Document:

Form of Restricted Stock Award

     

    
      
        

      

    RESTRICTED
      STOCK AWARD

    PURSUANT
      TO THE OMEGA HEALTHCARE INVESTORS, INC.

    2004
      STOCK INCENTIVE PLAN

    

    THIS
      AGREEMENT (sometimes referred to as this “Award”) is made as of the Grant Date,
      by Omega Healthcare Investors, Inc. (the “Company”) to ________________________
      (the “Recipient”) subject to acceptance by the Recipient.

    

    Upon
      and
      subject to the Terms and Conditions attached hereto and incorporated herein
      by
      reference as part of this Agreement, the Company hereby awards as of the Grant
      Date to the Recipient the Restricted Shares (the “Restricted Stock Grant”).
      Underlined and capitalized terms in items A through D below shall have the
      meanings there ascribed to them.

    

    
      	 	
              A.

            	
              Grant
                Date:
                May 7, 2007.

            

    

    

    
      	 	
              B.

            	
              Plan
                (under which Restricted Stock Grant is granted):
                Omega Healthcare Investors, Inc. 2004 Stock Incentive
                Plan.

            

    

    

    
      	 	
              C.

            	
              Restricted
                Shares:
                ______________ shares of the Company’s common stock (“Common Stock”),
                subject to adjustment as provided in the attached Terms and
                Conditions.

            

    

    

    
      	 	
              D.

            	
              Vesting
                Schedule:
                The Restricted Shares shall vest in accordance with Exhibit
                1
                hereto. The Restricted Shares which have become vested pursuant to
                the
                Vesting Schedule are herein referred to as the “Vested Shares.”
                

            

    

    

    

    IN
      WITNESS WHEREOF, the Company and the Recipient have executed this Agreement
      as
      of the Grant Date set forth above.

    

    

    RECIPIENT     OMEGA
      HEALTHCARE INVESTORS, INC.

    

    

    By:
            

     

    [Signature]     Title:
            

    

    TERMS
      AND CONDITIONS TO THE

    RESTRICTED
      STOCK AGREEMENT

    PURSUANT
      TO THE OMEGA HEALTHCARE INVESTORS, INC.

    2004
      STOCK INCENTIVE PLAN

    

    1.  Restricted
      Shares Held by the Share Custodian.
      The
      Recipient hereby authorizes and directs the Company to deliver any share
      certificate issued by the Company to evidence Restricted Shares to the Secretary
      of the Company or such other officer of the Company as may be designated by
      the
      Committee (the “Share Custodian”) to be held by the Share Custodian until the
      Restricted Shares become Vested Shares in accordance with the Vesting Schedule.
      When the Restricted Shares become Vested Shares, the Share Custodian shall
      deliver the Restricted Shares to the Recipient. In the event that the Recipient
      forfeits any of the Restricted Shares, and the number of Vested Shares includes
      a fraction of a share, the Share Custodian shall not be required to deliver
      the
      fractional share, and the Company may pay the Recipient the amount determined
      by
      the Company to be the estimated fair market value therefor. The Recipient hereby
      irrevocably appoints the Share Custodian, and any successor thereto, as the
      true
      and lawful attorney-in-fact of the Recipient with full power and authority
      to
      execute any stock transfer power or other instrument necessary to transfer
      the
      Restricted Shares to the Company in accordance with this Award, in the name,
      place, and stead of the Recipient. The term of such appointment shall commence
      on the date of the Restricted Stock Grant and shall continue until the
      Restricted Shares are delivered to the Recipient as provided above. In the
      event
      the number of shares of Common Stock is increased or reduced by a change in
      the
      par value, split-up, stock split, reverse stock split, reclassification, merger,
      reorganization, consolidation, or otherwise, the Recipient agrees that any
      certificate representing shares of Common Stock or other securities of the
      Company issued as a result of any of the foregoing shall be delivered to the
      Share Custodian and shall be subject to all of the provisions of this Award
      as
      if initially granted thereunder. To effect the provisions of this Section,
      the
      Recipient shall complete an irrevocable stock power in favor of the Share
      Custodian in the form attached hereto as Exhibit
      2.

    

    2.  Rights
      of a Shareholder.
      During
      the period that the Share Custodian holds the shares of Common Stock subject
      to
      Section 1, the Recipient shall be entitled to all rights applicable to shares
      of
      Common Stock not so held, except as otherwise provided in this award, including
      the right to receive dividends paid on Common Stock notwithstanding that all
      or
      some of the Restricted Shares may not be Vested Shares.

    

    3.  Tax
      Withholding.

    

    (a) The
      Recipient must deliver to the Company, within ten (10) days after written
      notification from the Company as to the amount of the tax withholding that
      is
      due, either (i) cash, or (ii) a certified check payable to the Company, in
      the
      amount of all tax withholding obligations imposed on the Company by reason
      of
      the vesting of the Restricted Shares, or the making of an election pursuant
      to
      Code Section 83(b), as applicable, except as provided in Section 3(b), or (iii)
      by tendering a number of whole shares of Common Stock which, when multiplied
      by
      the Fair Market Value of the Common Stock on the vesting date, is sufficient
      to
      satisfy the minimum amount of the required tax withholding obligations imposed
      on the Company (the “Stock Tendering Election”); provided, however, the
      Committee may in its sole discretion, disapprove and give no effect to the
      Stock
      Tendering Election by giving written notice to the Recipient within ten (10)
      days after receipt of the Stock Tendering Election, in which event the Recipient
      must deliver, within ten (10) days after receiving such notice, the tax
      withholding in the manner provided in clause (i) or (ii). If the Recipient
      does
      not timely satisfy payment of the tax withholding obligation, the Recipient
      will
      forfeit the Restricted Shares.

     

    (b) If
      the
      Recipient does not make an election pursuant to Code Section 83(b), in lieu
      of
      paying the tax withholding obligation as described in Section 3(a), Recipient
      may elect to have the actual number of Vested Shares reduced by the number
      of
      whole shares of Common Stock which, when multiplied by the Fair Market Value
      of
      the Common Stock on the vesting date, is sufficient to satisfy the minimum
      amount of the required tax obligations imposed on the Company by reason of
      the
      vesting of the Restricted Shares (the “Withholding Election”). Recipient may
      make a Withholding Election only if all of the following conditions are
      met:

     

    (i) the
      Withholding Election must be made within ten (10) days after the Recipient
      receives written notification from the Company as to the amount of the tax
      withholding that is due (the “Tax Notice Date”), by executing and delivering to
      the Company a properly completed Notice of Withholding Election, in
      substantially the form of Exhibit
      3
      attached
      hereto; and

     

    (ii) any
      Withholding Election made will be irrevocable; however, the Committee may,
      in
      its sole discretion, disapprove and give no effect to any Withholding Election,
      by giving written notice to the Recipient no later than ten (10) days after
      the
      Company’s receipt of the Notice of Withholding Election, in which event the
      Recipient must deliver to the Company, within ten (10) days after receiving
      such
      notice, the amount of the tax withholding pursuant to Section 3(a).

