “Affiliate” means any Person directly or indirectly controlled by, controlling or under common control with, a Holder, but only for so long
as such control shall continue. For purposes of this definition, “control” (including, with correlative meanings, “controlled by”, “controlling” and “under common control with”) means, with respect to a
Person, possession, direct or indirect, of (a) the power to direct or cause direction of the management and policies of such Person (whether through ownership of securities or partnership or other ownership interests, by contract or otherwise),
or (b) at least 50% of the voting securities (whether directly or pursuant to any option, warrant or other similar arrangement) or other comparable equity interests. 

(b) “Commission” means the United States Securities and Exchange Commission. 

(c) “Closing Sale Price” means, for any security as of any date, the last trade price for such security on the Principal Trading Market for
such security, as reported by Bloomberg Financial Markets, or, if such Principal Trading Market begins to operate on an extended hours basis and does not designate the last trade price, then the last trade price of such security prior to 4:00 P.M.,
New York City time, as reported by Bloomberg Financial Markets, or if the foregoing do not apply, the last trade price of such security in the over-the-counter market on
the electronic bulletin board for such security as reported by Bloomberg Financial Markets. If the Closing Sale Price cannot be calculated for a security on a particular date on any of the foregoing bases, the Closing Sale Price of such security on
such date shall be the fair market value as mutually determined in good faith by the Company and the Holder. If the Company and the Holder are unable to agree upon the fair market value of such security, then the Board of Directors of the Company
shall use its good faith judgment to determine the fair market value. The Board of Directors’ determination shall be binding upon all parties absent demonstrable error. All such determinations shall be appropriately adjusted for any stock
dividend, stock split, stock combination or other similar transaction during the applicable calculation period. 
 (d) “Principal Trading
Market” means the national securities exchange or other trading market on which the Common Stock is primarily listed on and quoted for trading, which, as of the Original Issue Date, shall be the Nasdaq Global Select Market. 

(e) “Registration Statement” means the Company’s Registration Statement on Form S-3 (File No. 333-227269), declared effective on September 21, 2018. 
 (f) “Securities Act” means the
Securities Act of 1933, as amended. 

 (g) “Trading Day” means any weekday on which the Principal Trading Market is normally open
for trading. 
 (h) “Transfer Agent” means EQ Shareowner Services, the Company’s transfer agent and registrar for the Common Stock, and
any successor appointed in such capacity. 
 2. Issuance of Securities; Registration of Warrants. The Warrant, as initially issued by the Company, is
offered and sold pursuant to the Registration Statement. As of the Original Issue Date, the Warrant Shares are issuable under the Registration Statement. Accordingly, the Warrant and, assuming issuance pursuant to the Registration Statement or an
exchange meeting the requirements of Section 3(a)(9) of the Exchange Act as in effect on the Original Issue Date, the Warrant Shares, are not “restricted securities” under Rule 144 promulgated under the Securities Act. The Company
shall register ownership of this Warrant, upon records to be maintained by the Company for that purpose (the “Warrant Register”), in the name of the record Holder (which shall include the initial Holder or, as the case may be, any
assignee to which this Warrant is assigned hereunder) from time to time. The Company may deem and treat the registered Holder of this Warrant as the absolute owner hereof for the purpose of any exercise hereof or any distribution to the Holder, and
for all other purposes, absent actual notice to the contrary. 
 3. Registration of Transfers. Subject to compliance with all applicable securities
laws, the Company shall, or will cause its Transfer Agent to, register the transfer of all or any portion of this Warrant in the Warrant Register, upon surrender of this Warrant, and payment for all applicable transfer taxes (if any). Upon any such
registration or transfer, a new warrant to purchase Common Stock in substantially the form of this Warrant (any such new warrant, a “New Warrant”) evidencing the portion of this Warrant so transferred shall be issued to the
transferee, and a New Warrant evidencing the remaining portion of this Warrant not so transferred, if any, shall be issued to the transferring Holder. The acceptance of the New Warrant by the transferee thereof shall be deemed the acceptance by such
transferee of all of the rights and obligations in respect of the New Warrant that the Holder has in respect of this Warrant. The Company shall, or will cause its Transfer Agent to, prepare, issue and deliver at the Company’s own expense any
New Warrant under this Section 3. Until due presentment for registration of transfer, the Company may treat the registered Holder hereof as the owner and holder for all purposes, and the Company shall not be affected by any
notice to the contrary. 
 4. Exercise and Duration of Warrants. 

