Document:

EX-10.3

 Exhibit 10.3 

FULGENT THERAPEUTICS LLC 

AMENDED AND RESTATED 

2015 EQUITY INCENTIVE PLAN 

NOTICE OF OPTION GRANT 

You have been granted an option to purchase Shares of the Company, subject to the terms and conditions of this Notice of Option Grant (the
“Notice”), the Fulgent Therapeutics LLC Amended and Restated 2015 Equity Incentive Plan, as amended from time to time (the “Plan”), and the attached Option Agreement as follows. Unless otherwise defined herein, the
terms defined in the Plan, the LLC Agreement and the Option Agreement shall have the same defined meanings in this Notice. 
  

			
	Name of Participant:	  	[●]
		
	Date of Award:	  	[●]
		
	Class of Shares:	  	Class D Non-Voting Common
		
	Exercise Price per Share:	  	$[●]
		
	Total Number of Shares	  	
	Subject to the Option:	  	[●]
		
	Total Exercise Price:	  	$[●]
		
	Type of Option:	  	Non-Qualified Option
		
	Expiration Date:	  	[●]
		
	Post-Termination Exercise Period:	  	90 days
		
	Vesting Schedule:	  	The Option shall vest with respect to 1/4 of the Shares subject thereto on the twelve-month anniversary of the Vesting Commencement Date and with respect to 1/16 of the Shares subject thereto at the end of every three-month period
thereafter. Notwithstanding such Vesting Schedule, the Option shall not be exercisable until the earlier of a Liquidity Event with respect to such Option or an Incorporation.
		
	Vesting Commencement Date:	  	[●]

 By your signature and the signature of the Company’s representative on the Option Agreement, you and the
Company agree that the Option is granted under and governed by the terms and conditions of this Notice and the Plan, the Option Agreement and the LLC Agreement, each of which are attached to and made a part of this document. 

 THE OPTION GRANTED PURSUANT TO THIS AGREEMENT, AND THE SHARES FOR WHICH SUCH OPTION IS EXERCISABLE, HAVE NOT BEEN
REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH
REGISTRATION IS NOT REQUIRED. THE PARTICIPANT HEREBY AGREES THAT ALL SHARES ACQUIRED PURSUANT TO THIS AGREEMENT SHALL BE SUBJECT TO CERTAIN RESTRICTIONS ON TRANSFER AS SET FORTH IN THE LLC AGREEMENT. 

FULGENT THERAPEUTICS LLC 

AMENDED AND RESTATED 

2015 EQUITY INCENTIVE PLAN: 

OPTION AGREEMENT 

THIS OPTION AGREEMENT (the “Agreement”) is entered into as of [●], by
Fulgent Therapeutics LLC, a California limited liability company (the “Company”), and [●] (the “Participant”). 
  

	SECTION 1.	GRANT OF OPTION. 

 The Company hereby grants to the Participant named in the Notice of
Option Grant (the “Notice”) an option (the “Option”) to purchase the total number and type of Shares subject to the Option (the “Optioned Shares”) set forth in the Notice, at the exercise price per
Share set forth in the Notice (the “Exercise Price”) subject to the terms and provisions of the Notice, this Agreement, the Company’s Amended and Restated 2015 Equity Incentive Plan, as amended from time to time (the
“Plan”), and the LLC Agreement, which are incorporated herein by reference. Unless otherwise defined herein, the terms defined in the Plan and the LLC Agreement shall have the same defined meanings in this Agreement. 

 

	SECTION 2.	EXERCISE OF OPTION. 

 (a) Right to Exercise. The Option shall vest during its term
in accordance with the Vesting Schedule set out in the Notice and with the applicable provisions of the Plan and this Agreement, provided that the Option shall not be exercisable, to the extent vested, until the earlier of a Liquidity Event with
respect to such Option or an Incorporation unless otherwise determined by the Manager in its discretion. The Option shall be subject to the provisions of the Notice and the Plan relating to the exercisability or termination of the Option in the
event of a Liquidity Event with respect to such Option. The Participant shall be subject to reasonable limitations on the number of requested exercises during any monthly or weekly period as determined by the Manager. In no event shall the Company
issue fractional Shares. 
 (b) Method of Exercise. The Option shall be exercisable by delivery of an exercise notice in a form
determined by the Manager from time to time or by such other procedure as specified from time to time by the Manager, which shall state the election to 

 
exercise the Option, the whole number of Shares in respect of which the Option is being exercised, and such other provisions as may be required by the Manager. The exercise notice shall be
delivered in person, by certified mail, or by such other method (including electronic transmission) as determined from time to time by the Manager to the Company accompanied by payment of the Exercise Price and all applicable income and employment
taxes required to be withheld. 
 (c) Taxes. No Shares will be delivered to the Participant pursuant to the exercise of the Option
until the Participant has made arrangements acceptable to the Manager for the satisfaction of applicable income tax and employment tax withholding obligations and such other tax obligations of the Participant as may be incident to the receipt of
Shares. Upon exercise of the Option, the Company or the Participant’s employer may offset or withhold (from any amount owed by the Company or the Participant’s employer to the Participant) or collect from the Participant an amount
sufficient to satisfy such tax withholding obligations. Furthermore, in the event of any determination that the Company has failed to withhold a sum sufficient to pay all withholding taxes due in connection with the Option, the Participant agrees to
pay the Company the amount of such deficiency in cash within five (5) days after receiving a written demand from the Company to do so, whether or not the Participant is an employee of the Company at that time. 

 

	SECTION 3.	CONDITIONS TO EXERCISE AND ISSUANCE OF SHARES. 

 The Participant understands that neither
the Option nor the Shares exercisable pursuant to the Option have been registered under the Securities Act or any other securities laws and are subject to the LLC Agreement. As a condition to exercise of the Option, the Participant shall make such
representations and warranties as are required by Section 8(b) of the Plan and take such other actions as the Manager requests in its reasonable discretion as a condition to the issuance of Shares to the Participant and the admission of such
Participant as a Member of the Company. 
  

	SECTION 4.	METHOD OF PAYMENT. 