     

    4.  Restrictions
      on Transfer of Restricted Shares.
      Except
      for the transfer of any 

    Restricted
      Shares by bequest or inheritance, the Recipient shall not have the right to
      make
      or permit to exist any transfer or hypothecation, whether outright or as
      security, with or without consideration, voluntary or involuntary, of all or
      any
      part of any right, title or interest in or to any unvested Restricted Shares.
      Any such disposition not made in accordance with this Award shall be deemed
      null
      and void. Any permitted transferee under this Section shall be bound by the
      terms of this Award.

    

    5.  Additional
      Restrictions on Transfer.
      Certificates evidencing the Restricted Shares shall have noted conspicuously
      on
      the certificate a legend required under applicable securities laws or otherwise
      determined by the Company to be appropriate, such as:

    

    Transfer
      is restricted

    

    The
      securities evidenced by this certificate are subject to restrictions on transfer
      and forfeiture provisions which also apply to the transferee as set forth in
      a
      restricted stock agreement
      dated MAY
      7,
      2007,
      a copy
      of which is available from the company. The
      securities evidenced by this certificate may not be sold, transferred, assigned,
      or hypothecated unless (1) there is an effective registration under such act
      covering such securities, (2) the transfer is made in compliance with rule
      144
      promulgated under such act, or (3) the issuer receives an opinion of counsel,
      reasonably satisfactory to the company, stating that such sale, transfer,
      assignment or hypothecation is exempt from the registration requirements of
      such
      act.

    

    6.  Change
      in Capitalization.

    

    (a) The
      number and kind of unvested Restricted Shares shall be proportionately adjusted
      for any increase or decrease in the number of issued shares of Common Stock
      resulting from a subdivision or combination of shares or the payment of a stock
      dividend in shares of Common Stock to holders of outstanding shares of Common
      Stock or any other increase or decrease in the number of shares of Common Stock
      outstanding is effected without receipt of consideration by the Company. No
      fractional shares shall be issued in making such adjustment. 

    

    (b) In
      the
      event of a merger, consolidation, extraordinary dividend, spin-off, sale of
      substantially all of the Company’s assets or other material change in the
      capital structure of the Company, or a tender offer for shares of Common Stock,
      or other reorganization of the Company or upon a Change in Control, the
      Committee shall take such action to make such adjustments with respect to the
      unvested Restricted Shares, in its sole discretion, determines in good faith
      is
      necessary or appropriate, including, without limitation, adjusting the number
      and class of securities subject to the unvested portion of the Award,
      substituting cash, other securities, or other property to replace the unvested
      portion of the Award, or removing of restrictions on unvested Restricted Shares.
      If the Committee substitutes cash, the unvested portion of the Award shall
      be
      adjusted through the vesting date by the annualized dividend yield of the
      Company for the four (4) most recently completed calendar quarters as of the
      date of the transaction and, at the vesting date, payment shall be released
      from
      escrow and made to the Recipient.

    

    (c) All
      determinations and adjustments made by the Committee pursuant to this Section
      will be final and binding on the Recipient. Any action taken by the Committee
      need not treat all recipients of awards under the Plan equally.

    

    (d) The
      existence of the Plan and the Restricted Stock Grant shall not affect the right
      or power of the Company to make or authorize any adjustment, reclassification,
      reorganization or other change in its capital or business structure, any merger
      or consolidation of the Company, any issue of debt or equity securities having
      preferences or priorities as to the Common Stock or the rights thereof, the
      dissolution or liquidation of the Company, any sale or transfer of all or part
      of its business or assets, or any other corporate act or
      proceeding.

    

    7.  Governing
      Laws.
      This
      Award shall be construed, administered and enforced according to the laws of
      the
      State of Maryland; provided, however, no Restricted Shares shall be issued
      except, in the reasonable judgment of the Committee, in compliance with
      exemptions under applicable state securities laws of the state in which
      Recipient resides, and/or any other applicable securities laws.

    

    8.  Successors.
      This
      Award shall be binding upon and inure to the benefit of the heirs, legal
      representatives, successors, and permitted assigns of the parties.

    

    9.  Notice.
      Except
      as otherwise specified herein, all notices and other communications under this
      Award shall be in writing and shall be deemed to have been given if personally
      delivered or if sent by registered or certified United States mail, return
      receipt requested, postage prepaid, addressed to the proposed recipient at
      the
      last known address of the recipient. Any party may designate any other address
      to which notices shall be sent by giving notice of the address to the other
      parties in the same manner as provided herein.

    

    10.  Severability.
      In the
      event that any one or more of the provisions or portion thereof contained in
      this Award shall for any reason be held to be invalid, illegal, or unenforceable
      in any respect, the same shall not invalidate or otherwise affect any other
      provisions of this Award, and this Award shall be construed as if the invalid,
      illegal or unenforceable provision or portion thereof had never been contained
      herein.

    

    11.  Entire
      Agreement.
      Subject
      to the terms and conditions of the Plan, this Award expresses the entire
      understanding and agreement of the parties with respect to the subject
      matter.

    

    12.  Headings
      and Capitalized Terms.
      Paragraph headings used herein are for convenience of reference only and shall
      not be considered in construing this Award. Capitalized
      terms used, but not defined, in this Award shall be given the meaning ascribed
      to them in the Plan.

    

    13.  Specific
      Performance.
      In the
      event of any actual or threatened default in, or breach of, any of the terms,
      conditions and provisions of this Award, the party or parties who are thereby
      aggrieved shall have the right to specific performance and injunction in
      addition to any and all other rights and remedies at law or in equity, and
      all
      such rights and remedies shall be cumulative.

    

    14.  No
      Right to Continued Retention.
      Neither
      the establishment of the Plan nor the award of Restricted Shares hereunder
      shall
      be construed as giving Recipient the right to continued employment with the
      Company or an Affiliate.

