Document:

EXHIBIT 10.4

 

NeuroDerm Ltd.

 

2007 SHARE OPTION PLAN

 

1.                                      PURPOSE

 

The purpose of this Share Option Plan is to secure for NeuroDerm Ltd. and its shareholders the benefits arising from ownership of share capital by employees, officers directors and consultants of the Company and its Affiliates (as defined below), who are expected to contribute to the Company’s future growth and success.

 

2.                                      DEFINITIONS

 

2.1                               DEFINED TERMS

 

Initially capitalized terms, as used in this Plan, shall have the meaning ascribed thereto as set forth below:

 

	
“Administrator”
    	
 
    	
means the Board of Directors of the   Company, or a committee to which the Board of Directors shall have delegated   specific power to act on its behalf with respect to specific provisions of   the Plan. Subject to the Articles of Association of the Company, as may be   amended from time to time, the Administrator, if it is a committee, shall   consist of such number of members (but not less than three (3)) as may be   determined by the Board.
    
	
 
    	
 
    	
 
    
	
“Affiliate(s)”
    	
 
    	
means a present or future company that   either (i) Controls NeuroDerm Ltd, or is Controlled by NeuroDerm Ltd.;   or (ii) is Controlled by the same person or entity that Controls   NeuroDerm Ltd.
    
	
 
    	
 
    	
 
    
	
“Allocate” or “Allocated”
    	
 
    	
with respect to Options, means the   allocation of Options by the Company to the Trustee on behalf of a   Participant.
    
	
 
    	
 
    	
 
    
	
“Cause”
    	
 
    	
means, when used in connection with the   termination of a Participant’s employment with, or service to the Company or   an Affiliate, as a result of a basis for termination: dishonesty toward the   Company or Affiliate, insubordination, substantial malfeasance or nonfeasance   of duty, unauthorized disclosure of confidential information, and conduct   substantially prejudicial to the business of the Company or Affiliate; or,   any substantial breach by the Participant of (i) his or her employment   or service agreement.
    
	
 
    	
 
    	
 
    
	
“Commencement Date”
    	
 
    	
means the date of commencement of the   vesting schedule with respect to a Grant of Options which, unless otherwise
    

 

 

	
 
    	
 
    	
determined by the Administrator, shall   be the date on which such Grant of Options shall be Allocated.
    
	
 
    	
 
    	
 
    
	
“Company”
    	
 
    	
means NeuroDerm Ltd., a company   incorporated under the laws of the State of Israel.
    
	
 
    	
 
    	
 
    
	
“Consultant”
    	
 
    	
means an Israeli resident who is not   entitled to receive Options under Section 102, on behalf of whom an   Option is Granted under Section 3i.
    
	
 
    	
 
    	
 
    
	
“Control” or “Controlled”
    	
 
    	
shall have the meaning ascribed thereto   in Section 102.
    
	
 
    	
 
    	
 
    
	
“Disability”
    	
 
    	
means physical or mental impairment or   sickness of a Participant, making it impossible for the Participant to   continue such Participant’s employment with or service to the Company or   Affiliate.
    
	
 
    	
 
    	
 
    
	
“Exercise Price”
    	
 
    	
means, the price determined by the   Administrator in accordance with Section 7.1 below which is to be paid   to the Company in order to exercise a Granted Option and convert such Option   into an Underlying Share.
    
	
 
    	
 
    	
 
    
	
“Grant Letter”
    	
 
    	
means a letter from the Company or   Affiliate to a Participant in which the Participant is notified of the   decision to Grant to the Participant Options according to the terms of the   Plan. The Grant Letter shall specify (i) the Tax Provision under which   the Option is Granted; (ii) the Tax Track that the Company chose   according to Section 11 of the Plan (if applicable); (iii) the   Exercise Price; (iv) the vesting schedule; and (v) the number of   Options Granted to the Participant.
    
	
 
    	
 
    	
 
    
	
“Grant of Options”
    	
 
    	
with respect to Options, means the grant   of Options by the Company to a Participant pursuant to a Letter of Grant.
    
	
 
    	
 
    	
 
    
	
“Holding Period”
    	
 
    	
means with regard to Options Granted   under Section 102, the period in which the Allocated Options granted to   a Participant or, upon exercise thereof the Underlying Shares, are to be held   by the Trustee on behalf of the Participant, in accordance with Section 102,   and pursuant to the Tax Track which the Company selects.
    
	
 
    	
 
    	
 
    
	
“IPO”
    	
 
    	
means the initial public offering of   shares of the Company and the listing of such shares for trading on any   recognized stock exchange or over-the-counter or computerized securities trading   system.
    
	
 
    	
 
    	
 
    
	
“Israeli Participant”
    	
 
    	
means an Israeli Participant who is   qualified to receive Options under the provisions of Section 102.
    
	
 
    	
 
    	
 
    
	
“Law”
    	
 
    	
means the laws of the State of Israel as   are in effect from time
    

 

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to time.
    
	
 
    	
 
    	
 
    
	
“Merger Transaction”
    	
 
    	
(i) a sale of all or substantially   all of the assets of the Company; or (ii) a sale (including an exchange)   of all or substantially all of the shares of the capital stock of the   Company; or (iii) a merger, consolidation or like transaction of the   Company with or into another corporation.
    
	
 
    	
 
    	
 
    
	
“Notice of Exercise”
    	
 
    	
shall have the meaning set forth in   Section 7.4 below.
    
	
 
    	
 
    	
 
    
	
“Option”
    	
 
    	
means an option to purchase one Share of   the Company.
    
	
 
    	
 
    	
 
    
	
“Non-Qualified Participant”
    	
 
    	
means an Israeli resident who is not   qualified to receive Options under the provisions of Section 102, on   behalf of whom an Option is Granted pursuant to Section 3i.
    
	
 
    	
 
    	
 
    
	
“Participant”
    	
 
    	
means an Israeli Participant, or a   Non-Qualified Israeli Participant, or a Consultant.
    
	
 
    	
 
    	
 
    
	
“Plan” or “Option Plan”
    	
 
    	
means this Share Option Plan, as may be   amended from time to time.
    
	
 
    	
 
    	
 
    
	
“Retirement”
    	
 
    	
means the termination of a Participant’s   employment as a result of his or her reaching the earlier of (i) the age   of retirement as defined by Law; or (ii) the age of retirement specified   in the Participant’s employment agreement.
    
	
 
    	
 
    	
 
    
	
“Section 102”
    	
 
    	
means Section 102 of the Tax   Ordinance.
    
	
 
    	
 
    	
 
    
	
“Section 102 Rules”
    	
 
    	
means the Income Tax Rules (Tax   Relief for Issuance of Shares to Employees), 2003.
    
	
 
    	
 
    	
 
    
	
“Section 3(i)” or   “Section 3(i) Rules”
    	
 
    	
means section 3(i) of the Israeli   Tax Ordinance and the applicable rules thereto or under applicable   regulations.
    
	
 
    	
 
    	
 
    
	
“Share(s)”
    	
 
    	
means an ordinary share of the Company,   having a par value of NIS 0.1.
    
	
 
    	
 
    	
 
    
	
“Tax Ordinance”
    	
 
    	
means the Israeli Income Tax Ordinance   [New Version], 1961, as amended, and any regulations, rules, orders or   procedures promulgated thereunder.
    
	
 
    	
 
    	
 
    
	
“Tax Track”
    	
 
    	
means one of the three tax tracks described   under Section 102, specifically: (1) the “Capital Gains Track   Through a Trustee”; (2) “Income Tax Track Through a Trustee”; or   (3) the “Income Tax Track Without a Trustee”; each as defined in   Sections 11.1-11.2 of this Plan, respectively.
    
	
 
    	
 
    	
 
    
	
“Tax Provision”
    	
 
    	
means, with respect to the Grant of   Options, the provisions of one of the three Tax Tracks in Section 102,   or the provisions
    

 

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of 3i.
    
	
 
    	
 
    	
 
    
	
“Term of the Options”
    	
 
    	
means, with respect to Granted but   unexercised Options, the time period set forth in Section 9 below.
    
	
 
    	
 
    	
 
    
	
“Trustee”
    	
 
    	
means a Trustee appointed by the Company   to hold in trust, Allocated Options and the Underlying Shares issued upon   exercise of such Options, on behalf of Participants.
    
	
 
    	
 
    	
 
    
	
“Underlying Shares”
    	
 
    	
means Shares issued or to be issued upon   exercise of Granted Options all in accordance with the Plan.
    

 

2.2                               GENERAL

 

Without derogating from the meanings ascribed to the capitalized terms above, all singular references in this Plan shall include the plural and vice versa, and reference to one gender shall include the other, unless otherwise required by the context.

 

3.                                     SHARES AVAILABLE FOR OPTIONS

 

The total number of Underlying Shares reserved for issuance under the Plan and any modification thereof, shall be determined from time to time by the Board of Directors of the Company.  Such number of Shares shall be subject to adjustment by the Board of Directors, in its sole discretion, if required for the implementation of the provisions of the Plan, in accordance with Section 4 below.

 

In the event that Options Allocated under the Plan expire or otherwise terminate in accordance with the provisions of the Plan, such expired or terminated Options shall become available for future Grants and Allocations under the Plan.

 

4.                                      ADJUSTMENTS

 

In the event that the number of outstanding Shares is increased or decreased or the Shares are changed into or exchanged for a different number of shares by reason of any recapitalization, stock split-up, stock dividend or other distribution payable in capital stock, or other increase or decrease in such shares effected, without receipt of consideration by the Company, the Administrator, in order to prevent diminution or enlargement of the benefits or potential benefits intended to be made available under the Plan, shall adjust the number and class of Shares that may be delivered under the Plan and/or the number, class, and price of Shares covered by each outstanding Option or Share Purchase Right Upon the occurrence of any such adjustment, references in this Plan to Shares and Underlying Shares shall be construed to mean the Shares of the Company subject to the Plan as so determined by the Administrator, following such adjustment.

 

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5.                                      ADMINISTRATION OF THE PLAN

 

5.1                               POWER

 

Subject to the Law, the Articles of Association of the Company, and in accordance with the resolutions by the Company’s Board of Directors for specific delegation of power, the Administrator is authorized, in its sole and absolute discretion, to exercise all powers and authorities specifically granted to it under the Plan or by the Board of Directors necessary or advisable in the administration of the Plan, including, without limitation,

 

(A)                               to determine:

 

(i)            the Participants in the Plan, the number of Options to be Granted for each Participant’s benefit and the Exercise Price (subject to the approval of the Board of Directors if such approval is required by Law);

 

(ii)           the time or times at which Options shall be Granted;

 

(iii)          whether, to what extent, and under what circumstances an Option may be settled, canceled, forfeited, exchanged, or surrendered;

 

(iv)          any terms and conditions in addition to those specified in the Plan under which an Option may be Granted; and

 

(v)           any measures, and to take actions, as deemed necessary or advisable for the administration and implementation of the Plan.

 

(B)                               to interpret the provisions of the Plan and to take all actions resulting therefrom including without limitation;

 

(i)            subject to Section 7, to accelerate the date on which any Allocated Option under the Plan becomes exercisable;

 

(ii)           to waive or amend Plan provisions relating to exercise of Options, including exercise of Options after termination of employment, for any reason; and

 

(iii)          to amend any of the terms of the Plan, or any prior determinations of the Administrator.

 

5.2                               LIMITATIONS

 

Notwithstanding the provisions of Section 5.1 above, no interpretations, determinations or actions of the Administrator shall contradict the provisions of applicable Law and Board of Directors resolutions, and no waiver or amendment with respect to the Plan shall have a material adverse effect on any Participant’s rights in connection with any Granted Option under the Plan without receiving the consent of such Participant.

 

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6.                                      GRANT AND ALLOCATION OF OPTIONS

 

6.1                               CONDITIONS FOR GRANT OF OPTIONS

 

Options may be Granted at any time after:

 

(A)                               the grant has been approved by the necessary corporate bodies of the Company; and

 

(B)                               all other approvals, consents or requirements necessary by Law have been received or met.

 

6.2                               CONDITIONS FOR ALLOCATION OF OPTIONS

 

Options may be Allocated at any time after:

 

(A)                               the Plan has been approved by the necessary corporate bodies of the Company; and

 

(B)                               30 days after a request for approval of the Plan has been submitted for approval to the Israeli Income Tax Authorities pursuant to the requirements of the Tax Ordinance; and

 

(C)                               all other approvals, consents or requirements necessary by Law have been received or met.

