Document:

ex4-5.htm

Exhibit 4.5

FORM OF PERFORMANCE STOCK UNIT AGREEMENT

 

Cutera, Inc.

 

Notice of Grant

Performance Stock Unit Award Agreement

 

 

Cutera, Inc. (the “Company”) hereby grants you,                                         (the “Participant”), an award of Performance Stock Units (the “PSU”) under the Cutera, Inc. 2004 Equity Incentive Plan as amended on April 20, 2015 (the “Plan”). The date of this Performance Stock Unit Award Agreement is                                                 . Subject to the provisions of Exhibit A (attached) and of the Plan, the principal features of this Award are as follows:

 

Number of Performance Stock Units: 

 

Vesting Commencement Date:           

 

Performance Measurement Period:          

 

Vesting Schedule: 

 

In the event Participant ceases to be a Service Provider for any or no reason before Participant vests in the Performance Shares, the Performance Shares and Participant’s right to acquire any Shares hereunder will immediately terminate.

 

By Participant’s signature and the signature of the Company’s representative below, Participant and the Company agree that this Award of Performance Shares is granted under and governed by the terms and conditions of this Award Agreement and the Plan, which is made a part of this document.

 

	
CUTERA, INC.  
	 	
PARTICIPANT  

	
 
	
 
	 	
 
	
 

	
By: 
	
 
	 	
 
	
 

	
 
	
 
	 	
 
	
 

	
 
	
 
	 	
 
	
 

	
 
	
Ronald Santilli
	 	
 
	
 

	
 
	
EVP and CFO  
	 	
Date: 
	
 

 

 

 

 

 

Exhibit A

 

Performance Stock Unit Award Agreement

 

1.     Grant. The Company hereby grants to the Participant named in the attached Notice of Grant an Award of Performance Shares, subject to all of the terms and conditions in this Award Agreement and the Plan, which is incorporated herein by reference. Subject to Section 20(c) of the Plan, in the event of a conflict between the terms and conditions of the Plan and the terms and conditions of this Award Agreement, the terms and conditions of the Plan will prevail.

 

2.     Company’s Obligation to Pay. Each Performance Share represents the right to receive a Share on the date it vests. Unless and until the Performance Shares will have vested in the manner set forth in Section 3, Participant will have no right to payment of any such Performance Shares. Prior to actual payment of any vested Performance Shares, such Performance Share will represent an unsecured obligation of the Company, payable (if at all) only from the general assets of the Company. 

 

Notwithstanding anything in the Plan or this Award Agreement to the contrary, if the vesting of the balance, or some lesser portion of the balance, of the Performance Shares is accelerated in connection with Participant’s termination as a Service Provider (provided that such termination is a “separation from service” within the meaning of Section 409A as determined by the Company), other than due to death, and if (x) Participant is a “specified employee” within the meaning of Section 409A at the time of such termination, and (y) the payment of such accelerated Performance Shares will result in the imposition of additional tax under Section 409A if paid to Participant on or within the six (6) month period following Participant’s termination, then the payment of such accelerated Performance Shares will not be made until the date six (6) months and one (1) day following the date of Participant’s termination, unless the Participant dies following his or her termination, in which case, the Performance Shares will be paid in Shares to the Participant’s estate as soon as practicable following his or her death. It is the intent of this Award Agreement to comply with the requirements of Section 409A so that none of the Performance Shares provided under this Award Agreement or Shares issuable thereunder will be subject to the additional tax imposed under Section 409A, and any ambiguities herein will be interpreted to so comply. For purposes of this Award Agreement, “Section 409A” means Section 409A of the Code, and any proposed, temporary or final U.S. Treasury Regulations and U.S. Internal Revenue Service guidance thereunder, as each may be amended from time to time.

 

3.     Vesting Schedule. Subject to Section 5, the Performance Shares awarded by this Award Agreement will vest in accordance with the vesting provisions set forth in the Notice of Grant. Performance Shares scheduled to vest on a certain date or upon the occurrence of a certain condition will not vest in Participant in accordance with any of the provisions of this Award Agreement, unless Participant will have been continuously a Service Provider from the Date of Grant until the date such vesting occurs.