 Payment of the Exercise Price shall be made by any of the following,
or a combination thereof, at the election of the Participant; provided, however, that such exercise method does not then violate any applicable law: by cash, check or wire transfer. 

 

	SECTION 5.	RESTRICTIONS ON EXERCISE. 

 (a) The Option may not be exercised if the issuance of the
Shares subject to the Option upon such exercise would constitute a violation of any applicable laws. If the exercise of the Option within the applicable time periods set forth in Sections 6, 7 and 8 of this Agreement is prevented by the
provisions of this Section 5(a), the Option shall remain exercisable until one (1) month after the date the Participant is notified by the Company that the Option is exercisable, but in any event no later than the expiration date set forth
in the Notice (the “Expiration Date”). 
 (b) Notwithstanding any provision herein to the contrary, the Option shall not be
exercisable until the earlier of a Liquidity Event with respect to such Option or an Incorporation unless otherwise determined by the Manager in its discretion. In the event the Participant’s Continuous Service is terminated prior to an
Incorporation or a Liquidity Event for any reason, including, but not limited to, voluntary resignation, termination without Cause, death or Disability, and unless otherwise determined by the Manager, there shall be no Post-Termination Exercise
Period and the Option (including the vested portions of the Option) shall terminate concurrently with the termination of the Participant’s Continuous Service. 

	SECTION 6.	TERMINATION OR CHANGE OF CONTINUOUS SERVICE. 

 (a) Subject to Section 5, in the
event the Participant’s Continuous Service terminates, other than for Cause, the Participant may, but only during the Post-Termination Exercise Period set forth in the Notice, exercise the portion of the Option that was vested at the date of
such termination (the “Termination Date”) to the extent such portion is not forfeited in accordance with the terms of the Notice. The Post-Termination Exercise Period shall commence on the Termination Date. In the event of
termination of the Participant’s Continuous Service for Cause, the Participant’s right to exercise the Option shall, except as otherwise determined by the Manager, terminate concurrently with the termination of the Participant’s
Continuous Service (also the “Termination Date”). In no event, however, shall the Option be exercised later than the Expiration Date set forth in the Notice. In the event of the Participant’s change in status from Employee to
Consultant or from Consultant to Employee, the Option shall remain in effect and the Option shall continue to vest in accordance with the Vesting Schedule set forth in the Notice. To the extent that the Option was unvested on the Termination Date,
or if the Participant does not exercise the vested portion of the Option within the Post-Termination Exercise Period, the Option shall terminate. 

(b) If the Participant commences working on a part-time basis, then the Manager may adjust the Vesting Schedule set forth in the Notice in
accordance with the Company’s part-time work policy or the terms of an agreement between the Participant and the Company pertaining to his or her part-time schedule. If the Participant goes on a leave of absence, then the Company may adjust the
Vesting Schedule set forth in the Notice in accordance with the Company’s leave of absence policy or the terms of such leave. 
  

	SECTION 7.	DISABILITY OF PARTICIPANT. 

 Subject to Section 5, in the event the
Participant’s Continuous Service terminates as a result of his or her Disability, the Participant may, but only within twelve (12) months from the Termination Date and in no event later than the Expiration Date, exercise the portion of the
Option that was vested on the Termination Date to the extent such portion is not forfeited in accordance with the terms of the Notice. To the extent that the Option was unvested on the Termination Date, or if the Participant does not exercise the
vested portion of the Option within the time specified herein, the Option shall terminate. For purposes of this Agreement, “Disability” shall have the same meaning as defined under the long-term disability policy of the Company or
the Related Entity to which the Participant provides services regardless of whether the Participant is covered by such policy. If the Company or the Related Entity to which the 

 
Participant provides service does not have a long-term disability plan in place, “Disability” means that the Participant is unable to carry out the responsibilities and functions
of the position held by the Participant by reason of any medically determinable physical or mental impairment for a period of not less than ninety (90) consecutive days. The Participant will not be considered to have incurred a Disability
unless he or she furnishes proof of such impairment sufficient to satisfy the Manager in its discretion. 
  

	SECTION 8.	DEATH OF PARTICIPANT. 

 Subject to Section 5, in the event of the termination of the
Participant’s Continuous Service as a result of his or her death, or in the event of the Participant’s death during the Post-Termination Exercise Period or during the twelve (12) month period following the Participant’s
termination of Continuous Service as a result of his or her Disability, the person who acquired the right to exercise the Option pursuant to Section 9 may, within twelve (12) months following the date of the Participant’s death but in
no event later than the Expiration Date, exercise the portion of the Option that was vested on the Termination Date to the extent such portion is not forfeited in accordance with the terms of the Notice. To the extent that the Option was unvested on
the date of death, or if the vested portion of the Option is not exercised within the time specified herein, the Option shall terminate. 
  

	SECTION 9.	TRANSFERABILITY OF OPTION. 

 The Option may not be transferred in any manner other than
by will or by the laws of descent and distribution; provided, however, that the Option may be transferred during the lifetime of the Participant to the extent and in the manner determined by the Manager in its sole discretion.
Notwithstanding the foregoing, the Participant may designate one or more beneficiaries of the Participant’s Option in the event of the Participant’s death on a beneficiary designation form provided by the Manager. Following the death of
the Participant, the Option, to the extent provided in Section 8, may be exercised (a) by the person or persons designated under the deceased Participant’s beneficiary designation, or (b) in the absence of an effectively
designated beneficiary, by the Participant’s legal representative or by any person empowered to do so under the deceased Participant’s will or under the then applicable laws of descent and distribution. The terms of the Option shall be
binding upon the executors, administrators, heirs, successors and transferees of the Participant. 
  

	SECTION 10.	TERM OF OPTION. 

 The Option must be exercised no later than the Expiration Date or such
earlier date as otherwise provided herein. After the Expiration Date or such earlier date, the Option shall be of no further force or effect and may not be exercised. 
  

	SECTION 11.	RESTRICTION ON TRANSFER OF SHARES. 

 (a) General. The Participant shall not
transfer, assign, encumber or otherwise dispose of any Shares issued hereunder without the Manager’s written consent, which may be granted or withheld in its sole discretion. 

