Document:

mgm-ex1015_130.htm

Exhibit 10.15

 

FORM
(RSU Award – EQUITY ELECTION DIRECTOR)

MGM RESORTS INTERNATIONAL
RESTRICTED STOCK UNITS AGREEMENT

No. of Restricted Stock Units:                     

This Agreement (including its Exhibit, the “Agreement”) is made by and between MGM Resorts International, a Delaware corporation (the “Company”), and                                       (the “Participant”) with an effective date of                      (the “Effective Date”).

RECITALS

A. The Board of Directors of the Company (the “Board”) has adopted the Company’s 2005 Omnibus Incentive Plan, as amended (the “Plan”), which provides for the granting of Restricted Stock Units (as that term is defined in Section 1 below) to selected service providers. Capitalized terms used and not defined in this Agreement shall have the same meanings as in the Plan.

B. The Board has authorized the grant of Restricted Stock Units to the Participant pursuant to the terms of the Plan and this Agreement.

C. The Company and the Participant intend that the Plan and this Agreement constitute the entire agreement between the parties hereto with regard to the subject matter hereof and shall supersede any other agreements, representations or understandings (whether oral or written and whether express or implied, and including, without limitation, any employment agreement between the Participant and the Company or any of its affiliates (including, without limitation, any Parent or Subsidiary) whether previously entered into, currently effective or entered into in the future) which relate to the subject matter hereof.

Accordingly, in consideration of the mutual covenants contained herein, the parties agree as follows:

1. Definitions.

1.1 “Code” means the Internal Revenue Code of 1986, as amended.

1.2 “Committee” means the Compensation Committee of the Board.

1.3 “Employer” means the Company, the Subsidiaries and any Parent and affiliated companies.

1.4 “Fair Market Value” means the closing price of a share of Stock reported on the New York Stock Exchange (“NYSE”) or other applicable established stock exchange or over the counter market on the applicable date of determination, or if no closing price was reported on such date, the first trading day immediately preceding the applicable date of determination on which such a closing price was reported. In the event shares of Stock are not publicly traded at the time a determination of their value is required to be made hereunder, the determination of their Fair Market Value shall be made by the Committee in such manner as it deems appropriate.

1.5 “Parent” means a parent corporation as defined in Section 424(e) of the Code.

 

 

1.6 “Restricted Stock Unit” means an award granted to a Participant pursuant to Article 8 of the Plan, except that no shares of Stock are actually awarded or granted to the Participant on the date of grant.

1.7 “Section 409A” means Section 409A of the Code, and the regulations and guidance promulgated thereunder to the extent applicable.

1.8 “Stock” means the Company’s common stock, $.01 par value per share.

1.9 “Subsidiary” means a subsidiary corporation of the Company as defined in Section 424(f) of the Code or corporation or other entity, whether domestic or foreign, in which the Company has or obtains a proprietary interest of more than fifty percent (50%) by reason of stock ownership or otherwise.

2. Grant to Participant. The Company hereby grants to the Participant, subject to the terms and conditions of the Plan and this Agreement, an award of                      Restricted Stock Units. Except as otherwise set forth in the Plan or this Agreement, (i) each Restricted Stock Unit represents the right to receive one (1) share of Stock upon vesting of such Restricted Stock Units,  and (ii) unless and until the Restricted Stock Units have vested in accordance with the terms of this Agreement, the Participant shall not have any right to delivery of the shares of Stock underlying such Restricted Stock Units or any other consideration in respect thereof. In no event will any Stock be delivered pursuant to this Agreement after December 31, 2020. If a Participant’s cash compensation is reduced at any time between April 1, 2020 and December 31, 2020, then a number of RSUs will be automatically forfeited on date the Participant’s cash compensation is reduced based on the following formula: (i) the gross amount of Participant’s actual compensation reduction between April 1, 2020 and December 31, 2020 multiplied by the Participant’s election percentage as set forth in their Election Form, divided by (ii) the grant date value of the stock subject to the RSUs, rounded to the nearest whole share. Any adjustment so made shall be final and binding upon the Participant.

3. Terms and Conditions.

3.1 Vesting Schedule. Subject to Section 3.2, the Restricted Stock Units shall vest and be paid on December 31, 2020 (the “Vesting Date”).

3.2 Vesting at Termination. Upon the Participant ceasing to be a member of the Board for any reason prior to the Vesting Date, Participant shall be paid a pro rata portion of the Restricted Stock Units on the date they cease to be a member of a Board, calculated as the total number of RSUs granted pursuant to this Agreement multiplied by a fraction, the numerator of which is the number of days between April 1, 2020 and the date such Participant ceases to serve on the Board and the denominator of which is the total number of days through the Vesting Date.

3.3 Board or Committee Discretion. The Board or Committee, as applicable, in its discretion, may accelerate the vesting of the balance, or some lesser portion, of the Participant’s unvested Restricted Stock Units at any time, subject to the terms of the Plan and this Agreement. If so accelerated, the Restricted Stock Units will be considered as having vested as of the date specified by the Board or Committee, as applicable, or an applicable written agreement but the Board or Committee, as applicable, will have no right to accelerate any payment under this Agreement if such acceleration would cause this Agreement to fail to comply with Section 409A.

 

 

3.4 Stockholder Rights and Dividend Equivalents. 

(i)Participant will have no rights as a stockholder with respect to any shares of Stock subject to Restricted Stock Units until the Restricted Stock Units have vested and shares of Stock relating thereto have been issued and recorded on the records of the Company or its transfer agent or registrars.

(ii)Notwithstanding the foregoing, each Restricted Stock Unit shall accrue dividend equivalents with respect to dividends that would otherwise be paid on the Stock underlying such Restricted Stock Unit during the period from the date of grant to the date such Stock is delivered.  Any such dividend equivalent shall be deemed reinvested in additional full and fractional Restricted Stock Units immediately upon the related dividend’s payment date, based on the then-current Fair Market Value, and shall be subject to the same vesting, settlement and other conditions applicable to the Restricted Stock Unit on which such dividend equivalent is paid.  Any fractional shares shall be paid in cash upon the vesting of such Restricted Share Units.