 

6.3                               DATE OF GRANT OR ALLOCATION

 

(a)                                 The date on which Options shall be deemed Granted under the Plan shall be the date on which the Company shall notify the Participant in a Grant Letter that such Options have been Granted to the Participant (“Date of Grant”).

 

(b)                                 The date on which Options shall be deemed Allocated under the Plan shall be the date on which the Company shall notify the Trustee that such Options have been Allocated in the name of the Trustee on behalf of a Participant (“Date of Allocation”).

 

7.                                      EXERCISE OF OPTIONS

 

7.1                               EXERCISE PRICE

 

The Exercise Price per Underlying Share deliverable upon the exercise of an Option shall be determined by the Administrator.  The Exercise Price shall be set forth in the Grant Letter.

 

7.2                               VESTING SCHEDULE

 

Unless otherwise determined by the Administrator, all Options Granted on a certain date shall, subject to continued employment with or service to the Company or Affiliate by the

 

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Participant, become vested and exercisable in accordance with the vesting schedule determined by the Administrator and specified in the Grant Letter.

 

7.3                               MINIMUM EXERCISE

 

No exercise of Options by any Participant shall be for the lower of:  (1) an aggregate Exercise Price of less than $100, or such other minimum sum determined by the Administrator, unless the exercise is of all of the Participant’s Options that are vested as of the date of exercise; or (2) a quantity of 100 Options.

 

An Option may not be exercised for fractional shares.

 

The exercise of a portion of the Options Granted shall not cause the expiration, termination or cancellation of the remaining unexercised Options held by the Trustee on behalf of the Participant.

 

7.4                               MANNER OF EXERCISE

 

An Option may be exercised by and upon the fulfillment of the following:

 

(A)                               Notice of Exercise

 

The signing by the Participant, and delivery to both the Company (at its principal office) and the Trustee (if the Options are held by a Trustee), of an exercise notice form as prescribed by the Administrator, including but not limited to:  (i) the identity of the Participant, (ii) the number of Options to be exercised, and (iii) the Exercise Price to be paid (the “Notice of Exercise”).

 

(B)                               Exercise Price

 

The payment by the Participant to the Company, in such manner as shall be determined by the Administrator, of the Exercise Price with respect to all the Options exercised, as set forth in the Notice of Exercise.

 

(C)                               Allocation of Shares

 

Upon the delivery of a duly signed Notice of Exercise and the payment to the Company of the Exercise Price with respect to all the Options specified therein, the Company shall issue the Underlying Shares to the Trustee (according to the applicable Holding Period) or to the Participant, as the case may be.

 

(D)                               Expenses

 

All costs and expenses including broker fees and bank commissions, derived from the exercise of Options or Underlying Shares, shall be borne solely on the Participant.

 

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8.                                      WAIVER OF OPTION RIGHTS

 

At any time prior to the expiration of any Granted (but unexercised) Option, a Participant may waive his rights to such Option by a written notice to the Company’s principal office.  Such notice shall specify the number of Options Granted, which the Participant waives, and shall be signed by the Participant.

 

Upon receipt by the Company of a notice of waiver of such rights, such Options shall expire and shall become available for future Grants and Allocations under the Plan.

 

9.                                      TERM OF THE OPTIONS

 

Unless earlier terminated pursuant to the provisions of this Plan or otherwise determined by the Board of Directors, all Granted but unexercised Options shall expire and cease to be exercisable at 5:00 p.m. Israel time on the 12th anniversary of the Commencement Date of such Options.

 

10.                               TERMINATION OF EMPLOYMENT

 

10.1                        TERMINATION OF EMPLOYMENT

 

If a Participant ceases to be an employee, director, officer or Consultant of the Company or Affiliate for any reason (“Termination of Employment”) other than death, Retirement, Disability or Cause, then any vested but unexercised Options on the date of Termination of Employment (as shall be determined by the Company or Affiliate, in its sole discretion), Allocated on the Participant’s behalf (“Exercisable Options”) may be exercised, if not previously expired, not later than the earlier of (i) in the event that the Participant has been employed in the Company or in Affiliate at the most two (2) years — one (1) year after the date of Termination of Employment; or (ii) in the event that the Participant has been employed in the Company or in Affiliate at least two (2) years but not more than three (3) years - two (2) years after the date of Termination of Employment; or (iii) in the event that the Participant has been employed in the Company or in Affiliate at least three (3) years after the date of Termination of Employment; (iv) in the event that the Participant resigns, 90 days from his resignation, or (v) Unless specifically otherwise determined by the Board of Directors, no longer than the Term of the Options.

 

All other Granted Options for the benefit of Participant shall expire upon the date of Termination of Employment.

 

10.2                        TERMINATION FOR CAUSE

 

In the event of Termination of Employment of a Participant for Cause, the Participant’s right to exercise any unexercised Options, Granted to such Participant, whether vested or not on the date of Termination of Employment, shall cease as of such date of Termination of Employment, and the Options shall thereupon expire.

 

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If subsequent to the Participant’s Termination of Employment, but prior to the exercise of Options Granted to such Participant, the Administrator determines that either prior or subsequent to the Participant’s Termination of Employment, the Participant engaged in conduct which would constitute Cause, then the Participant’s right to exercise the Options Granted to such Participant shall immediately cease upon such determination and the Options shall thereupon expire.

 

The determination by the Administrator as to the occurrence of Cause shall be final and conclusive for all purposes of this Plan.

 

10.3                        TERMINATION BY REASON OF DEATH, RETIREMENT, OR DISABILITY

 

In the event of Termination of Employment of a Participant by reason of death, Retirement, or Disability, any vested but unexercised Options shall be exercisable in the case of death, by his or her estate, personal representative or beneficiary, or in the case of Retirement or Disability, by the Participant or his or her personal representative (as the case may be), until the earlier of (i) three (3) years after the date of Termination of Employment; or (ii) the Term of the Options.

 

All other Granted Options for the benefit of Participant shall expire upon the date of Termination of Employment.

 

10.4                        EXCEPTIONS

 

In special circumstances, pertaining to the Termination of Employment of a certain Participant, the Administrator may in its discretion decide to extend any of the periods stated above in Sections 10.1-10.3.

 

10.5                        TRANSFER OF EMPLOYMENT OR SERVICE

 

A Participant’s right to Options or the exercise thereof that were Granted to him or her under this Plan, shall not be terminated or expire solely as a result of the fact that the Participant’s employment or service as an employee, officer, director or Consultant changes from the Company to an Affiliate or vice versa.

 

11.                               OPTIONS AND TAX PROVISIONS

 

All Options under this Plan shall be Granted in accordance with one of the Tax Provisions as follows:

 

·                  The Company may Grant Options to Israeli Participants in accordance with the provisions of Section 102 and the Rules.

 

·                  The Company may Grant Options to Non-Qualified Israeli Participants in accordance with the provisions of Section 3(i).

 

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11.1                        TAX PROVISION SELECTION

 

The Company shall elect under which Tax Provision each Option is Granted in accordance with any applicable Law and its sole discretion — i.e., the Company shall elect to Grant Options to Participants under one of the three Section 102 Tax Tracks, or under the provisions of Section 3i.  The Company shall notify each Participant in the Grant Letter, under which Tax Provision the Options are Granted and, if applicable, under which Section 102 Tax Track, each Option is Granted.

 

11.2                        SECTION 102 TRUSTEE TAX TRACKS

 

If the Company elects to Grant Options to Israeli Participants through (i) the Capital Gains Track Through a Trustee, or (ii) the Income Tax Track Through a Trustee, then, in accordance with the requirements of Section 102, the Company shall appoint a Trustee who will hold in trust on behalf of each Israeli Participant the Allocated Options and the Underlying Shares issued upon exercise of such Options in trust on behalf of each Israeli Participant.

 

The Holding Period for the Options will be as follows:

 

(A)                               The Capital Gains Tax Track Through a Trustee — if the Company elects to Allocate the Options according to the provisions of this track, then the Holding Period will be:  24 months from the date of Allocation; or such period as may be determined in any amendment of Section 102.

 

(B)                               Income Tax Track Through a Trustee — if the Company elects to Allocate Options according to the provisions of this track, then the Holding Period will be 12 months from the date of Allocation; or such period as may be determined in any amendment of Section 102.

 

Subject to Section 102 and the Rules, Israeli Participants shall not be able to receive from the Trustee, nor shall they be able to sell or dispose of Underlying Shares before the end of the applicable Holding Period.  If an Israeli Participant sells or removes the Underlying Shares from the Trustee before the end of the applicable Holding Period (“Breach”), the Israeli Participant shall pay all applicable taxes imposed on such Breach by Section 7 of the Rules.

 

In the event of a distribution of rights, including an issuance of bonus shares, in connection with Options originally Allocated (the “Additional Rights”), all such Additional Rights shall be Allocated and/or issued to the Trustee for the benefit of Israeli Participants, and shall be held by the Trustee for the remainder of the Holding Period applicable to the Options originally Allocated.  Such Additional Rights shall be treated in accordance with the provisions of the applicable Tax Track.

 

In the event of cash dividend, the Company shall transfer to the Trustee the amount of dividend resulting from the Underlying Shares held by the Trustee for the benefit of Israeli Participants in accordance with the provisions of the Plan.  The Trustee shall

 

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deduct all applicable taxes from the dividend amount and transfer the remaining dividend to such Israeli Participants.

 

11.3                        INCOME TAX TRACK WITHOUT A TRUSTEE

 

If the Company elects to Grant Options to Israeli Participants according to the provisions of this track, then the Options will not be subject to a Holding Period.  However, upon exercise of Options under this Tax Track, the Trustee shall hold such Underlying Shares for the benefit of the Israeli Participant in accordance with the provisions of Section 15 of this Plan.

 

11.4                        CONCURRENT CONDITIONS

 

The Holding Period of Section 102, if any, is in addition to the vesting period as specified in Section 7.2 of the Plan.  The Holding Period and vesting period may run concurrently, but neither is a substitute for the other, and each are independent terms and conditions for Options Granted.

 

11.5                        TRUST AGREEMENT

 

The terms and conditions applicable to the trust relating to the Tax Track selected by the Company, as appropriate, shall be set forth in an agreement signed by the Company and the Trustee (the “Trust Agreement”).

 

12.                               TERM OF SHARES HELD IN TRUST

 

No Underlying Shares or Additional Rights issued by the Company to the Trustee, shall be held by the Trustee on behalf of a Participant for a period longer than ten (10) years after the end of the Term of the Options.  The Administrator shall instruct the Trustee as to the transfer of these Shares.

 

13.                               RIGHTS AS A SHAREHOLDER

 

Unless otherwise specified in the Plan, a Participant shall not have any rights as a shareholder with respect to Shares issued under this Plan, until such time as the Shares shall be registered.

 

14.                               NO SPECIAL EMPLOYMENT RIGHTS

 

Nothing contained in this Plan shall confer upon any Participant any right with respect to the continuation of employment by or service to the Company or Affiliate or to interfere in any way with the right of the Company or Affiliate, to terminate such employment or service or to increase or decrease the compensation of the Israeli Participant.

 

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15.                               RESTRICTIONS ON SALE OF OPTIONS AND SHARES

 

15.1                        OPTIONS

 

Options may not be sold, assigned, transferred, pledged, hypothecated or otherwise disposed of, except by will or the laws of descent.

 

15.2                        RIGHT OF FIRST REFUSAL

 

(i)                                     Should a Participant wish to sell the Underlying Shares, in whole or in part (the “Offered Shares”), such Participant shall first offer these shares to all the shareholders of the Company who hold more than 1% of the Company’s shares on a fully diluted basis and to those Participants who would hold more than 1% of the Company’s shares on a fully diluted basis, if they exercise the full amount of their Granted Options (whether vested or not) (the “Offeror” and the “Offerees”, respectively).  Such an offer shall be in writing and shall include details as determined by the Company from time to time (the “Offer”).  In addition, the Offer shall be simultaneously delivered to the registered office of the Company.

 

(ii)                                  Each of the Offerees shall be entitled to notify the Offeror, within 30 days as of the receipt of the Offer, of his interest or lack of interest to accept the Offer and to purchase all or any part of the Offered Shares on the terms of the Offer (“Notice of Acceptance”).

 

(iii)                               Should the number of shares that all or any of the Offerees are interested to purchase exceed the number of the Offered Shares, the Offerees who have provide the Company a Notice of Acceptance shall receive their portion of the Offered Shares, according to their holdings in the Company (pro-rata) on the date of the acceptance of the Offer.