(a) All or any part of this Warrant shall be exercisable by the registered Holder in any manner permitted by this Warrant at any time and from time to time on
or after the Original Issue Date. 
 (b) The Holder may exercise this Warrant by delivering to the Company (i) an exercise notice, in the form attached
as Schedule 1 hereto (the “Exercise Notice”), completed and duly signed, and (ii) payment of the Exercise Price for the number of Warrant Shares as to which this Warrant is being exercised (which may take the form of a
“cashless exercise” if so indicated in the Exercise Notice pursuant to Section 10 below), and the date on which the last of such items is delivered to the Company (as determined in accordance with the notice
provisions hereof) is an “Exercise Date.” The Holder shall not be required to deliver the original Warrant in order to effect an exercise hereunder. Execution and delivery of the Exercise Notice shall have the same effect as
cancellation of the original Warrant and issuance of a New Warrant evidencing the right to purchase the remaining number of Warrant Shares, if any. The aggregate exercise price of this Warrant, except for the Exercise Price, was pre-funded to the Company on or before the Original Issue Date, and consequently no additional consideration (other than the Exercise Price) shall be required by to be paid by the Holder to effect any exercise of
this Warrant. The Holder shall not be entitled to the return or refund of all, or any portion, of such pre-funded exercise price under any circumstance or for any reason whatsoever. 

5. Delivery of Warrant Shares. 
 (a) Upon exercise of this
Warrant, the Company shall promptly (but in no event later than five (5) Trading Days after the Exercise Date), upon the request of the Holder, credit such aggregate number of shares of Common Stock to which the Holder is entitled pursuant to
such exercise to the Holder’s or its designee’s balance account with The Depository Trust Company (“DTC”) through its Deposit Withdrawal Agent Commission system, or if the Transfer Agent is not participating in the Fast
Automated Securities Transfer Program (the “FAST Program”) or if the certificates are required to bear a legend regarding restriction on transferability, issue and dispatch by overnight

 
courier to the address as specified in the Exercise Notice, a certificate, registered in the Company’s share register in the name of the Holder or its designee, for the number of shares of
Common Stock to which the Holder is entitled pursuant to such exercise. The Holder, DTC (or its nominee) or any natural person or legal entity (each, a “Person”) so designated by the Holder to receive Warrant Shares, shall be deemed to
have become the holder of record of such Warrant Shares as of the Exercise Date, irrespective of the date such Warrant Shares are credited to the Holder’s DTC account or the date of delivery of the certificates evidencing such Warrant Shares,
as the case may be. 
 (b) If by the close of the fifth (5th) Trading Day after the Exercise Date, the Company fails to deliver to the Holder a certificate
representing the required number of Warrant Shares in the manner required pursuant to Section 5(a) or fails to credit the Holder’s balance account with DTC for such number of Warrant Shares to which the Holder is
entitled, and if after such fifth (5th) Trading Day and prior to the receipt of such Warrant Shares, the Holder purchases (in an open market transaction or otherwise) shares of Common Stock to deliver in satisfaction of a sale by the Holder of the
Warrant Shares which the Holder anticipated receiving upon such exercise (a “Buy-In”), then the Company shall, within five (5) Trading Days after the Holder’s request and in the
Holder’s sole discretion, either (1) pay in cash to the Holder an amount equal to the Holder’s total purchase price (including brokerage commissions, if any) for the shares of Common Stock so purchased, at which point the
Company’s obligation to deliver such certificate (and to issue such Warrant Shares) shall terminate or (2) promptly honor its obligation to deliver to the Holder a certificate or certificates representing such Warrant Shares and pay cash
to the Holder in an amount equal to the excess (if any) of Holder’s total purchase price (including brokerage commissions, if any) for the shares of Common Stock so purchased in the Buy-In over the
product of (A) the number of shares of Common Stock purchased in the Buy-In, times (B) the Closing Sale Price of a share of Common Stock on the Exercise Date. 