3.5 Limits on Transferability. The Restricted Stock Units granted under this Agreement may be transferred solely to a trust in which the Participant or the Participant’s spouse control the management of the assets. With respect to Restricted Stock Units, if any, that have been transferred to a trust, references in this Agreement to vesting related to such Restricted Stock Units shall be deemed to include such trust. Any transfer of Restricted Stock Units shall be subject to the terms and conditions of the Plan and this Agreement and the transferee shall be subject to the same terms and conditions as if it were the Participant. No interest of the Participant under this Agreement shall be subject to attachment, execution, garnishment, sequestration, the laws of bankruptcy or any other legal or equitable process.

3.6 Adjustments. If there is any change in the Stock by reason of any stock dividend, recapitalization, reorganization, merger, consolidation, split-up, combination or exchange of shares of Stock, or any similar change affecting the Stock the Board or the Committee, as applicable, will make appropriate and proportionate adjustments (including relating to the Stock, other securities, cash or other consideration which may be acquired upon vesting of the Restricted Stock Units) that it deems necessary to the number and class of securities subject to the Restricted Stock Units and any other terms of this Agreement. Any adjustment so made shall be final and binding upon the Participant.

3.7 No Right to Continued Performance of Services. The grant of the Restricted Stock Units does not confer upon the Participant any right to continue to continue to serve on the Board, nor may it interfere in any way with the right of the Company or the Board to terminate the Participant’s services at any time. 

3.8 Compliance With Law and Regulations. The grant and vesting of Restricted Stock Units and the obligation of the Company to issue shares of Stock under this Agreement are subject to all applicable federal and state laws, rules and regulations, including those related to disclosure of financial and other information to the Participant and to approvals by any government or regulatory agency as may be required. The Company shall not be required to issue or deliver any certificates for shares of Stock prior to (A) the listing of such shares on any stock exchange on which the Stock may then be listed and (B) the completion of any registration or qualification of such shares under any federal or state law, or any rule or regulation of any government body which the Company shall, in its sole discretion, determine to be necessary or advisable.

 

 

3.9 Corporate Transaction. Upon the occurrence of a reorganization, merger, consolidation, recapitalization, or similar transaction, unless otherwise specifically prohibited under applicable laws or by the applicable rules and regulations of any governing governmental agencies or national securities exchanges, the Committee is authorized (but not obligated) to make adjustments in the terms and conditions of the Restricted Stock Units, including without limitation the following (or any combination thereof): (i) continuation or assumption of the Restricted Stock Units by the Company (if it is the surviving company or corporation) or by the surviving company or corporation or its parent; (ii) substitution by the surviving company or corporation or its parent of an award with substantially the same terms for the Restricted Stock Units; (iii) accelerated vesting with respect to the Restricted Stock Units immediately prior to the occurrence of such event and payment to the Participant within thirty (30) days thereafter; and (iv) cancellation of all or any portion of the Restricted Stock Units for fair value (in the form of cash or its equivalent (e.g., by check), other property or any combination thereof) as determined in the sole discretion of the Committee and which value may be zero (if the value of the underlying stock is zero), and payment to the Participant within thirty (30) days thereafter.

4. Investment Representation. The Participant must, within five (5) days of demand by the Company furnish the Company an agreement satisfactory to the Company in which the Participant represents that the shares of Stock acquired upon vesting are being acquired for investment. The Company will have the right, at its election, to place legends on the certificates representing the shares of Stock so being issued with respect to limitations on transferability imposed by federal and/or state laws, and the Company will have the right to issue “stop transfer” instructions to its transfer agent.

5. Participant Bound by Plan. The Participant hereby acknowledges receipt of a copy of the Plan and agrees to be bound by all the terms and provisions thereof as amended from time to time.

6. Withholding. The Company or any Parent or Subsidiary shall have the right and is hereby authorized to withhold, any applicable withholding taxes in respect of the Restricted Stock Units awarded by this Agreement, their grant, vesting or otherwise, and to take such other action as may be necessary in the opinion of the Company to satisfy all obligations for the payment of such withholding taxes, which may include, without limitation, reducing the number of shares otherwise distributable to the Participant by the number of shares of Stock whose Fair Market Value is equal to the amount of tax required to be withheld by the Company or a Parent or Subsidiary as a result of the vesting or settlement or otherwise of the Restricted Stock Units. 

7. Notices. Any notice hereunder to the Company must be addressed to: MGM Resorts International, 3600 Las Vegas Boulevard South, Las Vegas, Nevada 89109, Attention: 2005 Omnibus Incentive Plan Administrator, and any notice hereunder to the Participant must be addressed to the Participant at the Participant’s last address on the records of the Company, subject to the right of either party to designate at any time hereafter in writing some other address. Any notice shall be deemed to have been duly given on personal delivery or three (3) days after being sent in a properly sealed envelope, addressed as set forth above, and deposited (with first class postage prepaid) in the United States mail.

 

 

8. Entire Agreement. This Agreement and the Plan constitute the entire agreement between the parties hereto with regard to the subject matter hereof and shall supersede any other agreements, representations or understandings (whether oral or written and whether express or implied, and including, without limitation, any employment agreement between the Participant and the Company or any of its affiliates (including, without limitation, any Parent or Subsidiary) whether previously entered into, currently effective or entered into in the future that includes terms and conditions regarding equity awards) which relate to the subject matter hereof.

9. Waiver. No waiver of any breach or condition of this Agreement shall be deemed a waiver of any other or subsequent breach or condition whether of like or different nature.

10. Participant Undertaking. The Participant agrees to take whatever additional action and execute whatever additional documents the Company may deem necessary or advisable to carry out or effect one or more of the obligations or restrictions imposed on either the Participant or the Restricted Stock Units pursuant to this Agreement.

11. Successors and Assigns. The provisions of this Agreement shall inure to the benefit of, and be binding upon, the Company and its successors and assigns and upon the Participant, the Participant’s assigns and the legal representatives, heirs and legatees of the Participant’s estate, whether or not any such person shall have become a party to this Agreement and agreed in writing to be joined herein and be bound by the terms hereof.

12. Governing Law. The parties hereto agree that the validity, construction and interpretation of this Agreement shall be governed by the laws of the state of Nevada.

