Document:

EX-10.5

 Exhibit 10.5 
 THIS WARRANT IS ISSUED IN EXCHANGE FOR THE 12.5% PROMISSORY NOTE ORIGINALLY ISSUED ON SEPTEMBER 3, 2009 BY THE COMPANY TO THE HOLDER (AS SUCH TERMS ARE DEFINED BELOW), WITHOUT ANY ADDITIONAL
CONSIDERATION. FOR PURPOSES OF RULE 144, THIS WARRANT SHALL BE DEEMED TO HAVE BEEN ISSUED ON SUCH DATE. 
 THIS WARRANT DOES NOT
REQUIRE PHYSICAL SURRENDER OF THE WARRANT IN THE EVENT OF A PARTIAL EXERCISE. AS A RESULT, FOLLOWING EXERCISE OF ANY PORTION OF THIS WARRANT, THE NUMBER OF WARRANT SHARES REPRESENTED BY THIS WARRANT MAY BE LESS THAN THE AMOUNT SET FORTH BELOW.

 AMENDED AND RESTATED 
 COMMON STOCK PURCHASE WARRANT 
 FIBROCELL SCIENCE, INC.

  

			
	Warrant Shares:             1	  	Issue Date: June 1, 2012
		  	Amended and Restated: October         , 2012

 THIS AMENDED AND RESTATED COMMON STOCK PURCHASE WARRANT (the “Warrant”) certifies that,
for value received,                      (the “Holder”) is entitled, upon the terms and subject to the limitations on exercise and
the conditions hereinafter set forth, at any time and from time to time on or after the Issue Date (as defined above) and on or prior to the close of business on June 1, 2018 (the “Termination Date”) but not thereafter, to
subscribe for and purchase from FIBROCELL SCIENCE, INC., a Delaware corporation (the “Company”), up to                      shares
(the “Warrant Shares”) of Common Stock. The purchase price of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b) below. This Warrant amends, restates and
supersedes in all respects that certain Common Stock Purchase Warrant of the Company issued to the Holder on June 1, 2012 (the “Original Warrant”). The Original Warrant is henceforth void and shall be of no further force or
effect. 
 Section 1. Definitions. Capitalized terms used and not otherwise defined herein shall have the meanings
set forth in that certain Exchange Agreement pursuant to which this Warrant was issued (the “Exchange Agreement”), dated on or about the date hereof, among the Company, the Holder, and the other Persons signatory thereto.

 Section 2. Exercise. 
 (a) Exercise of Warrant. Exercise of the purchase rights represented by this Warrant may be made, in whole or in part, at any time and from time to time on or after the Issue Date and on or before
the Termination Date by delivery to the Company (or such other office or agency of the Company as it may designate by notice in writing to the registered Holder at the address of the Holder appearing on the books of the Company) of a duly executed
facsimile copy of the Notice of Exercise form annexed hereto (which delivery may be made in any manner set forth in Section 9(a) of the Notes, including without limitation by email); and, within 3 Trading Days of the date said Notice of
Exercise is delivered to the Company, the Company shall have received payment of the aggregate Exercise Price of the shares thereby purchased by wire transfer or cashier’s check drawn on a United States bank, unless payment is being made by
cashless exercise as provided in Section 2(c) below. Notwithstanding anything herein to the contrary, the Holder shall not be required to physically surrender this Warrant to the Company until the Holder has purchased all of the Warrant
Shares available hereunder and the Warrant has been exercised in full, in which case the Holder shall surrender this Warrant to the Company for cancellation within 3 Trading Days of the date the final Notice of Exercise is delivered to the Company.
Partial exercises of this Warrant resulting in purchases of a portion of the total number of Warrant Shares available hereunder shall have the effect of lowering the outstanding number of Warrant Shares purchasable hereunder in an amount equal to
the applicable number of Warrant Shares purchased. The Holder and the Company shall maintain records 
  

1
 Insert 2x original number of Warrant Shares. 

 
showing the number of Warrant Shares purchased and the date of such purchases. In the event of any dispute or discrepancy, the records of the Holder shall be controlling and determinative in the
absence of manifest error. The Holder and any assignee, by acceptance of this Warrant, acknowledge and agree that, by reason of the provisions of this paragraph, following the purchase of a portion of the Warrant Shares hereunder, the number of
Warrant Shares available for purchase hereunder at any given time may be less than the amount stated on the face hereof. 
 (b) Exercise Price. The exercise price per share of the Common Stock under this Warrant shall be $0.10, subject to adjustment hereunder (the “Exercise Price”). 

(c) Cashless Exercise. After November 30, 2012, this Warrant may also be exercised by means of a
“cashless exercise” in which the Holder shall be entitled to receive a certificate for the number of Warrant Shares equal to the quotient obtained by dividing [(A-B) (X)] by (A), where: 

(A) = the average of the daily VWAPs for the three (3) Trading Days immediately preceding the date of such election;

 (B) = the Exercise Price of this Warrant, as adjusted; and 

(X) = the number of Warrant Shares issuable upon exercise of this Warrant in accordance with the terms of this Warrant by

 means of a cash exercise rather than a cashless exercise; 

provided that half of the original number of Warrant Shares hereunder (as adjusted pursuant to the terms hereof) may only be exercised for
cash during such times that there is an effective registration statement registering, and a current prospectus available for, the resale of all the Warrant Shares by the Holder. 

Notwithstanding anything herein to the contrary, on the Termination Date, this Warrant shall be automatically exercised
via cashless exercise pursuant to this Section 2(c). 
 (d) Holder’s Restrictions. The
Company shall not effect any exercise of this Warrant, and a Holder shall not have the right to exercise any portion of this Warrant, pursuant to Section 2 or otherwise, to the extent that after giving effect to such issuance after
exercise as set forth on the applicable Notice of Exercise, the Holder (together with the Holder’s Affiliates, and any other person or entity acting as a group together with the Holder or any of the Holder’s Affiliates), would beneficially
own in excess of the Beneficial Ownership Limitation (as defined below). For purposes of the foregoing sentence, the number of shares of Common Stock beneficially owned by the Holder and its Affiliates shall include the number of shares of
Common Stock issuable upon 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 (A) exercise of the remaining, nonexercised portion
of this Warrant beneficially owned by the Holder or any of its Affiliates and (B) exercise or conversion of the unexercised or nonconverted portion of any other securities of the Company (including, without limitation, any other Common Stock
Equivalents) subject to a limitation on conversion or exercise analogous to the limitation contained herein beneficially owned by the Holder or any of its Affiliates. Except as set forth in the preceding sentence, for purposes of this
Section 2(d), beneficial ownership shall be calculated in accordance with Section 13(d) of the Exchange Act and the rules and regulations promulgated thereunder, it being acknowledged by the Holder that the Company is not representing to
the Holder that such calculation is in compliance with Section 13(d) of the Exchange Act and the Holder is solely responsible for any schedules required to be filed in accordance therewith. To the extent that the limitation contained in this
Section 2(d) applies, the determination of whether this Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates) and of which portion of this Warrant is exercisable shall be in the sole
discretion of the Holder, and the submission of a Notice of Exercise shall be deemed to be the Holder’s determination of whether this Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates) and
of which portion of this Warrant is exercisable, in each case subject to the Beneficial Ownership Limitation, and the Company shall have no obligation to verify or confirm the accuracy of such determination. In addition, a determination as to any
group status as contemplated above shall be determined in accordance with Section 13(d) of the Exchange Act and the rules and regulations promulgated thereunder. For purposes of this Section 2(d), in determining the number of outstanding

  
 2 

 
shares of Common Stock, a Holder may rely on the number of outstanding shares of Common Stock as reflected in (x) the Company’s most recent periodic or annual report, as the case may
be, (y) a more recent public announcement by the Company or (z) any other notice by the Company or the Company’s Transfer Agent setting forth the number of shares of Common Stock outstanding. Upon the written or oral request of a
Holder, the Company shall within two Trading Days confirm orally and in writing 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 or its Affiliates since the date as of which such number of outstanding shares of Common Stock was reported. The “Beneficial Ownership
Limitation” shall be 4.9% of the number of shares of the Common Stock outstanding immediately after giving effect to the issuance of shares of Common Stock issuable upon exercise of this Warrant. By written notice to the Company, the Holder
may at any time and from time to time increase or decrease (but not below 4.9%) the Beneficial Ownership Limitation to any other percentage specified in such notice (or specify that the Beneficial Ownership Limitation shall no longer be applicable),
provided, however, that (A) any such increase (or inapplicability) shall not be effective until the sixty-first (61st) day after such notice is delivered to the Company, and (B) any such increase or decrease shall apply only to the
Holder and not to any other holder of Warrants. The provisions of this paragraph shall be construed and implemented in a manner otherwise than in strict conformity with the terms of this Section 2(d) to correct this paragraph (or any portion
hereof) which may be defective or inconsistent with the intended Beneficial Ownership Limitation herein contained or to make changes or supplements necessary or desirable to properly give effect to such limitation. The limitations contained in this
paragraph shall apply to a successor holder of this Warrant. 
 (e) Mechanics of Exercise. 

