Document:

Exhibit 10.3

 

BLUE RIDGE BANK

 

2008 STOCK OPTION PLAN

 

ARTICLE 1

ESTABLISHMENT, PURPOSE, AND DURATION

 

1.1       ESTABLISHMENT
OF THE PLAN. BlueRidge Bank, a Maryland-chartered commercial bank (hereinafter referred to as the "Bank"), establishes
an equity compensation plan to be known as the BlueRidge Bank 2008 Stock Option Plan (hereinafter referred to as the "Plan"),
as set forth in this document.

The Plan permits the
grant of Nonqualified Stock Options and Incentive Stock Options.

 

The Plan is effective
as of September 23, 2008 (the "Effective Date") and shall remain in effect as provided in Section 1.3 hereof.

 

1.2        PURPOSE OF THE PLAN. The purpose
of the Plan is to promote the success and enhance the value of the Bank and its Affiliates by linking the personal interests of
the Participants to those of the Bank's stockholders, and by providing Participants with an incentive for outstanding performance.

 

The Plan is further intended to provide
flexibility to the Bank in its ability to motivate, attract, and retain the services of Participants upon whose judgment, interest,
and special effort the successful conduct of its operation largely is dependent.

 

1.3        DURATION OF THE PLAN. The Plan
shall commence as of the Effective Date, as described in Section 1.1 herein, and shall remain in effect, subject to the right
of the Committee or the Board to amend or terminate the Plan at any time pursuant to Article 10 herein, until the earlier of (i)
the tenth anniversary of the Effective Date, or (ii) such time as all Shares subject to the Plan have been purchased or acquired
according to the Plan's provisions.

 

ARTICLE 2

DEFINITIONS

 

Whenever used in the Plan, the following
terms shall have the meaning set forth below, and when the meaning is intended, the initial letter of the word shall be capitalized.

 

"AFFILIATE" shall mean
any entity that directly, or through one or more intermediaries, controls, is controlled by or is under common control with, the
Bank as determined by the Committee.

 

"AWARD" means, individually
or collectively, a grant under this Plan of NQSOs or, ISOs in each case subject to the terms of this Plan.

 

"AWARD AGREEMENT" means
either (i) a written agreement entered into by the Bank and a Participant setting forth the terms and provisions applicable to
Awards granted under this Plan; or (ii) a written statement issued by the Bank to a Participant describing the terms and provisions
of such Award.

 

    	 	 	 

     

    

 

"BANK" means BlueRidge
Bank, a Maryland-chartered commercial bank, and any successor thereto as provided in Article 12 herein.

 

"BENEFICIAL OWNER" OR "BENEFICIAL
OWNERSHIP" shall have the meaning ascribed to such term in rule 13d-3 of the General Rules and Regulations under the Exchange
Act.

 

"BOARD" OR "BOARD OF DIRECTORS"
means the Board of Directors of the Bank.

 

"CAUSE" means (i) the willful
failure by the Participant to perform substantially the Participant's duties as an Employee or Director (other than due to physical
or mental illness) after reasonable notice to the Participant of such failure, (ii) the Participant's engaging in serious misconduct
that is injurious to the Bank or any Affiliate in any way, including, but not limited to, by way of damage to their respective
reputations or standings in their respective industries, (iii) the Participant's having been convicted of, or having entered a
plea of nolo contendere to, a crime that constitutes a felony or (iv) the breach by the Participant of any written covenant or
agreement with the Bank or any Affiliate not to disclose or misuse any information pertaining to, or misuse any property of, the
Bank or any Affiliate or not to compete or interfere with the Bank or any Affiliate.

 

"CHANGE OF CONTROL" shall occur if
any of the following events occur:

 

(i)                
Any Person acquires Beneficial Ownership, directly or indirectly, of securities of the Bank representing twenty-five percent
(25%) or more of the combined Voting Power of the Bank's securities;

 

(ii)              
Within any twenty-four (24) month period, the individuals who were Directors of the Bank at the beginning of such period
(the "Incumbent Directors") shall cease to constitute at least a majority of the Board of Directors or the board of directors
of any successor to the Bank; provided, however, that any Director elected or nominated for election to the Board by a majority
of the Incumbent Directors then still in office shall be deemed to be an Incumbent Director for purposes of this (ii); or

 

(iii)            
The stockholders of the Bank approve a merger, consolidation, share exchange, division, sale or other disposition of all
or substantially all of the assets of the Bank which is consummated (a "Corporate Event"), and immediately following
the consummation of which the stockholders of the Bank immediately prior to such Corporate Event do not hold, directly or indirectly,
a majority of the Voting Power of (i) in the case of a merger or consolidation, the surviving or resulting corporation, (ii) in
the case of a share exchange, the acquiring corporation, or (iii) in the case of a division or a sale or other disposition of assets,
each surviving, resulting or acquiring corporation which, immediately following the relevant Corporate Event, holds more than twenty-five
percent (25%) of the consolidated assets of the Bank immediately prior to such Corporate Event.