    

    15.  Definitions.
      As used
      in these Terms and Conditions and this Award:

    

    “Cause”
shall
      have the meaning set forth in the employment agreement then in effect between
      the Recipient and the Company, or, if there is none, then Cause shall mean
      the
      occurrence of any of the following events:

    

    (a) willful
      refusal by the Recipient to follow a lawful direction of the person to whom
      the
      Recipient reports or the Board of Directors of the Company (the “Board”),
      provided the direction is not materially inconsistent with the duties or
      responsibilities of the Recipient’s position with the Company, which refusal
      continues after the Board has again given the direction in writing;

    

    (b) willful
      misconduct or reckless disregard by the Recipient of his duties or of the
      interest or property of the Company;

    

    (c) intentional
      disclosure by the Recipient to an unauthorized person of Confidential
      Information or Trade Secrets, which causes material harm to the Company;

    

    (d) any
      act
      by the Recipient of fraud against material misappropriation from, significant
      dishonesty to either the Company or an Affiliate, or any other party, but in
      the
      latter case only if in the reasonable opinion of at least two-thirds of the
      members of the Board (excluding the Recipient), such fraud, material
      misappropriation, or significant dishonesty could reasonably be expected to
      have
      a material adverse impact on the Company or its Affiliates; or 

    

    (e) commission
      by the Recipient of a felony as reasonably determined by at least two-thirds
      of
      the members of the Board (excluding the Recipient).

    

    “Change
      in Control”
means
      any one of the following events which occurs following the Grant
      Date:

    

    (a) the
      acquisition, directly or indirectly, by any “person” or “persons” (as such terms
      are used in Sections 13(d) and 14(d) of the Securities Exchange Act of 1934,
      as
      amended), other than the Company or any employee benefits plan of the Company
      or
      an Affiliate, or any corporation pursuant to a reorganization, merger or
      consolidation, of equity securities of the Company, resulting in such person
      or
      persons holding equity securities of the Company that in the aggregate represent
      thirty percent (30%) or more of the combined ordinary voting power of the
      Company’s then outstanding equity securities; 

    

    (b) individuals
      who as of the date hereof, constitute the Board (the “Incumbent Board”) cease
      for any reason to constitute at least a majority of the Board; provided,
      however, that any individual becoming a director subsequent to the date hereof
      whose election, or nomination for election by the Company’s shareholders, was
      approved by a vote of at least two-thirds of the directors then comprising
      the
      Incumbent Board shall be considered as though such individual were a member
      of
      the Incumbent Board, but excluding, for this purpose, any such individual whose
      initial assumption of office occurs as a result of an actual or threatened
      election contest with respect to the election or removal of directors or other
      actual or threatened solicitation of proxies or consents by or on behalf of
      a
      person other than the Board; 

    

    (c) a
      reorganization, merger or consolidation, with respect to which persons who
      were
      the holders of equity securities of the Company immediately prior to such
      reorganization, merger or consolidation do not, immediately thereafter, own
      equity securities of the surviving entity representing more than fifty percent
      (50%) of the combined ordinary voting power of the then outstanding voting
      securities of the surviving entity; or

    

    (d) a
      sale,
      or one or more sales occurring in a twelve-month period, of all or substantially
      all of the assets of the Company to any third party.

    

    Notwithstanding
      the foregoing, no Change in Control shall be deemed to have occurred for
      purposes of this Award by reason of any actions or events in which the Recipient
      participates in a capacity other than in his capacity as an officer, employee,
      or director of the Company or an Affiliate. 

    

    “Confidential
      Information”
means
      data and information relating to the Business of the Company or an Affiliate
      (which does not rise to the status of a Trade Secret) which is or has been
      disclosed to the Recipient or of which the Recipient became aware as a
      consequence of or through his relationship to the Company or an Affiliate and
      which has value to the Company or an Affiliate and is not generally known to
      its
      competitors. Confidential Information shall not include any data or information
      that has been voluntarily disclosed to the public by the Company or an Affiliate
      (except where such public disclosure has been made by the Recipient without
      authorization) or that has been independently developed and disclosed by others,
      or that otherwise enters the public domain through lawful means without breach
      of any obligations of confidentiality owed to the Company or any of its
      Affiliates.

    

    “Good
      Reason”
shall
      have the meaning set forth in the employment agreement then in effect between
      the Recipient and the Company, or, if there is none, then Good Reason shall
      mean
      the occurrence of all of the events listed in either (a) or (b)
      below:

    

    (a) (i)
      the
      Recipient experiences a material diminution of the Recipient’s responsibilities
      of his position, as reasonably modified by the person to whom the Recipient
      reports or the Board from time to time, such that the Recipient would no longer
      have responsibilities substantially equivalent to those of other executives
      holding equivalent positions at companies with similar revenues and market
      capitalization;

    

    (ii) the
      Recipient gives written notice to the Company of the facts and circumstances
      constituting the material diminution in responsibilities within ten (10) days
      following the occurrence of such material diminution;

    

    (iii) the
      Company fails to remedy the material diminution in responsibilities within
      ten
      (10) days following the Recipient’s written notice of the material diminution in
      responsibilities; and

    

    (iv) the
      Recipient terminates his employment and this Agreement within ten (10) days
      following the Company’s failure to remedy the material diminution in
      responsibilities.

     

    (b) (i)
      the
      Company requires the Recipient to relocate the Recipient’s primary place of
      employment to a new location, that is more than fifty (50) miles from its
      current location (determined using the most direct driving route), without
      the
      Recipient’s consent;

     

     

    (ii) the
      Recipient gives written notice to the Company within ten (10) days following
      receipt of notice of relocation of his objection to the relocation;

     

     

    (iii) the
      Company fails to rescind the notice of relocation within ten (10) days following
      the Recipient’s written notice; and

     

    

    (iv) the
      Recipient terminates his employment within ten (10) days following the Company’s
      failure to rescind the notice.

    

    “Trade
      Secrets”
means
      information including, but not limited to, technical or nontechnical data,
      formulae, patterns, compilations, programs, devices, methods, techniques,
      drawings, processes, financial data, financial plans, product plans or lists
      o
      actual or potential customers or suppliers which (i) derives economic value,
      actual or potential, from not being generally known to, and not being readily
      ascertainable by proper means by, other persons who can obtain economic value
      from its disclosure or use, and (ii) is the subject of efforts that are
      reasonable under the circumstances to maintain its secrecy. 

    

    

     

    

    

    EXHIBIT
      1

    

    

    VESTING
      SCHEDULE

    

    
      	
              A.