(c) To the extent permitted by law and subject to Section 5(b), the Company’s obligations to issue and deliver Warrant Shares in accordance with and
subject to the terms hereof (including the limitations set forth in Section 11 below) are absolute and unconditional, irrespective of any action or inaction by the Holder to enforce the same, any waiver or consent with
respect to any provision hereof, the recovery of any judgment against any Person or any action to enforce the same, or any setoff, counterclaim, recoupment, limitation or termination, or any breach or alleged breach by the Holder or any other Person
of any obligation to the Company or any violation or alleged violation of law by the Holder or any other Person, and irrespective of any other circumstance that might otherwise limit such obligation of the Company to the Holder in connection with
the issuance of Warrant Shares. Subject to Section 5(b), nothing herein shall limit the Holder’s right to pursue any other remedies available to it hereunder, at law or in equity including, without limitation, a decree of specific
performance and/or injunctive relief with respect to the Company’s failure to timely deliver certificates representing shares of Common Stock upon exercise of the Warrant as required pursuant to the terms hereof. 

6. Charges, Taxes and Expenses. Issuance and delivery of certificates for shares of Common Stock upon exercise of this Warrant shall be made without
charge to the Holder for any issue or transfer tax, transfer agent fee or other incidental tax or expense (excluding any applicable stamp duties) in respect of the issuance of such certificates, all of which taxes and expenses shall be paid by the
Company; provided, however, that the Company shall not be required to pay any tax that may be payable in respect of any transfer involved in the registration of any certificates for Warrant Shares or the Warrants in a name other than that of
the Holder or an Affiliate thereof. The Holder shall be responsible for all other tax liability that may arise as a result of holding or transferring this Warrant or receiving Warrant Shares upon exercise hereof. 

7. Replacement of Warrant. If this Warrant is mutilated, lost, stolen or destroyed, the Company shall issue or cause to be issued in exchange and
substitution for and upon cancellation hereof, or in lieu of and substitution for this Warrant, a New Warrant, but only upon receipt of evidence reasonably satisfactory to the Company of such loss, theft or destruction (in such case) and, in each
case, a customary and reasonable indemnity and surety bond, if requested by the Company. Applicants for a New Warrant under such circumstances shall also comply with such other reasonable regulations and procedures and pay such other reasonable
third-party costs as the Company may prescribe. If a New Warrant is requested as a result of a mutilation of this Warrant, then the Holder shall deliver such mutilated Warrant to the Company as a condition precedent to the Company’s obligation
to issue the New Warrant. 

 8. Reservation of Warrant Shares. The Company covenants that it will, at all times while this Warrant
is outstanding, reserve and keep available out of the aggregate of its authorized but unissued and otherwise unreserved Common Stock, solely for the purpose of enabling it to issue Warrant Shares upon exercise of this Warrant as herein provided, the
number of Warrant Shares that are initially issuable and deliverable upon the exercise of this entire Warrant, free from preemptive rights or any other contingent purchase rights of persons other than the Holder (taking into account the adjustments
and restrictions of Section 9). The Company covenants that all Warrant Shares so issuable and deliverable shall, upon issuance and the payment of the applicable Exercise Price in accordance with the terms hereof, be duly
and validly authorized, issued and fully paid and non-assessable. The Company will take all such action as may be reasonably necessary to assure that such shares of Common Stock may be issued as provided
herein without violation of any applicable law or regulation, or of any requirements of any securities exchange or automated quotation system upon which the Common Stock may be listed. The Company further covenants that it will not, without the
prior written consent of the Holder, take any actions to increase the par value of the Common Stock at any time while this Warrant is outstanding. 
 9.
Certain Adjustments. The Exercise Price and number of Warrant Shares issuable upon exercise of this Warrant are subject to adjustment from time to time as set forth in this Section 9. 

(a) Stock Dividends and Splits. If the Company, at any time while this Warrant is outstanding, (i) pays a stock dividend on its Common Stock or
otherwise makes a distribution on any class of capital stock issued and outstanding on the Original Issue Date and in accordance with the terms of such stock on the Original Issue Date or as amended, as described in the Registration Statement, that
is payable in shares of Common Stock, (ii) subdivides its outstanding shares of Common Stock into a larger number of shares of Common Stock, (iii) combines its outstanding shares of Common Stock into a smaller number of shares of Common
Stock or (iv) issues by reclassification of shares of capital stock any additional shares of Common Stock of the Company, then in each such case the Exercise Price shall be multiplied by a fraction, the numerator of which shall be the number of
shares of Common Stock outstanding immediately before such event and the denominator of which shall be the number of shares of Common Stock outstanding immediately after such event. Any adjustment made pursuant to clause (i) of this paragraph
shall become effective immediately after the record date for the determination of stockholders entitled to receive such dividend or distribution, provided, however, that if such record date shall have been fixed and such dividend is not fully paid
on the date fixed therefor, the Exercise Price shall be recomputed accordingly as of the close of business on such record date and thereafter the Exercise Price shall be adjusted pursuant to this paragraph as of the time of actual payment of such
dividends. Any adjustment pursuant to clause (ii) or (iii) of this paragraph shall become effective immediately after the effective date of such subdivision or combination. 