(i) Delivery of Certificates Upon Exercise. Certificates for shares purchased hereunder shall be transmitted by
the transfer agent of the Company to the Holder by crediting the account of the Holder’s prime broker with the Depository Trust Company (“DTC”) through its Deposit /Withdrawal at Custodian (“DWAC”) system if
the Company is a participant in such system and either (x) there is an effective Registration Statement permitting the resale of the Warrant Shares by the Holder, or (y) such shares may be sold pursuant to Rule 144, and otherwise by
physical delivery to the address specified by the Holder in the Notice of Exercise, within 3 Trading Days from the delivery to the Company of the Notice of Exercise, surrender of this Warrant (if required) and payment of the aggregate Exercise Price
as set forth above (“Warrant Share Delivery Date”). This Warrant shall be deemed to have been exercised on the date the Notice of Exercise is delivered to the Company. The Warrant Shares issuable upon any (1) cashless exercise
hereunder, or (2) cash exercise hereunder where there is an effective registration statement covering the resale of the Warrant Shares by the Holder, shall, unless prohibited by applicable law, be issued without any legends or trading
restrictions. If the Company fails for any reason to deliver to the Holder the Warrant Shares or certificates evidencing the Warrant Shares subject to a Notice of Exercise by the Warrant Share Delivery Date, the Company shall pay to the Holder, in
cash, as liquidated damages and not as a penalty, for each $1,000 of Warrant Shares subject to such exercise (based on the VWAP of the Common Stock on the date of the applicable Notice of Exercise), $10 per Trading Day (increasing to $20 per Trading
Day on the fifth Trading Day after such liquidated damages begin to accrue) for each Trading Day after such Warrant Share Delivery Date until such shares or certificates are delivered. 

(ii) Delivery of New Warrants Upon Exercise. If this Warrant shall have been exercised in part, the Company shall,
at the request of a Holder and upon surrender of this Warrant certificate, at the time of delivery of the certificate or certificates representing Warrant Shares, deliver to Holder a new Warrant evidencing the rights of Holder to purchase the
unpurchased Warrant Shares called for by this Warrant, which new Warrant shall in all other respects be identical with this Warrant. 

  
 3 

 (iii) Rescission Rights. If the Company fails to cause its transfer
agent to transmit to the Holder a certificate or certificates representing the Warrant Shares (or otherwise transmit such shares via DWAC to the Holder’s DTC account) pursuant to this Section 2(e) by the Warrant Share Delivery Date,
then the Holder will have the right to rescind such exercise. 
 (iv) Compensation for Buy-In on Failure to
Timely Deliver Certificates Upon Exercise. In addition to any other rights available to the Holder, if the Company fails to cause its transfer agent to transmit to the Holder a certificate or certificates representing the Warrant Shares (or
otherwise transmit such shares via DWAC to the Holder’s DTC account) pursuant to an exercise on or before the Warrant Share Delivery Date, and if after such date the Holder is required by its broker to purchase (in an open market transaction or
otherwise) or the Holder’s brokerage firm otherwise purchases, 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 (1) pay in cash to the Holder the amount by which (x) the Holder’s total purchase price (including brokerage commissions, if any) for the shares of Common Stock so purchased exceeds
(y) the amount obtained by multiplying (A) the number of Warrant Shares that the Company was required to deliver to the Holder in connection with the exercise at issue times (B) the price at which the sell order giving rise to such
purchase obligation was executed, and (2) at the option of the Holder, either reinstate the portion of the Warrant and equivalent number of Warrant Shares for which such exercise was not honored or deliver to the Holder the number of shares of
Common Stock that would have been issued had the Company timely complied with its exercise and delivery obligations hereunder. For example, if the Holder purchases Common Stock having a total purchase price of $11,000 to cover a Buy-In with respect
to an attempted exercise of shares of Common Stock with an aggregate sale price giving rise to such purchase obligation of $10,000, under clause (1) of the immediately preceding sentence the Company shall be required to pay the Holder $1,000.
The Holder shall provide the Company written notice indicating the amounts payable to the Holder in respect of the Buy-In and, upon request of the Company, evidence of the amount of such loss. Nothing herein shall limit a 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 the Warrant Shares or
certificates representing shares of Common Stock upon exercise of the Warrant as required pursuant to the terms hereof. 
 (v) No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued upon the exercise of this Warrant. As to any fraction of a share which the Holder
would otherwise be entitled to purchase upon such exercise, the Company shall at its election, either pay a cash adjustment in respect of such final fraction in an amount equal to such fraction multiplied by the Exercise Price or round up to the
next whole share. 
 (vi) Charges, Taxes and Expenses. Issuance of certificates for Warrant Shares shall
be made without charge to the Holder for any issue or transfer tax or other incidental expense in respect of the issuance of such certificate, all of which taxes and expenses shall be paid by the Company, and such certificates shall be issued in the
name of the Holder or in such name or names as may be directed by the Holder; provided, however, that in the event certificates for Warrant Shares are to be issued in a name other than the name of the Holder, this Warrant when
surrendered for exercise shall be accompanied by the Assignment Form attached hereto duly executed by the Holder; and the Company may require, as a condition thereto, the payment of a sum sufficient to reimburse it for any transfer tax incidental
thereto. 
 (vii) Closing of Books. The Company will not close its stockholder books or records in any
manner which prevents the timely exercise of this Warrant, pursuant to the terms hereof. 

  
 4 

 Section 3. Certain Adjustments. 

(a) Stock Dividends and Splits. If the Company, at any time while this Warrant is outstanding: (A) pays a
stock dividend or otherwise makes a distribution or distributions on shares of its Common Stock or any other equity or equity equivalent securities payable in shares of Common Stock (which, for avoidance of doubt, shall not include any shares of
Common Stock issued by the Company upon exercise of this Warrant or upon the Notes or upon the Company’s currently authorized shares of preferred stock ), (B) subdivides its outstanding shares of Common Stock into a larger number of
shares, (C) combines (including by way of reverse stock split) its outstanding shares of Common Stock into a smaller number of shares, or (D) issues by reclassification of shares of the Common Stock any shares of capital stock of the
Company, then in each case the Exercise Price shall be multiplied by a fraction of which the numerator shall be the number of shares of Common Stock (excluding treasury shares, if any) outstanding immediately before such event and of which the
denominator shall be the number of shares of Common Stock outstanding immediately after such event and the number of shares issuable upon exercise of this Warrant shall be proportionately adjusted such that the aggregate Exercise Price of this
Warrant shall remain unchanged. Any adjustment made pursuant to this Section 3(a) shall become effective immediately after the record date for the determination of stockholders entitled to receive such dividend or distribution and shall
become effective immediately after the effective date in the case of a subdivision, combination or re-classification. 
 (b) Subsequent Rights Offerings. The Company shall notify the Holder in writing at least 10 business days before it shall issue rights, options or warrants to all holders of Common Stock (and not
to Holders in their capacity as holders of Warrants) entitling them to subscribe for or purchase shares of Common Stock at a price per share less than the VWAP at the applicable record date. 

(c) Pro Rata Distributions. If the Company, at any time while this Warrant is outstanding, shall distribute to all
holders of Common Stock (and not to Holders in their capacity as holders of Warrants) evidences of its indebtedness or assets (including cash and cash dividends) or rights or warrants to subscribe for or purchase any security other than the Common
Stock (each a “Distribution”), then in each such case either (i) the Exercise Price shall be adjusted by multiplying the Exercise Price in effect immediately prior to the record date fixed for determination of stockholders
entitled to receive such distribution by a fraction of which the denominator shall be the VWAP determined as of the record date mentioned above, and of which the numerator shall be such VWAP on such record date less the then per share fair market
value at such record date of the portion of such assets or evidence of indebtedness so distributed applicable to one outstanding share of the Common Stock as determined by the Board of Directors in good faith, or (ii) the Company shall
distribute to the Holder the amount of the Distribution it would have received had it exercised this Warrant in full (without accounting for any limitations on ownership or exercise) immediately prior to the record date for such Distribution, in
each case as elected by the Holder. In either case the adjustments shall be described in a statement provided to the Holder of the portion of assets or evidences of indebtedness so distributed or such subscription rights applicable to one share of
Common Stock. Such adjustment shall be made whenever any such distribution is made and shall become effective immediately after the record date mentioned above. 
 (d) Fundamental Transaction. If, at any time while this Warrant is outstanding, (A) the Company effects any merger or consolidation of the Company with or into another Person, (B) the
Company effects any sale of all or substantially all of its assets in one or a series of related transactions, (C) any tender offer or exchange offer (whether by the Company or another Person) is completed pursuant to which holders of Common
Stock are permitted to tender or exchange their shares for other securities, cash or property, or (D) 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 (for the avoidance of doubt this subsection (D) shall not include any events set forth in Section 3(a) above) (each a “Fundamental
Transaction”), then, upon any subsequent exercise of this Warrant, the Holder shall have the right to receive, for each Warrant Share that would have been issuable upon such exercise immediately prior to the occurrence of such Fundamental
Transaction, the number of shares of Common Stock of the successor or acquiring corporation or of the Company, if it is the surviving corporation, and any additional consideration (the “Alternate Consideration”) receivable as a
result of such merger, consolidation or disposition of assets by a holder of the number of shares of 