 

4.     Payment after Vesting. Subject to Section 7, any Performance Shares that vest will be paid to Participant (or in the event of Participant’s death, to his or her properly designated beneficiary or estate) in whole Shares as soon as practicable after vesting, but in each such case within fourteen (14) days from the date the Performance Shares vest. 

 

 

 

 

  

5.     Forfeiture upon Termination of Status as a Service Provider. Notwithstanding any contrary provision of this Award Agreement, the balance of the Performance Shares that have not vested as of the time of Participant’s termination as a Service Provider for any or no reason and Participant’s right to acquire any Shares hereunder will immediately terminate.

 

6.     Death of Participant. Any distribution or delivery to be made to Participant under this Award Agreement will, if Participant is then deceased, be made to Participant’s designated beneficiary, or if no beneficiary survives Participant, the administrator or executor of Participant’s estate. Any such transferee must furnish the Company with (a) written notice of his or her status as transferee, and (b) evidence satisfactory to the Company to establish the validity of the transfer and compliance with any laws or regulations pertaining to said transfer.

 

7.     Withholding of Taxes. Notwithstanding any contrary provision of this Award Agreement, no certificate representing the Shares will be issued to Participant, unless and until satisfactory arrangements (as determined by the Administrator) will have been made by Participant with respect to the payment of income, employment and other taxes which the Company determines must be withheld with respect to such Shares. The Administrator, in its sole discretion and pursuant to such procedures as it may specify from time to time, may permit Participant to satisfy such tax withholding obligation, in whole or in part (without limitation) by (a) paying cash, (b) electing to have the Company withhold otherwise deliverable Shares having a Fair Market Value equal to the minimum amount required to be withheld, (c) delivering to the Company already vested and owned Shares having a Fair Market Value equal to the amount required to be withheld, or (d) selling a sufficient number of such Shares otherwise deliverable to Participant through such means as the Company may determine in its sole discretion (whether through a broker or otherwise) equal to the amount required to be withheld. To the extent determined appropriate by the Company in its discretion, it shall have the right (but not the obligation) to satisfy any tax withholding obligations by reducing the number of Shares otherwise deliverable to Participant. If Participant fails to make satisfactory arrangements for the payment of any required tax withholding obligations hereunder at the time any applicable Performance Shares otherwise are scheduled to vest pursuant to Sections 3, Participant will permanently forfeit such Performance Shares and any right to receive Shares thereunder and the Performance Shares will be returned to the Company at no cost to the Company.

 

8.     Rights as Stockholder. Neither Participant nor any person claiming under or through Participant will have any of the rights or privileges of a stockholder of the Company in respect of any Shares deliverable hereunder unless and until certificates representing such Shares will have been issued, recorded on the records of the Company or its transfer agents or registrars, and delivered to Participant. After such issuance, recordation and delivery, Participant will have all the rights of a stockholder of the Company with respect to voting such Shares and receipt of dividends and distributions on such Shares.

 

9.     No Guarantee of Continued Service. PARTICIPANT ACKNOWLEDGES AND AGREES THAT THE VESTING OF THE PERFORMANCE SHARES PURSUANT TO THE VESTING SCHEDULE HEREOF IS EARNED ONLY BY CONTINUING AS A SERVICE PROVIDER AT THE WILL OF THE COMPANY (OR THE PARENT OR SUBSIDIARY EMPLOYING OR RETAINING PARTICIPANT) AND NOT THROUGH THE ACT OF BEING HIRED, BEING GRANTED THIS AWARD OF PERFORMANCE SHARES OR ACQUIRING SHARES HEREUNDER. PARTICIPANT FURTHER ACKNOWLEDGES AND AGREES THAT THIS AWARD AGREEMENT, THE TRANSACTIONS CONTEMPLATED HEREUNDER AND THE VESTING SCHEDULE SET FORTH HEREIN DO NOT CONSTITUTE AN EXPRESS OR IMPLIED PROMISE OF CONTINUED ENGAGEMENT AS A SERVICE PROVIDER FOR THE VESTING PERIOD, FOR ANY PERIOD, OR AT ALL, AND WILL NOT INTERFERE IN ANY WAY WITH PARTICIPANT’S RIGHT OR THE RIGHT OF THE COMPANY (OR THE PARENT OR SUBSIDIARY EMPLOYING OR RETAINING PARTICIPANT) TO TERMINATE PARTICIPANT’S RELATIONSHIP AS A SERVICE PROVIDER AT ANY TIME, WITH OR WITHOUT CAUSE.