            	
              The
                Restricted Shares shall become Vested Shares in accordance with the
                schedule below:

            

    

     

    
      	
               

              Date

            	
              Fraction
                of Restricted

              Shares
                which are Vested Shares

            
	 	 
	
              December
                31, 2007

            	
              1/7

            
	
              December
                31, 2008

            	
              2/7

            
	
              December
                31, 2009

            	
              2/7

            
	
              December
                31, 2010

            	
              2/7

            

    

    

    ;provided
      the Recipient must remain an employee, director or consultant of the Company
      or
      an Affiliate through the indicated date set forth above to vest in accordance
      with the schedule above.

     

    
      	
              B.

            	
              Notwithstanding
                the foregoing, all Restricted Shares shall become Vested Shares if
                they
                have not been previously forfeited at the earliest to occur of the
                following:

            

    

     

    
      	 	
              1.

            	
              the
                Recipient’s cessation of services as an employee, director or consultant
                of the Company or an Affiliate due to the Recipient’s death or
                Disability;

            

    

     

    
      	 	
              2.

            	
              the
                Recipient’s resignation from the Company for Good Reason;
                or

            

    

     

    
      	 	
              3.

            	
              the
                Recipient’s termination of employment by the Company without
                Cause.

            

    

     

    
      	
              C.

            	
              Restricted
                Shares which have not become Vested Shares as of the Recipient’s cessation
                of services as an employee, director, or consultant of the Company
                or an
                Affiliate shall be forfeited.

            

    

    

    
      

    EXHIBIT
      2

    

    

    IRREVOCABLE
      STOCK POWER

    

    

    The
      undersigned hereby assigns and transfers to Omega Healthcare Investors, Inc.
      (the “Company”), ________ shares of the Common Stock of the Company registered
      in the name of the undersigned on the stock transfer records of the Company
      and
      represented by Stock Certificate No. ____________________ of the Company; and
      the undersigned does hereby irrevocably constitute and appoint
      ________________________________, his attorney-in-fact, to transfer the
      aforesaid shares on the books of the Company, with full power of substitution;
      and the undersigned does hereby ratify and confirm all that said
      attorney-in-fact lawfully shall do by virtue hereof.

    

    

    Date:      Signed:     

    

    Print
      Name:      

    

    

    IN
      THE
      PRESENCE OF:

    

    

     

    (Print
      Name)

    

    

     

    (Signature)

    

    

    

    EXHIBIT
      3

    

    

    NOTICE
      OF WITHHOLDING ELECTION

    PURSUANT
      TO OMEGA HEALTHCARE INVESTORS, INC.

    2004
      STOCK INCENTIVE PLAN

    

    

    TO: Omega
      Healthcare Investors, Inc.

    Attention:
      Chief Financial Officer

    

    FROM:      

    

    RE:  Withholding
      Election

    

    This
      election relates to the Restricted Stock Grant identified in Paragraph 3 below.
      I hereby certify that:

     

    (1) My
      correct name and social security number and my current address are set forth
      at
      the end of this document.

     

    (2) I
      am
      (check one, whichever is applicable).

     

    [
      ] the
      original recipient of the Restricted Stock Grant.

     

    
      	 	
              [
                ]

            	
              the
                legal representative of the estate of the original recipient of the
                Restricted Stock Grant.

            

    

     

    
      	 	
              [
                ]

            	
              a
                legatee of the original recipient of the Restricted Stock
                Grant.

            

    

     

    
      	 	
              [
                ]

            	
              the
                legal guardian of the original recipient of the Restricted Stock
                Grant.

            

    

     

    (3) The
      Restricted Stock Grant pursuant to which this election relates was issued with
      a
      Grant Date of __________________ under the Omega Healthcare Investors, Inc.
      2004
      Stock Incentive Plan (the “Plan”) in the name of _________________ for a total
      of ______________ shares of Common Stock. This election relates to ______ shares
      of Common Stock issued upon the vesting of the Restricted Shares, provided
      that
      the numbers set forth above shall be deemed changed as appropriate to reflect
      stock splits and other adjustments contemplated by the applicable Plan
      provisions.

    

    (4) I
      hereby
      elect to have certain of the shares withheld by the Company for the purpose
      of
      having the value of the shares applied to pay federal, state and local, if
      any,
      taxes arising from the exercise.

    

    The
      fair
      market value of the shares to be withheld in addition to $_________ in cash
      to
      be tendered to the Company by the recipient of the Restricted Stock Grant shall
      be equal to the minimum statutory tax withholding requirement under federal,
      state and local law in connection with the exercise.

    

    (5) This
      Withholding Election is made no later than ten (10) days after the Tax Notice
      Date and is otherwise timely made pursuant to the Plan.

    

    (6) I
      further
      understand that, if this Withholding Election is not disapproved by the
      Committee, the Company shall withhold from the Common Stock a whole number
      of
      shares of Common Stock having the value specified in Paragraph 4
      above.

    

    (7) The
      Plan
      has been made available to me by the Company, I have read and understand the
      Plan and I have no reason to believe that any of the conditions therein to
      the
      making of this Withholding Election have not been met. Capitalized terms used
      in
      this Notice of Withholding Election without definition shall have the meanings
      given to them in the Plan.

    

    

    Dated:
             

    

    Signature:
            

    

     

    Name
      (Printed)

    

    ______________________________

    Street
      Address

    

    ______________________________

    City,
      State, Zip CodeForm of Performance Restricted Stock Unit Agreement - Annual vesting

     

    
      
        

      

    PERFORMANCE
      RESTRICTED STOCK UNIT AGREEMENT

    PURSUANT
      TO THE OMEGA HEALTHCARE INVESTORS, INC.

    2004
      STOCK INCENTIVE PLAN

    

    THIS
      AGREEMENT (sometimes referred to as this “Award”) is made as of the Grant Date,
      by Omega Healthcare Investors, Inc. (the “Company”) to ______________ (the
“Recipient”) subject to acceptance by the Recipient.

    

    Upon
      and
      subject to the Terms and Conditions attached hereto and incorporated herein
      by
      reference as part of this Agreement, the Company hereby awards as of the Grant
      Date to the Recipient, the Restricted Units (the “Restricted Unit Grant”).
      Underlined and capitalized terms in items A through F below shall have the
      meanings there ascribed to them.

    

    
      	 	
              A.

            	
              Grant
                Date:
                May 7, 2007.

            

    

    

    
      	 	
              B.

            	
              Plan
                (under which Restricted Unit Grant is granted):
                Omega Healthcare Investors, Inc. 2004 Stock Incentive
                Plan.

            

    

    

    
      	 	
              C.

            	
              Restricted
                Units:
                _________Restricted Units. Each Restricted Unit represents the Company’s
                unsecured obligation to issue one share of the Company’s common stock
                (“Common Stock”) and accrued dividend equivalents (and accrued interest)
                in accordance with this Agreement, subject to the Vesting Schedule
                and
                subject to adjustment as provided in the attached Terms and
                Conditions.