(b) Pro Rata Distributions. If the Company, at any time while this Warrant is outstanding, distributes to all holders of Common Stock for no
consideration (i) evidences of its indebtedness, (ii) any security (other than a distribution of Common Stock covered by the preceding paragraph) or (iii) rights or warrants to subscribe for or purchase any security, or (iv) cash
or any other asset (in each case, “Distributed Property”), then, upon any exercise of this Warrant that occurs after the record date fixed for determination of stockholders entitled to receive such distribution, the Holder shall be
entitled to receive, in addition to the Warrant Shares otherwise issuable upon such exercise (if applicable), the Distributed Property that such Holder would have been entitled to receive in respect of such number of Warrant Shares had the Holder
been the record holder of such Warrant Shares immediately prior to such record date without regard to any limitation on exercise contained therein. 
 (c)
Fundamental Transactions. If, at any time while this Warrant is outstanding (i) the Company effects any merger or consolidation of the Company with or into another Person, in which the Company is not the surviving entity and in which the
stockholders of the Company immediately prior to such merger or consolidation do not own, directly or indirectly, at least 50% of the voting power of the surviving entity immediately after such merger or consolidation, (ii) the Company effects
any sale to another Person of all or substantially all of its assets in one transaction or a series of related transactions, (iii) pursuant to any tender offer or exchange offer (whether by the Company or another Person), holders of capital
stock tender shares representing more than 50% of the voting power of the capital stock of the Company and the Company or such other Person, as applicable, accepts such tender for payment, (iv) the Company consummates a stock purchase agreement
or other business combination (including, without limitation, a reorganization, recapitalization, spin-off or scheme of arrangement) with another Person whereby such other Person acquires more than the 50% of
the voting power of the capital stock of the Company (except for any such transaction in which the stockholders of the Company immediately prior to such transaction maintain, in substantially the same proportions, the voting power of such Person
immediately after the transaction), provided, however, the foregoing shall not include transactions for which the primary purpose is raising capital, or (v) the 

 
Company effects any reclassification of the Common Stock or any compulsory share exchange pursuant to which the Common Stock is effectively converted into or exchanged for other securities, cash
or property (other than as a result of a subdivision or combination of shares of Common Stock covered by Section 9(a) above) (in any such case, a “Fundamental Transaction”), then following such Fundamental
Transaction the Holder shall have the right to receive, upon exercise of this Warrant, the same amount and kind of securities, cash or property as it would have been entitled to receive upon the occurrence of such Fundamental Transaction if it had
been, immediately prior to such Fundamental Transaction, the holder of the number of Warrant Shares then issuable upon exercise in full of this Warrant without regard to any limitations on exercise contained herein. In the event the Holder does not
exercise this Warrant as contemplated by the foregoing sentence, this Warrant shall be deemed exercised in full without regard to any limitations on exercise contained herein pursuant to the “cashless exercise” provision in Section 10
hereof upon the effective date of the consummation of such Fundamental Transaction. 
 (d) Number of Warrant Shares. Simultaneously with any
adjustment to the Exercise Price pursuant to Section 9, the number of Warrant Shares that may be purchased upon exercise of this Warrant shall be increased or decreased proportionately, so that after such adjustment the
aggregate Exercise Price payable hereunder for the increased or decreased number of Warrant Shares shall be the same as the aggregate Exercise Price in effect immediately prior to such adjustment. 

(e) Calculations. All calculations under this Section 9 shall be made to the nearest
one-tenth of one cent or the nearest share, as applicable. 
 (f) Notice of Adjustments. Upon the occurrence
of each adjustment pursuant to this Section 9, the Company at its expense will, at the written request of the Holder, promptly compute such adjustment, in good faith, in accordance with the terms of this Warrant and prepare
a certificate setting forth such adjustment, including a statement of the adjusted Exercise Price and adjusted number or type of Warrant Shares or other securities issuable upon exercise of this Warrant (as applicable), describing the transactions
giving rise to such adjustments and showing in detail the facts upon which such adjustment is based. Upon written request, the Company will promptly deliver a copy of each such certificate to the Holder and to the Company’s transfer agent. 