 

(iv)                              Should the total number of shares that all the Offerees are interested in purchasing be lower than the number of the Offered Shares, the Offeror shall issue a written notice to this effect to all the Offerees who have sent timely Notice of Acceptance.  In his notice, the Offeror shall specify the number of shares with respect to which no Notice of Acceptance has been received (hereinafter:  “the Re-Offered Shares”).  Such Offerees shall be entitled to notify the Offeror within three (3) business days of the receipt of such notice regarding their interest to purchase an additional number of shares (hereinafter :  “the Additional Notice of Acceptance”).

 

(v)                                 Should the number of shares with respect to which the aforesaid Offerees have announced their interest in the purchase thereof by means of an Additional Notice of Acceptance exceed the number of the Re-Offered Shares, the Offerees that have submitted an Additional Notice of Acceptance shall receive their portion of the Re-Offered, according to their holdings in the Company (pro-rata) on the date of the acceptance of the Offer.

 

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(vi)                              Should a Notice of Acceptance not be provided to the Offeror within the 30-day period mentioned above, or should the Offerees notify that they do not accept the Offer, or should the total number of shares that all the Offerees are interested in purchasing, even after the re-offering of the shares, be lower than the number of the Offered Shares, the Offeror shall not be obligated to transfer the Offered Shares to the Offerees and he will be entitled to sell the Offered Shares to such purchaser (the “Purchaser”) on terms that are identical or better than the terms of the Offer, provided that the Offered Shares are sold to the Purchaser within 60 days as of the end of the 30-day period for the issuance of a Notice of Acceptance or of the date on which the notices of non-acceptance are received or after the three (3) business days period during which time the Offerees are entitled to issue an Additional Notice of Acceptance, as stated in Section (iv) above, as the case may be.

 

(vii)                           The provisions of Sections (i) — (vi) above shall only be in effect until the consummation of an IPO by the Company.

 

15.3                        MERGERS

 

In the event of a Merger Transaction, then, the Administrator in its sole discretion shall decide:

 

(A)                               if and how the unvested Options shall be canceled, replaced or accelerated;

 

(B)                               if and how vested Options (including Options with respect to which the vesting period has been accelerated according to Section 15.3(a)) shall be fairly exercised, replaced and/or sold by the Trustee or the Company (as the case may be) on the behalf of Israeli Participants; and

 

(C)                               how Underlying Shares issued upon exercise of the Options and held by the Trustee on behalf of Israeli Participants shall be fairly replaced and/or sold by the Trustee on behalf of the Israeli Participant.

 

(D)                               if to file an application for a pre-ruling with the Israeli Tax Authorities (for the purpose of tax ramifications only and if applicable).

 

15.4                        ACCELERATION PROVISION

 

The Administrator, in its sole discretion, may decide to add a provision in certain Grant Letters, according to which, in case of a Merger, all or some of the unvested Options, shall automatically accelerate.

 

15.5                        LOCK UP

 

Notwithstanding the Holding Period, following the Company’s IPO, at the request of the underwriter, the Administrator may determine that the Underlying Shares issued pursuant to the exercise of Options may be subject to a lock-up period of 180 days, or such longer

 

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period of time as may be recommended by the Company’s Board of Directors, during which time Participants shall not be allowed to sell Shares.

 

16.                               VOTING

 

Until consummation of the Company’s IPO, Shares issued pursuant to the exercise of Options to a Participant pursuant to this Plan which equal to 3% or less of the issued share capital of the Company, shall be voted by an irrevocable proxy assigned a member of the Board of Directors, who has been appointed from time to time by the Company’s Board of Directors as a representative (the “Representative”).

 

(A)                               The Company’s Board of Directors may, at its discretion, replace the Representative from time to time.

 

(B)                               Shares subject to proxy shall be voted by the Representative on any issue or resolution brought before the shareholders of the Company in the same proportion as the vote of the other outstanding Shares of the Company (i.e., if 80% of the other outstanding Shares of the Company will be voted in favor of a certain resolution, and 20% will be voted against, the Shares subject to proxy will be voted in the same manner).

 

(C)                               Each Participant, upon execution of the irrevocable proxy specified above, undertakes to hold the Representative harmless against any and all claims related or connected to said proxy.

 

(D)                               The Representative shall be indemnified and held harmless by the Company against any cost or expense (including attorneys’ fees) reasonably incurred by the Representative, or any liability (including any sum paid in settlement of a claim with the approval of the Company) arising out of any act or omission to act in connection with the voting of the Shares subject to proxy, unless arising out of the Representative’s own fraud or gross negligence, to the extent permitted by applicable law.  In the event the Representative shall have indemnification by virtue of other functions or services he or she performs for the Company or Affiliate (whether by agreement, insurance policy or decision of the appropriate corporate body(ies) of the Company and/or Affiliate), this indemnification shall be in addition to any such other indemnification.

 

17.                               TAX MATTERS

 

This Plan shall be governed by, and shall conform with and be interpreted so as to comply with, the requirements of the Ordinance and any written approval from any relevant Tax Authorities. All tax consequences under any applicable law (other than stamp duty) which may arise from the Grant or Allocation of Options, from the exercise thereof or from the holding or sale of Underlying Shares (or other securities issued under the Plan) by or on behalf of the Participant, shall be borne solely by the Participant The Participant shall indemnify the Company and/or Affiliate, as the case may be, and hold them harmless, against and from any liability for any such tax or any penalty, interest or indexing.

 

14

 

If the Company elects to Allocate Options according to the provisions of the Income Tax Track Without a Trustee (Section 11.3 of this Plan), and if prior to the exercise of any and/or all of these Options, such Israeli Participant ceases to be an employee, director, or officer of the Company or Affiliate, the Israeli Participant shall deposit with the Company a guarantee or other security as required by law, in order to ensure the payment of applicable taxes upon the Exercise of such Options.

 

18.                               WITHHOLDING TAXES

 

Whenever an amount with respect to withholding tax relating to Options Granted to a Participant and/or Underlying Shares issued upon the exercise thereof is due from the Participant and/or the Company and/or an Affiliate, the Company and/or an Affiliate shall have the right to demand from a Participant such amount sufficient to satisfy any applicable withholding tax requirements related thereto, and whenever Shares or any other non-cash assets are to be delivered pursuant to the exercise of an Option, or transferred thereafter, the Company and/or an Affiliate shall have the right to require the Participant to remit to the Company and/or to the Affiliate, or to the Trustee an amount in cash sufficient to satisfy any applicable withholding tax requirements related thereto.  If such amount is not timely remitted, the Company and/or the Affiliate shall have the right to withhold or set-off (subject to Law) such Shares or any other non-cash assets pending payment by the Participant of such amounts.

 

With regard to Options Granted to Israeli Participants - until all taxes have been paid in accordance with Rule 7 of the Section 102 Rules, Options and/or Underlying Shares may not be sold, transferred, assigned, pledged, encumbered, or otherwise willfully hypothecated or disposed of, and no power of attorney or deed of transfer , whether for immediate or future use may be validly given Notwithstanding the foregoing, the Options and/or Underlying Shares may be validly transferred in accordance with Section 20 below, provided that the transferee thereof shall be subject to the provisions of Section 102 and the Section 102 Rules as would have been applicable to the deceased Israeli Participant were he or she to have survived.

 

19.                               NO TRANSFER OF OPTIONS

 

The Trustee shall not transfer Options to any third party, including a Participant, except in accordance with instructions received from the Administrator.

 

20.                               TRANSFER OF RIGHTS UPON DEATH

 

No transfer of any right to an Option or Underlying Share issued upon the exercise thereof by will or by the laws of descent shall be effective to bind the Company unless the Company shall have been furnished with the following signed and notarized documents:

 

(A)                               A written request for such transfer and a copy of the legal documents creating and confirming the right of the person acting with respect to the Participant’s estate and of the transferee;

 

15

 

(B)                               A written consent by the transferee to pay any amounts in connection with the Options and Underlying Shares any payment due according to the provisions of the Plan and otherwise abide by all the terms of the Plan; and

 

(C)                               any such other evidence as the Administrator may deem necessary to establish the right to the transfer of the Option or Under lying Share issued upon the exercise thereof and the validity of the transfer.

 

21.                               NO RIGHT OF OTHERS TO OPTIONS

 

Subject to the provisions of the Plan, no person other than the Participant shall have any right with respect to Options Granted to the Participant’s under the Plan.

 

22.                               EXPENSES AND RECEIPTS

 

The expenses incurred in connection with the administration and implementation of the Plan (including any applicable stamp duty) shall be borne by the Company.  Any proceeds received by the Company in connection with the exercise of any Option may be used for general corporate purposes.

 

23.                               REQUIRED APPROVALS

 

The Plan is subject to the receipt of all approvals required under the Ordinance, the Code and the Law.

 

24.                               APPLICABLE LAW

 

This Plan and all documents delivered or executed by the Company or Affiliate in connection herewith shall be governed by, and construed and administered in accordance with the Law.

 

25.                               TREATMENT OF PARTICIPANTS

 

There is no obligation for uniformity of treatment of Participants.

 

26.                               NO CONFLICTS

 

In the event of any conflict between the terms of the Plan and the Grant Letter, the terms of the Plan shall prevail, unless the Grant Letter stated specifically that the conflicting provision in the Grant Letter shall prevail and the Board of Directors approved it.

 

27.                               PARTICIPANT UNDERTAKINGS

 

By entering into this Plan, the Participant shall (1) agree and acknowledge that he or she has received and read the Plan and the Grant Letter ; (2) undertake all the provisions set forth in:  Section 3i or Section 102 as applicable (including provisions regarding the applicable Tax Track that the Company has selected), the Plan, the Grant Letter and the Trust Agreement (if applicable); and (3) if the Options are Granted under Section 102,

 

16

 

the Israeli Participant shall undertake that subject to the provisions of Section 102 and the Rules, he or she shall not sell or release the Underlying Shares from trust before the end of the Holding Period (if any).

 

17Form of Floating Rate Senior Debt - 2008 Indenture

 Exhibit 4.40 

[FORM OF FLOATING RATE SENIOR DEBT SECURITY] 
  

					
	Registered No.            	  	 	CUSIP No.            	  
		  	 	ISIN No.            	  

 (Face of Security) 

[IF A GLOBAL SECURITY, INSERT — THIS SECURITY IS A GLOBAL SECURITY WITHIN THE MEANING OF THE 2008 INDENTURE AS DEFINED HEREIN ON THE
REVERSE OF THIS SECURITY AND IS REGISTERED IN THE NAME OF A DEPOSITARY OR A NOMINEE THEREOF. THIS SECURITY MAY NOT BE EXCHANGED IN WHOLE OR IN PART FOR A SECURITY REGISTERED, AND NO TRANSFER OF THIS SECURITY IN WHOLE OR IN PART MAY BE REGISTERED, IN
THE NAME OF ANY PERSON OTHER THAN SUCH DEPOSITARY OR A NOMINEE THEREOF, EXCEPT IN THE LIMITED CIRCUMSTANCES DESCRIBED IN THE 2008 INDENTURE.] 

[IF DTC IS THE DEPOSITARY, INSERT — UNLESS THIS CERTIFICATE IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPOSITORY TRUST
COMPANY, A NEW YORK CORPORATION (“DTC”), TO THE GOLDMAN SACHS GROUP, INC. OR ITS AGENT FOR REGISTRATION OF TRANSFER, EXCHANGE OR PAYMENT, AND ANY CERTIFICATE ISSUED IS REGISTERED IN THE NAME OF CEDE & CO. OR IN SUCH OTHER NAME AS
IS REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF DTC (AND ANY PAYMENT IS MADE TO CEDE & CO. OR TO SUCH OTHER ENTITY AS IS REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF DTC), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY
OR TO ANY PERSON IS WRONGFUL INASMUCH AS THE REGISTERED OWNER HEREOF, CEDE & CO., HAS AN INTEREST HEREIN.] 
 [INSERT ANY
LEGEND REQUIRED BY THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER.] 
 [INSERT ANY LEGEND REQUIRED BY THE EMPLOYEE
RETIREMENT INCOME SECURITY ACT AND THE REGULATIONS THEREUNDER.] 
 THIS SECURITY IS NOT A BANK DEPOSIT AND IS NOT INSURED BY THE
FEDERAL DEPOSIT INSURANCE CORPORATION OR ANY OTHER GOVERNMENTAL AGENCY, NOR IS IT AN OBLIGATION OF, OR GUARANTEED BY, A BANK. 