 (b) LLC Agreement. Shares issued hereunder shall be subject to the transfer provisions of
the LLC Agreement. 
 (c) Market Stand-Off. In connection with any underwritten public offering by the Company or the Company’s
successor in an acquisition or otherwise (collectively, the “Successor Entity”) of its equity securities pursuant to an effective registration statement filed under the Securities Act, including the Successor Entity’s initial
public offering, the Participant or any holder of the Shares acquired under this Agreement shall not directly or indirectly sell, make any short sale of, loan, hypothecate, pledge, offer, grant or sell any option or other contract for the purchase
of, purchase any option or other contract for the sale of, or otherwise dispose of or transfer, or agree to engage in any of the foregoing transactions with respect to, any Shares acquired under this Agreement (or other equity securities of the
Successor Entity) without the prior written consent of the Successor Entity or its underwriters. Such restriction (the “Market Stand-Off”) shall be in effect for such period of time following the date of the final prospectus for the
offering as may be requested by the Successor Entity or such underwriters. In no event, however, shall such period exceed 180 days. The Market Stand-Off shall in any event terminate two years after the date of the Successor Entity’s initial
public offering. In the event of the declaration of a stock dividend, a spin-off, a stock split, an adjustment in conversion ratio, a recapitalization or a similar transaction affecting the Successor
Entity’s outstanding securities without receipt of consideration, any new, substituted or additional securities which are by reason of such transaction distributed with respect to any Shares subject to the Market Stand-Off, or into which such
Shares thereby become convertible, shall immediately be subject to the Market Stand-Off. In order to enforce the Market Stand-Off, the Successor Entity may impose stop-transfer instructions with respect to the Shares acquired under this Agreement
until the end of the applicable stand-off period. The Successor Entity’s underwriters shall be beneficiaries of the agreement set forth in this Subsection (c). This Subsection (c) shall not apply to Shares registered in the public
offering under the Securities Act, and the Participant shall be subject to this Subsection (c) only if the directors and officers of the Successor Entity are subject to similar arrangements. 

(d) Securities Law Restrictions. Regardless of whether the issuance of Shares hereunder have been registered under the Securities Act
or have been registered or qualified under the securities laws of any state, the Company at its discretion may impose restrictions upon the sale, pledge or other transfer of the Shares (including the placement of appropriate legends on Share
certificates or the imposition of stop-transfer instructions) if, in the judgment of the Company, such restrictions are necessary or desirable in order to achieve compliance with the Securities Act, the
securities laws of any state or any other law. 
 (e) Rights of the Company. The Company shall not be required to (i) transfer
on its books any Shares that have been sold or transferred in contravention of this Agreement or the LLC Agreement or (ii) treat as a Member of the Company or as the owner of Shares, or otherwise to accord voting, distribution or liquidation
rights to, any transferee to whom Shares have been transferred in contravention of this Agreement or the LLC Agreement. 
 (f)
Administration. Any determination by the Company and its counsel in connection with any of the matters set forth in this Section 11 shall be conclusive and binding on the Participant and all other persons. 

	SECTION 12.	COMPANY’S REPURCHASE RIGHT. 

 (a) Grant of Repurchase Right. The
Company is hereby granted the right (the “Repurchase Right”), exercisable at any time (i) during the nine (9) month period following the Termination Date, or (ii) during the nine (9) month period following an
exercise of the Option that occurs after the Termination Date, to repurchase all or any portion of any Shares issued hereunder (the “Share Repurchase Period”). The Company shall be entitled to exercise such Repurchase Right
regardless of the reason for termination of the Participant’s Continuous Service, whether such termination occurs for Cause, for Good Reason, without Cause or as a result of the death or Disability of the Participant. 

(b) Exercise of the Repurchase Right. The Repurchase Right shall be exercisable by written notice delivered to each holder of the
Shares prior to the expiration of the Share Repurchase Period. The notice shall indicate the number of Shares to be repurchased and the date on which the repurchase is to be effected, such date to be not later than the last day of the Share
Repurchase Period. On the date on which the repurchase is to be effected, the Company and/or its assigns shall pay to the holder in cash or cash equivalents (including the cancellation of any purchase-money indebtedness) an amount equal to the
Repurchase Price on the date on which the repurchase is to be effected of the Shares which are to be repurchased from the holder. Upon such payment or deposit into escrow for the benefit of the holder, the Company and/or its assigns shall become the
legal and beneficial owner of the Shares being repurchased and all rights and interest thereon or related thereto, and the Company shall have the right to transfer to its own name or its assigns the number of Shares being repurchased, without
further action by the holder. 
 (c) Assignment. Whenever the Company shall have the right to purchase Shares under this
Repurchase Right, the Company may designate and assign one or more Employees, Officers or Members of the Company or other persons or organizations, to exercise all or a part of the Company’s Repurchase Right.  

(d) Termination of the Repurchase Right. The Repurchase Right shall terminate with respect to any Shares for which it is not
timely exercised and upon the effective date of a registration statement of the Company filed under the Securities Act of 1933, as amended (“IPO”).  

(e) Additional Shares or Substituted Securities. In the event of an Incorporation or any Liquidity Event, any new, substituted
or additional securities or other property which is by reason of any such transaction distributed with respect to the Shares shall be immediately subject to the Repurchase Right, but only to the extent the Shares are at the time covered by such
right. The Repurchase Price for such securities shall be appropriately adjusted to take into account the terms of such Incorporation or Liquidity Event as determined by the Manager in its reasonable discretion. 

 (f) Repurchase Price. For purposes of this Agreement, the “Repurchase
Price” with respect to a Share shall be: 
 (i) In the case of a termination of Continuous Service for Cause, $0. 