 

"CHANGE OF CONTROL PRICE" means
the highest price per share of Shares offered in conjunction with any transaction resulting in a Change of Control (as determined
in good faith by the Committee if any part of the offered price is payable other than in cash) or, in the case of a Change of Control
occurring solely by reason of a change in the composition of the Board, the highest Fair Market Value of the common stock on any
of the thirty (30) trading days immediately preceding the date on which a Change of Control occurs.

 

    	 	2	 

     

    

 

"CODE" means the U.S. Internal
Revenue Code of 1986, as amended from time to time, or any successor thereto.

 

"COMMITTEE" means the Compensation
Committee of the Board of Directors, or any other duly authorized committee of the Board appointed by the Board to administer the
Plan.

 

"DIRECTOR" means any individual
who is a member of the Board or the Board of Directors of an Affiliate who is also not an employee of the Bank or an Affiliate.

 

"EMPLOYEE" means any employee
of the Bank or an Affiliate. Directors who are not otherwise employed by the Bank or an Affiliate shall not be considered Employees
under this Plan.

 

"EXCHANGE ACT" means the
Securities Exchange Act of 1934, as amended from time to time, or any successor act thereto.

 

"FAIR MARKET VALUE" or
"FMV" means a price determined by the Committee based on objective criteria. If Shares are at any time traded
on an established stock exchange or market, FMV shall mean the closing selling price of a Share on the applicable date, the preceding
trading day, the next succeeding trading day, or an average of trading days, as determined by the Committee in its discretion.

 

"FISCAL YEAR" means the
year commencing on January 1 and ending December 31 or other time period as approved by the Board.

 

"INCENTIVE STOCK OPTION" or
"ISO" means an Option to purchase Shares granted under Article 6 herein and that is designated as an Incentive
Stock Option and is intended to meet the requirements of Section 422 of the Code, or any successor provision.

 

"NONQUALIFIED STOCK OPTION"
or "NQSO" means an Option to purchase Shares, granted under Article 6 herein, which is not intended to be
an Incentive Stock Option or that otherwise does not meet such requirements.

 

"OPTION" means the conditional
right to purchase Shares at a stated Option Price for a specified period of time in the form of an Incentive Stock Option or a
Nonqualified Stock Option subject to the terms of this Plan.

 

"OPTION PRICE" means the
price at which a Share may be purchased by a Participant pursuant to an Option, as determined by the Committee.

"PARTICIPANT" means an
Employee or Director who has been selected to receive an Award, or who has an outstanding Award granted under the Plan.

"PERSON" shall have the
meaning ascribed to such term in Section 3(a)(9) of the Exchange Act and used in Sections 13(d) and 14(d) thereof, including a
 "group" as defined in Section 13(d) thereof; provided, however, that "Person" shall not include (i) the Bank
or any Affiliate, or (ii) any employee benefit plan (including an employee stock ownership plan) sponsored by the Bank or any Affiliate.

 

"SHARES" means the shares of common
stock of the Bank, $1.25 par value per Share.

 

"VOTING POWER" shall mean
such number of Voting Securities as shall enable the holders thereof to cast all the votes which could be cast in an annual election
of directors of a bank or other corporation.

 

    	 	3	 

     

    

 

"VOTING SECURITIES" shall
mean all securities entitling the holders thereof to vote in an annual election of directors of a bank or other corporation.

 

ARTICLE 3

ADMINISTRATION

 

3.1        GENERAL. The Committee shall be responsible for
administering the Plan. The Committee may employ attorneys, consultants, accountants, agents, and other individuals, any of whom
may be an Employee or agent, and the Committee, the Bank, and its officers and Directors shall be entitled to rely upon the advice,
opinions, or valuations of any such persons. All actions taken and all interpretations and determinations made by the Committee
shall be final, conclusive, and binding upon the Participants, the Bank, and all other interested parties.