(g) Notice of Corporate Events. If, while this Warrant is outstanding, the Company (i) declares a dividend or any other distribution of cash,
securities or other property in respect of its Common Stock, including, without limitation, any granting of rights or warrants to subscribe for or purchase any capital stock of the Company or any subsidiary, (ii) authorizes or approves, enters
into any agreement contemplating or solicits stockholder approval for any Fundamental Transaction or (iii) authorizes the voluntary dissolution, liquidation or winding up of the affairs of the Company, then, except if such notice and the
contents thereof shall be deemed to constitute material non-public information, the Company shall deliver to the Holder a notice of such transaction at least ten (10) days prior to the applicable record
or effective date on which a Person would need to hold Common Stock in order to participate in or vote with respect to such transaction; provided, however, that the failure to deliver such notice or any defect therein shall not affect the
validity of the corporate action required to be described in such notice. In addition, if while this Warrant is outstanding, the Company authorizes or approves, enters into any agreement contemplating or solicits stockholder approval for any
Fundamental Transaction contemplated by Section 9(c), other than a Fundamental Transaction under clause (iii) of Section 9(c), the Company shall deliver to the Holder a notice of such Fundamental Transaction at
least thirty (30) days prior to the date such Fundamental Transaction is consummated. Holder agrees to maintain any information disclosed pursuant to this Section 9(g) in confidence until such information is publicly available, and shall
comply with applicable law with respect to trading in the Company’s securities following receipt any such information. 
 10. Payment of Exercise
Price. Notwithstanding anything contained herein to the contrary, the Holder may, in its sole discretion, satisfy its obligation to pay the Exercise Price through a “cashless exercise”, in which event the Company shall issue to the
Holder the number of Warrant Shares in an exchange of securities effected pursuant to Section 3(a)(9) of the Securities Act, as determined as follows: 

 X = Y [(A-B)/A] 

where: 
 “X” equals the number of Warrant Shares to be
issued to the Holder; 
 “Y” equals the total number of Warrant Shares with respect to which this Warrant is then being exercised; 