(ii) In the case of a termination of Continuous Service without Cause, the greater of (i) the amount paid by the Participant (or the
Participant’s successor) to acquire such Share and (ii) the Book Value Attributable to such Share. For this purpose, “Book Value” shall mean the aggregate cost basis of the assets of the Company (as adjusted for
depreciation and amortization) less the Company’s liabilities as reflected in the Company’s books and records, and the “Book Value Attributable to a Share” shall mean a Share’s proportionate interest in the Book Value
of the Company under the LLC Agreement, taking into account the distribution provisions thereunder and any applicable Profits Interest Threshold Amounts, in each case as determined by the Manager in its reasonable discretion. 

 

	SECTION 13.	ADJUSTMENT OF OPTIONS AND SHARES. 

 In the event of any transaction described in
Section 6(a) of the Plan, the number and kind of Shares for which the Option is exercisable shall be adjusted as set forth in Section 6 of the Plan. In the event that the Company engages in a Liquidity Event as described in
Section 6(c) of the Plan, the Option shall be subject to the agreement governing such Liquidity Event and the LLC Agreement. 
  

	SECTION 14.	TAX CONSEQUENCES. 

 (a) The Participant may incur tax liability as a result of the
Participant’s purchase or disposition of the Shares. THE PARTICIPANT SHOULD CONSULT A TAX ADVISER BEFORE EXERCISING THE OPTION OR DISPOSING OF THE SHARES. 

(b) Notwithstanding the Company’s good faith determination of the Fair Market Value of the Shares for purposes of determining the
Exercise Price Per Share of the Option as set forth in the Notice, the taxing authorities may assert that the Fair Market Value of the Shares on the Date of Award was greater than the Exercise Price Per Share. Under Section 409A of the Code, if
the Exercise Price Per Share of the Option is less than the Fair Market Value of the Shares on the Date of Award, the Option may be treated as a form of deferred compensation and the Participant may be subject to an acceleration of income
recognition, an additional 20% tax (plus any additional state tax penalty), plus interest and possible penalties. The Company makes no representation that the Option will comply with Section 409A of the Code and makes no undertaking to prevent
Section 409A of the Code from applying to the Option or to mitigate its effects on any deferrals or payments made in respect of the Option. The Participant is encouraged to consult a tax adviser regarding the potential impact of
Section 409A of the Code. 
  

	SECTION 15.	ENTIRE AGREEMENT; GOVERNING LAW. 

 The Notice, the Plan, this Agreement and the LLC
Agreement constitute the entire agreement of the parties with respect to the subject matter hereof and supersede in their entirety 

 
all prior undertakings and agreements of the Company and the Participant with respect to the subject matter hereof, and may not be modified adversely to the Participant’s interest except by
means of a writing signed by the Company and the Participant. Nothing in the Notice, the Plan, the LLC Agreement and this Agreement (except as expressly provided therein) is intended to confer any rights or remedies on any persons other than the
parties. The Notice, the Plan, the LLC Agreement and this Agreement are to be construed in accordance with and governed by the internal laws of the State of California without giving effect to any choice of law rule that would cause the application
of the laws of any jurisdiction other than the internal laws of the State of California to the rights and duties of the parties. Should any provision of the Notice, the Plan, the LLC Agreement or this Agreement be determined to be illegal or
unenforceable, such provision shall be enforced to the fullest extent allowed by law and the other provisions shall nevertheless remain effective and shall remain enforceable. 

 

	SECTION 16.	CONSTRUCTION. 

 The captions used in the Notice and this Agreement are inserted for
convenience and shall not be deemed a part of the Option for construction or interpretation. Except when otherwise indicated by the context, the singular shall include the plural and the plural shall include the singular. Use of the term
“or” is not intended to be exclusive, unless the context clearly requires otherwise. 
  

	SECTION 17.	ADMINISTRATION AND INTERPRETATION. 

 Any question or dispute regarding the administration
or interpretation of the Notice, the Plan or this Agreement shall be submitted by the Participant or by the Company to the Manager. The resolution of such question or dispute by the Manager shall be final and binding on all persons. 

 

	SECTION 18.	VENUE. 

 The Company, the Participant, and the Participant’s assignees pursuant to
Section 9 (the “Parties”) agree that any suit, action, or proceeding arising out of or relating to the Notice, the Plan or this Agreement shall be brought in the United States District Court for the District of Southern
California (or should such court lack jurisdiction to hear such action, suit or proceeding, in a California state court in the County of Los Angeles) and that the Parties shall submit to the jurisdiction of such court. The Parties irrevocably waive,
to the fullest extent permitted by law, any objection the party may have to the laying of venue for any such suit, action or proceeding brought in such court. If any one or more provisions of this Section 18 shall for any reason be held invalid
or unenforceable, it is the specific intent of the Parties that such provisions shall be modified to the minimum extent necessary to make it or its application valid and enforceable. 

 

	SECTION 19.	NOTICES. 

 Any notice required by the terms of this Agreement shall be given in writing,
which shall include electronic communications. Notice shall be addressed to the Company at its principal executive office and to the Participant at the address that he or she most recently provided to the Company. 

	SECTION 20.	LIQUIDITY EVENT. 

 In the event of a Liquidity Event, which for purposes of clarification
shall not include an IPO, and irrespective of whether the Option is Assumed or Replaced, the Option automatically shall become fully vested and exercisable immediately prior to the specified effective date of such Liquidity Event, for all of the
Shares at the time represented by the Option, provided that the Participant’s Continuous Service has not terminated prior to such date. 

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK 

 IN WITNESS WHEREOF, each of the parties has executed
this Agreement, in the case of the Company by its duly authorized officer, as of the day and year first above written. 
  