13. Arbitration. Except as otherwise provided in Exhibit A to this Agreement (which constitutes a material provision of this Agreement), disputes relating to this Agreement shall be resolved by arbitration pursuant to Exhibit A hereto.

14. Amendment. This Agreement may not be altered, modified, or amended except by written instrument signed by the parties hereto; provided that the Company may alter, modify or amend this Agreement unilaterally if such change is not materially adverse to the Participant or to cause this Agreement to comply with applicable law.

15. Severability. The provisions of this Agreement are severable and if any portion of this Agreement is declared contrary to any law, regulation or is otherwise invalid, in whole or in part, the remaining provisions of this Agreement shall nevertheless be binding and enforceable.

16. Execution. Each party agrees that an electronic, facsimile or digital signature or an online acceptance or acknowledgment will be accorded the full legal force and effect of a handwritten signature under Nevada law. 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.

17. Variation of Pronouns. All pronouns and any variations thereof contained herein shall be deemed to refer to masculine, feminine, neuter, singular or plural, as the identity of the person or persons may require.

 

 

18. Tax Treatment; Section 409A. The Participant shall be responsible for all taxes with respect to the Restricted Stock Units. Notwithstanding the forgoing or any provision of the Plan or this Agreement:

18.1 The parties agree that this Agreement shall be interpreted to comply with or be exempt from Section 409A, and all provisions of this Agreement shall be construed in a manner consistent with the requirements for avoiding taxes or penalties under Section 409A. If any provision of this Agreement or the Plan contravenes Section 409A or could cause the Participant to incur any tax, interest or penalties under Section 409A, the Committee may, in its sole discretion and without the Participant’s consent, modify such provision in order to comply with the requirements of Section 409A or to satisfy the conditions of any exception therefrom, or otherwise to avoid the imposition of the additional income tax and interest under Section 409A, while maintaining, to the maximum extent practicable, the original intent and economic benefit to the Participant, without materially increasing the cost to the Company, of the applicable provision. However, the Company makes no guarantee regarding the tax treatment of the Restricted Stock Units and none of the Company, its Parent, Subsidiaries or affiliates, nor any of their employees or representatives shall have any liability to the Participant with respect thereto.

18.2 A termination of employment shall not be deemed to have occurred for purposes of any provision of this Agreement providing for the payment of any amounts or benefits considered “nonqualified deferred compensation” under Section 409A upon or following a termination of employment unless such termination is also a “separation from service” within the meaning of Section 409A and, for purposes of any such provision of this Agreement, references to a “termination,” “termination of employment” or like terms shall mean “separation from service.” If the Participant is deemed on the date of termination to be a “specified employee” within the meaning of that term under Code Section 409A(a)(2)(B), then with regard to any payment or the provision of any benefit that is considered nonqualified deferred compensation under Section 409A payable on account of a “separation from service,” such payment or benefit shall be made or provided at the date which is the earlier of (i) the expiration of the six (6)-month period measured from the date of such “separation from service” of the Participant, and (ii) the date of the Participant’s death (the “Delay Period”). Upon the expiration of the Delay Period, all payments and benefits delayed pursuant to this Section 19.2 (whether they would have otherwise been payable in a single sum or in installments in the absence of such delay) shall be paid or reimbursed on the first business day following the expiration of the Delay Period to the Participant in a lump sum, and any remaining payments and benefits due under this Agreement shall be paid or provided in accordance with the normal payment dates specified for them herein.

18.3 For purposes of Section 409A, the Participant’s right to receive any installment payments pursuant to this Agreement shall be treated as a right to receive a series of separate and distinct payments. Whenever a payment under this Agreement specifies a payment period with reference to a number of days (e.g., “payment shall be made within thirty (30) days following the date of termination”), the actual date of payment within the specified period shall be within the sole discretion of the Company.

*          *          *

[The remainder of this page is left blank intentionally.]

 

 

 

IN WITNESS WHEREOF, the parties hereto have executed this Restricted Stock Units Agreement as of the date first written above.

 

	
MGM RESORTS INTERNATIONAL

	
 
	
 
	
 

	
By:
	
 
	
 

	
Name:
	
 
	
 

	
Title:
	
 
	
 

	
 
	
 
	
 

	
PARTICIPANT

	
 
	
 
	
 

	
By:
	
 
	
 

	
Name:
	
 
	
 

 

 

 

 

EXHIBIT A

ARBITRATION

This Exhibit A sets forth the methods for resolving disputes should any arise under the Agreement, and accordingly, this Exhibit A shall be considered a part of the Agreement.

1.Except for a claim by either Participant or the Company for injunctive relief where such would be otherwise authorized by law, any controversy or claim arising out of or relating to the Agreement or the breach hereof including without limitation any claim involving the interpretation or application of the Agreement or the Plan, shall be submitted to binding arbitration in accordance with the employment arbitration rules then in effect of the Judicial Arbitration and Mediation Service (“JAMS”), to the extent not inconsistent with this paragraph. This Exhibit A covers any claim Participant might have against any officer, director, employee, or agent of the Company, or any of the Company’s subsidiaries, divisions, and affiliates, and all successors and assigns of any of them. The promises by the Company and Participant to arbitrate differences, rather than litigate them before courts or other bodies, provide consideration for each other, in addition to other consideration provided under the Agreement.

2.Claims Subject to Arbitration. This Exhibit A contemplates mandatory arbitration to the fullest extent permitted by law. Only claims that are justiciable under applicable state or federal law are covered by this Exhibit A. Such claims include any and all alleged violations of any state or federal law whether common law, statutory, arising under regulation or ordinance, or any other law, brought by any current or former employees.

3.Non-Waiver of Substantive Rights. This Exhibit A does not waive any rights or remedies available under applicable statutes or common law. However, it does waive Participant’s right to pursue those rights and remedies in a judicial forum. By signing the Agreement and the acknowledgment at the end of this Exhibit A, the undersigned Participant voluntarily agrees to arbitrate his or her claims covered by this Exhibit A.