 

 

 

 

  

10.     Address for Notices. Any notice to be given to the Company under the terms of this Award Agreement will be addressed to the Company at Cutera, Inc., 3240 Bayshore Boulevard Brisbane, CA 94005, or at such other address as the Company may hereafter designate in writing.

 

11.     Grant is Not Transferable. Except to the limited extent provided in Section 6, this grant and the rights and privileges conferred hereby will not be transferred, assigned, pledged or hypothecated in any way (whether by operation of law or otherwise) and will not be subject to sale under execution, attachment or similar process. Upon any attempt to transfer, assign, pledge, hypothecate or otherwise dispose of this grant, or any right or privilege conferred hereby, or upon any attempted sale under any execution, attachment or similar process, this grant and the rights and privileges conferred hereby immediately will become null and void.

 

12.     Binding Agreement. Subject to the limitation on the transferability of this grant contained herein, this Award Agreement will be binding upon and inure to the benefit of the heirs, legatees, legal representatives, successors and assigns of the parties hereto.

 

13.     Additional Conditions to Issuance of Stock. If at any time the Company will determine, in its discretion, that the listing, registration or qualification of the Shares upon any securities exchange or under any state or federal law, or the consent or approval of any governmental regulatory authority is necessary or desirable as a condition to the issuance of Shares to Participant (or his or her estate), such issuance will not occur unless and until such listing, registration, qualification, consent or approval will have been effected or obtained free of any conditions not acceptable to the Company. Where the Company determines that the delivery of the payment of any Shares will violate federal securities laws or other applicable laws, the Company will defer delivery until the earliest date at which the Company reasonably anticipates that the delivery of Shares will no longer cause such violation. The Company will make all reasonable efforts to meet the requirements of any such state or federal law or securities exchange and to obtain any such consent or approval of any such governmental authority. 

 

14.     Plan Governs. This Award Agreement is subject to all terms and provisions of the Plan. In the event of a conflict between one or more provisions of this Award Agreement and one or more provisions of the Plan, the provisions of the Plan will govern. Capitalized terms used and not defined in this Award Agreement will have the meaning set forth in the Plan.

 

15.     Administrator Authority. The Administrator will have the power to interpret the Plan and this Award Agreement and to adopt such rules for the administration, interpretation and application of the Plan as are consistent therewith and to interpret or revoke any such rules (including, but not limited to, the determination of whether or not any Performance Shares have vested). All actions taken and all interpretations and determinations made by the Administrator in good faith will be final and binding upon Participant, the Company and all other interested persons. No member of the Administrator will be personally liable for any action, determination or interpretation made in good faith with respect to the Plan or this Award Agreement.

 

16.     Electronic Delivery. The Company may, in its sole discretion, decide to deliver any documents related to Performance Shares awarded under the Plan or future Performance Shares that may be awarded under the Plan by electronic means or request Participant’s consent to participate in the Plan by electronic means. Participant hereby consents to receive such documents by electronic delivery and agrees to participate in the Plan through any on-line or electronic system established and maintained by the Company or another third party designated by the Company.

 

 

 

 

  

17.     Captions. Captions provided herein are for convenience only and are not to serve as a basis for interpretation or construction of this Award Agreement.

 

18.     Agreement Severable. In the event that any provision in this Award Agreement will be held invalid or unenforceable, such provision will be severable from, and such invalidity or unenforceability will not be construed to have any effect on, the remaining provisions of this Award Agreement.

 

19.     Modifications to the Agreement. This Award Agreement constitutes the entire understanding of the parties on the subjects covered. Participant expressly warrants that he or she is not accepting this Award Agreement in reliance on any promises, representations, or inducements other than those contained herein. Modifications to this Award Agreement or the Plan can be made only in an express written contract executed by a duly authorized officer of the Company. Notwithstanding anything to the contrary in the Plan or this Award Agreement, the Company reserves the right to revise this Award Agreement as it deems necessary or advisable, in its sole discretion and without the consent of Participant, to comply with Section 409A or to otherwise avoid imposition of any additional tax or income recognition under Section 409A in connection to this Award of Performance Shares.