            

    

    

    
      	 	
              D.

            	
              Vesting
                Schedule:
                The Restricted Units and shares of Common Stock represented by the
                Restricted Units (the “Shares”) shall vest according to the Vesting
                Schedule attached hereto as Exhibit
                1
                (the “Vesting Schedule”). The Restricted Units and Shares which have
                become vested pursuant to the Vesting Schedule are herein referred
                to as
                the “Vested Units” and “Vested Shares,” respectively.
                

            

    

    

    
      	E.  	
              Distribution
                Date of Vested Shares.
                Vested Shares attributable to Vested Units are to be issued and
                distributable within ten (10) business days following the earliest
                of the
                events listed below, subject to receipt from the Recipient of the
                required
                tax withholding:

            

    

    

    
      	 	
              1.

            	
              January
                2, 2011;

            

    

     

    
      	 	
              2.

            	
              the
                Recipient’s cessation of services as an employee, director or consultant
                of the Company or an Affiliate due to the Recipient’s death or Disability;
                or

            

    

     

    
      	 	
              3.

            	
              the
                Recipient’s resignation from the Company for Good Reason or termination of
                employment by the Company without Cause provided that, if
                the Executive is a "specified employee" within the meaning of Code
                Section
                409A at the date of his termination of employment and the distribution
                of
                the Vested Shares would result in a tax under Code Section 409A,
                then the
                distribution shall be delayed for six months and paid to the Executive
                during the seventh month following the date of his termination of
                employment. 

            

    

     

    
      	F.  	
              Distribution
                Date of Dividend Equivalents.
                Dividend Equivalents (and accrued interest) attributable to Restricted
                Units that are or become Vested Units are distributable to the Recipient
                on the same date as Vested Shares are distributable to the Recipient
                under
                Section E above.

            

    

    

    IN
      WITNESS WHEREOF, the Company and the Recipient have executed this Agreement
      as
      of the Grant Date set forth above.

    

    RECIPIENT     OMEGA
      HEALTHCARE INVESTORS, INC.

    

    

    By:
            

     

    [Signature]     Title:
            

    

    TERMS
      AND CONDITIONS TO THE

    PERFORMANCE
      RESTRICTED STOCK UNIT AGREEMENT

    PURSUANT
      TO THE OMEGA HEALTHCARE INVESTORS, INC.

    2004
      STOCK INCENTIVE PLAN

    

    1.  Payment
      for Restricted Units.
      This
      Section applies to Vested Units. The Company shall issue and deliver a share
      certificate representing the number of Vested Shares attributable to Vested
      Units to the Recipient within ten (10) business days following the Distribution
      Date of Vested Shares. In the event that the Recipient forfeits any of the
      Restricted Units, and the number of Vested Units includes a fraction of a Share,
      the Company shall not deliver the fractional Share, and the Company shall pay
      the Recipient the amount determined by the Company to be the estimated fair
      market value thereof. In the event the number of shares of Common Stock is
      increased or reduced by a change in the par value, split-up, stock split,
      reverse stock split, reclassification, merger, reorganization, consolidation,
      or
      otherwise, the Recipient agrees that any certificate representing shares of
      Common Stock or other securities of the Company issued as a result of any of
      the
      foregoing shall be subject to all of the provisions of this Award as if
      initially granted thereunder.

    

    2.  Dividends
      Equivalents.
      Each
      Restricted Unit will accrue an amount equal to the dividends per share paid
      on
      Common Stock to Shareholders of record on or after the Grant Date. Dividends
      equivalents attributable to Restricted Units that are or become Vested Units
      will be paid to the Recipient
      within ten (10) business days following the Distribution Date for
      Dividend Equivalents,
      with
      interest accrued on a quarterly basis at a rate equal to the Company's average
      borrowing rate for the preceding calendar quarter as determined in the sole
      discretion of the Company, and
      less
      required tax withholding.
      Dividend
      equivalents (and interest) on Restricted Units that do not become Vested Units
      are not paid to the Recipient but are forfeited when the Restricted Units to
      which they relate are forfeited.

    

    3.  Tax
      Withholding.
      

     

    (a) The
      Recipient must deliver to the Company, within ten (10) days after written
      notification from the Company as to the amount of the tax withholding that
      is
      due, either (i) cash, or (ii) a certified check payable to the Company, in
      the
      amount of all tax withholding obligations imposed on the Company on the
      Distribution Date of the Restricted Shares, except as provided in Section 3(b),
      or (iii) by tendering a number of whole shares of Common Stock which, when
      multiplied by the Fair Market Value of the Common Stock on the Distribution
      Date
      of the Restricted Shares, is sufficient to satisfy the minimum amount of the
      required tax withholding obligations imposed on the Company (the “Stock
      Tendering Election”); provided, however, the Committee may in its sole
      discretion, disapprove and give no effect to the Stock Tendering Election by
      giving written notice to the Recipient within ten (10) days after receipt of
      the
      Stock Tendering Election, in which event the Recipient must deliver, within
      ten
      (10) days after receiving such notice, the tax withholding in the manner
      provided in clause (i) or (ii). If the Recipient does not timely satisfy payment
      of the tax withholding obligation, the Recipient will forfeit the Vested
      Shares.

    

    (b) In
      lieu
      of paying the tax withholding obligation as described in Section 3(a), Recipient
      may elect to have the actual number of Vested Shares reduced by the number
      of
      whole shares of Common Stock which, when multiplied by the Fair Market Value
      of
      the Common Stock on the Distribution Date of the Vested Shares, is sufficient
      to
      satisfy the minimum amount of the required tax obligations imposed on the
      Company on the Distribution Date of the Vested Shares (the “Withholding
      Election”). Recipient may make a Withholding Election only if all of the
      following conditions are met:

     

    (i) the
      Withholding Election must be made within ten (10) days after the Recipient
      receives written notification from the Company as to the amount of the tax
      withholding that is due (the “Tax Notice Date”), by executing and delivering to
      the Company a properly completed Notice of Withholding Election, in
      substantially the form of Exhibit
      2
      attached
      hereto; and

     

    (ii) any
      Withholding Election made will be irrevocable; however, the Committee may,
      in
      its sole discretion, disapprove and give no effect to any Withholding Election,
      by giving written notice to the Recipient no later than ten (10) days after
      the
      Company’s receipt of the Notice of Withholding Election, in which event the
      Recipient must deliver to the Company, within ten (10) days after receiving
      such
      notice, the amount of the tax withholding pursuant to Section 3(a).