4.Time Limit to Pursue Arbitration; Initiation: To ensure timely resolution of disputes, Participant and the Company must initiate arbitration within the statute of limitations (deadline for filing) provided for by applicable law pertaining to the claim. The failure to initiate arbitration within this time limit will bar any such claim. The parties understand that the Company and Participant are waiving any longer statutes of limitations that would otherwise apply, and any aggrieved party is encouraged to give written notice of any claim as soon as possible after the event(s) in dispute so that arbitration of any differences may take place promptly. The parties agree that the aggrieved party must, within the time frame provided by this Exhibit A, give written notice of a claim pursuant to Section 7 of the Agreement. In the event such notice is to be provided to the Company, the Participant shall provide a copy of such notice of a claim to the Company’s Executive Vice President and General Counsel. Written notice shall identify and describe the nature of the claim, the supporting facts and the relief or remedy sought.

 

 

5.Selecting an Arbitrator: This Exhibit A mandates Arbitration under the then current rules of the Judicial Arbitration and Mediation Service (JAMS) regarding employment disputes. The arbitrator shall be either a retired judge or an attorney experienced in employment law and licensed to practice in the state in which arbitration is convened. The parties shall select one arbitrator from among a list of three qualified neutral arbitrators provided by JAMS. If the parties are unable to agree on the arbitrator, each party shall strike one name and the remaining named arbitrator shall be selected.

6.Representation/Arbitration Rights and Procedures:

a.Participant may be represented by an attorney of his/her choice at his/her own expense.

b.The arbitrator shall apply the substantive law (and the law of remedies, if applicable) of Nevada (without regard to its choice of law provisions) and/or federal law when applicable. In all cases, this Exhibit A shall provide for the broadest level of arbitration of claims between the Company and Participant under Nevada or applicable federal law. The arbitrator is without jurisdiction to apply any different substantive law or law of remedies.

c.The arbitrator shall have no authority to award non-economic damages or punitive damages except where such relief is specifically authorized by an applicable state or federal statute or common law. In such a situation, the arbitrator shall specify in the award the specific statute or other basis under which such relief is granted.

d.The applicable law with respect to privilege, including attorney-client privilege, work product, and offers to compromise must be followed.

e.The parties shall have the right to conduct reasonable discovery, including written and oral (deposition) discovery and to subpoena and/or request copies of records, documents and other relevant discoverable information consistent with the procedural rules of JAMS. The arbitrator shall decide disputes regarding the scope of discovery and shall have authority to regulate the conduct of any hearing and/or trial proceeding. The arbitrator shall have the right to entertain a motion to dismiss and/or motion for summary judgment.  

f.The parties shall exchange witness lists at least 30 days prior to the trial/hearing procedure. The arbitrator shall have subpoena power so that either Participant or the Company may summon witnesses. The arbitrator shall use the Federal Rules of Evidence. Both parties have the right to file a post hearing brief. Any party, at its own expense, may arrange for and pay the cost of a court reporter to provide a stenographic record of the proceedings.

g.Any arbitration hearing or proceeding shall take place in private, not open to the public, in Las Vegas, Nevada.

 

 

7.Arbitrator’s Award: The arbitrator shall issue a written decision containing the specific issues raised by the parties, the specific findings of fact, and the specific conclusions of law. The award shall be rendered promptly, typically within 30 days after conclusion of the arbitration hearing, or the submission of post-hearing briefs if requested. The arbitrator may not award any relief or remedy in excess of what a court could grant under applicable law. The arbitrator’s decision is final and binding on both parties. Judgment upon an award rendered by the arbitrator may be entered in any court having competent jurisdiction.

a.Either party may bring an action in any court of competent jurisdiction to compel arbitration under this Exhibit A and to enforce an arbitration award.

b.In the event of any administrative or judicial action by any agency or third party to adjudicate a claim on behalf of Participant which is subject to arbitration under this Exhibit A, Participant hereby waives the right to participate in any monetary or other recovery obtained by such agency or third party in any such action, and Participant’s sole remedy with respect to any such claim shall be any award decreed by an arbitrator pursuant to the provisions of this Exhibit A.

8.Fees and Expenses: The Company shall be responsible for paying any filing fee and the fees and costs of the arbitrator; provided, however, that if Participant is the party initiating the claim, Participant will contribute an amount equal to the filing fee to initiate a claim in the court of general jurisdiction in the state in which Participant is (or was last) employed by the Company. Participant and the Company shall each pay for their own expenses, attorney’s fees (a party’s responsibility for his/her/its own attorney’s fees is only limited by any applicable statute specifically providing that attorney’s fees may be awarded as a remedy), and costs and fees regarding witness, photocopying and other preparation expenses. If any party prevails on a statutory claim that affords the prevailing party attorney’s fees and costs, or if there is a written agreement providing for attorney’s fees and/or costs, the arbitrator may award reasonable attorney’s fees and/or costs to the prevailing party, applying the same standards a court would apply under the law applicable to the claim(s).

9.The arbitration provisions of this Exhibit A shall survive the termination of Participant’s employment with the Company and the expiration of the Agreement. These arbitration provisions can only be modified or revoked in a writing signed by both parties and which expressly states an intent to modify or revoke the provisions of this Exhibit A.

10.The arbitration provisions of this Exhibit A do not alter or affect the termination provisions of this Agreement.

11.Capitalized terms not defined in this Exhibit A shall have the same definition as in the Agreement to which this is Exhibit A.

12.If any provision of this Exhibit A is adjudged to be void or otherwise unenforceable, in whole or in part, such adjudication shall not affect the validity of the remainder of Exhibit A. All other provisions shall remain in full force and effect.

 

 

 

ACKNOWLEDGMENT

BOTH PARTIES ACKNOWLEDGE THAT: THEY HAVE CAREFULLY READ THIS EXHIBIT A IN ITS ENTIRETY, THEY UNDERSTAND ITS TERMS, EXHIBIT A CONSTITUTES A MATERIAL TERM AND CONDITION OF THE RESTRICTED STOCK UNITS AGREEMENT BETWEEN THE PARTIES TO WHICH IT IS EXHIBIT A, AND THEY AGREE TO ABIDE BY ITS TERMS.