							
	PARTICIPANT:	 		 	FULGENT THERAPEUTICS LLC
			
	  
	 		 	  

				
	[●]	 		 	By:	 	[●]
		 		 	Title:	 	[●]

 IN EXECUTING THIS AGREEMENT, THE PARTICIPANT ACKNOWLEDGES RECEIPT OF A COPY OF THE PLAN, THE NOTICE AND THE LLC AGREEMENT IN
ADDITION TO THIS AGREEMENT AND REPRESENTS THAT HE OR SHE IS FAMILIAR WITH THE TERMS AND PROVISIONS THEREOF, AND HEREBY ACCEPTS THE AWARD SUBJECT TO ALL OF THE TERMS AND PROVISIONS HEREOF AND THEREOF. THE PARTICIPANT HAS REVIEWED THIS AGREEMENT, THE
PLAN, THE LLC AGREEMENT AND THE NOTICE IN THEIR ENTIRETY, HAS HAD AN OPPORTUNITY TO OBTAIN THE ADVICE OF COUNSEL PRIOR TO EXECUTING THIS AGREEMENT, AND FULLY UNDERSTANDS ALL PROVISIONS OF THIS AGREEMENT, THE LLC AGREEMENT, THE NOTICE AND THE PLAN.
THE PARTICIPANT HEREBY AGREES THAT ALL QUESTIONS OF INTERPRETATION AND ADMINISTRATION RELATING TO THIS AGREEMENT, THE NOTICE, THE PLAN AND THE LLC AGREEMENT SHALL BE RESOLVED BY THE MANAGER.EX-10.4

 Exhibit 10.4 

FULGENT THERAPEUTICS LLC 

AMENDED AND RESTATED 

2015 EQUITY INCENTIVE PLAN 

NOTICE OF PROFITS INTEREST GRANT 

You have been granted Shares of Fulgent Therapeutics LLC (the “Company”) pursuant to the terms of this Notice of Profits
Interest Grant (the “Notice”), the Fulgent Therapeutics LLC Amended and Restated 2015 Equity Incentive Plan, as amended from time to time (the “Plan”) and the attached Profits Interest Agreement, as follows. Unless
otherwise defined herein, the terms defined in the Plan, the Profits Interest Agreement and the LLC Agreement shall have the same defined meanings in this Notice. 
  

			
	Name of Participant:	 	[●]
		
	Class of Shares:	 	Class D Non-Voting Common
		
	Total Number of Shares:	 	[●]
		
	Date of Grant:	 	[●]
		
	Vesting Schedule:	 	All Shares shall vest on the Date of Grant.
		
	Class Liquidation Value:	 	$[●]
		
	Profits Interest Threshold Amount:	 	$[●]

 By your signature and the signature of the Company’s representative on the Profits Interest Agreement,
you and the Company agree that the Shares are granted under and governed by the terms and conditions of this Notice and the Plan, the Profits Interest Agreement and the LLC Agreement, each of which are attached to and made a part of this document.

 THE SHARES GRANTED PURSUANT TO THIS AGREEMENT HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS
AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR AN OPINION OF COUNSEL, SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED. THE PARTICIPANT
HEREBY AGREES THAT ALL PROFITS INTEREST SHARES ACQUIRED PURSUANT TO THIS AGREEMENT SHALL BE SUBJECT TO CERTAIN RESTRICTIONS ON TRANSFER AS SET FORTH IN THE LLC AGREEMENT. 

FULGENT THERAPEUTICS LLC 

AMENDED AND RESTATED 

2015 EQUITY INCENTIVE PLAN: 

PROFITS INTEREST AGREEMENT 

THIS PROFITS INTEREST AGREEMENT (the “Agreement”) is entered
into as of [●], by Fulgent Therapeutics LLC, a California limited liability company (the “Company”), and [●] (the “Participant”). Unless otherwise defined herein, the terms defined in the Plan, the LLC
Agreement and the Notice shall have the same defined meanings in this Agreement. 
 SECTION 1. GRANT OF PROFITS INTEREST. 

(a) Profits Interest. On the terms and conditions set forth in the Notice (the “Notice”) and this Agreement, the
Company grants to the Participant on the Date of Grant the number of Shares issued as a Profits Interest (the “Profits Interest Shares”) set forth in the Notice. The Profits Interest Shares granted under this Agreement are intended
to meet the definition of a “profits interest” in IRS Revenue Procedure 93-27, 1993-2 C.B. 343, and IRS Revenue Procedure 2001-43, 2001-2 C.B. 191. Accordingly, at the time the Profits Interest Shares are granted, such Profits Interest
Shares will not give the Participant a share of the proceeds if the Company’s assets were sold at fair market value and the proceeds of such disposition were distributed in complete liquidation of the Company, but will give the holder a right
to share in the appreciation in the value of the Company from the date of grant forward, as specifically provided in the LLC Agreement. For this purpose, the Class Liquidation Value (the “Class Liquidation Value”) set forth in the
Notice shall be used as the deemed fair market value, as of the time of grant, of the portion of the Company to which the Profits Interest Shares relate and the Profits Interest Threshold Amount applicable to each Profits Interest Share shall be
derived from such Class Liquidation Value based on the distribution provisions of the LLC Agreement. The Manager may adjust the Class Liquidation Value and the Profits Interest Threshold Amount in its reasonable discretion to take into account
Capital Contributions, Share issuances, splits, reclassifications, recapitalizations, exercises of options or warrants and similar events and to otherwise preserve the treatment of the Profits Interest Shares as “profits interests” for
U.S. federal income tax purposes. 

 (b) Member of the Company. Upon the Date of Grant set forth in the Notice, the
Participant shall be admitted as a Member of the Company, subject to the terms of the LLC Agreement. 
 (c) Equity Plan and LLC
Agreement. The Profits Interest Shares are granted pursuant to the Plan and pursuant to the LLC Agreement, a copy of each of which the Participant acknowledges having received. The provisions of the Plan are incorporated into this Agreement by
this reference. By executing this Agreement, the Participant shall be deemed to have executed a copy of the LLC Agreement. Participant acknowledges that he or she (i) has read the LLC Agreement, the Plan and this Agreement, (ii) accepts
and agrees to be bound by the terms of the LLC Agreement, the Plan and this Agreement, and (iii) assumes all of the rights and obligations of a Member of the Company. Schedule D to the LLC Agreement shall be amended to reflect the issuance of
Profits Interest Shares to Participant pursuant to the Plan and this Agreement. 
 SECTION 2. WITHHOLDING TAXES. The Participant shall make such
arrangements as the Manager may require for the satisfaction of any federal, state, local or foreign withholding tax obligations that may arise in connection with the grant of Profits Interest Shares under this Agreement or distributions or
allocations with respect to such Profits Interest Shares. The Participant shall also make such arrangements as the Manager may require for the satisfaction of any federal, state, local or foreign withholding tax obligations that may arise in
connection with the disposition of the Profits Interest Shares. 
 SECTION 3. IRS FORM W-8 OR W-9. The Participant shall deliver to the Company a
duly completed and properly executed Form W-8 (in the case of non-U.S. residents) or Form W-9 (in the case of U.S. citizens or residents) and such other forms as the Manager may reasonably request. 