“A” equals the Closing Sale Prices of the shares of Common Stock (as reported by Bloomberg Financial Markets) as of the Trading Day on the date
immediately preceding the Exercise Date; and 
 “B” equals the Exercise Price then in effect for the applicable Warrant Shares at the time of such
exercise. 
 For purposes of Rule 144 promulgated under the Securities Act, it is intended, understood and acknowledged that the Warrant Shares issued in a
“cashless exercise” transaction shall be deemed to have been acquired by the Holder, and the holding period for the Warrant Shares shall be deemed to have commenced, on the date this Warrant was originally issued (provided that the
Commission continues to take the position that such treatment is proper at the time of such exercise). In the event that the Registration Statement or another registration statement registering the issuance of Warrant Shares is, for any reason, not
effective at the time of exercise of this Warrant, then the Warrant may only be exercised through a cashless exercise, as set forth in this Section 10. Except as set forth in Section 5(b) (Buy-In
remedy) and Section 12 (payment of cash in lieu of fractional shares), in no event will the exercise of this Warrant be settled in cash. 
 11.
Limitations on Exercise. 
 (a) Notwithstanding anything to the contrary herein, the Company shall not effect any exercise of this Warrant, and the
Holder shall not be entitled to exercise this Warrant for a number of Warrant Shares in excess of that number of Warrant Shares which, upon giving effect or immediately prior to such exercise, would cause (i) the aggregate number of shares of
Common Stock beneficially owned by the Holder, its Affiliates and any Persons who are members of a Section 13(d) group with such Holder or its Affiliates to exceed 9.99% (the “Maximum Percentage”) of the total number of issued and
outstanding shares of Common Stock of the Company following such exercise, or (ii) the combined voting power of the securities of the Company beneficially owned by the Holder and its Affiliates and any other Persons who are members of a
Section 13(d) group with such Holder or its Affiliates to exceed the Maximum Percentage of the combined voting power of all of the securities of the Company then outstanding following such exercise. For purposes of this paragraph, beneficial
ownership and whether a holder is a member of a Section 13(d) group shall be calculated and determined in accordance with Section 13(d) of the Exchange Act and the rules promulgated thereunder. For purposes of this Warrant, in determining
the number of outstanding shares of Common Stock, the Holder may rely on the number of outstanding shares of Common Stock as reflected in (x) the Company’s most recent Quarterly Report on Form 10-Q
or Annual Report on Form 10-K, as the case may be, filed with the Commission prior to the date hereof, (y) a more recent public announcement by the Company or (z) any other notice by the Company or
the Transfer Agent setting forth the number of shares of Common Stock outstanding. Upon the written request of the Holder, the Company shall within five (5) Trading Days confirm in writing or by electronic mail to the Holder the number of
shares of Common Stock then outstanding. In any case, the number of outstanding shares of Common Stock shall be determined after giving effect to the conversion or exercise of securities of the Company, including this Warrant, by the Holder since
the date as of which such number of outstanding shares of Common Stock was reported. By written notice to the Company, the Holder may from time to time increase or decrease the Maximum Percentage to any other percentage specified not in excess of
19.99% specified in such notice; provided that any such increase will not be effective until the sixty-first (61st) day after such notice is delivered to the Company. For purposes of this Section 11(a), the aggregate number of shares of Common
Stock or voting securities beneficially owned by the Holder and its Affiliates and any other Persons who are members of a Section 13(d) group with such Holder or its Affiliates shall include the shares of Common Stock issuable upon (x) the
exercise of this Warrant with respect to which such determination is being made, but shall exclude the number of shares of Common Stock which would be issuable upon exercise of the remaining unexercised and
non-cancelled portion of this Warrant by the Holder and (y) the exercise or conversion of the unexercised, non-converted or
non-cancelled portion of any other securities of the Company that do not have voting power (including without limitation any securities of the Company which would entitle the holder thereof to acquire at any
time Common Stock, including without limitation any debt, preferred stock, right, option, warrant or other instrument that is at any time convertible into or exercisable or exchangeable for, or otherwise entitles the holder thereof to receive,
Common Stock), is subject to a limitation on conversion or exercise analogous to the limitation contained herein and is beneficially owned by the Holder or any of its Affiliates and other Persons who are members of a Section 13(d) group with
such Holder or its Affiliates. 

 (b) This Section 11 shall not restrict the number of shares of Common Stock which
a Holder may receive or beneficially own in order to determine the amount of securities or other consideration that such Holder may receive in the event of a Fundamental Transaction as contemplated in Section 9(c) of this
Warrant. 
 12. No Fractional Shares. No fractional Warrant Shares will be issued in connection with any exercise of this Warrant. In lieu of any
fractional shares that would otherwise be issuable, the number of Warrant Shares to be issued shall be rounded down to the next whole number and the Company shall pay the Holder in cash the fair market value (based on the Closing Sale Price) for any
such fractional shares. 
 13. Notices. Any and all notices or other communications or deliveries hereunder (including, without limitation, any
Exercise Notice) shall be in writing and shall be deemed given and effective on the earliest of (i) the date of transmission, if such notice or communication is delivered via facsimile or e-mail at the
facsimile number or e-mail address specified in the books and records of the Transfer Agent prior to 5:30 P.M., New York City time, on a Trading Day so long as the sender of an
e-mail has not received an automated notice of delivery failure from the proposed recipient’s computer server, (ii) the next Trading Day after the date of transmission, if such notice or
communication is delivered via facsimile or e-mail at the facsimile number or e-mail address specified in the books and records of the Transfer Agent on a day that is
not a Trading Day or later than 5:30 P.M., New York City time, on any Trading Day so long as the sender of an e-mail has not received an automated notice of delivery failure from the proposed recipient’s
computer server, (iii) the Trading Day following the date of mailing, if sent by nationally recognized overnight courier service specifying next business day delivery, or (iv) upon actual receipt by the Person to whom such notice is
required to be given, if by hand delivery. 
 14. Warrant Agent. The Company shall initially serve as warrant agent under this Warrant. Upon thirty
(30) days’ notice to the Holder, the Company may appoint a new warrant agent. Any corporation into which the Company or any new warrant agent may be merged or any corporation resulting from any consolidation to which the Company or any new
warrant agent shall be a party or any corporation to which the Company or any new warrant agent transfers substantially all of its corporate trust or shareholders services business shall be a successor warrant agent under this Warrant without any
further act. Any such successor warrant agent shall promptly cause notice of its succession as warrant agent to be mailed (by first class mail, postage prepaid) to the Holder at the Holder’s last address as shown on the Warrant Register. 