The parties also specifically acknowledge that by agreeing to the terms of this Exhibit A, they are waiving the right to pursue claims covered by this Exhibit A in a judicial forum and instead agree to arbitrate all such claims before an arbitrator without a court or jury. It is specifically understood that this Exhibit A does not waive any rights or remedies which are available under applicable state and federal statutes or common law. Both parties enter into this Exhibit A voluntarily and not in reliance on any promises or representation by the other party other than those contained in the Agreement or in this Exhibit A.

Participant further acknowledges that Participant has been given the opportunity to discuss this Exhibit A with Participant’s private legal counsel and that Participant has availed himself/herself of that opportunity to the extent Participant wishes to do so.

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[The remainder of this page is left blank intentionally.]Exhibit
4.1

 

THIS
NOTE HAS NOT BEEN REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED, OR UNDER THE SECURITIES LAWS OF ANY STATE
OR OTHER JURISDICTION, AND MAY NOT BE SOLD, ASSIGNED, TRANSFERRED, PLEDGED OR OTHERWISE DISPOSED OF EXCEPT IN COMPLIANCE WITH,
OR PURSUANT TO AN EXEMPTION FROM, THE REQUIREMENTS OF SUCH ACT OR SUCH LAWS.

 

NEUROONE
MEDICAL TECHNOLOGIES CORPORATION

 

CONVERTIBLE
PROMISSORY NOTE

 

	Principal
    Amount: US $_______________ 	Date:
    _______________

 

NeuroOne
Medical Technologies Corporation, a Delaware
corporation (the “Company”), for value received, hereby promises to pay to ___________________
or his, her or its permitted assigns or successors (the “Holder”), the principal amount of $____________________
(the “Principal Amount”), without demand, on the Maturity Date (as hereinafter defined), together
with any accrued and unpaid interest due thereon.

 

This
Convertible Promissory Note (this “Note”) shall bear interest at a fixed rate of 13% per annum, beginning
on the Issue Date, which interest amount may be increased pursuant to Section 6.4. Interest shall be computed based on
a 360-day year of twelve 30-day months and shall be payable, along with the Principal Amount, on the Maturity Date. Except as
set forth in Section 3.1, payment of all principal and interest due shall be in such coin or currency of the United States
of America as shall be legal tender for the payment of public and private debts at the time of payment.

 

This
Note is a convertible promissory note referred to in that certain Subscription Agreement dated as of _______________ (the “Subscription
Agreement”), or series of like subscription agreements, among the Company and the subscribers named therein, pursuant
to which the Company is seeking to raise an aggregate of up to $3,000,000 (or such higher amount as the Company’s Board
of Directors shall determine). By acceptance hereof, the Holder acknowledges and agrees that this Note is one of a series of Convertible
Promissory Notes of similar tenor issued by the Company (collectively, the “Related Notes”).

 

    1

     

    

 

1.
Definitions.

 

1.1
Definitions. The terms defined in this Section 1 whenever used in this
Note shall have the respective meanings hereinafter specified.

 

“Applicable
Laws” means any and all applicable foreign, federal, state and local statutes, laws, regulations, ordinances, policies,
and rules or common law (whether now existing or hereafter enacted or promulgated), of any and all governmental authorities, agencies,
departments, commissions, boards, courts, or instrumentalities of the United States, any state of the United States, any other
nation, or any political subdivision of the United States, any state of the United States or any other nation, and all applicable
judicial and administrative, regulatory or judicial decrees, judgments and orders, including common law rules and determinations.

 

“Change
in Control” means a merger or consolidation of the Company with or into any other entity in which the stockholders
of the Company immediately prior to the merger or consolidation do not own more than 50% of the outstanding voting power (assuming
conversion of all convertible securities and the exercise of all outstanding options and warrants) of the surviving entity or
the sale, lease, licensing, transfer or other disposition of all or substantially all the assets of the Company; provided, however,
that any new issuance of capital stock of the Company to one or more third parties for the sole purpose of providing new funding
for the Company or solely in connection with a public offering of the Company’s stock shall not constitute a Change in Control.

 

“Common
Stock” means the common stock, par value $0.001 per share, of the Company.

 

“Common
Stock Equivalents” means notes, debentures or shares of preferred stock of the Company that are convertible into
Common Stock or warrants or other rights to purchase Common Stock upon exercise thereof.

 

“Conversion
Shares” means the New Round Stock issued or issuable to the Holder upon a Conversion Date pursuant to Article
3.

 

“Conversion
Date” shall have the meaning set forth in Section 3.1.

 

“Event
of Default” shall have the meaning set forth in Section 6.1.

 

“Holder”
or “Holders” means the person named above or any Person who shall thereafter become a recordholder
of this Note in accordance with the terms hereof.

 

“Issue
Date” means the issue date stated above.

 

“Maturity
Date” shall mean the earlier of (i) the date that is six months following the final closing of the Related Notes,
(ii) the date that is six months following July 31, 2020, and (iii) a Change in Control.

 

“New
Round Stock” means, in the event of a Qualified Financing, the securities (or units of equity securities if more
than one security are sold as a unit) issued by the Company in the closing on the date a Qualified Financing occurs.

 

“Person”
means an individual, corporation, partnership, limited liability company, association, trust, joint venture, unincorporated
organization or any government, governmental department or agency or political subdivision thereof.

 

    2

     

    

 

“Qualified
Financing” means the next equity round of financing of the Company of Common Stock in a transaction or series of
transactions that raises in excess of $5,000,000 gross proceeds.

 

“Securities
Act” means the United States Securities Act of 1933, as amended.

 

“Strategic
Transaction” means any transaction entered into by and between the Company and any company (or an affiliate of any
such company) that is included in the S&P 500 Health Care Index as published from time to time by S&P Dow Jones Indices
LLC that includes an investment or upfront payments resulting in gross proceeds to the Company of least $2,000,000 upon the execution
of such transaction or definitive agreement and provides for terms of collaboration, manufacturing, distribution, licensing or
supply of the Company’s products.

 

“Warrants”
means the warrants to purchase capital stock pursuant to Section 1.1 of the Subscription Agreement and Section 3.1(d)
hereof, which shall be evidenced by the warrant agreement, the form of which is attached to the Subscription Agreement as
Exhibit C.