  
 5 

 
Common Stock for which this Warrant is exercisable immediately prior to such event. For purposes of any such exercise, the determination of the Exercise Price shall be appropriately adjusted to
apply to such Alternate Consideration based on the amount of Alternate Consideration issuable in respect of one share of Common Stock in such Fundamental Transaction, and the Company shall apportion the Exercise Price among the Alternate
Consideration in a reasonable manner reflecting the relative value of any different components of the Alternate Consideration. If holders of Common Stock are given any choice as to the securities, cash or property to be received in a Fundamental
Transaction, then the Holder shall be given the same choice as to the Alternate Consideration it receives upon any exercise of this Warrant following such Fundamental Transaction. To the extent necessary to effectuate the foregoing provisions, any
successor to the Company or surviving entity in such Fundamental Transaction shall issue to the Holder a new warrant consistent with the foregoing provisions and evidencing the Holder’s right to exercise such warrant into Alternate
Consideration. The terms of any agreement pursuant to which a Fundamental Transaction is effected shall include terms requiring any such successor or surviving entity to comply with the provisions of this Section 3(d) and insuring that
this Warrant (or any such replacement security) will be similarly adjusted upon any subsequent transaction analogous to a Fundamental Transaction. Notwithstanding anything to the contrary, in the event of any Bankruptcy Event (as defined in the
Notes) or any Fundamental Transaction that is (1) an all cash transaction, (2) a “Rule 13e-3 transaction” as defined in Rule 13e-3 under the Securities Exchange Act of 1934, as amended, or (3) a Fundamental Transaction
involving a person or entity not traded on a national securities exchange, the Nasdaq Global Select Market, the Nasdaq Global Market, or the Nasdaq Capital Market, or in the event that the Company’s Common Stock ceases to be listed, traded or
quoted (as applicable) on a Trading Market (as defined in the Notes) for a period of 15 Trading Days, then the Company or any Successor Entity (as defined below) shall redeem this Warrant, at the Holder’s option, exercisable at any time
concurrently with or within 30 days after the consummation of the Fundamental Transaction described in this sentence, for cash equal to the Black Scholes Value of the remaining unexercised portion of this Warrant on the date of the consummation of
such Fundamental Transaction described in this sentence. “Black Scholes Value” means the value of this Warrant based on the Black and Scholes Option Pricing Model obtained from the “OV” function on Bloomberg, L.P.
(“Bloomberg”) determined as of the day of consummation of the applicable Fundamental Transaction for pricing purposes and reflecting (A) a risk-free interest rate corresponding to the U.S. Treasury rate for a period equal to
the time between the date of the public announcement of the applicable Fundamental Transaction and the Termination Date, (B) an expected volatility equal to the greater of 100% and the 100 day volatility obtained from the HVT function on
Bloomberg as of the Trading Day immediately following the public announcement of the applicable Fundamental Transaction, (C) the underlying price per share used in such calculation shall be the sum of the price per share being offered in cash,
if any, plus the value of any non-cash consideration, if any, being offered in such Fundamental Transaction and (D) a remaining option time equal to the time between the date of the public announcement of the applicable Fundamental Transaction
and the Termination Date. 
 The Company shall cause any successor entity in a Fundamental Transaction in which the Company is
not the survivor (the “Successor Entity”) to assume in writing all of the obligations of the Company under this Warrant in accordance with the provisions of this Section 3(d) prior to such Fundamental Transaction and
shall, at the option of the holder of this Warrant, deliver to the Holder in exchange for this Warrant a security of the Successor Entity evidenced by a written instrument substantially similar in form and substance to this Warrant which is
exercisable for a corresponding number of shares of capital stock of such Successor Entity (or its parent entity) equivalent to the shares of Common Stock acquirable and receivable upon exercise of this Warrant (without regard to any limitations on
the exercise of this Warrant) prior to such Fundamental Transaction, and with an exercise price which applies the exercise price hereunder to such shares of capital stock (but taking into account the relative value of the shares of Common Stock
pursuant to such Fundamental Transaction and the value of such shares of capital stock, such number of shares of capital stock and such exercise price being for the purpose of protecting the economic value of this Warrant immediately prior to the
consummation of such Fundamental Transaction). Upon the occurrence of any such Fundamental Transaction, the Successor Entity shall succeed to, and be substituted for (so that from and after the date of such Fundamental Transaction, the provisions of
this Warrant referring to the “Company” shall refer instead to the Successor Entity), and may exercise every right and power of the Company and shall assume all of the obligations of the Company under this Warrant with the same effect as
if such Successor Entity had been named as the Company herein, including without limitation honoring any redemption right of the Holder set forth herein. 

  
 6 

 (e) Calculations. All calculations under this Section 3
shall be made to the nearest four decimal places or the nearest 1/100th of a share, as the case may be. For purposes of this Section 3, the number of shares of Common Stock deemed to be issued and outstanding as of a given date shall be
the sum of the number of shares of Common Stock (excluding treasury shares, if any) issued and outstanding. 

(f) Voluntary Adjustment By Company. The Company may at any time during the term of this Warrant reduce the then
current Exercise Price to any amount and for any period of time deemed appropriate by the Board of Directors of the Company. 
 (g) Notice to Holder. 
 (i) Adjustment to Exercise
Price. Whenever the Exercise Price is adjusted pursuant to any provision of this Section 3, the Company shall promptly mail to the Holder a notice setting forth the Exercise Price after such adjustment and setting forth a brief
statement of the facts requiring such adjustment. 
 (ii) Notice to Allow Exercise by Holder. If
(A) the Company shall declare a dividend (or any other distribution in whatever form) on the Common Stock; (B) the Company shall declare a special nonrecurring cash dividend on or a redemption of the Common Stock; (C) the Company
shall authorize the granting to all holders of the Common Stock rights or warrants to subscribe for or purchase any shares of capital stock of any class or of any rights; (D) the approval of any stockholders of the Company shall be required in
connection with any reclassification of the Common Stock, any consolidation or merger to which the Company is a party, any sale or transfer of all or substantially all of the assets of the Company, of any compulsory share exchange whereby the Common
Stock is converted into other securities, cash or property; (E) the Company shall authorize the voluntary or involuntary dissolution, liquidation or winding up of the affairs of the Company; then, in each case, the Company shall cause to be
mailed to the Holder at its last address as it shall appear upon the Warrant Register of the Company, at least 20 calendar days prior to the applicable record or effective date hereinafter specified, a notice stating (x) the date on which a
record is to be taken for the purpose of such dividend, distribution, redemption, rights or warrants, or if a record is not to be taken, the date as of which the holders of the Common Stock of record to be entitled to such dividend, distributions,
redemption, rights or warrants are to be determined or (y) the date on which such reclassification, consolidation, merger, sale, transfer or share exchange is expected to become effective or close, and the date as of which it is expected that
holders of the Common Stock of record shall be entitled to exchange their shares of the Common Stock for securities, cash or other property deliverable upon such reclassification, consolidation, merger, sale, transfer or share exchange; provided
that the failure to mail such notice or any defect therein or in the mailing thereof shall not affect the validity of the corporate action required to be specified in such notice. The Holder is entitled to exercise this Warrant during the period
commencing on the date of such notice to the effective date of the event triggering such notice. 
 Section 4.
Transfer of Warrant. 
 (a) Transferability. Subject to compliance with any applicable securities
laws and the conditions set forth in Section 4(d) hereof, this Warrant and all rights hereunder (including, without limitation, any registration rights) are transferable, in whole or in part, upon surrender of this Warrant at the
principal office of the Company or its designated agent, together with a written assignment of this Warrant substantially in the form attached hereto duly executed by the Holder or its agent or attorney and funds sufficient to pay any transfer taxes
payable upon the making of such transfer. Upon such surrender and, if required, such payment, the Company shall execute and deliver a new Warrant or Warrants in the name of the assignee or assignees and in the denomination or denominations specified
in such instrument of assignment, and shall issue to the assignor a new Warrant evidencing the portion of this Warrant not so assigned, and this Warrant shall promptly be cancelled. A Warrant, if properly assigned, may be exercised by a new holder
for the purchase of Warrant Shares without having a new Warrant issued. 

  
 7 

 (b) New Warrants. This Warrant may be divided or combined with other
Warrants upon presentation hereof at the aforesaid office of the Company, together with a written notice specifying the names and denominations in which new Warrants are to be issued, signed by the Holder or its agent or attorney. Subject to
compliance with Section 4(a), as to any transfer which may be involved in such division or combination, the Company shall execute and deliver a new Warrant or Warrants in exchange for the Warrant or Warrants to be divided or combined in
accordance with such notice. All Warrants issued on transfers or exchanges shall be dated the original Issue Date and shall be identical with this Warrant except as to the number of Warrant Shares issuable pursuant thereto. 

(c) Warrant Register. The Company shall register this Warrant, upon records to be maintained by the Company for
that purpose (the “Warrant Register”), in the name of the record Holder hereof 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. 
 (d)
Transfer Restrictions. If, at the time of the surrender of this Warrant in connection with any transfer of this Warrant, the transfer of this Warrant shall not be registered pursuant to an effective registration statement under the Securities
Act and under applicable state securities or blue sky laws or eligible for resale under Rule 144, the Company may require, as a condition of allowing such transfer, that the Holder or transferee of this Warrant, as the case may be, comply with the
provisions of Section 5.7 of the Exchange Agreement. 
 Section 5. Miscellaneous. 

(a) No Rights as Shareholder Until Exercise. This Warrant does not entitle the Holder to any voting rights or other
rights as a shareholder of the Company prior to the exercise hereof as set forth in Section 2(e)(i). 