 

3.2        AUTHORITY OF THE COMMITTEE. The
Committee shall have full and exclusivediscretionary power to interpret the terms and the intent of the Plan and any Award Agreement
or other agreement ancillary to or in connection with the Plan, to determine eligibility for Awards, and to adopt such rules,
regulations, and guidelines for administering the Plan as the Committee may deem necessary or proper. Such authority shall include,
but not be limited to, selecting Award recipients, establishing all Award terms and conditions and, subject to Article 10, adopting
modifications and amendments to the Plan or any Award Agreement.

 

3.3        DELEGATION. The Committee may delegate
to one or more of its members or to one or more officers of the Bank or its Affiliates, any of its duties or powers as it may
deem advisable; provided, however, that the Committee may not delegate any of its non-administrative powers with respect to Awards;
and provided further, that such member(s) or officer(s) shall report periodically to the Committee regarding the nature and scope
of the Awards granted pursuant to the authority delegated pursuant to this Section 3.3. Subject to the terms of the previous sentence,
the Committee may delegate to any individual(s) such administrative duties or powers as it may deem advisable.

 

ARTICLE 4

SHARES SUBJECT TO THE PLAN AND MAXIMUM
AWARDS

 

4.1        NUMBER OF SHARES AVAILABLE FOR AWARDS.
Subject to adjustment as provided in Section 4.2 herein, the number of Shares hereby reserved for issuance to Participants
under the Plan shall be 270,000 (such total number of Shares, the "Total Share Authorization").

 

Any Shares related to Awards that terminate
by expiration, forfeiture, cancellation, or otherwise without the issuance of such Shares shall be available again for grant under
the Plan. Moreover, if the Option Price of any Option granted under the Plan is satisfied by tendering Shares to the Bank (by either
actual delivery or by attestation), only the number of Shares issued, net of the Shares tendered, if any, will be deemed delivered
for purposes of determining the maximum number of Shares available for issuance under the Plan. The Shares available for issuance
under the Plan may be authorized and unissued Shares or treasury Shares. The maximum aggregate number of Shares that may be granted
in the form of Options, pursuant to any Award granted in any one Fiscal Year to any one Participant, shall be 100,000.

 

4.2        ADJUSTMENTS IN AUTHORIZED SHARES. In
the event of any corporate event or transaction (including, but not limited to, a change in the Shares of the Bank or the capitalization
of the Bank) such as a merger, consolidation, reorganization, recapitalization, separation, stock dividend, extraordinary dividend,
stock split, reverse stock split, split up, spin-off, or other distribution of stock or property of the Bank, combination of securities,
exchange of securities, dividend in kind, or other like change in capital structure or distribution (other than normal cash dividends)
to stockholders of the Bank, or any similar corporate event or transaction, the number and kind of Shares that may be issued under
the Plan and the number and kind of Shares subject to outstanding Awards shall automatically be adjusted proportionately.

 

    	 	4	 

     

    

 

The Committee, in its sole discretion, may
also make other appropriate adjustments in the terms of Awards issued under the Plan and may modify any other terms of outstanding
Awards. The determination of the Committee as to the foregoing adjustments, if any, shall be conclusive and binding on Plan Participants.

 

Subject to the provisions of Article 9 and
any applicable law or regulatory requirement, without affecting the number of Shares reserved or available hereunder, the Committee
may authorize the issuance, assumption, substitution, or conversion of Awards under this Plan in connection with any such corporate
event or transaction upon such terms and conditions as it may deem appropriate. Additionally, the Committee may amend the Plan,
or adopt supplements to the Plan, in such manner as it deems appropriate to provide for such issuance, assumption, substitution,
or conversion as provided in the previous sentence.

 

ARTICLE 5

ELIGIBILITY AND PARTICIPATION

 

5.1        ELIGIBILITY. Individuals eligible
to participate in the Plan include all Employees and Directors designated by the Board of Directors as eligible.

 

5.2        ACTUAL
PARTICIPATION. Subject to the provisions of the Plan, the Committee may from time to time, select from all eligible Employees
and Directors, those to whom Awards shall be granted and shall determine in its discretion, the nature, terms, and amount of each
Award.

 

ARTICLE 6

STOCK OPTIONS

 

6.1        GRANT OF OPTIONS. Subject to the
terms and provisions of the Plan, Options may be granted to Participants in such number, and upon such terms, and at any time
and from time to time as shall be determined by the Committee in its discretion. Notwithstanding the foregoing, no ISOs may be
granted more than ten (10) years after the earlier of (a) adoption of the Plan by the Board, and (b) the Effective Date.