 

20.     Amendment, Suspension or Termination of the Plan. By accepting this Award, Participant expressly warrants that he or she has received an Award of Performance Shares under the Plan, and has received, read and understood a description of the Plan. Participant understands that the Plan is discretionary in nature and may be amended, suspended or terminated by the Company at any time.

 

21.     Governing Law. This Award Agreement shall be governed by the laws of the State of California, without giving effect to the conflict of law principles thereof. For purposes of litigating any dispute that arises under this Award of Performance Shares or this Award Agreement, the parties hereby submit to and consent to the jurisdiction of California, and agree that such litigation shall be conducted in the courts of San Mateo County, California, or the federal courts for the United States for the San Mateo County of California, and no other courts, where this Award of Performance Shares is made and/or to be performed.  

 

 

 

 

 

EXHIBIT B

 

PERFORMANCE MATRIXExhibit 4.1

 

EXHIBIT
A

 

SUBSCRIPTION
AGREEMENT

 

Workhorse
Group, Inc. 

 

Workhorse
Group Inc. (f/k/a AMP Holding Inc.) (the "Company") has
authorized for sale up to 4,000,000 shares of common stock, $0.001 par value common stock (“Common Stock”), on a “best
efforts” basis for the maximum offering of $1,000,000. The undersigned hereby subscribes
for the Shares for the Subscription Price (as defined on the signature page attached
hereto). The shares of Common Stock offered for sale by the Company are hereinafter referred to as the Shares.

 

The
undersigned agrees to pay the Subscription Price for the Shares being purchased hereunder. The entire purchase price is due and
payable upon the submission of this Subscription Agreement and shall be payable by wire transfer or check.

The
Company has the right to reject this subscription in whole or in part.

 

The
undersigned acknowledges that the Securities being purchased hereunder and its component securities will not be registered under
the Securities Act of 1933 (the "Act"), or the securities laws of any state (the “State Acts”), in reliance
upon an exemption from the registration requirements of the Act and the State Acts; that absent an exemption from registration
contained in the Act and the State Acts, the Securities, would require registration; and that the Company's reliance upon such
exemptions is based, in material part, upon the undersigned's representations, warranties, and agreements contained in this Subscription
Agreement.

 

1.      The
undersigned represents, warrants, and agrees as follows:

 

a.       The
undersigned agrees that this Subscription Agreement is and shall be irrevocable.

 

b.       The
undersigned has carefully read the Confidential Private Offering Memorandum, dated August 11, 2015, and exhibits thereto (the
“Memorandum”) as well as the Company's filings with the Securities and Exchange Commission. The undersigned has been
given the opportunity to ask questions of, and receive answers from, the Company concerning the terms and conditions of this Offering
and the Memorandum and to obtain such additional information, to the extent the Company possesses such information or can acquire
it without unreasonable effort or expense, necessary to verify the accuracy of same as the undersigned reasonably desires in order
to evaluate the investment. The undersigned understands the Memorandum and the undersigned has had the opportunity to discuss
any questions regarding any of the disclosure in the Memorandum with his counsel or other advisor. Notwithstanding the foregoing,
the only information upon which the undersigned has relied is that set forth in the Memorandum and the associated risk factors.
The undersigned has received no representations or warranties from the Company, its employees, agents or attorneys, in making
this investment decision other than as set forth in the Memorandum. The undersigned does not desire to receive any further information.

 

    	

    	 

    

 

c.       The
undersigned is aware that the purchase of the Shares is a speculative investment involving a high degree of risk, that there is
no guarantee that the undersigned will realize any gain from this investment, and that the undersigned could lose the total amount
of this investment.

 

d.
     The undersigned understands that no federal or state agency has made any finding or determination regarding the fairness
of the Shares for investment, or any recommendation or endorsement of the Shares.

 

e.     
The undersigned is purchasing the Shares for the undersigned's own account, with the intention of holding the Shares with no
present intention of dividing or allowing others to participate in this investment or of reselling or otherwise
participating, directly or indirectly, in a distribution of the Shares, and shall not make any sale, transfer, or pledge
thereof without registration under the Act and any applicable securities laws of any state or unless an exemption from
registration is available under those laws.

 

f.       
The undersigned represents that if an individual, he has adequate means of providing for his or her current needs and
personal and family contingencies and has no need for liquidity in this investment in the Securities. The undersigned has no
reason to anticipate any material change in his or her personal financial condition for the foreseeable future.