SECTION 4. DISTRIBUTIONS AND ALLOCATIONS. 

(a) Distributions. Distributions to the Participant with respect to his or her Profits Interest Shares shall be governed by the LLC
Agreement. 
 (b) Allocations. Allocations of income, gain, deduction, loss or credit to the Participant with respect to his or her
Profits Interest Shares shall be governed by the LLC Agreement. 
 SECTION 5. NO REGISTRATION RIGHTS. 

The Company may, but shall not be obligated to, register or qualify the sale of Profits Interest Shares under the Securities Act or any other
applicable law. The Company shall not be obligated to take any affirmative action in order to cause the sale of Profits Interest Shares under this Agreement to comply with any law. 

  
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 SECTION 6. RESTRICTIONS ON TRANSFER. 

(a) General. In addition to any restrictions set forth on the LLC Agreement, the Participant shall not transfer, assign, encumber or
otherwise dispose of any Profits Interest Shares without the Manager’s written consent, which may be granted or withheld in its sole discretion. 

(b) LLC Agreement. Profits Interest Shares acquired under this Agreement shall be subject to the transfer provisions of the LLC
Agreement. 
 (c) Market Stand-Off. In connection with any underwritten public offering by the Company or the Company’s
successor in an acquisition or otherwise (collectively, the “Successor Entity”) of its equity securities pursuant to an effective registration statement filed under the Securities Act, including the Successor Entity’s initial
public offering, the Participant or any holder of the Profits Interest Shares acquired under this Agreement shall not directly or indirectly sell, make any short sale of, loan, hypothecate, pledge, offer, grant or sell any option or other contract
for the purchase of, purchase any option or other contract for the sale of, or otherwise dispose of or transfer, or agree to engage in any of the foregoing transactions with respect to, any Profits Interest Shares acquired under this Agreement (or
other equity securities of the Successor Entity) without the prior written consent of the Successor Entity or its underwriters. Such restriction (the “Market Stand-Off”) shall be in effect for such period of time following the date
of the final prospectus for the offering as may be requested by the Successor Entity or such underwriters. In no event, however, shall such period exceed 180 days. The Market Stand-Off shall in any event terminate two years after the date of the
Successor Entity’s initial public offering. In the event of the declaration of a stock dividend, a spin-off, a stock split, an adjustment in conversion ratio, a recapitalization or a similar transaction
affecting the Successor Entity’s outstanding securities without receipt of consideration, any new, substituted or additional securities which are by reason of such transaction distributed with respect to any Profits Interest Shares subject to
the Market Stand-Off, or into which such Profits Interest Shares thereby become convertible, shall immediately be subject to the Market Stand-Off. In order to enforce the Market Stand-Off, the Successor Entity may impose stop-transfer instructions
with respect to the Profits Interest Shares acquired under this Agreement until the end of the applicable stand-off period. The Successor Entity’s underwriters shall be beneficiaries of the agreement set forth in this Subsection (c). This
Subsection (c) shall not apply to Profits Interest Shares registered in the public offering under the Securities Act, and the Participant shall be subject to this Subsection (c) only if the directors and officers of the Successor Entity
are subject to similar arrangements. 
 (d) Securities Law Restrictions. Regardless of whether the offering and issuance of Profits
Interest Shares under this Agreement have been registered under the Securities Act or have been registered or qualified under the securities laws of any state, the Company at its discretion may impose restrictions upon the sale, pledge or other
transfer of the Profits Interest Shares (including the placement of appropriate legends on Profits Interest Share certificates or the imposition of stop-transfer instructions) if, in the judgment of the
Company, such restrictions are necessary or desirable in order to achieve compliance with the Securities Act, the securities laws of any state or any other law. 

  
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 (e) Rights of the Company. The Company shall not be required to (i) transfer on its
books any Profits Interest Shares that have been sold or transferred in contravention of this Agreement or the LLC Agreement or (ii) treat as a Member of the Company or as the owner of Profits Interest Shares, or otherwise to accord voting,
distribution or liquidation rights to, any transferee to whom Profits Interest Shares have been transferred in contravention of this Agreement or the LLC Agreement. 

(f) Administration. Any determination by the Manager in connection with any of the matters set forth in this Section 6 shall be
conclusive and binding on the Participant and all other persons. 
 SECTION 7. COMPANY’S REPURCHASE RIGHT. 

(a) Grant of Repurchase Right. The Company is hereby granted the right (the “Repurchase Right”), exercisable at any
time during the nine (9) month period following the termination of a Participant’s Continuous Service, to repurchase all or any portion of any Shares issued hereunder (the “Share Repurchase Period”). The Company shall be
entitled to exercise such Repurchase Right regardless of the reason for termination of the Participant’s Continuous Service, whether such termination occurs for Cause, for Good Reason, without Cause or as a result of the death or disability of
the Participant. 
 (b) Exercise of the Repurchase Right. The Repurchase Right shall be exercisable by written notice delivered to
each holder of the Shares prior to the expiration of the Share Repurchase Period. The notice shall indicate the number of Shares to be repurchased and the date on which the repurchase is to be effected, such date to be not later than the last day of
the Share Repurchase Period. On the date on which the repurchase is to be effected, the Company and/or its assigns shall pay to the holder in cash or cash equivalents (including the cancellation of any purchase-money indebtedness) an amount equal to
the Repurchase Price on the date on which the repurchase is to be effected of the Shares which are to be repurchased from the holder. Upon such payment or deposit into escrow for the benefit of the holder, the Company and/or its assigns shall become
the legal and beneficial owner of the Shares being repurchased and all rights and interest thereon or related thereto, and the Company shall have the right to transfer to its own name or its assigns the number of Shares being repurchased, without
further action by the holder. 
 (c) Assignment. Whenever the Company shall have the right to purchase Shares under this Repurchase
Right, the Company may designate and assign one or more Employees, Officers or Members of the Company or other persons or organizations, to exercise all or a part of the Company’s Repurchase Right. 