(b) Loss, Theft, Destruction or Mutilation of Warrant. The Company covenants that upon receipt by the Company of
evidence reasonably satisfactory to it of the loss, theft, destruction or mutilation of this Warrant or any stock certificate relating to the Warrant Shares, and in case of loss, theft or destruction, of indemnity or security reasonably satisfactory
to it (which, in the case of the Warrant, shall not include the posting of any bond), and upon surrender and cancellation of such Warrant or stock certificate, if mutilated, the Company will make and deliver a new Warrant or stock certificate of
like tenor and dated as of such cancellation, in lieu of such Warrant or stock certificate. 
 (c) Saturdays,
Sundays, Holidays, etc. If the last or appointed day for the taking of any action or the expiration of any right required or granted herein shall not be a Business Day, then such action may be taken or such right may be exercised on the next
succeeding Business Day. 
 (d) Authorized Shares. 

The Company covenants that at all times during the period the Warrant is outstanding on and after the date of the Share
Increase (as defined in the Exchange Agreement) it will reserve from its authorized and unissued Common Stock a sufficient number of shares to provide for the issuance of the Warrant Shares upon the exercise of any purchase rights under this
Warrant. The Company further covenants that its issuance of this Warrant shall constitute full authority to its officers who are charged with the duty of executing stock certificates to execute and issue the necessary certificates for the Warrant
Shares upon the exercise of the purchase rights under this Warrant. The Company will take all such reasonable action as may be necessary to assure that such Warrant Shares may be issued as provided herein without violation of any applicable law or
regulation, or of any requirements of the Trading Market upon which the Common Stock may be listed. The Company covenants that all Warrant Shares which may be issued upon the exercise of the purchase rights represented by this Warrant will, upon
exercise of the purchase rights represented by this Warrant, be duly authorized, validly issued, fully paid and nonassessable and free from all taxes, liens and charges created by the Company in respect of the issue thereof (other than taxes in
respect of any transfer occurring contemporaneously with such 

  
 8 

 
issue), provided, however, that prior to the Share Increase, the Company shall not be required to reserve such Warrant Shares and it is acknowledged that prior to such time the Company
shall not be required to deliver any Warrant Shares upon exercise hereof to the extent it does not have a sufficient number of duly authorized shares of Common Stock available for issuance hereunder, provided further that if after at any time
on or after October 1, 2012 the Company fails to have a sufficient number duly authorized Warrant Shares reserved for issuance upon exercise hereof (without taking into account any limitations on exercise or ownership), the Company shall, at
the Holder’s election, purchase all or any portion of this Warrant for a redemption price equal to the value of this Warrant using the Black-Scholes Value (computed as if such Warrant Shares were so available for issuance). 

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 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 the 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 nonassessable 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.

 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. 

(e) Jurisdiction. All questions concerning the construction, validity, enforcement and interpretation of this
Warrant shall be determined in accordance with the provisions of the Exchange Agreement. 
 (f)
Restrictions. The Holder acknowledges that the Warrant Shares acquired upon the exercise of this Warrant, if not registered and not issued pursuant to a cashless exercise, will have restrictions upon resale imposed by state and federal
securities laws. 
 (g) Nonwaiver and Expenses. No course of dealing or any delay or failure to exercise
any right hereunder on the part of the Holder shall operate as a waiver of such right or otherwise prejudice the Holder’s rights, powers or remedies, notwithstanding the fact that all rights hereunder terminate on the Termination Date. If the
Company willfully and knowingly fails to comply with any provision of this Warrant, which results in any material damages to the Holder, the Company shall pay to the Holder such amounts as shall be sufficient to cover any costs and expenses
including, but not limited to, reasonable attorneys’ fees, including those of appellate proceedings, incurred by the Holder in collecting any amounts due pursuant hereto or in otherwise enforcing any of its rights, powers or remedies hereunder.

 (h) Notices. Any notice, request or other document required or permitted to be given or delivered to
the Holder by the Company shall be delivered in accordance with the notice provisions of the Exchange Agreement. 

(i) Limitation of Liability. No provision hereof, in the absence of any affirmative action by the Holder to
exercise this Warrant to purchase Warrant Shares, and no enumeration herein of the rights or privileges of the Holder, shall give rise to any liability of the Holder for the purchase price of any Common Stock or as a stockholder of the Company,
whether such liability is asserted by the Company or by creditors of the Company. 

  
 9 

 (j) Remedies. The Holder, in addition to being entitled to exercise
all rights granted by law, including recovery of damages, will be entitled to specific performance of its rights under this Warrant. The Company agrees that monetary damages would not be adequate compensation for any loss incurred by reason of a
breach by it of the provisions of this Warrant and hereby agrees to waive and not to assert the defense in any action for specific performance that a remedy at law would be adequate. 

(k) Successors and Assigns. Subject to applicable securities laws, this Warrant and the rights and obligations
evidenced hereby shall inure to the benefit of and be binding upon the successors of the Company and the successors and permitted assigns of Holder. The provisions of this Warrant are intended to be for the benefit of all Holders from time to time
of this Warrant and shall be enforceable by the Holder or holder of Warrant Shares. 
 (l) Amendment. This
Warrant may be modified or amended or the provisions hereof waived with the written consent of the Company and the Holder. 
 (m) Severability. Wherever possible, each provision of this Warrant shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this Warrant shall
be prohibited by or invalid under applicable law, such provision shall be ineffective to the extent of such prohibition or invalidity, without invalidating the remainder of such provisions or the remaining provisions of this Warrant. 

(n) Headings. The headings used in this Warrant are for the convenience of reference only and shall not, for any
purpose, be deemed a part of this Warrant. 
 ******************** 

  
 10 

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

			
	FIBROCELL SCIENCE, INC.
		
	 By:
	 	 
	 Name:
	 	Declan Daly
	 Title:
	 	Chief Operating Officer

  
 11 

 NOTICE OF EXERCISE 
 TO: FIBROCELL SCIENCE, INC. 
 RE: Warrant originally issued on or about June 1,
2012 and amended and restated on October        , 2012 

to                    for  
                   Warrant Shares. 

(1) The undersigned hereby elects to
purchase                     Warrant Shares of the Company pursuant to the terms of the attached Warrant (only if exercised in full), and tenders
herewith payment of the exercise price in full, together with all applicable transfer taxes, if any. 
 (2) Payment shall take
the form of (check applicable box): 
 [ ] in lawful money of the United States; or 

[ ] the cancellation of such number of Warrant Shares as is necessary, in accordance with the formula set forth in subsection 2(c), to
exercise this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless exercise procedure set forth in subsection 2(c). 
 (3) Please issue a certificate or certificates representing said Warrant Shares in the name of the undersigned or in such other name as is specified below: 

 
  
 The Warrant Shares shall be delivered to the following DWAC Account Number or by physical delivery of a certificate to: 
  

 
  

 
  

 
 (4)
Accredited Investor. The undersigned is an “accredited investor” as defined in Regulation D promulgated under the Securities Act of 1933, as amended. 
 [SIGNATURE OF HOLDER] 
 Name of Warrant Holder:
                                         
                                         
                           
 Signature of Authorized Signatory of Warrant Holder:
                                         
                    
 Name of Authorized
Signatory:
                                         
                                         
               
 Title of Authorized Signatory:
                                         
                                         
                   
 Date:
                                         
                                         
                                         
                  

 ASSIGNMENT FORM 

(To assign the foregoing warrant, execute 
 this form and supply required information. 
 Do not use this form to exercise the
warrant.) 
 FOR VALUE RECEIVED, [        ] all of or
[            ] shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to 
                                  
                                         
                               whose address is 

					
		
	      
	 	.
		
	  
	 	

Dated:                    , 
        
  

			
	Holder’s Signature:	 	 
		
	Holder’s Address:	 	 
		
		 	 

 Signature Guaranteed:
                                         
                                         
   
 NOTE: The signature to this Assignment Form must correspond with the name as it appears on the face of the Warrant, without
alteration or enlargement or any change whatsoever, and must be guaranteed by a bank or trust company. Officers of corporations and those acting in a fiduciary or other representative capacity should file proper evidence of authority to assign the
foregoing Warrant.2012 Exchange Agreement

 Exhibit 4.2 

 
  
 EXCHANGE AGREEMENT 
 dated as of 

            , 2012 

among 

SILVERCREST ASSET MANAGEMENT GROUP INC., 
 SILVERCREST L.P. 
 and 

THE CLASS B PARTNERS SET FORTH 
 ON THE SIGNATURE PAGES HERETO 
  

 

 TABLE OF CONTENTS 

 