  
 (Face of Security
continued on next page) 

  

 THE GOLDMAN SACHS GROUP, INC. 

[TITLE OF SECURITY/SERIES] 

The Goldman Sachs Group, Inc., a corporation duly organized and existing under the laws of the State of Delaware (herein called the
“Company”, which term includes any successor Person under the 2008 Indenture as defined on the reverse of this Security), for value received, hereby promises to pay to
            , or registered assigns, the principal sum of [Insert Principal Amount] ($[Insert Numeric Principal Amount]) on [Insert Maturity] and to pay interest thereon, from [insert Issue
Date, unless there is a Predecessor Security, in which case this date shall be the issue date of the first Predecessor Security] (such date, the “Original Issuance Date”) or from the most recent Interest Payment Date to which
interest has been paid or made available for payment, on the Interest Payment Date(s) in each year, commencing on the first such date specified on the face of this Security, and at the maturity of the principal hereof, at a rate per annum determined
in accordance with the applicable provisions of Section 3 on the reverse hereof, until the principal hereof is paid or made available for payment. Any premium and any such installment of interest that is overdue at any time shall also bear
interest (to the extent that the payment of such interest shall be legally enforceable) at the rate per annum at which the principal then bears interest, from the date any such overdue amount first becomes due until it is paid or made available for
payment. Notwithstanding the foregoing, interest on any principal, premium or installment of interest that is overdue shall be payable on demand. 

The interest so payable, and punctually paid or made available for payment, on any Interest Payment Date will, as provided in the 2008
Indenture, be paid to the Person in whose name this Security (or one or more Predecessor Securities) is registered at the close of business on the [if Global Security, insert — calendar day (whether or not a Business Day (as defined in
Section 3(e) on the reverse hereof))] [if not a Global Security, insert alternative provision acceptable to Trustee and Registrar] immediately preceding the day on which payment is to be made (as such payment date may be adjusted in
accordance with the Business Day Convention specified on the face hereof and the second paragraph under “Payments Due on a Business Day” below) (a “Regular Record Date”). Any interest so payable, but not punctually paid or
made available for payment, on any Interest Payment Date will forthwith cease to be payable to the Holder on such Regular Record Date and such Defaulted Interest may either be paid to the Person in whose name this Security (or one or more
Predecessor Securities) is registered at the close of business on a Special Record Date for the payment of such Defaulted Interest to be fixed by the Trustee, notice whereof being given to the Holder of this Security not less than 10 days prior
to such Special Record Date, or be paid in any other lawful manner not inconsistent with the requirements of any securities exchange on which this Security may be listed, and upon such notice as may be required by such exchange, all as more fully
provided in the 2008 Indenture. For the purpose of determining the Holder at the close of business on any relevant record date when business is not being conducted, the close of business will mean 5:00 P.M., New York City time, on that day.

  
 (Face of Security
continued on next page) 

  
 -2- 

 Currency and Manner of Payment 

[IF PAYMENT IS IN U.S. DOLLARS, INSERT — Payment of the principal of and interest on this Security will be made in such coin or
currency of the United States of America as at the time of payment is legal tender for payment of public and private debts. Notwithstanding any other provision of this Security or the 2008 Indenture, if this Security is a Global Security, any
payment in respect of this Security may be made pursuant to the Applicable Procedures of the Depositary as permitted in the 2008 Indenture. 

Subject to the prior paragraph and except as provided in the next paragraph, payment of any amount payable on this Security will be made at
the office or agency of the Company maintained for that purpose in The City of New York (and at any other office or agency maintained by the Company for that purpose), against surrender of this Security in the case of any payment due at the Maturity
of the principal hereof (other than any payment of interest that first becomes due on an Interest Payment Date); provided, however, that, at the option of the Company and subject to the next paragraph, payment of interest may be made
by check mailed to the address of the Person entitled thereto as such address shall appear in the Security Register. 
 Subject to the
second preceding paragraph, payment of any amount payable on this Security will be made by wire transfer of immediately available funds to an account maintained by the payee with a bank located in the Borough of Manhattan, The City of New York, if
(i) the principal of this Security is at least $1,000,000 and (ii) the Holder entitled to receive such payment transmits a written request for such payment to be made in such manner to the Trustee at its Corporate Trust Office, Attention:
Global Corporate Trust, on or before the fifth Business Day before the day on which such payment is to be made; provided that, in the case of any such payment due at the Maturity of the principal hereof (other than any payment of interest
that first becomes due on an Interest Payment Date), this Security must be surrendered at the office or agency of the Company maintained for that purpose in The City of New York (or at any other office or agency maintained by the Company for that
purpose) in time for the Paying Agent to make such payment in such funds in accordance with its normal procedures. Any such request made with respect to any payment on this Security payable to a particular Holder will remain in effect for all later
payments on this Security payable to such Holder, unless such request is revoked on or before the fifth Business Day before a payment is to be made, in which case such revocation shall be effective for such payment and all later payments. In the
case of any payment of interest payable on an Interest Payment Date, such written request must be made by the Person who is the registered Holder of this Security on the relevant Regular Record Date.] 

[IF PAYMENT IS IN EUROS, INSERT — Payment of the principal of and interest on this Security will be made will be made in such coin
or currency as at the time of payment is legal tender for payment of public and private debts in all of the countries (if any) then participating in the European Economic and Monetary Union (or any successor union) pursuant to the Treaty on European
Union of February 1992 (or any successor treaty), as it may be amended from time to time. Notwithstanding any other provision of this Security or the 2008 Indenture, if this Security is a Global Security, any payment in respect of this Security
may be made pursuant to the Applicable Procedures of the Depositary as permitted in the 2008 Indenture. 

  
 (Face of Security
continued on next page) 

  
 -3- 

 Subject to the prior paragraph and except as provided in the next two paragraphs, payment of any
amount payable on this Security will be made at the office or agency of the Company maintained for that purpose in The City of New York (and at any other office or agency maintained by the Company for that purpose), against surrender of this
Security in the case of any payment due at the Maturity of the principal hereof (other than any payment of interest that first becomes due on an Interest Payment Date); provided, however, that, at the option of the Company and subject
to the next paragraph, payment of interest may be made by check mailed to the address of the Person entitled thereto as such address shall appear in the Security Register. 

Subject to the second preceding paragraph, payment of any amount payable on this Security will be made by wire transfer of immediately
available funds to an account maintained by the payee in euros at a bank or other financial institution acceptable to the Company and the Trustee, if (i) the principal of this Security is at least USD $1,000,000 (or the equivalent in euros) and
(ii) the Holder entitled to receive such payment transmits a written request for such payment to be made in such manner to the Trustee at its Corporate Trust Office, Attention: Global Corporate Trust, on or before the fifth Business Day before
the day on which such payment is to be made; provided that, in the case of any such payment due at the Maturity of the principal hereof (other than any payment of interest that first becomes due on an Interest Payment Date), this Security
must be surrendered at the office or agency of the Company maintained for that purpose in The City of New York (or at any other office or agency maintained by the Company for that purpose) in time for the Paying Agent to make such payment in such
funds in accordance with its normal procedures. Any such request made with respect to any payment on this Security payable to a particular Holder will remain in effect for all later payments on this Security payable to such Holder, unless such
request is revoked on or before the fifth Business Day before a payment is to be made, in which case such revocation shall be effective for such payment and all later payments. In the case of any payment of interest payable on an Interest Payment
Date, such written request must be made by the Person who is the registered Holder of this Security on the relevant Regular Record Date.] 

[IF PAYMENT IS IN EUROS, INSERT — Payments Made in U.S. Dollars 

Notwithstanding any provision of this Security or the 2008 Indenture, if any amount payable on this Security is payable on any day and if
euros are not available to the Company on the two Business Days before such day, due to the imposition of exchange controls, disruption in a currency market or any other circumstances beyond the control of the Company, the Company will be entitled
to satisfy its obligation to pay such amount in euros by making such payment in U.S. dollars. The amount of such payment in U.S. dollars shall be determined by the Exchange Rate Agent on the basis of an exchange rate for euros published at
approximately 12:00 noon, New York City time, by a generally recognized and publicly available source, to be determined in the sole discretion of the Exchange Rate Agent (the “Exchange Rate”) as of the latest day before the day on
which such payment is to be made. Any payment made under such circumstances in U.S. dollars where the required payment is in euros will not constitute an Event of Default under this Security or the 2008 Indenture. 

  
 (Face of Security
continued on next page) 

  
 -4- 

 Exchange Rate Agent 

As used herein, the “Exchange Rate Agent” shall initially mean [Goldman Sachs International]; provided that the Company may,
and in its sole discretion, appoint any other institution (including any affiliate of the Company) to serve as any such agent from time to time. The Company will give the Trustee prompt written notice of any change in any such appointment. Insofar
as this Security provides for any such agent to obtain rates, quotes or other data from a bank, dealer or other institution for use in making any determination hereunder, such agent may do so from any institution or institutions of the kind
contemplated hereby notwithstanding that any one or more of such institutions are any such agent, affiliates of any such agent or affiliates of the Company. 

All determinations made by the Exchange Rate Agent pursuant to the terms of this Security shall be, absent manifest error, conclusive for all
purposes and binding on the holder of this Security and the Company, and the Exchange Rate Agent shall have no liability therefor.] 

Calculation Agent 
 As used herein,
the “Calculation Agent” shall initially mean The Bank of New York Mellon; provided that the Company may, in its sole discretion, appoint any other institution (including any affiliate of the Company) to serve as any such agent from
time to time. The Company will give the Trustee prompt written notice of any change in any such appointment. Insofar as this Security provides for any such agent to obtain rates, quotes or other data from a bank, dealer or other institution for use
in making any determination hereunder, such agent may do so from any institution or institutions of the kind contemplated hereby notwithstanding that any one or more of such institutions are any such agent, affiliates of any such agent or affiliates
of the Company. 
 All determinations made by the Calculation Agent may be made by such agent in its sole discretion and, absent manifest
error, shall be conclusive for all purposes and binding on the Holder of this Security and the Company. The Calculation Agent shall not have any liability therefor. 

Payments Due on a Business Day 

Notwithstanding any provision of this Security or the 2008 Indenture, if the maturity of the principal hereof occurs on a day that is not a
Business Day, any amount of principal, premium or interest that would otherwise be due on this Security on such day (the “Specified Day”) may be paid or made available for payment on the Business Day that is next succeeding the
Specified Day with the same force and effect as if such amount were paid on the Specified Day, and no interest will accrue on the amount so payable for the period from the Specified Day to such next succeeding Business Day. 

If any Interest Reset Date or Interest Payment Date other than one that falls on the date of Maturity of the principal hereof would otherwise
fall on a day that is not a Business Day, [INSERT IF BUSINESS DAY CONVENTION IS FOLLOWING — then such date shall be 

  
 (Face of Security
continued on next page) 

  
 -5- 

 
postponed to the next day that is a Business Day][INSERT IF BUSINESS DAY CONVENTION IS MODIFIED FOLLOWING — then such date shall be postponed to the next day that is a Business Day;
provided that, if such next succeeding Business Day falls in the next calendar month, then such date shall be advanced to the immediately preceding Business Day][INSERT IF BUSINESS DAY CONVENTION IS FOLLOWING UNADJUSTED — any
payment due on such date shall be postponed to the next day that is a Business Day; provided that interest due with respect to an Interest Payment Date shall not accrue from and including such Interest Payment Date to and including the date
of payment of such interest as so postponed; provided further that Interest Reset Dates and Interest Periods shall not be adjusted for non-Business Days][INSERT IF BUSINESS DAY CONVENTION IS MODIFIED FOLLOWING UNADJUSTED — any
payment due on such date shall be postponed to the next day that is a Business Day; provided that interest due with respect to such an Interest Payment Date shall not accrue from and including such Interest Payment Date to and including the
date of payment of such interest as so postponed, and provided further that, if such day would fall in the next succeeding calendar month, the date of payment with respect to such Interest Payment Date shall be advanced to the Business Day
immediately preceding such Interest Payment Date; and provided further that Interest Reset Dates and Interest Periods shall not be adjusted for non-Business Days]. 

The provisions of the two immediately preceding paragraphs shall apply to this Security in lieu of the provisions of Section 1.13 of the
2008 Indenture. 
  
  

Reference is hereby made to the further provisions of this Security set forth on the reverse hereof, which further provisions shall for all
purposes have the same effect as if set forth at this place. 
 Unless the certificate of authentication hereon has been executed by the
Trustee by manual signature, this Security shall not be entitled to any benefit under the 2008 Indenture or be valid or obligatory for any purpose. 