(d) Termination of the Repurchase Right. The Repurchase Right shall terminate with respect to any Shares for which it is not timely
exercised and upon the effective date of a registration statement of the Company filed under the Securities Act of 1933, as amended. 
 (e)
Additional Shares or Substituted Securities. In the event of any transaction described in Section 6(a) of the Plan or any Liquidity Event, any new, substituted or 

  
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additional securities or other property which is by reason of any such transaction distributed with respect to the Shares shall be immediately subject to the Repurchase Right, but only to the
extent the Shares are at the time covered by such right. The Repurchase Price for such securities shall be appropriately adjusted to take into account the terms of such transaction or Liquidity Event as determined by the Manager in its reasonable
discretion. 
 (f) Repurchase Price. For purposes of this Agreement, the “Repurchase Price” with respect to a Share
shall be: 
 (i) In the case of a termination of Continuous Service for Cause, $0. 

(ii) In the case of a termination of Continuous Service without Cause, the Fair Market Value of such Share, taking into account the
distribution provisions of the LLC Agreement and any applicable Profits Interest Threshold Amounts, and as determined by the Manager in its discretion. 

SECTION 8. ADJUSTMENT OF PROFITS INTEREST SHARES. 

In the event of any transaction described in Section 6(a) of the Plan, the number and kind of Profits Interest Shares shall be adjusted
as set forth in Section 6 of the Plan. In the event that the Company engages in a Liquidity Event as described in Section 6(b) of the Plan, the Profits Interest Shares shall be subject to the agreement governing such Liquidity Event and
the LLC Agreement. 
 SECTION 9. SUCCESSORS AND ASSIGNS. 

Except as otherwise expressly provided to the contrary, the provisions of this Agreement shall inure to the benefit of, and be binding upon,
the Company and its successors and assigns and be binding upon the Participant and the Participant’s legal representatives, heirs, legatees, distributees, assigns and transferees by operation of law, whether or not any such person has become a
party to this Agreement or the LLC Agreement or has agreed in writing to join herein and to be bound by the terms, conditions and restrictions hereof or of the LLC Agreement. 

SECTION 10. NO RETENTION RIGHTS. 

Nothing in this Agreement shall confer upon the Participant any right to continue in Service for any period of specific duration or interfere
with or otherwise restrict in any way the rights of the Company (or any Related Entity employing or retaining the Participant) or of the Participant, which rights are hereby expressly reserved by each, to terminate his or her Service at any time and
for any reason, with or without cause. 
 SECTION 11. TAX ELECTION. 

The acquisition of the Profits Interest Shares may result in adverse tax consequences that may be avoided or mitigated by filing an election
under Code Section 83(b). Such election may be filed only within 30 days after the date of grant. The form for making the Code Section 83(b) election is attached to this Agreement as Exhibit I. The Participant should

  
 5 

 
consult with his or her tax advisor to determine the tax consequences of acquiring the Profits Interest Shares and the advantages and disadvantages of filing the Code Section 83(b)
election. The Participant acknowledges that it is his or her sole responsibility, and not the Company’s, to file a timely election under Code Section 83(b), even if the Participant requests that the Company or its representatives make this
filing on his or her behalf. 
 SECTION 12. LEGENDS. 

All certificates (if any) evidencing Profits Interest Shares shall bear the following legends: 

“THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “ACT”) OR
THE SECURITIES LAWS OF ANY OTHER JURISDICTION, AND MAY NOT BE OFFERED, SOLD, PLEDGED, HYPOTHECATED, TRANSFERRED OR OTHERWISE DISPOSED OF EXCEPT IN ACCORDANCE WITH THE REQUIREMENTS OF ACT. THE SHARES REPRESENTED BY THIS CERTIFICATE ALSO ARE SUBJECT
TO CERTAIN RESTRICTIONS ON TRANSFER AND RIGHTS OF FIRST REFUSAL HELD BY THE COMPANY OR ITS ASSIGNEE(S), AND OTHER CONDITIONS AND RESTRICTIONS, AS SET FORTH IN THAT CERTAIN THIRD AMENDED AND RESTATED OPERATING AGREEMENT FOR FULGENT THERAPEUTICS LLC,
DATED AS OF [●], AS THE SAME MAY BE AMENDED, A COPY OF WHICH WILL BE FURNISHED BY THE COMPANY, WITHOUT CHARGE, TO THE HOLDER OF THIS CERTIFICATE UPON WRITTEN REQUEST THEREFOR. SUCH RIGHTS AND RESTRICTIONS ARE BINDING ON TRANSFEREES OF THE
PROFITS INTEREST SHARES.” 
 If required by the authorities of any state in connection with the issuance of the Profits Interest Shares, the legend or
legends required by such state authorities shall also be endorsed on all such certificates. 
 SECTION 13. NOTICE. 

Any notice required by the terms of this Agreement shall be given in writing, which shall include electronic communications. Notice shall be
addressed to the Company at its principal executive office and to the Participant at the address that he or she most recently provided to the Company. 

SECTION 14. ENTIRE AGREEMENT. 
 The
Notice, this Agreement, the Plan, and the LLC Agreement constitute the entire contract between the parties hereto with regard to the subject matter hereof. They supersede any other agreements, representations or understandings (whether oral or
written and whether express or implied) which relate to the subject matter hereof. 

  
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 SECTION 15. CHOICE OF LAW. 

This Agreement shall be governed by, and construed in accordance with, the laws of the State of California, as such laws are applied to
contracts entered into and performed in such State. 
 SECTION 16. PARTICIPANT REPRESENTATIONS. 