 

2.
GENERAL PROVISIONS.

 

2.1
Loss, Theft, Destruction of Note. Upon receipt of evidence satisfactory to the
Company of the loss, theft, destruction or mutilation of this Note and, in the case of any such loss, theft or destruction, upon
receipt of indemnity or security reasonably satisfactory to the Company, or, in the case of any such mutilation, upon surrender
and cancellation of this Note, the Company will make and deliver, in lieu of such lost, stolen, destroyed or mutilated Note, a
new Note of like tenor and unpaid principal amount dated as of the date hereof. This Note shall be held and owned upon the express
condition that the provisions of this Section 2.1 are exclusive with respect to the replacement of a mutilated, destroyed,
lost or stolen Note and shall preclude any and all other rights and remedies notwithstanding any law or statute existing or hereafter
enacted to the contrary with respect to the replacement of negotiable instruments or other securities without their surrender.

 

2.2
Prepayment; Redemption. This Note may not be prepaid by the Company in whole
or in part, except with the prior written consent of the Holder. This Note may not be redeemed by the Company in whole or in part,
except with the prior written consent of the Holder.

 

3.
CONVERSION OF NOTE.

 

3.1
Conversion.

 

(a)
Optional Conversion Prior to a Qualified Financing. Subject to the applicable provisions of this Section 3.1, at
any time prior to a Qualified Financing, at the sole election of the Holder, all or a portion of the outstanding principal
and accrued and unpaid interest on this Note (the “Outstanding Balance”) may be converted into that
number of shares of the Company’s common stock, par value $0.001 per share (the “Common
Stock”) equal to: (i) the Outstanding Balance elected by the Holder to be converted (the “Conversion
Amount”) divided by (ii) an amount equal to 0.6 multiplied by the VWAP of the Common Stock for the ten (10)
Trading Days immediately preceding the Conversion Date (as defined below).

 

    3

     

    

 

(b)
Automatic Conversion upon Qualified Financing. Subject to the applicable provisions of this Section 3.1, if a Qualified
Financing occurs prior to the Maturity Date, without any action on the part of the Holder, all of the Outstanding Balance shall
convert into that number of shares of New Round Stock equal to: (i) the Outstanding Balance divided by (ii) the lower of 0.6 multiplied
by (A) the actual per share price of New Round Stock and (B) the VWAP of the Common Stock for the ten (10) Trading Days immediately
preceding the date of the Qualified Financing.

 

(c)
Automatic Conversion upon Strategic Transaction. Subject to the applicable provisions of this Section 3.1, if the Company
first publicly announces a Strategic Transaction prior to the Maturity Date, without any action on the part of the Holder, on
the first trading day following such announcement, all of the Outstanding Balance shall convert into that number of shares of
Common Stock equal to: (i) the Outstanding Balance divided by (ii) the lower of 0.6 multiplied by (A) the VWAP of the Common Stock
for the ten (10) Trading Days immediately preceding the announcement by the Company of a Strategic Transaction or (B) closing
price of the Common Stock on the day preceding the first announcement by the Company of a Strategic Transaction. For the purpose
of this Section 3.1(c), information shall be considered “publicly announced” if such information is publicly
filed with the SEC or disseminated via any other method of public disclosure reasonably designed to provide broad, non-exclusionary
distribution of the information to the public.

 

(d)
Conversion Mechanics. To convert any Conversion Amount into New Round Stock or shares of the Common Stock (in either case,
the “Conversion Shares”), the Holder shall by delivering to the Company at its principal office, or
at such other office as the Company may designate (i) the notice of conversion attached as Exhibit
A hereto (the “Notice of Conversion”), duly executed by the Holder and (ii) this Note (or
an indemnification undertaking with respect to this Note in the case of its loss, theft or destruction) (together, the “Conversion
Materials”). As soon as practicable after the date that the Company receives the Conversion Materials, or a later
date, if selected by the Holder in the Notice of Conversion (the “Conversion Date”), the Company, at
its expense, shall cause to be issued in the name of and delivered to the Holder (x) written confirmation that the Conversion
Shares have been issued in the name of the Holder, and (y) a new Note of like tenor representing the Outstanding Balance not converted
by the Holder. The person or persons entitled to receive the shares of the Common Stock issuable upon a conversion of this Note
shall be treated for all purposes as the record holder or holders of such shares of the Common Stock on the Conversion Date.

 

    4

     

    

 

(e)
Definitions. For the purposes of this Note the following defined terms shall have the following meanings: (i) “VWAP”
means, for any date, the price determined by the first of the following clauses that applies: (A) if the Common Stock
is then listed or quoted on a Trading Market (other than the OTC Bulletin Board or OTC Markets, Inc.), the daily volume weighted
average price of the Common Stock for such date (or the nearest preceding Trading Day) on the Trading Market on which the Common
Stock is then listed or quoted as reported by Bloomberg L.P. (based on a Trading Day from 9:30 a.m. (New York City time) to 4:02
p.m. (New York City time)), (B) if the Common Stock is then quoted on the OTC Bulletin Board, the volume weighted average price
of the Common Stock for such date (or the nearest preceding Trading Day) on the OTC Bulletin Board, (C) if the Common Stock is
not then listed or quoted for trading on the OTC Bulletin Board and if prices for the Common Stock are then reported on OTC Markets,
Inc. (or a similar organization or agency succeeding to its functions of reporting prices), the most recent bid price per share
of the Common Stock so reported, or (D) in all other cases, the fair market value of a share of Common Stock as determined
by an independent appraiser selected in good faith by the Holders of a majority in interest of the Warrants then outstanding and
reasonably acceptable to the Company, the fees and expenses of which shall be paid by the Company; (ii) “Trading Day”
means a day on which the principal Trading Market is open for trading; and (iii) “Trading Market”
means any of the following markets or exchanges on which the Common Stock is listed or quoted for trading on the date in question:
the NYSE MKT, the Nasdaq Capital Market, the Nasdaq Global Market, the Nasdaq Global Select Market, the New York Stock Exchange
(or any successors to any of the foregoing), the OTC Bulletin Board or OTC Markets, Inc.