  
 (Face of Security
continued on next page) 

  
 -6- 

 IN WITNESS WHEREOF, the Company has caused this instrument to be duly executed. 

Dated:                      

 

			
	THE GOLDMAN SACHS GROUP, INC.
		
	By:	 	  

		 	Name:
		 	Title:

 This is one of the Securities of the series designated herein and referred to in the 2008 Indenture.

 Dated:                      

 

			
	 THE BANK OF NEW YORK
 MELLON, as
Trustee

		
	By:	 	  

		 	Authorized Signatory

  
 -7- 

 (Reverse of Security) 
  

	 	1.	Securities and Indenture. 

 This Security is one of a duly authorized issue of
securities of the Company (herein called the “Securities”) issued and to be issued in one or more series under a Senior Debt Indenture, dated as of July 16, 2008 (herein called the “2008 Indenture”, which term
shall have the meaning assigned to it in such instrument), between the Company and The Bank of New York Mellon, as Trustee (herein called the “Trustee”, which term includes any successor trustee under the 2008 Indenture), and
reference is hereby made to the 2008 Indenture for a statement of the respective rights, limitations of rights, duties and immunities thereunder of the Company, the Trustee and the Holders of the Securities and of the terms upon which the Securities
are, and are to be, authenticated and delivered. 
  

	 	2.	Series and Denominations. 

 This Security is one of the series designated on the
face hereof, limited to an aggregate principal amount as shall be determined and may be increased from time to time by the Company. Any election by the Company so to increase such aggregate principal amount shall be evidenced by a certificate of an
Authorized Person (as defined in the Determination of an Authorized Person, dated             , with respect to this series). References herein to “this series” mean the
series of Securities designated on the face hereof. The Securities of this series are issuable only in registered form without coupons in denominations of integral multiples of
            , subject to a minimum denomination of             . 

 

	 	3.	Calculation of Interest Payment and Interest Rate. 

 Payments of interest hereon
with respect to any Interest Payment Date or at the maturity of the principal hereof will include interest accrued to but excluding the next date to which interest will accrue (which may be the Interest Payment Date depending on the Business Day
Convention) or the date of such maturity, as the case may be. Accrued interest from the Original Issue Date or from the last date to which interest has accrued shall be calculated by the Calculation Agent by multiplying the principal amount
by an accrued interest factor for the Interest Period. Such accrued interest factor shall be expressed as a decimal and computed by multiplying the interest rate determined as set forth below for such Interest Period (also expressed as a
decimal) by the Day Count Convention (as defined below) for such Interest Period. 
 All percentages resulting from any calculation with
respect to this Security will be rounded upward or downward, as appropriate, to the next higher or lower one hundred-thousandth of a percentage point (e.g., 9.876541% (or .09876541) being rounded down to 9.87654% (or .0987654) and
9.876545% (or .09876545) being rounded up to 9.87655% (or .0987655)). All amounts used in or resulting from any calculation with respect to this Security will be rounded upward or downward, as appropriate, to the nearest cent, in the case of U.S.
dollars, or to the nearest corresponding hundredth of a unit, in the case of a currency other than U.S. dollars, with one-half cent or one-half of a corresponding hundredth of a unit or more being rounded upward. 

  
 (Reverse of Security
continued on next page) 

  
 -8- 

 (a) Interest Rate Reset. The interest rate on this Security will be reset
from time to time as provided in this Section 3, and each date upon which such rate is reset as so provided is hereinafter called an “Interest Reset Date”. The Interest Reset Dates with respect to this Security will be [each
Interest Payment Date]; provided, however, that any Interest Reset Date shall be subject to adjustment if and as provided in the second paragraph under the heading “Payments Due on a Business Day” on the face of this
Security. 
 Subject to applicable provisions of law, the interest rate on this Security in effect from and including the Original Issuance
Date to but excluding the last day of the first Interest Period will be [Insert Initial Rate, including and spread or multiplier]. 

Subject to applicable provisions of law and except as otherwise specified herein, on each Interest Reset Date the interest rate on this
Security shall be the rate determined in accordance with Section 3(b) below (the “Base Rate”), [INSERT AS APPLICABLE IF SPREAD APPLIES — as adjusted by the [addition] [subtraction] of [    ]%]
[INSERT AS APPLICABLE IF SPREAD MULTIPLIER APPLIES — as adjusted by multiplying such Base Rate by [Insert Spread Multiplier], and subject to adjustment as provided in Section 3(c) below. The Calculation Agent shall determine the
interest rate of this Security in accordance with the applicable Sections below. 
 The Calculation Agent will determine the interest rate
on this Security that takes effect on any Interest Reset Date [INSERT IF THE BASE RATE IS THE TREASURY RATE — on the Interest Reset Date or, in the circumstances described in Section 3(b) below, a day no later than the applicable
Calculation Date (as defined in Section 3(d) below), corresponding Treasury Interest Determination Date] [INSERT IF THE BASE RATE IS THE FEDERAL FUNDS RATE OR PRIME RATE — on the applicable Interest Reset Date] [INSERT IF THE
BASE RATE IS THE CMS RATE, CMT RATE, EURIBOR OR LIBOR — on the applicable Interest Determination Date (as defined in paragraph (b) below) corresponding to such Interest Reset Date.] 

[INSERT IF THE BASE RATE IS THE TREASURY RATE — However, the Calculation Agent need not wait until the Calculation Date to
determine interest rates if the rate information it needs to make such determination in the manner specified in the applicable provisions of Section 3(b) hereof is available from the relevant sources specified in such applicable provisions.]
Upon request of the Holder to the Calculation Agent, the Calculation Agent will provide the interest rate then in effect on this Security and, if determined, the interest rate that will become effective on the next Interest Reset Date. 

(b) Determination of Base Rate. [INSERT IF THE BASE RATE IS THE CMS RATE — The Base Rate that takes effect on
any Interest Reset Date shall equal the rate appearing on the Reuters Screen ISDAFIX1 Page for U.S. dollar swaps having a maturity equal to the Index Maturity specified on the face hereof as of approximately 11:00 A.M., New York

  
 (Reverse of Security
continued on next page) 

  
 -9- 

 
City time on the second U.S. Government Securities Business Day immediately preceding such Interest Reset Date (the “Interest Determination Date”). If the CMS Rate cannot be
determined as described above, the following procedures will apply in determining the CMS Rate: 
 (i) If the rate described
above does not so appear on the Reuters Screen ISDAFIX1 Page, then the CMS Rate will be determined on the basis of the mid-market semi-annual swap rate quotations provided by five leading swap dealers in the New York City interbank market at
approximately 11:00 A.M., New York City time, on the relevant Interest Determination Date. For this purpose, the “semi-annual swap rate” means the mean of the bid and offered rates for the semi-annual fixed leg, calculated using the
30/360 (ISDA) Day Count Convention (as defined in Section 3(e) below), of a fixed-for-floating U.S. dollar interest rate swap transaction with a term equal to the Index Maturity commencing on such Interest Reset Date with an acknowledged dealer
of good credit in the swap market, where the floating leg, calculated using the Actual/360 (ISDA) Day Count Convention, is equivalent to LIBOR with a designated maturity of three months, as such rate may be determined as provided below. The
Calculation Agent will select the five swap dealers in its sole discretion and will request the principal New York City office of each of those dealers to provide a quotation of its rate. 

(ii) If at least three quotations are provided as described in clause (i) above, the CMS Rate for such Interest Reset Date
will be the arithmetic mean of the quotations described above, eliminating the highest and lowest quotations or, in the event of equality, one of the highest and one of the lowest quotations. 

(iii) If fewer than three quotations are provided, the Calculation Agent will determine the CMS Rate in its sole discretion.]

 [INSERT IF THE BASE RATE IS THE CMT RATE — The Base Rate that takes effect on any Interest Reset Date shall equal the CMT
Rate determined as described below. “CMT Rate” means: 
 (i) If the Designated CMT Reuters Screen Page is
the Reuters Screen FRBCMT Page, then the CMT Rate for such Interest Reset Date will be the yield for Treasury securities at “constant maturity” for a period of the Designated CMT Index Maturity as set forth in H.15(519) under the caption
“Treasury constant maturities”, as such yield is displayed on the Designated CMT Reuters Screen Page on the second U.S. Government Securities Business Day immediately preceding such Interest Reset Date (the “Interest Determination
Date”). 
  

	 	(A)	If the applicable rate described in clause (i) above is not displayed on the Designated CMT Reuters Screen Page, then the CMT Rate will be the rate for Treasury securities at “constant maturity” for a
period of the Designated CMT Index Maturity as published in H.15(519) under the caption “Treasury constant maturities”. 

  
 (Reverse of Security
continued on next page) 

  
 -10- 

	 	(B)	If the applicable rate described in clause (A) above does not appear in H.15(519), then the CMT Rate for such Interest Reset Date will be the Treasury constant maturity rate, for the Designated CMT Index Maturity
that: 

 a. is published by the Board of Governors of the Federal Reserve System, or the U.S. Department of
the Treasury, and 
 b. is determined by the Calculation Agent to be comparable to the applicable rate that would have
otherwise been published in H.15(519). 
  

	 	(C)	If, on the Interest Determination Date, the Board of Governors of the Federal Reserve System or the U.S. Department of the Treasury does not publish a yield on Treasury securities at “constant maturity” for
the Designated CMT Index Maturity, then the CMT Rate for such Interest Reset Date will be the yield to maturity of the arithmetic mean of the secondary market bid rates for the most recently issued Treasury securities having an original maturity of
approximately the Designated CMT Index Maturity, having a remaining term to maturity of not less than the Designated CMT Index Maturity minus one year and in a Representative Amount: as of approximately 3:30 P.M., New York City time, on such
Interest Determination Date, quoted by three primary U.S. government securities dealers in New York City selected by the Calculation Agent. In selecting such bid rates, the Calculation Agent will request quotations from five such primary dealers and
will disregard the highest quotation — or, if there is equality, one of the highest — and the lowest quotation — or, if there is equality, one of the lowest. If fewer than five but more than two such bid rates are provided, the CMT
Rate will be based on the arithmetic mean of the bid prices provided, and neither the highest nor lowest of such quotations will be eliminated. 

  

	 	(D)	 If the Calculation Agent is unable to obtain three quotations of the kind described in clause (C) above, the CMT Rate for such Interest Reset
Date will be the yield to maturity of the arithmetic mean of the secondary market offered rates for Treasury securities having an original maturity longer than the Designated CMT Index Maturity, having a remaining term to maturity closest to the
Designated CMT Index Maturity and in a Representative Amount, as of approximately 3:30 p.m., New York City time, on such CMT Interest Determination Date, of three primary U.S. government securities dealers in New York City selected by the
Calculation Agent. In selecting such bid rates, the Calculation Agent will request quotations from five such primary dealers and will disregard the highest quotation — or, if there is equality, one of the highest — and the lowest quotation
— or, if there is equality, one of the lowest. If fewer than 

  
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 -11- 

	 	
five but more than two of these primary dealers are quoting, then the CMT Rate for such Interest Reset Date will be based on the arithmetic mean of the bid rates so obtained, and neither the
highest nor the lowest of such quotations will be disregarded. If two Treasury securities with an original maturity longer than the CMT Designated Index Maturity have remaining terms to maturity that are equally close to the Designated CMT Index
Maturity, the Calculation Agent will obtain quotations for the Treasury securities with the shorter original term to maturity. 

  

	 	(E)	If two or fewer primary dealers selected by the Calculation Agent are quoting as described in clause (D) above, then the CMT Rate for such Interest Reset Date shall be determined by the Calculation Agent in its
sole discretion, after consulting such sources as it deems comparable to any of the foregoing quotations or display page, or any such source as it deems reasonable from which to estimate the rate for Treasury securities at “constant
maturity” or any of the foregoing bid rates. 

 (ii) if the Designated CMT Reuters Screen Page is the
Reuters Screen FEDCMT Page, the CMT Rate for such Interest Reset Date will be the one-week average yield for Treasury securities at “constant maturity” for a period of the Designated CMT Index Maturity as set forth in H.15(519) under the
heading “Week Ending” and opposite the heading “Treasury constant maturities” for the week preceding such Interest Reset Date, as such average is displayed on the Designated CMT Reuters Screen Page for the week preceding such
Interest Reset Date. 
  