							
	 	 	 	  	PAGE	 
			
	 ARTICLE I
	 	 DEFINITIONS
	  	 	1	  
			
	 1.1
	 	 Certain Definitions
	  	 	1	  
			
	 ARTICLE II
	 	 EXCHANGE
	  	 	3	  
			
	 2.1
	 	 Exchange Dates
	  	 	3	  
			
	 2.2
	 	 Permissible Exchanges by Class B Partners
	  	 	4	  
			
	 2.3
	 	 Exchange Request
	  	 	5	  
			
	 2.4
	 	 Suspensions
	  	 	5	  
			
	 2.5
	 	 Closing Date
	  	 	6	  
			
	 2.6
	 	 Closing Conditions
	  	 	6	  
			
	 2.7
	 	 Closing Deliveries
	  	 	7	  
			
	 2.8
	 	 Expenses
	  	 	7	  
			
	 ARTICLE III
	 	 MISCELLANEOUS
	  	 	7	  
			
	 3.1
	 	 Termination of Partner Group Membership; Cancellation of Class B Units; Issuance of Class A Units
	  	 	7	  
			
	 3.2
	 	 Tax Treatment
	  	 	8	  
			
	 3.3
	 	 Notices
	  	 	8	  
			
	 3.4
	 	 Term of the Agreement
	  	 	8	  
			
	 3.5
	 	 Amendments; Waivers
	  	 	9	  
			
	 3.6
	 	 Adjustment Upon Changes in Capitalization
	  	 	9	  
			
	 3.7
	 	 Severability
	  	 	9	  
			
	 3.8
	 	 Representatives, Successors and Assigns
	  	 	9	  
			
	 3.9
	 	 Governing Law
	  	 	9	  
			
	 3.10
	 	 Submission to Jurisdiction; Waiver of Immunity
	  	 	10	  
			
	 3.11
	 	 Waiver of Jury Trial
	  	 	10	  
			
	 3.12
	 	 Further Assurances
	  	 	10	  
			
	 3.13
	 	 Counterparts
	  	 	10	  
			
	 3.14
	 	 Entire Agreement
	  	 	11	  
			
	 3.15
	 	 Construction
	  	 	11	  
			
	 3.16
	 	 Interpretation
	  	 	11	  
			
	 3.17
	 	 Assignment
	  	 	11	  

 Annex A — Instrument of Transfer 

 This EXCHANGE AGREEMENT (this “Agreement”) is dated as of
[            ], 2012, by and among Silvercrest Asset Management Group Inc., a Delaware corporation (the “Company”), Silvercrest L.P., a Delaware limited partnership (the
“Partnership”), and the Class B Partners signatory hereto or to the Additional Party Signature Page in the form attached hereto as Annex A. 
 WITNESSETH 
 WHEREAS, the Class B Partners beneficially own all of
the outstanding Class B Units of the Partnership and all of the outstanding Class B Shares of the Company; 
 WHEREAS, the
Company is the general partner of the Partnership and owns all of the Class A Units of the Partnership; 
 WHEREAS, the
Company and the Class B Partners are parties to the Second Amended and Restated Limited Partnership Agreement of the Partnership, dated as of [            ], 2012, as amended from time to
time (the “Silvercrest LPA”); and 
 WHEREAS, the parties hereto desire to agree to the exchange of Class B
Units for Class A Shares by the Class B Partners at such time and upon the terms and subject to the conditions set forth in this Agreement; 
 NOW, THEREFORE, in consideration of the premises and of the mutual agreements, covenants and provisions herein contained and for good and valuable consideration, the receipt and sufficiency of which is
hereby acknowledged, the parties hereto agree as follows: 
 ARTICLE I 

DEFINITIONS 
 1.1 Certain Definitions. As used in this Agreement, the following terms shall have the following meanings: 
 “Act” shall have the meaning set forth in the Silvercrest LPA. 

“Affiliate” means, (i) as to any Person who is an individual, the Immediate Family of such Person and trusts,
limited partnerships or other entities for the exclusive benefit of such Person or such Immediate Family and any entity (other than the Company or its Affiliates) that, directly or indirectly, through one or more intermediaries is controlled by or
is under common control with such Person, the Immediate Family of such Person, or trusts, limited partnerships or other entities for the exclusive benefit of such Person or such Immediate Family, and (ii) as to any Person which is not an
individual, any other Person that, directly or indirectly, through one or more intermediaries, controls, is controlled by or is under common control with such Person. For the avoidance of doubt, the Company’s Affiliates shall include its
Control Affiliates. As used in this definition, the term “control” means the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a Person, whether through ownership of
voting securities, by contract or otherwise. 

 “Agreement” has the meaning set forth in the preamble. 

“Board” shall mean the board of directors of the Company. 

“Cause” shall have the meaning set forth in the Silvercrest LPA. 

“Class A Shares” shall mean shares of Class A common stock, par value $.01 per share, of the Company. 

“Class A Units” shall have the meaning set forth in the Silvercrest LPA. 

“Class B Partner” shall mean an employee of the Company or any of its Affiliates who holds Class B Units. 

“Class B Shares” shall mean shares of Class B common stock, par value $.01 per share, of the Company. 

“Class B Units” shall have the meaning set forth in the Silvercrest LPA. 

“Closing” has the meaning set forth in Section 2.5. 

“Closing Date” has the meaning set forth in Section 2.5. 

“Company” has the meaning set forth in the preamble. 

“Control Affiliate” means any Person for which the Partnership serves as general partner, investment manager or in a
similar capacity. 
 “Disability” shall have the meaning set forth in the Silvercrest LPA. 

“Exchange” shall mean the exchange by a Class B Partner of one or more Class B Units for an equal number of Class A
Shares pursuant to the provisions of this Agreement. 
 “Exchange Date” has the meaning set forth in
Section 2.1(a). 
 “Exchange Request” has the meaning set forth in Section 2.3. 

“Executive Committee” shall mean the Executive Committee of the Partnership established pursuant to the Silvercrest LPA.

 “Immediate Family” has the meaning assigned to it in the Silvercrest LPA. 

“IPO Date” shall mean the date of the closing of the initial public offering of the Class A Shares. 

“Lien” shall mean a mortgage, pledge, hypothecation, right of others, claim, security interest, encumbrance, easement,
right of way, restriction on the use of real property, title defect, title retention agreement, voting trust agreement, option, right of first refusal, lien, charge, license to third-parties, lease to third parties, restriction on transfer or
assignment, or other restriction or limitation of any nature or irregularity in title. 

  
 2 

 “Member Tax Obligation” has the meaning set forth in Section 2.2(c).

 “Open Window Period” shall mean the open window period for trading of Class A Shares by employees of
the Partnership and its Subsidiaries that occurs once each fiscal quarter of the Company pursuant to the Insider Trading Policy established by the Board, as may be amended from time to time in its sole discretion. 

“Partner Group” has the meaning set forth in Section 2.2(a). 

“Partnership” has the meaning set forth in the preamble. 

“Permitted Charitable Institution” means an organization formed for the purpose of producing goods and services whose
status does not permit them to be a source of income, profit or other financial gain for the units that establish, control or finance them and exempted from certain taxation pursuant to Section 501(c)(3) of the U.S. Internal Revenue Code.

 “Person” means and includes an individual and any legal entity including a corporation, partnership,
association, limited liability company, joint stock company, trust or estate. 
 “Registration Rights
Agreement” shall mean the Resale and Registration Rights Agreement, dated as of the date hereof, by and among the Company and the Class B Partners named on the signature pages thereto. 

“Retirement” shall have the meaning set forth in the Silvercrest LPA. 

“Silvercrest LPA” has the meaning set forth in the recitals. 

“Specified Permitted Transferee” shall have the meaning set forth in the Silvercrest LPA. 

“Subsidiary” means, when used with reference to an entity, any corporation or other entity, a majority of the
outstanding voting securities of which are owned directly or indirectly by such entity, and when used without reference to an entity, shall mean a Subsidiary with reference to the Partnership. 

“Unit(s)” shall mean the Class A Units and the Class B Units (whether or not vested). 

ARTICLE II 
 EXCHANGE 
 2.1 Exchange Dates. Each Class B Partner shall be
permitted to Exchange its Class B Units at any time during the first ten (10) days of an Open Window Period unless the Executive Committee elects to extend the period during which Exchanges may be made, in its sole discretion (each day within
such ten (10) day period, as extended, is referred to herein as an “Exchange Date”). The Company shall ensure that an Open Window Period occurs once each 

  
 3 

 
fiscal quarter of the Company; provided that the Company may close any Open Window Period and restrict trading in any such period as required by the Company’s Insider Trading Policy
and applicable securities laws. For the avoidance of doubt, the Company may establish as many Exchange Dates as it shall determine in its sole discretion. 
 2.2 Permissible Exchanges by Class B Partners. 
 (a) General
Rule. Subject to Sections 2.2(b) through (e) and 2.6, during any twelve (12) month period commencing on or following the six-month anniversary of the IPO Date and until the date of termination of employment of a Class B Partner, each
Class B Partner (along with his or her Specified Permitted Transferees) (collectively, the “Partner Group”) shall be permitted collectively to Exchange, or to transfer or gift Class B Units held by the Partner Group to a Permitted
Charitable Institution, a number of vested Class B Units in an amount not to exceed twenty percent (20%) of the aggregate number of vested and unvested Class B Units held by such Partner Group as of the first day of such 12-month period in
which the applicable Exchange (or transfer or gift) occurs; provided that, at all times following the IPO Date until termination of employment, (i) each Class B Partner who was a Class B Partner on the IPO Date must retain at least
twenty-five percent (25%) of the number of Class B Units held by such Class B Partner on the IPO Date (as adjusted for any stock splits, reverse stock splits, share combinations, dividends and reclassifications occurring after the IPO Date) and
(ii) each Class B Partner who became a Class B Partner at any time after the IPO Date must retain at least twenty-five percent (25%) of the number of Class B Units held by such Class B Partner on the date of admission of such Class B
Partner to the Partnership (as adjusted for any stock splits, reverse stock splits, share combinations, dividends and reclassifications occurring after the date of his or her admission to the Partnership). Notwithstanding the foregoing, Class B
Partners whose employment is terminated due to Retirement may Exchange any number of Class B Units for Class A Shares at any time. 
 (b) Post-IPO Date Class B Partners. Notwithstanding Section 2.2(a), but subject to Sections 2.2(c) through (e) and 2.6, any Person who becomes an employee of the Company or
any of its Affiliates after the IPO Date may not exchange any Class B Units during his or her first year of employment. 
 (c)
Exceptions. Notwithstanding Section 2.2(a) and (b), (i) following the six-month anniversary of the IPO Date, the Board may permit any Class B Partner or his or her Specified Permitted Transferees to exchange vested Class B Units in
an amount exceeding that described in Section 2.2(a), which permission may be withheld, delayed, or granted on such terms and conditions as the Board may determine in its sole discretion, and (ii) in the event that the aggregate amount of
income taxes payable by a member of a Partner Group and attributable to any of (A) the grant or vesting of Class B Units, (B) the exercise of options to acquire Class B Units and/or (C) the Exchange of Class B Units for Class A
Shares upon termination of employment (whether or not such partner is or was an employee of the Company or any of its Affiliates at the time that such income tax first became due and payable) (the “Member Tax Obligation”) exceeds
the net proceeds such partner would receive upon the sale of all of the Class A Shares issued to such Class B Partner in exchange for vested Class B Units pursuant to Section 2.2(a) as of the first day of the relevant twelve month period
during which the Member Tax Obligation first becomes due and payable, such partner shall instead, in the case of a 