     

    4.  Restrictions
      on Transfer.
      Except
      for the transfer by bequest
      or
      inheritance, the Recipient shall not have the right to make or permit to exist
      any transfer or hypothecation, whether outright or as security, with or without
      consideration, voluntary or involuntary, of all or any part of any right, title
      or interest in or to any Restricted Units. Any such disposition not made in
      accordance with this Award shall be deemed null and void. Any permitted
      transferee under this Section shall be bound by the terms of this
      Award.

    

    5.  Additional
      Restrictions on Transfer. Certificates
      evidencing the Restricted Shares shall have noted conspicuously on the
      certificate a legend required under applicable securities laws or otherwise
      determined by the Company to be appropriate, such as:

    

    TRANSFER
      IS RESTRICTED

    

    The
      securities evidenced by this certificate are subject to restrictions on transfer
      and forfeiture provisions which also apply to the transferee as set forth in
      a
      restricted stock agreement dated May 7,
      2007,
      a copy
      of which is available from the company. The
      securities evidenced by this certificate may not be sold, transferred, assigned,
      or hypothecated unless (1) there is an effective registration under such act
      covering such securities, (2) the transfer is made in compliance with rule
      144
      promulgated under such act, or (3) the issuer receives an opinion of counsel,
      reasonably satisfactory to the company, stating that such sale, transfer,
      assignment or hypothecation is exempt from the registration requirements of
      such
      act.

    

    6.  Change
      in Capitalization.

    

    (a) The
      number and kind of Shares shall be proportionately adjusted for any increase
      or
      decrease in the number of issued shares of Common Stock resulting from a
      subdivision or combination of shares or the payment of a stock dividend in
      shares of Common Stock to holders of outstanding shares of Common Stock or
      any
      other increase or decrease in the number of shares of Common Stock outstanding
      is effected without receipt of consideration by the Company. No fractional
      shares shall be issued in making such adjustment. 

    

    (b) In
      the
      event of a merger, consolidation, extraordinary dividend, spin-off, sale of
      substantially all of the Company’s assets or other material change in the
      capital structure of the Company, or a tender offer for shares of Common Stock,
      or other reorganization of the Company or upon a Change in Control, the
      Committee shall take such action to make such adjustments with respect to the
      Shares or the terms of this Award as the Committee, in its sole discretion,
      determines in good faith is necessary or appropriate, including, without
      limitation, adjusting the number and class of securities subject to the Award,
      substituting cash, other securities, or other property to replace the Award,
      or
      removing of restrictions on Shares. If the Committee substitutes cash, the
      unvested portion of the Award shall be adjusted through the Distribution Date
      for Vested Shares by the annualized dividend yield of the Company for the four
      (4) most recently completed calendar quarters as of the date of the transaction
      and, within ten (10) business days following the Distribution Date of Vested
      Shares, payment shall be released from escrow and made to the
      Recipient.

    

    (c) All
      determinations and adjustments made by the Committee pursuant to this Section
      will be final and binding on the Recipient. Any action taken by the Committee
      need not treat all recipients of awards under the Plan equally.

    

    (d) The
      existence of the Plan and the Restricted Unit Grant shall not affect the right
      or power of the Company to make or authorize any adjustment, reclassification,
      reorganization or other change in its capital or business structure, any merger
      or consolidation of the Company, any issue of debt or equity securities having
      preferences or priorities as to the Common Stock or the rights thereof, the
      dissolution or liquidation of the Company, any sale or transfer of all or part
      of its business or assets, or any other corporate act or
      proceeding.

    

    7. Governing
      Laws.
      This
      Award shall be construed, administered and enforced according to the laws of
      the
      State of Maryland; provided, however, no Shares shall be issued except, in
      the
      reasonable judgment of the Committee, in compliance with exemptions under
      applicable state securities laws of the state in which Recipient resides, and/or
      any other applicable securities laws.

    

    8. Successors.
      This
      Award shall be binding upon and inure to the benefit of the heirs, legal
      representatives, successors, and permitted assigns of the parties.

    

    9. Notice.
      Except
      as otherwise specified herein, all notices and other communications under this
      Award shall be in writing and shall be deemed to have been given if personally
      delivered or if sent by registered or certified United States mail, return
      receipt requested, postage prepaid, addressed to the proposed recipient at
      the
      last known address of the recipient. Any party may designate any other address
      to which notices shall be sent by giving notice of the address to the other
      parties in the same manner as provided herein.

    

    10. Severability.
      In the
      event that any one or more of the provisions or portion thereof contained in
      this Award shall for any reason be held to be invalid, illegal, or unenforceable
      in any respect, the same shall not invalidate or otherwise affect any other
      provisions of this Award, and this Award shall be construed as if the invalid,
      illegal or unenforceable provision or portion thereof had never been contained
      herein.

    

    11. Entire
      Agreement.
      Subject
      to the terms and conditions of the Plan, this Award expresses the entire
      understanding and agreement of the parties with respect to the subject matter.
      

    

    12. Headings
      and Capitalized Terms.
      Paragraph headings used herein are for convenience of reference only and shall
      not be considered in construing this Award. Capitalized
      terms used, but not defined, in this Award shall be given the meaning ascribed
      to them in the Plan.

    

    13. Specific
      Performance.
      In the
      event of any actual or threatened default in, or breach of, any of the terms,
      conditions and provisions of this Award, the party or parties who are thereby
      aggrieved shall have the right to specific performance and injunction in
      addition to any and all other rights and remedies at law or in equity, and
      all
      such rights and remedies shall be cumulative.

    

    14. No
      Right to Continued Retention.
      Neither
      the establishment of the Plan nor the award of Restricted Shares hereunder
      shall
      be construed as giving Recipient the right to continued service with the Company
      or an Affiliate.

     

    15. Definitions.
      As used
      in these Terms and Conditions in this Agreement:

     

    “Applicable
      Performance Period”
      means the period from and including the Grant Date through (i) December 31,
      2008; (ii) December 31, 2009; or (iii) December 31, 2010.
      Notwithstanding the foregoing, the Applicable Performance Period shall end
      on
      the earliest to occur of the following:

     

    (a) the
      date
      of the Change in Control;

     

    (b) the
      Recipient’s cessation of services as an employee, director or consultant of the
      Company or an Affiliate due to death or Disability;

     

    (c) the
      Recipient’s resignation from the Company for Good Reason; or

     

    (d) the
      Recipient’s termination of employment by the Company for Cause. 