	 	(A)	If the applicable average described in clause (ii) above is not displayed on the Designated CMT Reuters Screen Page, then the CMT Rate for such Interest Reset Date will be the one-week average yield for Treasury
securities at “constant maturity” for a period of the Designated CMT Index Maturity and for the week preceding such Interest Reset Date as published in H.15(519) under the heading “Week Ending” and opposite the heading
“Treasury constant maturities”. 

  

	 	(B)	If the applicable average described in clause (A) above does not appear on the Designated Reuters Screen Page or in H.15(919), then the CMT Rate for such Interest Reset Date will be the one-week average yield for
Treasury securities at “constant maturity” for a period equal to the Designated CMT Index Maturity as otherwise announced by the Federal Reserve Bank of New York for the week preceding such Interest Reset Date. 

 

	 	(C)	 If the Federal Reserve Bank of New York does not publish a one-week average yield for Treasury securities at “constant maturity” for a
period equal to the Designated CMT Index Maturity for the week prior to such Interest Reset Date, then the CMT Rate for such Interest Reset Date will 

  
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 -12- 

 
be the yield to maturity of the arithmetic mean of the secondary market bid rates for the most recently issued Treasury securities having an original maturity of approximately the Designated CMT
Index Maturity, having a remaining term to maturity of not less than the Designated CMT Index Maturity minus one year and in a Representative Amount: as of approximately 3:30 P.M., New York City time, on the Interest Determination Date, quoted
by three primary U.S. government securities dealers in New York City selected by the Calculation Agent. In selecting these bid rates, the Calculation Agent will request quotations from five primary dealers and will disregard the highest quotation
or, if there is equality, one of the highest, and the lowest quotation or, if there is equality, one of the lowest. If fewer than five but more than two such bid rates are provided, the CMT Rate will be based on the arithmetic mean of the bid prices
provided, and neither the highest nor lowest of such quotations will be eliminated. 
  

	 	(D)	If the Calculation Agent is unable to obtain three quotations of the kind described in clause (C) above, then the CMT Rate for such Interest Reset Date will be the yield to maturity of the arithmetic mean of the
secondary market offered rates for Treasury securities having an original maturity longer than the Designated CMT Index Maturity, having a remaining term to maturity closest to the Designated CMT Index Maturity and in a Representative Amount, as of
approximately 3:30 p.m., New York City time, on the Interest Determination Date, of three primary U.S. government securities dealers in New York City selected by the Calculation Agent. In selecting such bid rates, the Calculation Agent will
request quotations from five such primary dealers and will disregard the highest quotation — or, if there is equality, one of the highest — and the lowest quotation — or, if there is equality, one of the lowest. If fewer than five but
more than two of these primary dealers are quoting, then the CMT Rate for such Interest Reset Date will be based on the arithmetic mean of the bid rates so obtained, and neither the highest nor the lowest of such quotations will be disregarded. If
two Treasury securities with an original maturity longer than the CMT Designated Index Maturity have remaining terms to maturity that are equally close to the Designated CMT Index Maturity, the Calculation Agent will obtain quotations for the
Treasury securities with the shorter original term to maturity. 

  

	 	(E)	If two or fewer primary dealers selected by the Calculation Agent are quoting as described in clause (D) above, the CMT Rate for such Interest Reset Date shall be the rate determined by the Calculation Agent in its
sole discretion, after consulting such sources as it deems comparable to any of the foregoing quotations or display page, or any such source as it deems reasonable from which to estimate the one-week average for Treasury securities at “constant
maturity” or any of the foregoing bid rates.] 

  
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 -13- 

 [INSERT IF THE BASE RATE IS EURIBOR — the Base Rate that takes effect on any Interest
Reset Date shall be the rate equal to the interest rate for deposits in euros designated as “EURIBOR” and sponsored jointly by the European Banking Federation and ACI — The Financial Markets Association (or any company
established by the joint sponsors for purposes of compiling and publishing that rate) on the second Euro Business Day (as defined in Section 3(e) below) before such Interest Reset Date (an “Interest Determination Date”), and
will be determined in accordance with the following provisions: 
 (i) EURIBOR for such Interest Reset Date will be the
offered rate for deposits in euros having the Index Maturity as that rate appears on the Reuters Screen EURIBOR01 Page as of approximately 11:00 A.M., Brussels time, on such Interest Determination Date. 

(ii) If the rate described in clause (i) above does not so appear on the Reuters Screen EURIBOR01 Page, EURIBOR will be
determined on the basis of the rates at which deposits in euros are offered by four major banks in the Euro-Zone (as defined in Section 3(d) below) interbank market, at approximately 11:00 A.M., Brussels time, on such Interest
Determination Date, to prime banks in the Euro-Zone interbank market for a period of the Index Maturity commencing on such Interest Determination Date and in a Representative Amount, assuming an Actual/360 (ISDA) Day Count Convention. The
Calculation Agent will request the principal Euro-Zone office of each of these four banks to provide a quotation of its rate. If at least two quotations are provided, EURIBOR for such Interest Reset Date will be the arithmetic mean of such
quotations. 
 (iii) If fewer than two quotations are provided as described in clause (ii) above, EURIBOR for such
Interest Reset Date will be the arithmetic mean of the rates quoted by major banks in the Euro-Zone, selected by the Calculation Agent at approximately 11:00 A.M., Brussels time, on such Interest Reset Date, for loans of euros to leading European
banks for the Index Maturity beginning on such Interest Reset Date, and in a Representative Amount. 
 (iv) If no quotation
is provided as described in clause (iii) above, then the Calculation Agent, after consulting such sources as it deems comparable to any of the foregoing quotations or display page, or any such source as it deems reasonable from which to
estimate EURIBOR or any of the foregoing lending rates, shall determine EURIBOR for the Interest Determination Date in its sole discretion.] 

  
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 [INSERT IF THE BASE RATE IS THE FEDERAL FUNDS RATE — the Base Rate that takes effect
on any Interest Reset Date shall be the rate equal to the rate, on such Interest Reset Date, as set forth in H.15(519) opposite the heading “Federal funds (effective)”, as that rate is displayed on the Reuters Screen FEDFUNDS1 Page for
that day. If the Federal Funds Rate cannot be determined as described above, the following procedures will apply in determining the Federal Funds Rate: 

(i) If the rate described above is not displayed on the Reuters Screen FEDFUNDS1 Page by approximately 5:00 P.M., New York
City time, on the day that is one New York City Banking Day following such Interest Reset Date, the Federal Funds Rate for such Interest Reset Date will be the rate published on H.15(519) under the heading “Federal funds (effective)”. 

(ii) If the rate is not displayed on the Reuters Screen FEDFUNDS1 Page and does not appear in H.15(519) at approximately
5:00 P.M., New York City time, on the day that is one New York City Banking Day following such Interest Reset Date, then the Federal Funds (Effective) Rate for such Interest Reset Date will be the rate described above as published in H.15 Daily
Update, or another recognized electronic source used for displaying that rate, opposite the heading “Federal funds (effective)”. 

(iii) If the rate cannot be determined as described above, then the Federal Funds (Effective) Rate for such Interest Reset Date
will be the rate for the first day preceding such Interest Reset Date for which such rate is set forth in H.15(519) opposite the caption “Federal funds (effective)”, as such rate is displayed on the Reuters Screen FEDFUNDS1 Page.] 

[INSERT IF THE BASE RATE IS LIBOR — the Base Rate that takes effect on any Interest Reset Date shall be LIBOR, which will be the
London interbank offered rate for deposits in U.S. dollars or any other Index Currency for the Index Maturity, appearing on the Reuters Screen LIBOR Page (as defined in Section 3(d) below) as of approximately 11:00 A.M., London time, on the day
that is two London Business Days prior to such Interest Reset Date (such date, the “LIBOR Interest Determination Date”). 

(i) If LIBOR does not so appear on the Reuters Screen LIBOR Page, then LIBOR will be determined on the basis of the rates at
which deposits in U.S. dollars or any other Index Currency are offered by four major banks in the London interbank market selected by the Calculation Agent at approximately 11:00 A.M., London time, on such LIBOR Interest Determination Date, to
prime banks in the London interbank market for a period of the Index Maturity beginning on the relevant LIBOR Interest Determination Date and in a Representative Amount. The Calculation Agent will request the principal London office of each such
bank to provide a quotation of its rate. If at least two quotations are provided, LIBOR for such Interest Reset Date will be the arithmetic mean of the quotations. 

(ii) If fewer than two of the requested quotations described in clause (i) above are provided, LIBOR for such Interest
Reset Date will be the arithmetic mean of the rates quoted by major banks in New York City, or the specified Index Currency is not U.S. dollars, in the principal financial center for the country issuing the Index Currency, selected by the
Calculation Agent at approximately 11:00 A.M. New York City time (or 

  
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 -15- 

 
the time in the relevant principal financial center if the specified Index Currency is not U.S. dollars) on such Interest Reset Date, for loans in U.S. dollars (or the Index Currency) to leading
European banks for a period of the Index Currency having the Index Maturity beginning on such Interest Reset Date and in a Representative Amount. 

(iii) If no quotation is provided as described in clause (ii) above, then the Calculation Agent, after consulting such
sources as it deems comparable to any of the foregoing quotations or display page, or any such source as it deems reasonable from which to estimate LIBOR or any of the foregoing lending rates, shall determine LIBOR for such Interest Reset Date in
its sole discretion.] 
 [INSERT IF THE BASE RATE IS THE PRIME RATE — the Base Rate that takes effect on any Interest Reset Date
shall be the rate equal to the rate for such Interest Reset Date published in H.15(519) opposite the heading “Bank prime loan”. If the Prime Rate cannot be determined as described above, the following procedures will apply in determining
the Prime Rate: 
 (i) If the rate described above is not yet published in H.15(519) by approximately 5:00 P.M., New
York City time, on the day that is one New York City Banking Day following such Interest Reset Date, then the Prime Rate will be the rate, for such Interest Reset Date, as published in H.15 Daily Update or another recognized electronic source used
for the purpose of displaying that rate, opposite the heading “Bank prime loan”. 
 (ii) If the rate described in
clause (i) above does not appear in H.15(519), H.15 Daily Update or another recognized electronic source by approximately 5:00 P.M., New York City time, on the day that is one New York City Banking Day following such Interest Reset Date,
then the Prime Rate will be the rate for the day first preceding such Interest Reset Date for which such rate is set forth in H.15(519) opposite the caption “Bank prime rate”.] 

[INSERT IF THE BASE RATE IS THE TREASURY RATE — the Base Rate that takes effect on any Interest Reset Date shall be the rate on
such Interest Reset Date (if direct obligations of the United States (“Treasury Bills”) have been auctioned on such day, as that rate appears on the Reuters Screen USAUCTION10 Page or the Reuters Screen USAUCTION11 Page opposite the
Index Maturity under the heading “INVEST RATE”. If the Treasury Rate cannot be determined as described above, the following procedures will apply in determining the Treasury Rate: 

(i) If the rate described above does not appear on either the Reuters Screen USAUCTION10 or USAUCTION11 Page on the Calculation
Date (unless the calculation is made earlier and the rate is available from that source at that time), but Treasury Bills having the Index Maturity have been auctioned during the relevant Interest Period, then the Treasury Rate will be the Bond
Equivalent Yield (as defined in Section 3(d) below) of the rate, for such Interest Reset Date, as published in H.15 Daily Update, or another 

  
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 -16- 

 
recognized electronic source used for displaying that rate, for that day and for the Index Maturity, under a heading indicating that such rate is the “auction high” rate for Treasury
Bills. 
 (ii) If the rate cannot be determined as described in clause (i) above, then the Treasury Rate will be the
Bond Equivalent Yield of the auction rate for Treasury Bills with a remaining maturity equal to the Index Maturity as announced by the United States Treasury 

(iii) If no such auction is held for any period of seven consecutive calendar days ending on, and including, any Friday and an
Interest Reset Date occurred during such period, then the Treasury Rate for such Interest Reset Date will be the Bond Equivalent Yield of the rate for the date on which such auction would have been ordinarily been held in accordance with the usual
practices of the United Stated Treasury of the rate set forth in H.15(519) under the heading “U.S. government securities/Treasury bills (secondary market)” 

(iv) If the rate described in clause (iii) above does not appear in H.15(519) on such Calculation Date (unless the
calculation is made earlier and the rate is available from that source at that time), then the Treasury Rate will be the rate, for such Interest Reset Date and for Treasury Bills having the Index Maturity, as published in H.15 Daily Update, or
another recognized electronic source used for displaying that rate, under the heading “U.S. government securities/ Treasury bills (secondary market)”. 