 

g.        The
undersigned is financially able to bear the economic risk of this investment, including the ability to hold the Shares indefinitely,
or to afford a complete loss of his investment in the Shares.

 

h.        The
undersigned represents that the undersigned's overall commitment to investments which are not readily marketable is not disproportionate
to the undersigned's net worth, and the undersigned's investment in the Shares will not cause such overall commitment to become
excessive. The undersigned understands that the statutory basis on which the Securities are being sold to the undersigned and
others would not be available if the undersigned's present intention were to hold the Securities for a fixed period or until the
occurrence of a certain event. The undersigned realizes that in the view of the Securities and Exchange Commission (the “Commission”),
a purchase now with a present intent to resell by reason of a foreseeable specific contingency or any anticipated change in the
market value, or in the condition of the Company, or that of the industry in which the business of the Company is engaged or in
connection with a contemplated liquidation, or settlement of any loan obtained by the undersigned for the acquisition of the Securities,
and for which such Shares may be pledged as security or as donations to religious or charitable institutions for the purpose of
securing a deduction on an income tax return, would, in fact, represent a purchase with an intent inconsistent with the undersigned's
representations to the Company, and the Commission would then regard such sale as a sale for which the exemption from registration
is not available. The undersigned will not pledge, transfer or assign this Subscription Agreement.

 

i.        The
undersigned represents that the funds provided for this investment are either separate property of the undersigned, community
property over which the undersigned has the right of control, or are otherwise funds as to which the undersigned has the sole
right of management. The undersigned is purchasing the Shares with the funds of the undersigned and not with the funds of any
other person, firm, or entity and is acquiring the Securities for the undersigned's account. No person other than the undersigned
has any beneficial interest in the Securities being purchased hereunder.

 

    	2

    	 

    

 

j.        The
address shown under the undersigned's signature at the end of this Subscription Agreement is the undersigned's principal residence
if he or she is an individual, or its principal business address if it is a corporation or other entity.

 

k.        The
undersigned has such knowledge and experience in financial and business matters as to be capable of evaluating the merits and
risks of an investment in the Shares.

 

l.         The
undersigned acknowledges that the certificates for the Shares which the undersigned will receive will contain a legend substantially
as follows:

 

			THE
                                         SECURITIES WHICH ARE REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE
                                         SECURITIES ACT OF 1933, AS AMENDED (THE "ACT"). THE SECURITIES HAVE BEEN ACQUIRED
                                         FOR INVESTMENT PURPOSES ONLY AND NOT WITH A VIEW TO DISTRIBUTION OR RESALE, AND MAY NOT
                                         BE SOLD, TRANSFERRED, MADE SUBJECT TO A SECURITY INTEREST, PLEDGED, HYPOTHECATED OR OTHERWISE
                                         DISPOSED OF UNLESS AND UNTIL REGISTERED UNDER THE SECURITIES ACT OF 1933 (THE "ACT"),
                                         AS AMENDED, OR EVIDENCE SATISFACTORY TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED
                                         UNDER SUCH ACT.

The
undersigned further acknowledges that a stop transfer order will be placed upon the certificates for the securities in accordance
with the Act. The undersigned further acknowledges that the Company is under no obligation to aid the undersigned in obtaining
any exemption from registration requirements.

 

m.        The undersigned represents that he is an “accredited investor” as that term is defined under the Act.

 

2.       The
undersigned expressly acknowledges and agrees that the Company is relying upon the undersigned's representations
contained in the Subscription Agreement.

 

3.       The
Company has been duly and validly incorporated and is validly existing and in good standing as a corporation under the laws of
the State of Nevada. The Company represents that it has all requisite power and authority, and all necessary authorizations, approvals
and orders required as of the date hereof to enter into this Subscription Agreement and to be bound by the provisions and conditions
hereof.

 

    	3

    	 

    

4.       Except
as otherwise specifically provided for hereunder, no party shall be deemed to have waived any of his or its rights hereunder or
under any other agreement, instrument or papers signed by any of them with respect to the subject matter hereof unless such waiver
is in writing and signed by the party waiving said right. Except as otherwise specifically provided for hereunder, no delay or
omission by any party in exercising any right with respect to the subject matter hereof shall operate as a waiver of such right
or of any such other right. A waiver on any one occasion with respect to the subject matter hereof shall not be construed as a
bar to, or waiver of, any right or remedy on any future occasion. All rights and remedies with respect to the subject matter hereof,
whether evidenced hereby or by any other agreement, instrument, or paper, will be cumulative, and may be exercised separately
or concurrently.