 

6.2        AWARD AGREEMENT. Each Option grant
shall be evidenced by an Award Agreement that shall specify the Option Price, the duration of the Option, the number of Shares
to which the Option pertains, the conditions upon which an Option shall become vested and exercisable, and any such other provisions
as the Committee shall determine. The Award Agreement also shall specify whether the Option is intended to be an ISO or a NQSO.

 

6.3        OPTION
PRICE. The Option Price for each grant of an Option under this Plan shall be determined by the Committee and shall be specified
in the Award Agreement. The Option Price shall be not less than one hundred percent (100%) of the FMV of the Shares on the date
of grant, provided that, in the case of a Participant who owns more than ten percent (10%) of the total combined voting power
of all classes of stock of the Bank, the Option Price shall not be less than 110% of the FMV of the Shares on the date of grant.

 

    	 	5	 

     

    

6.4        DURATION
OF OPTIONS. Each Option granted to a Participant shall expire at such time as the Committee shall determine at the time of
grant; provided, however, that no Option shall be exercisable later than the tenth (10th) anniversary date of its grant;
provided further, that in the case of a Participant who owns more than ten percent (10%) of the total combined voting power of
all classes of stock of the Bank, no option shall be exercisable later than the fourth (5th) anniversary of the date
of its grant.

 

6.5        EXERCISE OF OPTIONS. Options
granted under this Article 6 shall be exercisable at such times and on the occurrence of such events, and be subject to such restrictions and conditions, as the Committee shall in
each instance approve, which need not be the same for each grant or for each Participant.

 

6.6        PAYMENT.
Options granted under this Article 6 shall be exercised by the delivery of a notice of exercise to the Bank or an agent designated
by the Bank in a form specified or accepted by the Committee, or by complying with any alternative procedures which may be authorized
by the Committee, setting forth the number of Shares with respect to which the Option is to be exercised, accompanied by full
payment for the Shares.

 

The Option Price upon exercise of any Option
shall be payable to the Bank in full either: (a) in cash or its equivalent; (b) by tendering (either by actual delivery or attestation)
previously acquired Shares having an aggregate FMV at the time of exercise equal to the total Option Price; (c) by a combination
of (a) and (b); or (d) any other method approved or accepted by the Committee in its sole discretion subject to such rules and
regulations as the Committee may establish. Cashless exercise of the Option is also permissible provided that the Participant concurrently
provides irrevocable instructions (i) to his or her broker or dealer to effect the immediate sale of the purchased Shares and remit
to the Bank out of sale proceeds available on the settlement date, sufficient funds to cover the Option Price and (ii) to Bank
to deliver the certificates for such Shares of Stock directly to such broker or dealer in order to complete the sale.

 

Subject to Section 6.7 and any governing
rules or regulations, as soon as practicable after receipt of a notification of exercise and full payment, the Committee shall
cause to be delivered to the Participant Share certificates or evidence of book entry Shares in an appropriate amount based upon
the number of Shares purchased under the Option(s). Unless otherwise determined or accepted by the Committee, all payments in cash
shall be paid in United States dollars.

 

6.7        RESTRICTIONS
ON SHARE TRANSFERABILITY. The Committee may impose such restrictions on any Shares acquired pursuant to the exercise of an
Option granted pursuant to this Plan as it may deem advisable, including, without limitation, requiring the Participant to hold
the Shares acquired pursuant to exercise for a specified period of time, or restrictions under applicable laws or under the requirements
of any stock exchange or market upon which such Shares are listed and/or traded.

 

6.8        TERMINATION
OF EMPLOYMENT OR SERVICE. Each Participant's Award Agreement shall set forth the extent to which the Participant shall have
the right to exercise the Option following termination of the Participant's employment with the Bank or Affiliates. Such provisions
shall be determined in the sole discretion of the Committee, shall be included in the Award Agreement entered into with each Participant,
need not be uniform among all Options issued pursuant to this Article 6, and may reflect distinctions based on the reasons for
termination; provided, however, that no Option shall be exercisable more than three months following a Participant's termination
of employment for a reason other than death or disability. If a Participant is terminated as a result of death or disability,
no exercise of an Option may occur after the expiration of the one-year period following the termination, or if earlier, the expiration
of the term of the Option as provided under Section 6.4.