 

(f)
Warrants. On the issuance date of this Note, the Holder shall receive a Warrant granting the Holder the right to purchase
up to a number of shares of Common Stock equal to (i) 0.5 multiplied by (ii) the Outstanding Balance divided by 1.87,
with an exercise price per share equal to $1.87.

 

(g)
Registration Rights. Promptly following the earlier of (i) the final closing the sale and issuance of the Related Notes, (ii)
the final closing of a Qualified Financing, (iii) the Maturity Date or (iv) the occurrence of a Strategic Transaction (the “Registration
Date”), the Company shall enter into a registration rights agreement with the Holder and the holders of outstanding
Related Notes containing customary and usual terms pursuant to which the Company shall agree to prepare and file with the Securities
and Exchange Commission a registration statement on or prior to the 90th calendar day following the Registration Date,
covering the resale of any Conversion Shares, and shares of Common Stock underlying the Warrants (the “Registration
Rights Agreement”). The Holder agrees to execute the Registration Rights Agreement as a condition to the Holder’s
right to receive the registration rights set forth in the Registration Rights Agreement.

 

    5

     

    

 

(h)
Trading Market Regulation. Notwithstanding anything to the contrary, if on the Conversion Date the Common Stock is listed
on a national securities exchange, the Holder may only convert an amount of the Outstanding Balance such that the total cumulative
number of Conversion Shares and all shares issued upon the conversion of the Related Notes and the exercise of the Warrants and
all warrants issued to holders of the Related Notes shall not exceed the requirements of Nasdaq Listing Rule 5635(d), except that
such limitation shall not apply to the extent that the Company obtains the approval of its stockholders for such issuance.

 

3.2
Delivery of Securities Upon Conversion.

 

(a)
Within ten (10) business days of the Company’s receipt of all the Conversion Agreements, the Company shall deliver or
cause to be delivered to the Holder, written confirmation that the Conversion Shares have been issued in the name of the Holder.

 

(b)
Upon conversion of this Note, the Company shall take all such actions as are necessary in order to ensure that the Conversion
Shares so issued upon such conversion shall be validly issued, fully paid and nonassessable.

 

3.3
Fractional Shares. No fractional shares or scrip representing fractional shares
shall be issued upon conversion of this Note. If any conversion of this Note would create a fractional share or a right to acquire
a fractional share, the Company shall round to the nearest whole number.

 

4.
STATUS; RESTRICTIONS ON TRANSFER.

 

4.1
Status of Note. This Note is a direct, general and unconditional obligation
of the Company, and constitutes a valid and legally binding obligation of the Company, enforceable in accordance with its terms
subject, as to enforcement, to bankruptcy, insolvency, reorganization and other similar laws of general applicability relating
to or affecting creditors’ rights and to general principles of equity. This Note does not confer upon the Holder any right
to vote or to consent or to receive notice as a stockholder of the Company, as such, in respect of any matters whatsoever, or
any other rights or liabilities as a stockholder, prior to conversion hereof into Conversion Shares.

 

4.2
Restrictions on Transferability. This Note and any Conversion Shares issued
with respect to this Note, have not been registered under the Securities Act, or under any state securities or so-called “blue
sky laws,” and may not be offered, sold, transferred, hypothecated or otherwise assigned except (a) pursuant to a registration
statement with respect to such securities which is effective under the Act or (b) upon receipt from counsel satisfactory to the
Company of an opinion, which opinion is satisfactory in form and substance to the Company, to the effect that such securities
may be offered, sold, transferred, hypothecated or otherwise assigned (i) pursuant to an available exemption from registration
under the Act and (ii) in accordance with all applicable state securities and so-called “blue sky laws.” If Holder
has entered into the Registration Rights Agreement and the Company has not filed with the Securities and Exchange Commission a
registration statement on or prior to the 90th calendar day following the Registration Date, covering the resale of any Conversion
Shares, and shares of Common Stock underlying the Warrants, then such opinion will be provided at the expense of the Company.
The Holder agrees to be bound by such restrictions on transfer. The Holder further consents that the certificates representing
the Conversion Shares that may be issued with respect to this Note may bear a restrictive legend to such effect. In addition,
this Note shall be subject to the restrictions on transfer set forth in Article III of the Subscription Agreement.

 

    6

     

    

 

5.
COVENANTS. In addition to the other covenants and agreements of the Company set forth in this Note, the Company covenants
and agrees that so long as this Note shall be outstanding:

 

5.1
Payment of Note. The Company will punctually, according to the terms hereof,
pay or cause to be paid all amounts due under this Note.

 

5.2
Notice of Default. If any one or more events occur which constitute or which,
with the giving of notice or the lapse of time or both, would constitute an Event of Default or if the Holder shall demand payment
or take any other action permitted upon the occurrence of any such Event of Default, the Company will forthwith give notice to
the Holder, specifying the nature and status of the Event of Default or other event or of such demand or action, as the case may
be.

 

5.3
Compliance with Laws. The Company will comply in all material respects with
all Applicable Laws, except where the necessity of compliance therewith is contested in good faith by appropriate proceedings.

 

5.4
Use of Proceeds. The Company shall use the proceeds of this Note for general
working capital.

 

6.
REMEDIES.

 

6.1
Events of Default. “Event of Default” wherever used herein
means any one of the following events:

 

(a)
The Company shall fail to issue and deliver the Conversion Shares in accordance with Section 3;

 

(b)
Default in the due and punctual payment of the principal of, or any other amount owing in respect of (including interest),
this Note when and as the same shall become due and payable;

 

(c)
Default in the performance or observance of any covenant or agreement of the Company in this Note (other than a covenant or
agreement a default in the performance of which is specifically provided for elsewhere in this Section 6.1), and the continuance
of such default for a period of ten (10) days after there has been given to the Company by the Holder a written notice specifying
such default and requiring it to be remedied;

 

    7

     

    

 

(d)
The entry of a decree or order by a court having jurisdiction adjudging the Company as bankrupt or insolvent; or approving
as properly filed a petition seeking reorganization, arrangement, adjustment or composition of or in respect of the Company under
the Federal Bankruptcy Code or any other applicable federal or state law, or appointing a receiver, liquidator, assignee, trustee
or sequestrator (or other similar official) of the Company or of any substantial part of its property, or ordering the winding-up
or liquidation of its affairs, and the continuance of any such decree or order unstayed and in effect for a period of 60 calendar
days;