In connection with the issuance and acquisition of the Profits Interest Shares under this Agreement, the Participant hereby represents and
warrants to the company as follows: 
 (a) The Participant is acquiring and will hold the Profits Interest Shares for investment for his or
her account only and not with a view to, or for resale in connection with, any “distribution” thereof within the meaning of the Securities Act. 

(b) The Participant understands that the Profits Interest Shares have not been registered under the Securities Act by reason of a specific
exemption therefrom and that the Profits Interest Shares must be held indefinitely, unless they are subsequently registered under the Securities Act or the Participant obtains an opinion of counsel, in form and substance satisfactory to the Company
and its counsel, that such registration is not required. The Participant further acknowledges and understands that the Company is under no obligation to register the Profits Interest Shares. 

(c) The Participant is aware of the adoption of Rule 144 by the Securities and Exchange Commission under the Securities Act, which
permits limited public resales of securities acquired in a non-public offering, subject to the satisfaction of certain conditions, including (without limitation) the availability of certain current public information about the issuer, the resale
occurring only after the holding period required by Rule 144 has been satisfied, the sale occurring through an unsolicited “broker’s transaction,” and the amount of securities being sold during any
three-month period not exceeding specified limitations. The Participant acknowledges and understands that the conditions for resale set forth in Rule 144 have not been satisfied and that the Company has
no plans to satisfy these conditions in the foreseeable future. 
 (d) The Participant will not sell, transfer or otherwise dispose of the
Profits Interest Shares in violation of the Securities Act, the Securities Exchange Act of 1934, or the rules promulgated thereunder, including Rule 144 under the Securities Act. The Participant agrees that he or she will not dispose of the
Profits Interest Shares unless and until he or she has complied with all requirements of this Agreement applicable to the disposition of Profits Interest Shares and he or she has provided the Company with written assurances, in substance and form
satisfactory to the Company, that (A) the proposed disposition does not require registration of the Profits Interest Shares under the Securities Act or all appropriate action necessary for compliance with the registration requirements of the
Securities Act or with any exemption from registration available under the Securities Act (including Rule 144) has been taken and (B) the proposed disposition will not result in the contravention of any transfer restrictions applicable to
the Profits Interest Shares under the securities laws or regulations of any State. 
 (e) The Participant has been furnished with, and has
had access to, such information as he or she considers necessary or appropriate for deciding whether to invest in the 

  
 7 

 
Profits Interest Shares, and the Participant has had an opportunity to ask questions and receive answers from the Company regarding the terms and conditions of the issuance of the Profits
Interest Shares. 
 (f) The Participant is aware that his or her investment in the Company is a speculative investment that has limited
liquidity and is subject to the risk of complete loss. The Participant is able, without impairing his or her financial condition, to hold the Profits Interest Shares for an indefinite period and to suffer a complete loss of his or her investment in
the Profits Interest Shares. 
 Signature Page Follows 

  
 8 

 IN WITNESS WHEREOF, each of the parties has
executed this Agreement, in the case of the Company by its duly authorized officer, as of the day and year first above written. 
  

					
	PARTICIPANT:	 		 	FULGENT THERAPEUTICS LLC
			
	  
	 		 	  

			
		 		 	By: [●]
			
		 		 	Title: [●]

 IN EXECUTING THIS AGREEMENT, THE PARTICIPANT ACKNOWLEDGES RECEIPT OF A COPY OF THE PLAN, THE NOTICE AND THE LLC AGREEMENT IN
ADDITION TO THIS AGREEMENT AND REPRESENTS THAT HE OR SHE IS FAMILIAR WITH THE TERMS AND PROVISIONS THEREOF, AND HEREBY ACCEPTS THE AWARD SUBJECT TO ALL OF THE TERMS AND PROVISIONS HEREOF AND THEREOF. THE PARTICIPANT HAS REVIEWED THIS AGREEMENT, THE
PLAN, THE LLC AGREEMENT AND THE NOTICE IN THEIR ENTIRETY, HAS HAD AN OPPORTUNITY TO OBTAIN THE ADVICE OF COUNSEL PRIOR TO EXECUTING THIS AGREEMENT, AND FULLY UNDERSTANDS ALL PROVISIONS OF THIS AGREEMENT, THE LLC AGREEMENT, THE NOTICE AND THE PLAN.
THE PARTICIPANT HEREBY AGREES THAT ALL QUESTIONS OF INTERPRETATION AND ADMINISTRATION RELATING TO THIS AGREEMENT, THE NOTICE, THE PLAN AND THE LLC AGREEMENT SHALL BE RESOLVED BY THE MANAGER. 

 EXHIBIT I 

SECTION 83(b) ELECTION 

This statement is made under Section 83(b) of the Internal Revenue Code of 1986, as amended, pursuant to Treasury Regulations Section 1.83-2. 

 

	(1)	The taxpayer who performed the services is: 

  

					
	Name:	 	[●]	 	
			
	Address:	 	 [●]
	 	
		 	[●]	 	
			
	Social Security No.:	 	  
	 	

  

	(2)	The property with respect to which the election is made is [●] Class D Shares of Fulgent Therapeutics LLC. 

  

	(3)	The property was transferred on [●]. 

  

	(4)	The taxable year for which the election is made is the calendar year [●]. 

  

	(5)	The property is subject to a repurchase right in favor of the issuer, exercisable if the taxpayer’s service with the issuer is terminated. 

 

	(6)	The fair market value of such property at the time of transfer (determined without regard to any restriction other than a restriction that, by its terms, will never lapse) is $0 per Share. 

 

	(7)	The amount paid for such property is $[●] per Share. 

  

	(8)	A copy of this statement was furnished to Fulgent Therapeutics LLC, for whom taxpayer rendered the services underlying the transfer of such property. 

 

	(9)	This statement is executed on                  , [●]. 

 

					
	  
	 		 	  

	Signature of Spouse (if any)	 		 	Signature of Taxpayer

 Within 30 days after the date of grant, this election must be filed with the Internal Revenue Service Center where the
Participant files his or her federal income tax returns. The filing should be made by registered or certified mail, return receipt requested. The Participant must (a) file a copy of the completed form with his or her federal tax return for the
current tax year and (b) deliver an additional copy to the Company.

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