 

    	 	6	 

     

    

 

6.9        NONTRANSFERABILITY OF OPTIONS.

 

		(a)	INCENTIVE STOCK OPTIONS. No ISO granted under the Plan may be sold, transferred, pledged, assigned, or otherwise alienated
or hypothecated, other than by will or by the laws of descent and distribution. Further, all ISOs granted to a Participant under
this Article 6 shall be exercisable during his or her lifetime only by such Participant.

 

		(b)	NONQUALIFI ED STOCK OPTIONS. Except as otherwise provided in a Participant's Award Agreement at the time of grant, or
thereafter by the Committee, NQSO granted under this Article 6 may not be sold, transferred, pledged, assigned, or otherwise alienated
or hypothecated, other than by will or by the laws of descent and distribution. Further, except as otherwise provided in a Participant's
Award Agreement at the time of grant or thereafter by the Committee, all NQSOs granted to a Participant under this Article 6 shall
be exercisable during the Participant's lifetime only by such Participant.

 

6.10        NOTIFICATION
OF DISQUALIFYING DISPOSITION. The Participant will notify the Bank upon the disposition of Shares issued pursuant to the exercise
of an ISO or Shares received as a dividend on ISO stock. The Bank will use such information to determine whether a disqualifying
disposition as described in Section 421(b) of the Code has occurred.

 

ARTICLE 7

BENEFICIARY DESIGNATION

 

A Participant's "beneficiary"
is the person or persons entitled to receive payments or other benefits or exercise rights that are available under the Plan in
the event of the Participant's death. A Participant may designate a beneficiary or change a previous beneficiary designation at
such times prescribed by the Committee by using forms and following procedures approved or accepted by the Committee for that purpose.
If no beneficiary designated by the Participant is eligible to receive payments or other benefits or exercise rights that are available
under the Plan at the Participant's death the beneficiary shall be the Participant's estate.

 

Notwithstanding the provisions above, the
Committee may in its discretion, after notifying the affected Participants, modify the foregoing requirements, institute additional
requirements for beneficiary designations, or suspend the existing beneficiary designations of living Participants or the process
of determining beneficiaries under this Article 7, or both, in favor of another method of determining beneficiaries.

 

ARTICLE 8

RIGHTS OF EMPLOYEES AND AGENTS

 

8.1       EMPLOYMENT.
Nothing in the Plan or an Award Agreement shall interfere with or limit in any way the right of the Bank or an Affiliate to
terminate any Participant's employment or other service relationship at any time, nor confer upon any Participant any right to
continue in the capacity in which he or she is employed or otherwise serves the Bank or an Affiliate.

 

    	 	7	 

     

    

 

Neither an Award nor any benefits arising
under this Plan shall constitute part of an employment contract with the Bank or an Affiliate and, accordingly, subject to the
terms of this Plan, this Plan may be terminated or modified at any time in the sole and exclusive discretion of the Committee without
giving rise to liability on the part of the Bank or an Affiliate for severance payments or otherwise except as provided in this
Plan.

 

For purposes of the Plan, unless otherwise
provided by the Committee, transfer of employment of a Participant between the Bank and an Affiliate or among Affiliates, shall
not be deemed a termination of employment. The Committee may stipulate in a Participant's Award Agreement or otherwise the conditions
under which a transfer of employment or Agency to an entity that is spun-off from the Bank or an Affiliate, if any, shall not be
deemed a termination of employment for purposes of an Award.

 

8.2        PARTICIPATION.
No Employee or Director shall have the right to be selected to receive an Award. No Employee or Director, having been selected
to receive an Award, shall have the right to be selected to receive a future Award or (if selected to receive such a future Award)
the right to receive such a future Award on terms and conditions identical or in proportion in any way to any prior Award.

 

8.3        RIGHTS
AS A STOCKHOLDER. Except as specifically provided for in this Plan or an Award Agreement, a Participant shall have none of
the rights of a stockholder with respect to Shares covered by any Award until the Participant becomes the record holder of such
Shares.