(v) If the rate described in clause (iv) above does not appear in H.15 Daily Update or another recognized electronic
source on such Calculation Date (unless the calculation is made earlier and the rate is available from that source at that time), the Treasury Rate will be the Bond Equivalent Yield of the arithmetic mean of the following secondary market bid rates
for the issue of Treasury Bills with a remaining maturity closest to the Index Maturity: the rates bid as of approximately 3:30 P.M., New York City time, on such Interest Reset Date, by primary U.S. government securities dealers in New York
City selected by the Calculation Agent. 
 (vi) If no quotation is provided as described in the preceding paragraph, then the
Calculation Agent, after consulting such sources as it deems comparable to any of the foregoing secondary market bids or any display page or other U.S. government publication or source, or any other source as it deems reasonable from which to
estimate the Treasury Bills auction rate or any of the foregoing secondary market bid rates, shall determine the Treasury Rate for such Interest Reset Date in its sole discretion.] 

(c) Minimum and Maximum Limits. Notwithstanding the foregoing, the rate at which interest accrues on this Security
[INSERT AS APPLICABLE IF CAP OR FLOOR APPLIES — (i) shall not at any time be higher than [    %], or less than [    %], in each case on an accrual basis, and (ii)] shall not at any time
be higher than the maximum rate permitted by New York law, as the same may be modified by United States law of general application. 

  
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 (d) Definitions of Calculation Terms. As used in this Security, the
following terms have the meanings set forth below: [INSERT RELEVANT TERMS BELOW AS APPLICABLE — 
 “Bond Equivalent
Yield” means a yield expressed as a percentage and calculated in accordance with the following formula: 
  

									
		 	 Bond Equivalent

Yield =
	  	 D x N 
	 	x 100,	  	
		 	  	360 – (D x M)	 		  	

 where 
  

	 	•	 	“D” equals the annual rate for Treasury Bills quoted on a bank discount basis and expressed as a decimal; 

  

	 	•	 	“N” equals 365 or 366, as the case may be; and 

  

	 	•	 	“M” equals the actual number of days in the applicable Interest Reset Period. 

 The
“Calculation Date” means the Business Day immediately preceding the date on which interest will next be paid on this Security. 

“H.15(519)” means the weekly statistical release designated as such published by the Federal Reserve System Board of
Governors, or its successor, available through the website of the Board of Governors of the Federal Reserve System at http://www.federalreserve.gov/releases/h15/update/h15upd.htm, or any successor site or publication. 

“H.15 Daily Update” means the daily update of H.15(519), available through the website of the Board of Governors of the
Federal Reserve System, at http://www.federalreserve.gov/releases/h15/update/h15upd.htm, or any successor site or publication. 

“Interest Period” means [INSERT IF BUSINESS DAY CONVENTION IS FOLLOWING UNADJUSTED OR MODIFIED FOLLOWING UNADJUSTED
— the period from and including an Interest Payment Date (or, with respect to the initial Interest Period, the Original Issue Date) to but excluding the next succeeding Interest Payment Date] [INSERT IF BUSINESS DAY CONVENTION IS
FOLLOWING OR MODIFIED FOLLOWING — means the period from and including the last date on which interest was paid (or, with respect to the initial Interest Period, the Original Issue Date) to but excluding the next succeeding date on which
interest will be paid.] 

  
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 “Money Market Yield” means a yield expressed as a percentage and calculated in
accordance with the following formula: 
  

																	
		 	 
  
	Money Market
 Yield  =
	 
   
	 	 	D x 360	  	 	 	x	 	 	100,	 	
		 	 	 	360 – (D x M)	  	 				 		 	

 where 
  

	 	•	 	“D” equals the per annum rate for commercial paper quoted on a bank discount basis and expressed as a decimal; and 

  

	 	•	 	“M” equals the actual number of days in the applicable Interest Reset Period. 

“Representative Amount” means an amount that, in the Calculation Agent’s judgment, is representative of a single
transaction in the relevant market at the relevant time. 
 “Reuters Screen” means the display on the Reuters 3000 Xtra
service or any successor or replacement service, on the page or pages, or any successor or replacement page or pages on that service. 

“Reuters Screen LIBOR Page” means Reuters Screen LIBOR01 Page. 

“Reuters Screen USPRIME1 Page” means the display on the Reuters Screen page titled “USPRIME1”, for the purpose of
displaying Prime Rates or base lending rates of major U.S. banks.] 
 (e) Other Definitions.  

“Business Day” means, for this Security, a day that is a new York Business Day (as defined below) [INSERT IF THE BASE RATE IS
USD LIBOR — , is also a London Business Day] [INSERT IF THE BASE RATE IS EURIBOR OR IF THE CURRENCY FOR PAYMENT OF PRINCIPAL OF OR INTEREST ON THIS SECURITY IS EUROS, OR THE BASE RATE IS LIBOR FOR WHICH THE INDEX CURRENCY IS EUROS — , is
also a Euro Business Day, and solely with respect to any payment or other action to be made or taken at any Place of Payment outside The City of New York, is a Monday, Tuesday, Wednesday, Thursday or Friday that is not a day on which banking
institutions in such Place of Payment generally are authorized or obligated by law, regulation or executive order to close.] 
 “Day
Count Convention” means: 
 [IF DAY COUNT CONVERSION IS “1/1 (ISDA)”, INSERT — 1.] 

[IF DAY COUNT CONVERSION IS “ACTUAL/ACTUAL (ISDA)” OR “ACT/ACT (ISDA)”, INSERT — the actual number of days in the
Interest Period divided by 365 (or, if any portion of that Interest Period falls in a leap year, the sum of (1) the actual number of days in that portion of the Interest Period falling in a leap year divided by 366 and
(2) the number of days in that portion of the Interest Period falling in a non-leap year divided by 365).] 

  
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 [IF DAY COUNT CONVERSION IS “ACTUAL/ACTUAL (ICMA)”, INSERT — the number of days in
the Interest Period, including February 29 in a leap year, divided by the product of (1) the actual number of days in such Interest Period and (2) the number of Interest Periods in the calendar year.] 

[IF DAY COUNT CONVERSION IS “ACTUAL/ACTUAL (BOND)”, INSERT — the number of calendar days in the Interest Period, divided
by the number of calendar days in the Interest Period multiplied by the number of Interest Periods in the calendar year.] 
 [IF DAY COUNT
CONVERSION IS “ACTUAL/ACTUAL (EURO)”, INSERT — the number of calendar days in the Interest Period divided by 365 or, if the Interest Period includes February 29, 366.] 

[IF DAY COUNT CONVERSION IS “ACTUAL/365 (FIXED)”, INSERT — “Act/365 (Fixed)”, “A/365 (Fixed)” or
“A365F”, the actual number of days in the Interest Period divided by 365.] 
 [IF DAY COUNT CONVERSION IS “ACTUAL/360
(ISDA)”, “Act/360 (ISDA)” or “A/360 (ISDA)”, INSERT — the actual number of days in the Interest Period divided by 360.] 

[IF DAY COUNT CONVERSION IS “ACTUAL/360 (ICMA)”, INSERT — the number of calendar days in the period, including February 29
in a leap year, divided by 360 days.] 
 [IF DAY COUNT CONVERSION IS “30/360”, INSERT — the calculation shall be made
assuming a 360-day year of 12 30-day months.] 
 [IF DAY COUNT CONVERSION IS “30/360 (ISDA)”, “360/360 (ISDA)” or
“BOND BASIS (ISDA)”, INSERT — the number of days in the Interest Period in respect of which payment is being made divided by 360, calculated on a formula basis as follows: 

 

			
	 Day Count Fraction =    
	  	
[360 x (Y2 – Y1)] + [30 x (M2 – M1)] + (D2 – D1)

		  	360

 where 
  

	 	•	 	“Y1” is the year, expressed as a number, in which the first day of the Interest Period falls; 

  
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	 	•	 	“Y2” is the year, expressed as a number, in which the day immediately following the last day included in the Interest Period falls; 

 

	 	•	 	“M1” is the calendar month, expressed as a number, in which the first day of the Interest Period falls; 

 

	 	•	 	“M2” is the calendar month, expressed as a number, in which the day immediately following the last day included in the Interest Period falls;

  

	 	•	 	“D1” is the first calendar day, expressed as a number, of the Interest Period, unless such number would be 31, in which case D1 will be 30; and 

  

	 	•	 	“D2” is the calendar day, expressed as a number, immediately following the last day included in the Interest Period, unless such number would be 31 and D1 is greater than 29, in which case D2 will be 30.] 

[IF DAY COUNT CONVERSION IS “30E/360”, “30E/360 (ISDA)” or “EUROBOND BASIS”, INSERT — the number of days in
the Interest Period in respect of which payment is being made divided by 360, calculated on a formula basis as follows: 
  

			
	 Day Count Fraction =    
	  	
[360 x (Y2 – Y1)] + [30 x (M2 – M1)] + (D2 – D1)

		  	360

 where 
  

	 	•	 	“Y1” is the year, expressed as a number, in which the first day of the Interest Period falls; 

 

	 	•	 	“Y2” is the year, expressed as a number, in which the day immediately following the last day included in the Interest Period falls; 

 

	 	•	 	“M1” is the calendar month, expressed as a number, in which the first day of the Interest Period falls; 

 

	 	•	 	“M2” is the calendar month, expressed as a number, in which the day immediately following the last day included in the Interest Period falls;

  

	 	•	 	“D1” is the first calendar day, expressed as a number, of the Interest Period, unless (1) such number would be 31, or (2), if “30E/360
(ISDA)” is specified, that day is the last day of February, in which cases D1 will be 30; and 

  

	 	•	 	“D2” is the calendar day, expressed as a number, immediately following the last day included in the Interest Period, unless (1) such number would be
31, or (2), if “30E/360 (ISDA)” is specified, that day is also the last day of February and not the maturity date, in which cases D2 will be 30.] 

  
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 “Euro Business Day” means each Monday, Tuesday, Wednesday, Thursday and Friday
on which the Trans-European Automated Real-Time Gross Settlement Express Transfer (TARGET) System, or any successor system, is open for business. 

“Euro-Zone” means, at any time, the region comprised of the EMU Countries. 

“London Business Day” means each Monday, Tuesday, Wednesday, Thursday and Friday that is not a day on which banking
institutions in London generally are authorized or obligated by law, regulation or executive order to close and, if the Base Rate for this Security is LIBOR, is also a day on which dealings in the Index Currency specified on the face hereof are
transacted in the London interbank market. 
 “New York Business Day” means each Monday, Tuesday, Wednesday, Thursday and
Friday that is not a day on which banking institutions in New York City generally are authorized or obligated by law, regulation or executive order to close. 

“New York City Banking Day” means any day on which commercial banks are open for general business (including dealings in
foreign exchange and foreign currency deposits) in New York City. 
 “U.S. Government Securities Business Day” means any
day except for a Saturday, Sunday or a day on which the Securities Industry and Financial Markets Association recommends that the fixed income department of its members be closed for the entire day for purposes of trading in U.S. government
securities. 
 (f) Sources and Corrections. References herein to a Base Rate as set forth on a display page, other
published source, information vendor or other vendor officially designated by the sponsor of that rate, if there is a successor source for the display page, other published source, information vendor or other official vendor, include that successor
source as applicable as determined by the Calculation Agent. References herein to a particular heading or headings on any such sources, include any successor or replacement heading or headings as determined by the Calculation Agent. 

[INSERT AS APPLICABLE — If the Base Rate is based on information obtained from a Reuters Screen, such rate will be subject to the
corrections, if any, published on such Reuter’s Screen within one hour of the time such information was first displayed on such source. If the Base Rate is based on information obtained from H.15(519) or H.15 Daily Update, such rate will be
subject to the corrections, if any, published by that source within 30 days of the day such rate was first published in that source.] 
  

	 	4.	[IF APPLICABLE, INSERT — Additional Amounts. 