  
 4 

 
condition described in subsection (ii)(A) and (ii)(B) above, be entitled to Exchange a number of vested Class B Units and resell an equal number of Class A Shares issued in exchange for such
Class B Units, and in the case of a condition described in subsection (ii)(C) above, sell sufficient Class A Shares issued in exchange for exchanged Class B Units, such that, in each case, the net proceeds from the sale of such Class A
Shares would enable such member to satisfy the Member Tax Obligations. For the avoidance of doubt, the Member Tax Obligation shall be mutually agreed to by the relevant Class B Partner and the Executive Committee and calculated by taking into
account the marginal federal, state and applicable local income tax rate applicable to the relevant member of the Partner Group, the deductibility of state and local income taxes for federal income tax purposes, the availability of offsetting losses
or tax credits, and such other relevant factors as are mutually agreed to by such partner and the Executive Committee, acting in good faith. 
 (d) Restrictions on Class A Shares. Each Class B Partner hereby acknowledges and agrees that (i) the Company shall not have any obligation to deliver Class A Shares that have been
registered under the Securities Act, and (ii) the Company reserves the right on any Exchange Date to provide registered Class A Shares, unregistered Class A Shares or any combination thereof, as it may determine in its sole
discretion. The Company reserves the right to cause certificates evidencing such Class A Shares to be imprinted with legends as to restrictions on transfer that it may deem necessary or appropriate, including legends as to applicable U.S.
federal or state securities laws or other legal or contractual restrictions and may require any Class B Partner to which Class A Shares are to be issued to agree in writing (A) that such Class A Shares will not be transferred except
in compliance with such restrictions and (B) to such other matters as the Company may deem reasonably necessary or appropriate in light of applicable law and existing agreements. 

(e) Vested Class B Units. For the avoidance of doubt, a Class B Partner may not Exchange any vested Class B Units for six
(6) months following the IPO Date. 
 (f) Unvested Class B Units. For the avoidance of doubt, a Class B Partner may
not Exchange any unvested Class B Units at any time. 
 2.3 Exchange Request. A Class B Partner may submit a
request to effect an Exchange by delivering to the Company, not less than fourteen (14) calendar days prior to an Exchange Date (or such lesser number of days as the Company may permit in its sole discretion), a written notice (the
“Exchange Request”). An Exchange Request shall set forth the number of Class B Units such Class B Partner’s Partner Group elects to Exchange for Class A Shares and the proposed Exchange Date. The Class B Partner shall
represent to the Company that such Class B Partner’s Partner Group owns the Class B Units to be delivered at such Closing pursuant to Section 2.7, free and clear of all Liens, except as set forth therein, and, if there are any Liens
identified in the Exchange Request, such Class B Partner shall covenant that such Class B Partner’s Partner Group will deliver at the applicable Closing evidence reasonably satisfactory to the Company that all such Liens have been released. An
Exchange Request is not revocable or modifiable, except with the written consent of the Company. 
 2.4
Suspensions. Notwithstanding anything to the contrary contained in this Agreement, the Company shall be entitled, at all times, in its sole discretion and without a limitation, to block any Exchange by a Partner Group or shorten the
Open Window Period if it becomes aware of any nonpublic information that has not been disclosed to the public. 

  
 5 

 2.5 Closing Date. 

(a) If an Exchange Request has been timely delivered pursuant to Section 2.3, then, on the Exchange Date set forth in the Exchange
Request (as may be extended pursuant to this Section 2.5, the “Closing Date”), the parties shall effect the closing (the “Closing”) of the transactions contemplated by this Article II at the offices of the
Company at 1330 Avenue of the Americas, 38th Floor, New York, New York 10019, or at such other time, at such other place, and in such other manner, as the applicable parties to such Exchange shall agree in writing; provided, however,
that, except as may be determined otherwise by the Company in its sole discretion, if an applicable Exchange Date falls on a day during which directors, officers or other employees of the Company or any of its Affiliates are prohibited by the
trading policies of the Company from disposing of equity securities of the Company, then with respect to all requested Exchanges, the Closing Date shall instead be deemed to be the first business day after such Exchange Date that such officers and
directors are allowed to dispose of equity securities of the Company pursuant to the trading policies of the Company. 
 2.6
Closing Conditions. 
 (a) The obligations of any of the parties to consummate an Exchange pursuant to this
Article II shall be subject to the conditions that there shall be no injunction, restraining order or decree of any nature of any governmental or regulatory authority that is then in effect that restrains or prohibits the Exchange of Class B Units
or the transfer of Class B Shares for redemption. 
 (b) The obligations of the Company to consummate an Exchange pursuant to
this Article II shall be subject to the following conditions: 
 (1) The Class B Partner shall have taken all actions
reasonably requested by the Company to permit the automatic redemption, immediately following the Closing, of a number of Class B Shares equal to the number of Class B Units being Exchanged by such Class B Partner’s Partner Group at such
Closing (including delivery to the Company of certificates evidencing such number of Class B Shares and confirmation that any Liens on such Class B Shares shall have been released); and 

(2) If such Class B Partner is not a party to the Registration Rights Agreement, such Class B Partner shall have executed and delivered
a counterpart signature page of the Registration Rights Agreement and all other documents reasonably requested by the Company in connection therewith. 
 (c) The obligations of each Person in the Class B Partner’s Partner Group exchanging Class B Units at such Closing shall be subject to the following conditions: 

(1) The Company shall have taken all actions reasonably required to permit the automatic redemption, immediately following the Closing,
of a number of Class B Shares held by such Class B Partner’s Partner Group equal to the number of Class B Units being Exchanged by such Class B Partner’s Partner Group at such Closing; and 

  
 6 

 (2) If such Class B Partner is not a party to the Registration Rights Agreement, the
Company shall have executed and delivered a copy of the Registration Rights Agreement. 
 2.7 Closing Deliveries.
At each Closing, the Company and each Class B Partner that has submitted an Exchange Request in respect of such Closing shall deliver the following: 
 (a) each such Person in such Class B Partner’s Partner Group Exchanging Class B Unit shall deliver an instrument of transfer, substantially in the form of Annex A hereto or otherwise in form
reasonably satisfactory to the Company, sufficient (i) to transfer to the Company the number of vested Class B Units set forth in the Exchange Request of such Class B Partner’s Partner Group and (ii) to affirm that such Class B
Partner agrees to comply with the covenants contained in Section 3.1 of the Registration Rights Agreement and Section 8.5 of the Silvercrest LPA as may be applicable to such Class B Partner at that time; 

(b) if applicable, each such Person in such Class B Partner’s Partner Group shall deliver evidence reasonably satisfactory to the
Company, that all Liens on such Class B Partner’s Partner Group’s Class B Units delivered pursuant to this Section 2.7 have been released; 
 (c) the Company shall deliver to the Partnership a certificate issued in the name of each such Class B Partner representing a number of Class A Shares equal to the number of Class B Units such Class
B Partner elected to Exchange; and 
 (d) the Partnership shall deliver to each such Class B Partner a certificate representing
a number of Class A Shares equal to the number of such Class B Units such Class B Partner elected to Exchange. 
 2.8
Expenses. Each party hereto shall bear such party’s own expenses in connection with the consummation of any of the transactions contemplated hereby, whether or not any such transaction is ultimately consummated. 

ARTICLE III 
 MISCELLANEOUS 
 3.1 Termination of Partner Group Membership;
Cancellation of Class B Units; Issuance of Class A Units. Upon consummation of each Closing contemplated by Article II, each Class B Unit transferred to the Company at such Closing shall be cancelled, the Partnership shall issue one
Class A Unit to the Company in respect of each such Class B Unit that was transferred and surrendered and the Executive Committee shall modify the books and records of the Partnership to reflect such cancellation and issuance. In the event
that, as a result of an Exchange, a Class B Partner shall cease to hold any vested or unvested Class B Units, such Class B Partner shall cease to be a Class B Partner for any purpose under the Silvercrest LPA, this Agreement and the Act. 