 

5.      The
parties have not made any representations or warranties with respect to the subject matter hereof not set forth herein, and this
Subscription Agreement, together with any instruments or documents executed simultaneously herewith in connection with this offering,
constitutes the entire agreement between them with respect to the subject matter hereof. All understandings and agreements heretofore
had between the parties with respect to the subject matter hereof are merged in this Subscription Agreement and any such instruments
and documents, which alone fully and completely expresses their agreement.

 

6.       This
Subscription Agreement may not be changed, modified, extended, terminated or discharged orally, but only by an agreement in writing,
which is signed by all of the parties to this Subscription Agreement.

 

7.      
The parties agree to execute any and all such other further instruments and documents, and to take any and all such further
actions reasonably required to effectuate this Subscription Agreement and the intent and purposes hereof.

 

8.       This
Subscription Agreement shall be governed by and construed in accordance with the laws of the State of Ohio and the undersigned
hereby consents to the jurisdiction of the courts of the State of Ohio and the United States District Courts situated therein.

 

9.
      The undersigned represents and warrants that he, she or it comes within one category
marked below, and that for any category marked, he, she or it has truthfully set forth, where applicable, the factual basis
or reason the undersigned comes within that category. ALL INFORMATION IN RESPONSE TO THIS SECTION WILL BE KEPT STRICTLY
CONFIDENTIAL. The undersigned agrees to furnish any additional information which the Company deems necessary in order to
verify the answers set forth below.

 

    	4

    	 

    

 

	Category A___	 	The undersigned is an individual (not a
    partnership, corporation, etc.) whose individual net worth, or joint net worth with his or her spouse, presently exceeds $1,000,000.
    (In calculating net worth you may include equity in personal property and real estate, including your principal residence,
    cash, short-term investments, stock and securities. Equity in personal property and real estate should be based on the fair
    market value of such property less debt secured by such property.)
	 	 	 
	Category B___	 	The undersigned is an individual (not a partnership, corporation,
    etc.) who had an income in excess of $200,000 in each of the two most recent years, or joint income with his or her spouse
    in excess of $300,000 in each of those years (in each case including foreign income, tax exempt income and full amount of
    capital gains and losses but excluding any income of her family members and any unrealized capital appreciation) and has a
    reasonable expectation of reaching the same income level in the current year.
	 	 	 
	Category C___ 	 	The undersigned is a director or executive officer of the Company.
	 	 	 
	Category D___	 	The undersigned is a bank; a savings and loan association; insurance
    company; registered investment company; registered business development company; licensed small business investment company
    ("SBIC"); or employee benefit plan within the meaning of Title 1 of ERISA and (a) the investment decision is made
    by a plan fiduciary which is either a bank, savings and loan association, insurance company or registered investment advisor,
    or (b) the plan has total assets in excess of $5,000,000 or (c) is a self directed plan with investment decisions made solely
    by persons that are accredited investors. (describe entity)
	 	 	 
	Category E___	 	The undersigned is a private business development company as defined
    in section 202(a)(22) of the Investment Advisors Act of 1940. (describe entity)
	 	 	 
	Category F___	 	The
        undersigned is either a corporation, partnership, Massachusetts business trust, or non-profit organization within the
        meaning of Section 501(c)(3) of the Internal Revenue Code, in each case not formed for the specific purpose of acquiring
        the Securities and with total assets in excess of $5,000,000. (describe entity)

	 	 	 
	Category G___	 	The undersigned is a trust with total assets in excess of $5,000,000,
    not formed for the specific purpose of acquiring the Securities, where the purchase is directed by a "sophisticated investor"
    as defined in Regulation 506(b)(2)(ii) under the Act.
	 	 	 
	Category H___	 	The
        undersigned is an entity (other than a trust) in which all of the equity owners are "accredited investors" within
        one or more of the above categories. If relying upon this Category alone, each equity owner must complete a separate copy
        of this agreement.

 

The
undersigned agrees that the undersigned will notify the Company at any time on or prior to the closing in the event that the representations
and warranties in this agreement shall cease to be true, accurate and complete.