     

    “Beginning
      Stock Price”
means
      the average closing price per share of the Company’s Common Stock for the twenty
      (20) days the exchange on which the Company’s Common Stock is traded is open
      which immediately precede the Grant Date.

     

    “Cause”
shall
      have the meaning set forth in the employment agreement then in effect between
      the Recipient and the Company, or, if there is none, then Cause shall mean
      the
      occurrence of any of the following events:

     

    (a) willful
      refusal by the Recipient to follow a lawful direction of the person to whom
      the
      Recipient reports or the Board of Directors of the Company (the “Board”),
      provided the direction is not materially inconsistent with the duties or
      responsibilities of the Recipient’s position with the Company, which refusal
      continues after the Board has again given the direction in writing;

     

    (b) willful
      misconduct or reckless disregard by the Recipient of his duties or of the
      interest or property of the Company;

     

    (c) intentional
      disclosure by the Recipient to an unauthorized person of Confidential
      Information or Trade Secrets, which causes material harm to the Company;

     

    (d) any
      act
      by the Recipient of fraud against material misappropriation from, significant
      dishonesty to either the Company or an Affiliate, or any other party, but in
      the
      latter case only if in the reasonable opinion of at least two-thirds of the
      members of the Board (excluding the Recipient), such fraud, material
      misappropriation, or significant dishonesty could reasonably be expected to
      have
      a material adverse impact on the Company or its Affiliates; or 

     

    (e) commission
      by the Recipient of a felony as reasonably determined by at least two-thirds
      of
      the members of the Board (excluding the Recipient).

     

    “Change
      in Control”
means
      any one of the following events which occurs following the Grant
      Date:

     

    (a) the
      acquisition, directly or indirectly, by any “person” or “persons” (as such terms
      are used in Sections 13(d) and 14(d) of the Securities Exchange Act of 1934,
      as
      amended), other than the Company or any employee benefits plan of the Company
      or
      an Affiliate, or any corporation pursuant to a reorganization, merger or
      consolidation, of equity securities of the Company, resulting in such person
      or
      persons holding equity securities of the Company that in the aggregate represent
      thirty percent (30%) or more of the combined ordinary voting power of the
      Company’s then outstanding equity securities;

     

    (b) individuals
      who as of the date hereof, constitute the Board (the “Incumbent Board”) cease
      for any reason to constitute at least a majority of the Board; provided,
      however, that any individual becoming a director subsequent to the date hereof
      whose election, or nomination for election by the Company’s shareholders, was
      approved by a vote of at least two-thirds of the directors then comprising
      the
      Incumbent Board shall be considered as though such individual were a member
      of
      the Incumbent Board, but excluding, for this purpose, any such individual whose
      initial assumption of office occurs as a result of an actual or threatened
      election contest with respect to the election or removal of directors or other
      actual or threatened solicitation of proxies or consents by or on behalf of
      a
      person other than the Board;

     

    (c) a
      reorganization, merger or consolidation, with respect to which persons who
      were
      the holders of equity securities of the Company immediately prior to such
      reorganization, merger or consolidation do not, immediately thereafter, own
      equity securities of the surviving entity representing more than fifty percent
      (50%) of the combined ordinary voting power of the then outstanding voting
      securities of the surviving entity; or

     

    (d) a
      sale,
      or one or more sales occurring in a twelve-month period, of all or substantially
      all of the assets of the Company to any third party.

     

    Notwithstanding
      the foregoing, no Change in Control shall be deemed to have occurred for
      purposes of this Award by reason of any actions or events in which the Recipient
      participates in a capacity other than in his capacity as an officer, employee,
      or director of the Company or an Affiliate.

     

    “Confidential
      Information”
means
      data and information relating to the Business of the Company or an Affiliate
      (which does not rise to the status of a Trade Secret) which is or has been
      disclosed to the Recipient or of which the Recipient became aware as a
      consequence of or through his relationship to the Company or an Affiliate and
      which has value to the Company or an Affiliate and is not generally known to
      its
      competitors. Confidential Information shall not include any data or information
      that has been voluntarily disclosed to the public by the Company or an Affiliate
      (except where such public disclosure has been made by the Recipient without
      authorization) or that has been independently developed and disclosed by others,
      or that otherwise enters the public domain through lawful means without breach
      of any obligations of confidentiality owed to the Company or any of its
      Affiliates.

     

    “Ending
      Stock Price”
means
      the average closing price per share of the Company’s Common Stock for the twenty
      (20) days the exchange on which the Company’s Common Stock is traded is open
      which end on the last day of the Applicable Performance Period, except that
      in
      the case of a Change in Control, the Ending Stock Price shall mean the closing
      price per share of the Company’s Common Stock on the date of the Change in
      Control or, if no closing price, the implied price the share of Common Stock
      paid in the Change in Control transaction.

     

    “Good
      Reason”
shall
      have the meaning set forth in the employment agreement then in effect between
      the Recipient and the Company, or, if there is none, then Good Reason shall
      mean
      the occurrence of all of the events listed in either (a) or (b)
      below:

     

    (a) (i)
      the
      Recipient experiences a material diminution of the Recipient’s responsibilities
      of his position, as reasonably modified by the person to whom the Recipient
      reports or the Board from time to time, such that the Recipient would no longer
      have responsibilities substantially equivalent to those of other executives
      holding equivalent positions at companies with similar revenues and market
      capitalization;

     

    (ii) the
      Recipient gives written notice to the Company of the facts and circumstances
      constituting the material diminution in responsibilities within ten (10) days
      following the occurrence of such material diminution;

     

    (iii) the
      Company fails to remedy the material diminution in responsibilities within
      ten
      (10) days following the Recipient’s written notice of the material diminution in
      responsibilities; and

     

    (iv) the
      Recipient terminates his employment and this Agreement within ten (10) days
      following the Company’s failure to remedy the material diminution in
      responsibilities.

     

    (b) (i)
      the
      Company requires the Recipient to relocate the Recipient’s primary place of
      employment to a new location, that is more than fifty (50) miles from its
      current location (determined using the most direct driving route), without
      the
      Recipient’s consent;

     

    (ii) the
      Recipient gives written notice to the Company within ten (10) days following
      receipt of notice of relocation of his objection to the relocation;

     

    (iii) the
      Company fails to rescind the notice of relocation within ten (10) days following
      the Recipient’s written notice; and

     

    (iv) the
      Recipient terminates his employment within ten (10) days following the Company’s
      failure to rescind the notice.

     

    “Target
      Shareholder Return”
means
      an annualized Total Shareholder Return of at least 11% compounded as of December
      31, 2007 and thereafter annually as of the last day of each Applicable
      Performance Period.