  
 7 

 3.2 Tax Treatment. As required by the Code and the Regulations: (i) the
parties shall report an Exchange consummated hereunder as a taxable sale of Class B Units by a Class B Partner to the Company (in conjunction with an associated cancellation of Class B Shares) and (ii) no party shall take a contrary position on
any income tax return, amendment thereof or communication with a taxing authority. 
 3.3 Notices. All notices,
requests, consents and other communications hereunder to any party shall be deemed to be sufficient if contained in a written instrument delivered in person or sent by facsimile (provided a copy is thereafter promptly delivered as provided in this
Section 3.3) or nationally recognized overnight courier, addressed to such party at the address or facsimile number set forth below or such other address or facsimile number as may hereafter be designated in writing by such party to the other
parties: 
 (a) if to the Company, to: 
 Silvercrest Asset Management Group Inc. 
 1330 Avenue of the Americas 

38th Floor 
 New York, NY 10019 
 (T) (212) 649-0600 

(F) (212) 649-0606 
 Attention: General Counsel 
 with a copy to: 

Bingham McCutchen LLP 
 399 Park Avenue 
 New York, New York 10022 

(T) (212) 705-7000 
 (F) (212) 752-5378 
 Attention: Floyd I. Wittlin, Esq. 

(b) if to any of the Class B Partners, to: 
 the address and facsimile number set forth in the records of the Company. 
 (c)
All such notices, requests, demands, waivers and other communications shall be deemed to have been given and received (i) if by personal delivery or telecopy, on the day of such delivery, (ii) if by first-class, registered or certified
mail, on the fifth Business Day after the mailing thereof or (iii) if by reputable overnight delivery service, on the day delivered. 
 3.4 Term of the Agreement. 
 (a) This Agreement shall become
effective on the date hereof and shall terminate on the earlier of (i) the first date on which there are no Class B Units remaining, (ii) the date on which the Executive Committee and all Class B Partners agree to terminate this Agreement,
or (iii) the dissolution of the Partnership. Unless this Agreement is theretofore terminated pursuant to this Section 3.4(a), all Class B Partners shall be bound by its terms. 

  
 8 

 (b) A Class B Partner shall cease to be a party to this Agreement upon the Transfer of all
the Class B Units held by such Class B Partner to another Person in accordance with the terms of this Agreement. 
 3.5
Amendments; Waivers. 
 (a) This Agreement may be amended or modified, and any provision in this Agreement may be
waived, with the consent of the Company, the Partnership and the Class B Partners that hold, in aggregate, sixty percent (60%) of the outstanding Class B Units, and who are then bound by the terms of this Agreement (other than an amendment
that, in the good faith judgment of the Executive Committee, is intended to cure any ambiguity or correct or supplement any provisions of this Agreement that may be incomplete or inconsistent with any other provision contained herein, which
amendment may be made by the Company); provided, that, without the consent of any Person, a Person who becomes a Class B Partner after the date hereof shall execute and deliver an Additional Party Signature Page to this Agreement in the form
attached hereto as Annex A to become a party to this Agreement. 
 (b) The failure of any party at any time or times to require
performance of any provision of this Agreement shall in no manner affect the rights at a later time to enforce the same. No waiver by any party of the breach of any term contained in this Agreement, whether by conduct or otherwise, in any one or
more instances, shall be deemed to be or construed as a further or continuing waiver of any such breach or the breach of any other term of this Agreement. 
 3.6 Adjustment Upon Changes in Capitalization. In the event of any change in the outstanding Class B Units of the Partnership or Class A Shares of the Company by reason of stock
dividends, split-ups, recapitalizations, combinations, exchanges of shares and the like, the terms “Class B Units” and “Class A Shares” shall refer to and include the securities received or resulting therefrom and the terms and
provisions of this Agreement shall be appropriately adjusted so that each Class B Partner will thereafter continue to have and be subject to, to the greatest extent practicable, the same rights and obligations he, she or it had been subject to prior
to such change. 
 3.7 Severability. If the final determination of a court of competent jurisdiction declares,
after the expiration of the time within which judicial review (if permitted) of such determination may be perfected, that any term or provision hereof is invalid or unenforceable, (a) the remaining terms and provisions hereof shall be
unimpaired and (b) the invalid or unenforceable term or provision shall be deemed replaced by a term or provision that is valid and enforceable and that comes closest to expressing the intention of the invalid or unenforceable term or
provision. 
 3.8 Representatives, Successors and Assigns. This Agreement shall be binding upon and inure to the
benefit of the respective parties hereto and their respective legatees, legal representatives, successors and assigns. 
 3.9
Governing Law. THIS AGREEMENT SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF 

  
 9 

 
DELAWARE (WITHOUT GIVING EFFECT TO CONFLICT OF LAWS PRINCIPLES THEREOF). The parties hereto agree that irreparable damage would occur in the event that any of the provisions of this
Agreement were not performed in accordance with its specific terms or was otherwise breached. It is accordingly agreed that the parties hereto shall be entitled to an injunction or injunctions and other equitable remedies to prevent breaches of this
Agreement and to enforce specifically the terms and provisions hereof in the United States District Court for the Southern District of New York and the courts of the state of New York sitting in the County of New York (and any court to which an
appeal therefrom may be taken), this being in addition to any other remedy to which they are entitled at law or in equity. Any requirements for the securing or posting of any bond with respect to such remedy are hereby waived by each of the parties
hereto. Each party further agrees that, in the event of any action for an injunction or other equitable remedy in respect of such breach or enforcement of specific performance, it will not assert the defense that a remedy at law would be adequate.

 3.10 Submission to Jurisdiction; Waiver of Immunity. Each Class B Partner, for itself and its successors and
assigns, hereby irrevocably waives (a) any objection, and agrees not to assert, as a defense in any legal or equitable action, suit or proceeding against such Class B Partner arising out of or relating to this Agreement or any transaction
contemplated hereby or the subject matter of any of the foregoing, that (i) it is not subject thereto or that such action, suit or proceeding may not be brought or is not maintainable before such arbitral body or in said courts, (ii) the
venue thereof may not be appropriate and (iii) the internal laws of the State of Delaware do not govern the validity, interpretation or effect of this Agreement, (b) any immunity from jurisdiction to which it might otherwise be entitled in
any such arbitration, action, suit or proceeding which may be instituted for specific performance before any state or federal court in the State of Delaware or the State of New York and (c) any immunity from the maintaining of an action against
it to enforce any judgment for money obtained in any such arbitration, action, suit or proceeding and, to the extent permitted by applicable law, any immunity from execution. 
 3.11 Waiver of Jury Trial. EACH PARTY TO THIS AGREEMENT ACKNOWLEDGES AND AGREES THAT ANY CONTROVERSY WHICH MAY ARISE UNDER THIS AGREEMENT IS LIKELY TO INVOLVE COMPLICATED AND DIFFICULT
ISSUES, AND THEREFORE, IT HEREBY IRREVOCABLY AND UNCONDITIONALLY WAIVES ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN RESPECT OF ANY LITIGATION DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATING TO THIS AGREEMENT AND ANY OF THE AGREEMENTS DELIVERED IN
CONNECTION WITH THIS AGREEMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY OR THEREBY. 
 3.12 Further Assurances.
Each party shall execute, deliver, acknowledge and file such other documents and take such further actions as may be reasonably requested from time to time by the other party hereto to give effect to and carry out the transactions contemplated
herein. 
 3.13 Counterparts. This Agreement may be executed in any number of counterparts, including electronic
counterparts, each of which shall be deemed an original, but all such counterparts shall together constitute but one and the same instrument, it being understood that both parties need not sign the same counterpart. 

  
 10 

 3.14 Entire Agreement. This Agreement, including Annex A hereto, contains the
entire understanding of the parties with respect to the subject matter hereof, and supersedes all prior agreements and understandings, both written and oral, among the parties with respect to the subject matter hereof. 

3.15 Construction. This Agreement shall be decided by a court of law and shall not be construed in favor of the drafters of
this Agreement. 
 3.16 Interpretation. The headings contained in this Agreement are for reference purposes only
and shall not affect in any way the meaning or interpretation of this Agreement. Whenever the words “included”, “includes” or “including” are used in this Agreement, they shall be deemed to be followed by the words
“without limitation.” 
 3.17 Assignment. Neither this Agreement nor any of the rights or obligations
hereunder shall be assigned by any of the parties hereto without the prior written consent of the other parties. 

  
 11 

 IN WITNESS WHEREOF, the parties have caused this Exchange Agreement to be duly executed and
delivered, all as of the date first set forth above. 
  

			
	SILVERCREST ASSET MANAGEMENT GROUP INC.
		
	By:	 	  

		 	Name:
		 	Title:
	
	SILVERCREST L.P.
		
	By:	 	  

		 	Name:
		 	Title:
	
	CLASS B PARTNERS
	
	  

	
	  

	
	  

	
	  

	
	  

	
	  

  
 12 

 ANNEX A 
 INSTRUMENT OF TRANSFER 
 This INSTRUMENT OF TRANSFER (this
“Instrument”) is made as of the Applicable Date by the undersigned (the “Transferor”). Capitalized terms used but not otherwise defined herein shall have the meanings set forth on the signature page to this
Instrument and, if not defined therein, in the Second Amended and Restated Limited Partnership Agreement (as amended or modified, the “Silvercrest LPA”) of Silvercrest L.P., a Delaware limited partnership (the
“Partnership”) between Silvercrest Asset Management Group Inc., a Delaware corporation (the “Company”), the Partnership and the Transferors. 
 W I T N E S S E T H 
 WHEREAS, Transferor is the owner of the Applicable Number of vested Class B Units (the “Transferred Units”) and a party to the Silvercrest LPA; 

WHEREAS, Transferor has submitted to the Company an Exchange Request, dated as of the Exchange Request Date, electing to exchange (the
“Exchange”) the Transferred Units for an equal number of Class A Shares of the Company (the “Exchange Shares”); and 
 WHEREAS, in connection with the Exchange, Transferor desires to transfer to the Company all of Transferor’s right, title and interest in, to and under the Transferred Units. 