 

    	5

    	 

    

 

10.SUITABILITY
(please answer each question)

 

(a)
Please describe your current employment, including the company by which you are employed and its principal business:

 

(b)
Please describe any college or graduate degrees held by you:

 

(c)
Please list types of prior investments:

 

(d)
Please state whether you have participated in other private placements before:

 

YES_______
NO_______

 

(e)
If your answer to question (d) above was "YES", please indicate frequency of such prior participation in private
placements of:

 

	 	Public
    Companies	Private
    Companies
	Frequently	 	 
	Occasionally	 	 
	Never	 	 

 

(f)
Do you expect your current level of income to significantly decrease in the foreseeable future:

 

YES_______
NO_______

 

(g)
For trust, corporate, partnership and other institutional subscribers, do you expect your total assets to significantly decrease
in the foreseeable future:

 

YES_______
NO_______

  

    	6

    	 

    

 

(h)
Do you have any other investments or contingent liabilities which you reasonably anticipate could cause you to need sudden
cash requirements in excess of cash readily available to you:

 

YES_______
NO_______

 

(i)
Are you familiar with the risk aspects and the non-liquidity of investments such as the securities for which you seek to subscribe?

 

YES_______
NO_______

 

(j)
Do you understand that there is no guarantee of financial return on this investment and that you run the risk of losing your
entire investment?

 

YES_______
NO_______

 

11.
MANNER IN WHICH TITLE IS TO BE HELD. (circle one)

 

(a)Individual
Ownership

(b)Community
Property

(c)Joint
Tenant with Right of Survivorship (both parties must sign)

(d)
Partnership

(e)
Tenants in Common

(f)
Company

(g)
Trust

(h)
Other

 

12.
FINRA AFFILIATION.

 

Are
you affiliated or associated with an FINRA member firm (please check one):

 

Yes
_________ No __________

 

If
Yes, please describe:

 

If
you are affiliated or associated with an FINRA member firm, please advise if you are purchasing the Securities in the ordinary
course of business and that you have no agreements or understandings, directly or indirectly, with any person to distribute the
securities. (please check one):

 

Yes
_________ No __________

 

    	7

    	 

    

 

*If
the undersigned is a Registered Representative with an FINRA member firm, have the following acknowledgment signed by the appropriate
party:

 

The
undersigned FINRA member firm acknowledges receipt of the notice required by Article 3, Sections 28(a) and (b) of the Rules of
Fair Practice.

 

____________________________

Name
of FINRA Member Firm

 

 

By:
_________________________

                 Authorized Officer

 

Date:

 

13.
The undersigned is informed of the significance to the Company of the foregoing representations and answers contained therein
and such answers have been provided under the assumption that the Company will rely on them.

 

 

 

 

[REMAINDER
OF PAGE INTENTIONALLY LEFT BLANK]

 

 

    	8

    	 

    

 

 

EXECUTION
BY SUBSCRIBER

 

	Investment
    Amount $	 	[1]	 	 	 
	Price
    per share	$0.25
    	[2]	 	 	 
	Number
    of Shares	 	[1]/[2]	 	 	 
	 	 	 	 	 	 
	Subscriber's
    Information	 	 	 	 	 
	Exact
    Name in which the title is to be held	 	 	 	 	 
	 	 	 	 	 	 
	Signature	 	 	 	 	 
	Name
    and Title (if applicable)	 	 	 	 	 
	Address	 	 	 	 	 
	Number
    and Street	 	 	 	 	 
	City	 	 	 	 	 
	State	 	 	 	 	 
	Zip
    Code	 	 	 	 	 
	Social
    Security Number or Tax ID	 	 	 	 	 
	email	 	 	 	 	 
	Phone
    number	 	 	 	 	 
	 	 	 	 	 	 
	Wire
    / Check Information	 	 	 	 	 
	Number	 	 	 	 	 
	Date	 	 	 	 	 
	 	 	 	 	 	 
	 	 	 	 	 	 
	Workhorse
    Group Inc. Signature	 	 	 	 	 
	 	 	 	 	 	 
	By:	 	 	 	 	 
	Name:	 	 	 	 	 
	Title:	 	 	 	 	 
	Date:	 	 	 	 	 

 

9

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