     

    “Total
      Shareholder Return”
means,
      with respect to each Applicable Performance Period, the sum of the total
      increase (decrease) of the Ending Stock Price over the Beginning Stock Price,
      plus any dividends paid to a shareholder of record with respect to one share
      of
      Common Stock during each Applicable Performance Period.

     

    “Trade
      Secrets”
means
      information including, but not limited to, technical or nontechnical data,
      formulae, patterns, compilations, programs, devices, methods, techniques,
      drawings, processes, financial data, financial plans, product plans or lists
      of
      actual or potential customers or suppliers which (i) derives economic value,
      actual or potential, from not being generally known to, and not being readily
      ascertainable by proper means by, other persons who can obtain economic value
      from its disclosure or use, and (ii) is the subject of efforts that are
      reasonable under the circumstances to maintain its secrecy.

     

     

    EXHIBIT
      1

    

    VESTING
      SCHEDULE

    

    
      	
              A.

            	
              The
                Restricted Units shall become Vested Units in accordance with the
                schedule
                below:

            

    

     

    
      	
               

              Date

            	
              Fraction
                of Restricted

              Units
                which are Vested Units

            
	 	 
	
              December
                31, 2008

            	
              1/3

            
	
              December
                31, 2009

            	
              1/3

            
	
              December
                31, 2010

            	
              1/3

            

    

    

    ;
      provided that the Company has achieved the Target Shareholder Return as of
      the
      last day of the Applicable Performance Period set forth above, and provided
      further that the Recipient must remain an employee, director or consultant
      of
      the Company or an Affiliate through the date set forth above to vest in
      accordance with the schedule above. In the event the Company fails to achieve
      the Target Shareholder Return as of the last day of any Applicable Performance
      Period, the Restricted Units that would have become Vested Units on the last
      day
      of such Applicable Performance Period shall become Vested Units on December
      31,
      2010 if the Company achieves the Target Shareholder Return for the period
      beginning on the Grant Date and ending on December 31, 2010, provided that
      the
      Recipient must remain an employee, director or consultant of the Company or
      an
      Affiliate through December 31, 2010.

     

    
      	
              B.

            	
              Notwithstanding
                the foregoing, all Restricted Units shall become Vested Units if
                they have
                not been previously forfeited on the earliest to occur of the
                following:

            

    

     

    
      	 	
              1.

            	
              the
                Recipient’s cessation of services as an employee, director or consultant
                of the Company or an Affiliate due to the Recipient’s death or
                Disability;

            

    

     

    
      	 	
              2.

            	
              the
                Recipient’s resignation from the Company for Good Reason;
                or

            

    

     

    
      	 	
              3.

            	
              the
                Recipient’s termination of employment by the Company without
                Cause.

            

    

     

    ,
      but, in
      each case, only if the Company has achieved the Target Shareholder Return as
      of
      the date of such event. If the Company has not achieved the Target Shareholder
      Return as of such date, the Restricted Units which have not become Vested Units
      shall be forfeited.

     

    
      	
              C.

            	
              Notwithstanding
                any other provision hereof, Restricted Units which have not become
                Vested
                Units by December 31, 2010 are forfeited. Restricted
                Shares which have not become Vested Shares as of the Recipient’s cessation
                of services as an employee, director, or consultant of the Company
                or an
                Affiliate shall be forfeited.

            

    

     

    

    

     

    

    

    EXHIBIT
      2

    

    

    NOTICE
      OF WITHHOLDING ELECTION

    PURSUANT
      TO OMEGA HEALTHCARE INVESTORS, INC.

    2004
      STOCK INCENTIVE PLAN

    

    

    TO: Omega
      Healthcare Investors, Inc.

    Attention:
      Chief Financial Officer

    

    FROM:      

    

    RE:  Withholding
      Election

    

    This
      election relates to the Performance Restricted Unit Grant identified in
      Paragraph 3 below. I hereby certify that:

     

    (1) My
      correct name and social security number and my current address are set forth
      at
      the end of this document.

     

    (2) I
      am
      (check one, whichever is applicable).

     

    [
      ] the
      original recipient of the Performance Restricted Unit Grant.

     

    
      	 	
              [
                ]

            	
              the
                legal representative of the estate of the original recipient of the
                Performance Restricted Unit Grant.

            

    

     

    
      	 	
              [
                ]

            	
              a
                legatee of the original recipient of the Performance Restricted Unit
                Grant.

            

    

     

    
      	 	
              [
                ]

            	
              the
                legal guardian of the original recipient of the Performance Restricted
                Unit Grant.

            

    

     

    (3) The
      Performance Restricted Unit Grant pursuant to which this election relates was
      issued with a Grant Date of __________________ under the Omega Healthcare
      Investors, Inc. 2004 Stock Incentive Plan (the “Plan”) in the name of
      _________________ for a total of ______________ Restricted Units. This election
      relates to ______ shares of Common Stock issuable pursuant to the Performance
      Restricted Unit Grant, provided that the numbers set forth above shall be deemed
      changed as appropriate to reflect stock splits and other adjustments
      contemplated by the applicable Plan provisions.

    

    (4) I
      hereby
      elect to have certain of the shares of Common Stock withheld by the Company
      for
      the purpose of having the value of the shares applied to pay federal, state
      and
      local, if any, taxes arising from the exercise.

    

    The
      fair
      market value of the shares of Common Stock to be withheld in addition to
      $_________ in cash to be tendered to the Company by the recipient of the
      Performance Restricted Unit Grant shall be equal to the minimum statutory tax
      withholding requirement under federal, state and local law in connection with
      the exercise.

    

    (5) This
      Withholding Election is made no later than ten (10) days after the Tax Notice
      Date and is otherwise timely made pursuant to the Plan.

    

    (6) I
      further
      understand that, if this Withholding Election is not disapproved by the
      Committee, the Company shall withhold from the Common Stock issuable to me
      a
      whole number of shares of Common Stock having the value specified in Paragraph
      4
      above.

    

    (7) The
      Plan
      has been made available to me by the Company, I have read and understand the
      Plan and I have no reason to believe that any of the conditions therein to
      the
      making of this Withholding Election have not been met. Capitalized terms used
      in
      this Notice of Withholding Election without definition shall have the meanings
      given to them in the Plan.

    

    

    Dated:
             

    

    Signature:
            

    

     

    Name
      (Printed)

    

    ______________________________

    Street
      Address

    

    ______________________________

    City,
      State, Zip Code

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00122-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00122-of-00352.parquet"}]]