NOW, THEREFORE, in consideration of the promises and mutual covenants set forth herein and in the Silvercrest LPA and for other good and
valuable consideration, the receipt and adequacy of which is hereby acknowledged, Transferor hereby agrees as follows: 
 1.
Transfer. Transferor hereby transfers, assigns and delivers to the Company, free and clear of all Liens, all of Transferor’s right, title and interest in, to and under the Transferred Units. 

2. Representations and Warranties. Transferor hereby represents and warrants to the Company as follows: 

(a) Transferred Units. Immediately prior to giving effect to the transfer contemplated by this Instrument, Transferor owns,
beneficially and of record, the Transferred Units free and clear of any Liens. 
 (b) Authority of Transferor. If
Transferor is not a natural person, Transferor is duly formed or organized, validly existing and in good standing under the laws of the jurisdiction in which Transferor was formed or organized. Transferor has full right, authority, power and legal
capacity to enter into this Instrument and each agreement, document and instrument to be executed and delivered by Transferor pursuant to, or as contemplated by, this Instrument and to carry out the transactions contemplated hereby and thereby. This
Instrument and each agreement, document and instrument executed and delivered by Transferor pursuant to, or as contemplated by, this Instrument constitutes, or when executed and delivered will

  
 A1 

 
constitute, the legal, valid and binding obligations of Transferor enforceable in accordance with their respective terms. The execution, delivery and performance by Transferor of this Instrument
and each such other agreement, document and instrument: 
  

	 	(i)	does not and will not violate any laws applicable to Transferor, or require Transferor to obtain any approval, consent or waiver of, or make any filing with, any person
or entity (governmental or otherwise) that has not been obtained or made; 

  

	 	(ii)	does not and will not result in a breach of, constitute a default under, accelerate any obligation under, or give rise to a right of termination of, any agreement,
contract, instrument, lien, security interest, lease, permit, authorization, order, writ, judgment, injunction, decree, determination or arbitration award to which Transferor is a party or by which the property of Transferor is bound or affected, or
result in the creation or imposition of any Lien on any of the assets of Transferor; and 

  

	 	(iii)	in the event that Transferor is not a natural person, does not and will not violate any provision of any organization document of Transferor. 

(c) Accredited Investor. Transferor has either (1) completed and delivered to the Company a questionnaire in the form of
Schedule 1 attached hereto in respect of Transferor’s qualification as an “accredited investor,” as such term is defined in Rule 501 of Regulation D promulgated under the Securities Act, and the representations and warranties
made by Transferor to the Company in such questionnaire are true, complete and accurate or (2) provided to the Company such representations, warranties and undertakings as the Company shall reasonably require to ensure that the Exchange does
not violate the Securities Act and/or other applicable securities laws. 
 (d) Investment Purpose. The Exchange Shares to
be acquired by Transferor upon the consummation of the Exchange are being acquired by Transferor for investment for Transferor’s own account, not as a nominee or agent, and not with a view towards the public sale or distribution thereof, except
pursuant to a sale or sales that are registered under the Securities Act or exempt from such registration. Transferor (other than a natural person) either (1) was not formed for the purpose of investing in the Company or (2) has provided
to the Partnership and the Company such representations, warranties and undertakings as the Partnership and the Company shall reasonably require to ensure that the Exchange does not violate the Securities Act and/or other applicable securities laws.
Transferor acknowledges that holders of the Exchange Shares must bear the economic risk of an investment in the Exchange Shares so acquired for an indefinite period of time because, among other reasons, such Exchange Shares have not been registered
under the Securities Act and, therefore, such Exchange Shares cannot be sold unless subsequently registered under the Securities Act or an exemption from such registration is available. Transferor also acknowledges that transfers of the Exchange
Shares so acquired are further restricted by applicable United States federal and state and foreign securities laws. 

  
 A2 

 (e) Access to Information. Transferor understands the risks of, and other
considerations relating to, the acquisition and ownership of the Exchange Shares. Transferor has been provided an opportunity to ask questions of, and has received answers satisfactory to Transferor from, the Company and its representatives
regarding the Exchange Shares, and has obtained any and all additional information from the Company and its representatives that Transferor deems necessary regarding the Exchange Shares. 

(f) Evaluation of and Ability to Bear Risks. Transferor has such knowledge and experience in financial affairs that Transferor is
capable of evaluating the merits and risks of, and other considerations relating to, the ownership of the Exchange Shares, and has not relied in connection with the acquisition of the Exchange Shares upon any representations, warranties or
agreements other than those set forth in this Instrument. Transferor’s financial situation is such that Transferor can afford to bear the economic risk of holding the Exchange Shares for an indefinite period of time, and Transferor can afford
to suffer the complete loss of its investment in the Exchange Shares. 
 (g) Registration Rights Agreement. Transferor
has executed and delivered to the Company a countersigned signature page to the Registration Rights Agreement and understands that the Exchange Shares will be subject to the provisions of the Registration Rights Agreement, which provides certain
restrictions on the transferability of such Exchange Shares. 
 3. Transferor Acknowledgement. Transferor hereby
acknowledges that he or she is receiving a significant economic benefit by Exchanging the otherwise illiquid Transferred Units into the Exchange Shares and therefore reaffirms his or her obligation to comply with the restrictive covenants contained
in the Silvercrest LPA and the Resale and Registration Rights Agreement each dated as of the date hereof as may be applicable to such Transferor on and following the date hereof. 

4. Further Assurance. Transferor hereby agrees to execute and deliver such further agreements and instruments and take such other
actions as may be necessary to make effective the transfer contemplated by this Instrument. 
 5. Successors and Assigns.
This Instrument shall be binding upon, inure to the benefit of and be enforceable by the respective successors and permitted assigns of the parties hereto. 
 6. Governing Law. This Instrument shall be governed by and construed and enforced in accordance with the law of the State of Delaware, without regard to principles of conflict of laws. 

7. Descriptive Headings. The descriptive headings in this Instrument are for convenience of reference only and shall not be deemed
to alter or affect the meaning or interpretation of any provision of this Instrument. 
 8. Counterparts. This Instrument
may be executed in one or more counterparts, each of which shall be deemed an original and all of which taken together shall constitute one and the same instrument. 

  
 A3 

 9. Entire Agreement. This Instrument and any other schedules, certificates, lists and
documents referred to herein, and any documents executed by any of the parties simultaneously herewith or pursuant thereto, constitutes the entire agreement of the parties hereto, except as expressly provided herein, and supersedes all prior
agreements and understandings, discussions, negotiations and communications, written and oral, among the parties with respect to the subject matter hereof. 
 [Remainder of page intentionally left blank] 

  
 A4 

 IN WITNESS WHEREOF, intending to be legally bound hereby, Transferor has executed
this Instrument as of the Applicable Date. 
  

	
	TRANSFEROR:
	
	  

	Name:

  

	
	Acknowledged and accepted
	as of the Applicable Date by:
	
	SILVERCREST ASSET MANAGEMENT GROUP INC.
	
	  

	Name:
	Title:

 Certain Defined Terms 

 

							
		 	Applicable Date:	 	  
	 	
				
		 	Transferor:	 	  
	 	
				
		 	Applicable Number:	 	  
	 	
				
		 	Exchange Request Date:    	 	  
	 	

 [Signature Page to Instrument of Transfer] 

  
 A5 

 Schedule 1 
 Transferor represents and warrants to the Company that Transferor is an “accredited investor” within the meaning of Regulation D promulgated under the Securities Act and has answered
“Yes” to the applicable statements below pursuant to which Transferor so qualify. 
  

			
	  
 Yes
	  	If Transferor is a natural person, Transferor’s own net worth, taken together with the net worth of Transferor’s spouse, exceeds $1,000,000. “Net worth” for this
purpose means total assets (excluding the value of the primary residence of such Transferor and any indebtedness secured by the residence, but including indebtedness secured by the residence in excess of its estimated fair market value and any
indebtedness incurred 60 days before the date the securities are offered (unless such indebtedness is used to purchase the residence)) in excess of total liabilities.
		
	  
 Yes
	  	If Transferor is a natural person, Transferor had an individual gross income in excess of $200,000 (or joint income with Transferor’s spouse in excess of $300,000) in each of
the two previous years and reasonably expects a gross individual income in excess of $200,000 (or joint income with Transferor’s spouse in excess of $300,000) this year.
		
	  
 Yes
	  	If Transferor is an entity, Transferor has total assets in excess of $5,000,000, AND was not formed for the specific purpose of acquiring the securities offered, AND is any of the
following:
		
		  	 •    a corporation,

		
		  	 •    a partnership,

		
		  	 •    a limited liability company,

		
		  	 •    a Massachusetts or similar business trust, or

		
		  	 •    an organization described in Section 501(c)(3) of the Internal Revenue Code

		
	  
 Yes
	  	If Transferor is an entity, all of Transferor’s equity owners are “accredited investors” within the meaning of Regulation D (taking into account the need to look
through certain entities under applicable law).

  
 A6

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00208-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00208-of-00352.parquet"}]]