 

(e)
The institution by the Company of proceedings to be adjudicated as bankrupt or insolvent, or the consent by it to the institution
of bankruptcy or insolvency proceedings against it, or the filing by it of a petition or answer or consent seeking reorganization
or relief under the Federal Bankruptcy Code or any other applicable federal or state law, or the consent by it to the filing of
any such petition or to the appointment of a receiver, liquidator, assignee, trustee or sequestrator (or other similar official)
of the Company or of any substantial part of its property, or the making by it of an assignment for the benefit of creditors;

 

(f)
The Company seeks the appointment of a statutory manager or proposes in writing or makes a general assignment or an arrangement
or composition with or for the benefit of its creditors or any group or class thereof or files a petition for suspension of payments
or other relief of debtors or a moratorium or statutory management is agreed or declared in respect of or affecting all or any
material part of the indebtedness of the Company; or

 

(g)
It becomes unlawful for the Company to perform or comply with its obligations under this Note.

 

6.2
Effects of Default. If an Event of Default occurs and is continuing, then and
in every such case the holders of Related Notes whose aggregate principal amount represents a majority of the outstanding principal
amount of all then-outstanding Related Notes (the “Requisite Holders”) may declare the Related Notes
to be due and payable immediately, by a notice in writing to the Company, and upon any such declaration, the Company shall pay
to the holders the outstanding principal amount of the Related Notes plus all accrued and unpaid interest through the date the
Related Notes are paid in full.

 

6.3
Remedies Not Waived; Exercise of Remedies. No course of dealing between the
Company and the Holder or any delay in exercising any rights hereunder shall operate as a waiver by the Holder. No failure or
delay by the Holder in exercising any right, power or privilege under this Note shall operate as a waiver thereof nor shall any
single or partial exercise thereof preclude any other or further exercise thereof or the exercise of any other right, power or
privilege. The rights and remedies herein provided shall be cumulative and not exclusive of any rights or remedies provided by
Applicable Law. By acceptance hereof, the Holder acknowledges and agrees that upon the occurrence and during the continuance of
any Event of Default, the Requisite Holders shall have the right to act on behalf of the holders of all Related Notes in exercising
and enforcing all rights and remedies available to all of such holders under the Related Notes, including, without limitation,
foreclosure of any judgment lien on any assets of the Company. By acceptance hereof, the Holder agrees not to independently exercise
any such right or remedy without the consent of the Requisite Holders.

 

    8

     

    

 

6.4
Default Interest Rate. Unless otherwise waived by the Requisite Holders, commencing
fifteen (15) trading days after the occurrence of any Event of Default that results in the eventual acceleration of the Notes
(as accelerated by the Requisite Holders) (the “Default Interest Start Date”), the interest rate of
the Note shall increase to the lower of (i) 20% and (ii) the maximum interest rate allowable under local usury laws (the “Default
Interest Rate”). If the Default Interest Rate is below 20%, then at the time that the Company makes a payment to
the Holder for interest accrued at the Default Interest Rate following the Default Interest Start Date (the “Default
Interest Amount”) or if any amount of the Default Interest Amount is converted into shares of Common Stock pursuant
to Section 3.1, the Company will issue to Holder an additional Warrant granting the Holder the right to purchase up to
a number of shares of Common Stock equal to (x) the difference between the Default Interest Amount and the amount of interest
that would have accrued at an interest rate of 20%, divided by (y) 1.87, with an exercise price per share equal to $1.87.

 

7. MISCELLANEOUS.

 

7.1 Severability.
If any provision of this Note shall be held to be invalid or unenforceable, in whole or in part, neither the validity
nor the enforceability of the remainder hereof shall in any way be affected.

 

7.2 Notice.
Where this Note provides for notice of any event, such notice shall be given (unless otherwise herein expressly provided)
in writing and either (a) delivered personally, (b) sent by certified, registered or express mail, postage prepaid or (c) sent
by electronic transmission, and shall be deemed given when so delivered personally, sent by electronic transmission or mailed.
Notices shall be addressed, if to Holder, to its address or e-mail address as provided in the Subscription Agreement or, if to
the Company, to its principal office.

 

7.3 Governing
Law. This Note shall be governed by, and construed in accordance with, the laws of the State of Delaware (without giving
effect to any conflicts or choice of law provisions that would cause the application of the domestic substantive laws of any other
jurisdiction).

 

7.4 Forum.
The Holder and the Company hereby agree that any dispute which may arise out of or in connection with this Note shall
be adjudicated before a court of competent jurisdiction in the State of Minnesota and they hereby submit to the exclusive jurisdiction
of the courts of the State of Minnesota, as well as to the jurisdiction of all courts to which an appeal may be taken from such
courts, with respect to any action or legal proceeding commenced by either of them and hereby irrevocably waive any objection
they now or hereafter may have respecting the venue of any such action or proceeding brought in such a court or respecting the
fact that such court is an inconvenient forum.

 

7.5 Headings.
The headings of the Articles and Sections of this Note are inserted for convenience only and do not constitute a part
of this Note.

 

7.6 Amendments.
This Note may be amended or waived only with the written consent of the Company and the Requisite Holders. Any such
amendment or waiver shall be binding on all holders of the Notes, even if they do not execute such consent, amendment or waiver.

 

    9

     

    

 

7.7 No
Recourse Against Others. The obligations of the Company under this Note are solely obligations of the Company and no
officer, employee or stockholder shall be liable for any failure by the Company to pay amounts on this Note when due or perform
any other obligation.

 

7.8 Assignment;
Binding Effect. This Note may be assigned by the Company without the prior written consent of the Holder. This Note
shall be binding upon and inure to the benefit of both parties hereto and their respective permitted successors and assigns.

 

In Witness Whereof,
the Company has caused this Note to be signed by its duly authorized officer on the date hereinabove written.

 

	 	NeuroOne 
    Medical Technologies Corporation
	 	 	 
	 	By:	 
	 	Name: 	David
    A. Rosa
	 	Title:	Chief
    Executive Officer and President

 

 

10

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