15. Miscellaneous. 
 (a) No Rights as a Stockholder.
The Holder, solely in such Person’s capacity as a holder of this Warrant, shall not be entitled to vote or receive dividends or be deemed the holder of share capital of the Company for any purpose, nor shall anything contained in this Warrant
be construed to confer upon the Holder, solely in such Person’s capacity as the Holder of this Warrant, any of the rights of a stockholder of the Company or any right to vote, give or withhold consent to any corporate action (whether any
reorganization, issue of stock, reclassification of stock, consolidation, merger, amalgamation, conveyance or otherwise), receive notice of meetings, receive dividends or subscription rights, or otherwise, prior to the issuance to the Holder of the
Warrant Shares which such Person is then entitled to receive upon the due exercise of this Warrant. In addition, nothing contained in this Warrant shall be construed as imposing any liabilities on the Holder to purchase any securities (upon exercise
of this Warrant or otherwise) or as a stockholder of the Company, whether such liabilities are asserted by the Company or by creditors of the Company. 
 (b)
Authorized Shares. (i) Except and to the extent as waived or consented to by the Holder, the Company shall not by any action, including, without limitation, amending its certificate or articles of incorporation or through any
reorganization, transfer of assets, consolidation, merger, dissolution, issue or sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms of this Warrant, but will at all times in
good faith assist in the carrying out of all such terms and in the taking of all such actions as may be necessary or appropriate to protect the rights of Holder as set forth in this Warrant against impairment. Without limiting the generality of the
foregoing, the Company will (a) not increase the par value of any Warrant Shares above the amount payable therefor upon such exercise immediately prior to such increase in par value, (b) take all such action as may be necessary or
appropriate in order that the Company may validly and legally issue fully paid and non-assessable Warrant Shares upon the exercise of this Warrant, and (c) use commercially reasonable efforts to obtain
all such authorizations, exemptions or consents from any public regulatory body having jurisdiction thereof as may be necessary to enable the Company to perform its obligations under this Warrant. 

 (ii) Before taking any action which would result in an adjustment in the number of Warrant Shares for which
this Warrant is exercisable or in the Exercise Price, the Company shall obtain all such authorizations or exemptions thereof, or consents thereto, as may be necessary from any public regulatory body or bodies having jurisdiction thereof. 

(c) Successors and Assigns. Subject to the restrictions on transfer set forth in this Warrant and compliance with applicable securities laws, this
Warrant may be assigned by the Holder. This Warrant may not be assigned by the Company without the written consent of the Holder, except to a successor in the event of a Fundamental Transaction. This Warrant shall be binding on and inure to the
benefit of the Company and the Holder and their respective successors and assigns. Subject to the preceding sentence, nothing in this Warrant shall be construed to give to any Person other than the Company and the Holder any legal or equitable
right, remedy or cause of action under this Warrant. This Warrant may be amended only in writing signed by the Company and the Holder, or their successors and assigns. 