 If the
beneficial owner of this Security is a United States Alien (as defined below), the Company will pay all additional amounts that may be necessary so that every net payment of the principal of and interest on this Security to such beneficial owner,
after deduction or withholding for or on account of any present or future tax, assessment or governmental charge imposed with 

  
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respect to such payment by any U.S. Taxing Authority (as defined below), will not be less than the amount provided for in this Security to be then due and payable; provided,
however, that the Company shall have no obligation to pay additional amounts for or on account of any one or more of the following: 

(i) any tax, assessment or other governmental charge imposed solely because at any time there is or was a connection between
such beneficial owner (or between a fiduciary, settlor, beneficiary or member of such beneficial owner, if such beneficial owner is an estate, trust or partnership) and the United States (as defined below) (other than the mere receipt of a payment
on, or the ownership or holding of, a Security), including because such beneficial owner (or such fiduciary, settlor, beneficiary or member) at any time, for U.S. federal income tax purposes: (a) is or was a citizen or resident, or is or was
treated as a resident, of the United States, (b) is or was present in the United States, (c) is or was engaged in a trade or business in the United States, (d) has or had a permanent establishment in the United States, (e) is or
was a domestic or foreign personal holding company, a passive foreign investment company or a controlled foreign corporation, (f) is or was a corporation that accumulates earnings to avoid U.S. federal income tax or (g) is or was a
“10-percent shareholder” of the Company as defined in section 871(h)(3) of the U.S. Internal Revenue Code or any successor provision; 

(ii) any tax, assessment or governmental charge imposed solely because of a change in applicable law or regulation, or in any
official interpretation or application of applicable law or regulation, that becomes effective more than 15 days after the day on which the payment becomes due or is duly provided for, whichever occurs later; 

(iii) any estate, inheritance, gift, sales, excise, transfer, wealth or personal property tax or any similar tax, assessment or
other governmental charge; 
 (iv) any tax, assessment or other governmental charge imposed solely because such beneficial
owner or any other Person fails to comply with any certification, identification or other reporting requirement concerning the nationality, residence, identity or connection with the United States of the Holder or any beneficial owner of this
Security, if compliance is required by statute, by regulation of the U.S. Treasury Department or by an applicable income tax treaty to which the United States is a party, as a precondition to exemption from such tax, assessment or other governmental
charge; 
 (v) any tax, assessment or other governmental charge that is payable otherwise than by deduction or withholding
from payments of principal of or interest on this Security; 
 (vi) any tax, assessment or other governmental charge imposed
solely because the payment is to be made by a particular Paying Agent (which term may include the Company) and would not be imposed if made by another Paying Agent (which term may include the Company); 

(vii) any tax, assessment or other governmental charge imposed solely because

  
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the Holder (1) is a bank purchasing this Security in the ordinary course of its lending business or (2) is a bank that is neither (A) buying this Security for investment purposes
only nor (B) buying this Security for resale to a third party that either is not a bank or holding the note for investment purposes only; or 

(viii) any combination of the taxes, assessments or other governmental charges described in items (i) through
(vii) of this Section 4. 
 Additional amounts also will not be paid with respect to any payment of principal of or interest on
this Security to any United States Alien who is a fiduciary or a partnership, or who is not the sole beneficial owner of any such payment, to the extent that the Company would not be required to pay additional amounts to any beneficiary or settlor
of such fiduciary or any member of such a partnership, or to any beneficial owner of the payment, if that Person had been treated as the beneficial owner of this Security for this purpose. 

In addition, any amounts to be paid on this Security will be paid net of any deduction or withholding imposed or required pursuant to Sections
1471 through 1474 of the U.S. Internal Revenue Code, any current or future regulations or official interpretations thereof, any agreement entered into pursuant to Section 1471(b) of the Code, or any fiscal or regulatory legislation, rules or
practices adopted pursuant to any intergovernmental agreement entered into in connection with the implementation of such Sections of the U.S. Internal Revenue Code, and no additional amounts will be required to be paid on account of any such
deduction or withholding. 
 The term “United States Alien” means any Person who, for U.S. federal income tax purposes, is
a nonresident alien individual, a foreign corporation, a foreign partnership one or more of the members of which is, for United States federal income tax purposes, a foreign corporation, a nonresident alien individual or a nonresident alien
fiduciary of a foreign estate or trust, or a nonresident alien fiduciary of an estate or trust that is not subject to U.S. federal income tax on a net income basis on income or gain from this Security. For the purposes of this Section 4 and
Section 5 only, (a) the term “United States” means the United States of America (including the states thereof and the District of Columbia), together with the territories, possessions and all other areas subject to the
jurisdiction of the United States of America and (b) the term “U.S. Taxing Authority” means the United States of America or any state, other jurisdiction or taxing authority in the United States. 

Except as specifically provided in this Security, the Company shall not be required to make any payment with respect to any tax, assessment or
other governmental charge imposed by any government or any political subdivision or taxing authority thereof or therein. 
 Whenever in the
Securities of this series (or in the 2008 Indenture, including in Sections 5.01(1) and (2) thereof, insofar as applicable to this series) there is a reference, in any context, to the payment of the principal of or interest on any Security of
this series, such mention shall be deemed to include mention of any payment of additional amounts to United States Aliens in respect of such payment of principal or interest to the extent that, in such context, such additional amounts are, were or
would be payable in respect thereof pursuant to this Section 4 or any 

  
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corresponding section of another Security of this series, as the case may be. Express mention of the payment of additional amounts in any provision of any Security of this series shall not be
construed as excluding additional amounts in the provisions of any Security of this series (or of the 2008 Indenture insofar as it applies to this series) where such express mention is not made.] 

 

	 	5.	Redemption at the Company’s Option. 

 The Securities of this series may be
redeemed, as a whole but not in part, at the option of the Company, at a redemption price equal to 100% of the principal amount of the Securities to be redeemed, together with interest accrued to the date fixed for redemption, if, as a result of any
amendment to, or change in, the laws or regulations of any U.S. Taxing Authority (as defined in Section 4 above), or any amendment to or change in any official interpretation or application of such laws or regulations, which amendment or change
becomes effective or is announced on or after             , the Company will become obligated to pay, on the next Interest Payment Date, additional amounts in respect of any Security of
this series pursuant to Section 4 of this Security or any corresponding section of another Security of this series. If the Company becomes entitled to redeem the Securities of this series, it may do so on any day thereafter pursuant to the 2008
Indenture; provided, however, that (1) the Company gives the Holder of this Security notice of such redemption not more than 60 days nor less than 30 days prior to the date fixed for redemption as provided in the 2008 Indenture,
(2) no such notice of redemption may be given earlier than 90 days prior to the next Interest Payment Date on which the Company would be obligated to pay such additional amounts and (3) at the time such notice is given, such obligation to
pay such additional amounts remains in effect. Immediately prior to the giving of any notice of redemption of Securities pursuant to this Section 5, the Company will deliver to the Trustee an Officers’ Certificate stating that the Company
is entitled to effect such redemption and setting forth in reasonable detail a statement of facts showing that the conditions precedent to the right of the Company to so redeem the Securities have occurred. Interest installments due on or prior to a
Redemption Date will be payable to the Holder of this Security or one or more Predecessor Securities, of record at the close of business on the relevant record date, all as provided in the 2008 Indenture. 

 

	 	6.	Defeasance. 

 The 2008 Indenture contains provisions for defeasance at any time of
the entire indebtedness of this Security or certain restrictive covenants and Events of Default with respect to this Security, in each case upon compliance with certain conditions set forth in the 2008 Indenture. Both of such provisions are
applicable to this Security. 
  

	 	7.	Modification and Waiver. 

 The 2008 Indenture permits, with certain exceptions as
therein provided, the amendment thereof and the modification of the rights and obligations of the Company and the rights of the Holders of the Securities to be affected under the 2008 Indenture at any time by the Company and the Trustee with the
consent of the Holders of a majority in principal amount of all Securities at the time Outstanding to be affected, considered together as one class for this purpose (such 

  
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Securities to be affected may be Securities of the same or different series and, with respect to any series, may comprise fewer than all the Securities of such series). The 2008 Indenture also
contains provisions (i) permitting the Holders of a majority in principal amount of the Securities at the time Outstanding to be affected under the 2008 Indenture, considered together as one class for this purpose (such affected Securities may
be Securities of the same or different series and, with respect to any particular series, may comprise fewer than all the Securities of such series), on behalf of the Holders of all Securities so affected, to waive compliance by the Company with
certain provisions of the 2008 Indenture and (ii) permitting the Holders of a majority in principal amount of the Securities at the time Outstanding of any series to be affected under the 2008 Indenture (with each such series considered
separately for this purpose), on behalf of the Holders of all Securities of such series, to waive certain past defaults under the 2008 Indenture and their consequences. Any such consent or waiver by the Holder of this Security shall be conclusive
and binding upon such Holder and upon all future Holders of this Security and of any Security issued upon the registration of transfer hereof or in exchange herefor or in lieu hereof, whether or not notation of such consent or waiver is made upon
this Security. 
  

	 	8.	Remedies. 

 If an Event of Default with respect to Securities of this series shall
occur and be continuing, the principal of the Securities of this series may be declared due and payable in the manner and with the effect provided in the 2008 Indenture. 

As provided in and subject to the provisions of the 2008 Indenture, the Holder of this Security shall not have the right to institute any
proceeding with respect to the 2008 Indenture, or for the appointment of a receiver or trustee, or for any other remedy thereunder, unless such Holder shall have previously given the Trustee written notice of a continuing Event of Default with
respect to the Securities of this series, the Holders of not less than 25% in principal amount of the Securities of this series at the time Outstanding shall have made written request to the Trustee to institute proceedings in respect of such Event
of Default as Trustee and offered the Trustee indemnity reasonably satisfactory to it, and the Trustee shall not have received from the Holders of a majority in principal amount of Securities of this series at the time Outstanding a direction
inconsistent with such request, and shall have failed to institute any such proceeding, for 60 days after receipt of such notice, request and offer of indemnity. 

The foregoing shall not apply to any suit instituted by the Holder of this Security for the enforcement of any payment of principal hereof or
any premium or interest hereon on or after the respective due dates expressed herein. 
 No reference herein to the 2008 Indenture and no
provision of this Security or of the 2008 Indenture shall alter or impair the obligation of the Company, which is absolute and unconditional, to pay the principal of and interest on this Security at the times, place and rate, and in the coin or
currency, herein prescribed. 

  
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	 	9.	Transfer and Exchange. 

 As provided in the 2008 Indenture and subject to certain
limitations therein set forth, the transfer of this Security is registrable in the Security Register, upon surrender of this Security for registration of transfer at the office or agency of the Company in any place where the principal of and
interest on this Security are payable, duly endorsed by, or accompanied by a written instrument of transfer in form satisfactory to the Company and the Security Registrar duly executed by, the Holder hereof or his or her attorney duly authorized in
writing, and thereupon one or more new Securities of this series and of like tenor, of authorized denominations and for the same aggregate principal amount, will be issued to the designated transferee or transferees. 

As provided in the 2008 Indenture and subject to certain limitations therein set forth, Securities of this series are exchangeable for a like
aggregate principal amount of Securities of this series and of like tenor of a different authorized denomination, as requested by the Holder surrendering the same. 

No service charge shall be made for any such registration of transfer or exchange, but the Company may require payment of a sum sufficient to
cover any tax or other governmental charge payable in connection therewith. 
 Prior to due presentment of this Security for registration of
transfer, the Company, the Trustee and any agent of the Company or the Trustee may treat the Person in whose name this Security is registered as the owner hereof for all purposes, whether or not this Security be overdue, and neither the Company, the
Trustee nor any such agent shall be affected by notice to the contrary. 
 [INSERT IF GLOBAL SECURITY — This Security is a Global
Security and is subject to the provisions of the 2008 Indenture relating to Global Securities, including the limitations in Section 3.05 thereof on transfers and exchanges of Global Securities.] 

 

	 	9.	Governing Law. 

 This Security and the 2008 Indenture shall be governed
by and construed in accordance with the laws of the State of New York. 
  

	 	10.	Terms Defined in the 2008 Indenture. 

 All terms used in this Security which are
defined in the 2008 Indenture but not otherwise defined herein shall have the meanings assigned to them in the 2008 Indenture. 

  
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 -27- 

 ASSIGNMENT 

FOR VALUE RECEIVED, the undersigned hereby sell(s), assign(s) and transfer(s) unto
             
  

                          
                                         
                                         
                                         
                                         
                                         
      
 PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE 

[                         
                                         
                                         
                         ] 

(Please Print or Typewrite Name and Address Including Postal Zip Code of Assignee) 

the attached Security and all rights thereunder, and hereby irrevocably constitutes and appoints 

 
 to transfer said Security on the books of the Company, with full power of substitution
in the premises. 
 Dated:                      

Signature Guaranteed 
  

			
	 NOTICE: Signature must be
 Medallion Signature
Guaranteed.
	  	 NOTICE: The signature to this assignment must

correspond with the name of the Holder as written upon
 the face
of the attached Security in every particular,
 without alteration or any change whatever.

  
 -28-

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