(d) Amendment and Waiver. Except as otherwise provided herein, the provisions of the Warrants may be amended and the Company may take any action herein
prohibited, or omit to perform any act herein required to be performed by it, only if the Company has obtained the written consent of the Holder or those registered holders of the Warrants representing no less than a majority of the Warrant Shares
obtainable upon exercise of the Warrants then outstanding. 
 (e) Acceptance. Receipt of this Warrant by the Holder shall constitute acceptance of and
agreement to all of the terms and conditions contained herein. 
 (f) Governing Law; Jurisdiction. ALL QUESTIONS CONCERNING THE CONSTRUCTION,
VALIDITY, ENFORCEMENT AND INTERPRETATION OF THIS WARRANT SHALL BE GOVERNED BY AND CONSTRUED AND ENFORCED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK WITHOUT REGARD TO THE PRINCIPLES OF CONFLICTS OF LAW THEREOF. EACH OF THE COMPANY AND THE
HOLDER HEREBY IRREVOCABLY SUBMITS TO THE EXCLUSIVE JURISDICTION OF THE STATE AND FEDERAL COURTS SITTING IN THE CITY OF NEW YORK, BOROUGH OF MANHATTAN, FOR THE ADJUDICATION OF ANY DISPUTE HEREUNDER OR IN CONNECTION HEREWITH OR WITH ANY TRANSACTION
CONTEMPLATED HEREBY OR DISCUSSED HEREIN (INCLUDING WITH RESPECT TO THE ENFORCEMENT OF ANY OF THE TRANSACTION DOCUMENTS), AND HEREBY IRREVOCABLY WAIVES, AND AGREES NOT TO ASSERT IN ANY SUIT, ACTION OR PROCEEDING, ANY CLAIM THAT IT IS NOT PERSONALLY
SUBJECT TO THE JURISDICTION OF ANY SUCH COURT. EACH OF THE COMPANY AND THE HOLDER HEREBY IRREVOCABLY WAIVES PERSONAL SERVICE OF PROCESS AND CONSENTS TO PROCESS BEING SERVED IN ANY SUCH SUIT, ACTION OR PROCEEDING BY MAILING A COPY THEREOF VIA
REGISTERED OR CERTIFIED MAIL OR OVERNIGHT DELIVERY (WITH EVIDENCE OF DELIVERY) TO SUCH PERSON AT THE ADDRESS IN EFFECT FOR NOTICES TO IT AND AGREES THAT SUCH SERVICE SHALL CONSTITUTE GOOD AND SUFFICIENT SERVICE OF PROCESS AND NOTICE THEREOF. NOTHING
CONTAINED HEREIN SHALL BE DEEMED TO LIMIT IN ANY WAY ANY RIGHT TO SERVE PROCESS IN ANY MANNER PERMITTED BY LAW. EACH OF THE COMPANY AND THE HOLDER HEREBY WAIVES ALL RIGHTS TO A TRIAL BY JURY. 

(g) Headings. The headings herein are for convenience only, do not constitute a part of this Warrant and shall not be deemed to limit or affect any of
the provisions hereof. 
 (h) Severability. In case any one or more of the provisions of this Warrant shall be invalid or unenforceable in any
respect, the validity and enforceability of the remaining terms and provisions of this Warrant shall not in any way be affected or impaired thereby, and the Company and the Holder will attempt in good faith to agree upon a valid and enforceable
provision which shall be a commercially reasonable substitute therefor, and upon so agreeing, shall incorporate such substitute provision in this Warrant. 

[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK] 

 IN WITNESS WHEREOF, the Company has caused this Warrant to be duly executed by its authorized officer as of
the date first indicated above. 
  

			
	OTONOMY, INC.
		
	By:	 	
                 

	Name:	 	
	Title:	 	

 SCHEDULE 1 

FORM OF EXERCISE NOTICE 
 [To be
executed by the Holder to purchase shares of Common Stock under the Warrant] 
 Ladies and Gentlemen: 

(1) The undersigned is the Holder of Warrant No. __ (the “Warrant”) issued by Otonomy, Inc. , a Delaware corporation (the
“Company”). Capitalized terms used herein and not otherwise defined herein have the respective meanings set forth in the Warrant. 
 (2) The
undersigned hereby exercises its right to purchase Warrant Shares pursuant to the Warrant. 
 (3) The Holder intends that payment of the Exercise Price shall
be made as (check one): 
     ☐ Cash Exercise 

    ☐ “Cashless Exercise” under Section 10 of the Warrant 

(4) If the Holder has elected a Cash Exercise, the Holder shall pay the sum of $ in immediately available funds to the Company in accordance with the terms of
the Warrant. 
 (5) Pursuant to this Exercise Notice, the Company shall deliver to the Holder Warrant Shares determined in accordance with the terms of the
Warrant. 
 (6) By its delivery of this Exercise Notice, the undersigned represents and warrants to the Company that in giving effect to the exercise
evidenced hereby the Holder will not beneficially own in excess of the number of shares of Common Stock (as determined in accordance with Section 13(d) of the Securities Exchange Act of 1934, as amended) permitted to be owned under
Section 11(a) of the Warrant to which this notice relates. 
  

	
	
Dated:                  
                                         
          

	
	
Name of Holder:              
                                      

	
	
By:                  
                                         
              

	
Name:                  
                                         
         

	
Title:                  
                                         
           

 (Signature must conform in all respects to name of Holder as specified on the face of the Warrant)

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00311-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00311-of-00352.parquet"}]]