 

ARTICLE 9

CHANGE OF CONTROL

 

9.1        ACCELERATED
VESTING AND PAYMENT. Subject to the provisions of Section 9.2 or as otherwise provided in the Award Agreement, in the event
of a Change of Control, unless otherwise specifically prohibited under law or by the rules and regulations of a national security
exchange:

 

		(a)	Any and all Options granted to Employees hereunder shall become immediately exercisable; additionally, if an Employee's employment
or service is involuntarily terminated for any reason except Cause within twelve (12) months of such Change of Control, the Employee
shall have until the earlier of (i) twelve (12) months following such termination date, or (ii) the term of the Option, to exercise
such Options;

 

		(b)	If the Change of Control occurs after the third anniversary of the chartering of the Bank, any and all Options granted to Directors
hereunder shall become immediately exercisable; and

 

		(c)	Subject to the provisions of Section 9.1(b), the Committee shall have the ability to unilaterally determine that all outstanding
Awards are cancelled upon a Change in Control, and the value of such Awards, as determined by the Committee in accordance with
the terms of the Plan and the Award Agreement, be paid out in cash in an amount based on the Change of Control Price within a reasonable
time subsequent to the Change in Control; provided, however, that no such payment shall be made on account of an ISO using a value
higher than the FMV on the date of settlement.

 

    	 	8	 

     

    

 

9.2        ALTERNATIVE
AWARDS. Notwithstanding Section 9.1, no cash settlement or other payment shall occur with respect to any Award if the Committee
reasonably determines in good faith prior to the occurrence of a Change of Control that such Award shall be honored or assumed,
or new rights substituted therefor (such honored, assumed or substituted Award hereinafter called an "Alternative Award")
by any successor as described in Article 12; provided that any such Alternative Award must:

 

		(a)	Be based on stock which is traded on an established U.S. securities market, or that the Committee reasonably believes will
be so traded within sixty (60) days after the Change of Control;

 

		(b)	Provide such Participant with rights and entitlements substantially equivalent to or better than the rights, terms and conditions
applicable under such Award, including, but not limited to, an identical or better exercise or vesting schedule and identical or
better timing and methods of payment;

 

		(c)	Have substantially equivalent economic value to such Award (determined at the time of the Change of Control); and

 

		(d)	Have terms and conditions which provide that in the event that the Participant's employment is involuntarily terminated or
constructively terminated, any conditions on a Participant's rights under, or any restrictions on transfer or exercisability applicable
to, each such Alternative Award shall be waived or shall lapse, as the case may be.

 

ARTICLE 10

AMENDMENT, MODIFICATION, SUSPENSION,
AND TERMINATION

 

10.1        AMENDMENT,
MODIFICATION, SUSPENSION, AND TERMINATION. The Committee or Board may, at any time and from time to time, alter, amend, modify,
suspend, or terminate the Plan in whole or in part; provided however, that:

 

		(a)	Without the prior approval of the Bank's stockholders, Options issued under the Plan will not be repriced, replaced, or regranted
through cancellation or by lowering the exercise price of a previously granted Option.

 

		(b)	To the extent necessary under any applicable law, regulation or exchange requirement, no amendment shall be effective unless
approved by the stockholders of the Bank in accordance with applicable law, regulation, or exchange requirement.

 

10.2        ADJUSTMENT
OF AWARDS UPON THE OCCURRENCE OF CERTAIN UNUSUAL OR NONRECURRING EVENTS. The Committee may make adjustments in the terms and
conditions of, and the criteria included in, Awards in recognition of unusual or nonrecurring events (including, without limitation,
the events described in Section 4.2 hereof) affecting the Bank or the financial statements of the Bank or of changes in applicable
laws, regulations, or accounting principles, whenever the Committee determines that such adjustments are appropriate in order to
prevent unintended dilution or enlargement of the benefits or potential benefits intended to be made available under the Plan.
The determination of the Committee as to the foregoing adjustments, if any, shall be conclusive and binding on Participants under
the Plan.

 

10.3        AWARDS
PREVIOUSLY GRANTED. Notwithstanding any other provision of the Plan to the contrary, no termination, amendment, suspension,
or modification of the Plan shall adversely affect in any material way any Award previously granted under the Plan, without the
written consent of the Participant holding such Award.

 

    	 	9	 

     

    

 

10.4        BANK
REGULATION. The terms and conditions of each Award granted shall comply with applicable banking laws and regulations. Awards
are subject to exercise or forfeiture upon the direction of the Maryland Commissioner of Financial Regulation or the Federal Deposit
Insurance

Corporation (or any other state or federal agency having primary
regulatory jurisdiction over the Bank) if the Bank's capital falls below applicable minimum regulatory requirements.

 

ARTICLE 11

WITHHOLDING

 

The Bank or any Affiliate shall have the
power and the right to deduct or withhold, or require a Participant to remit to the Bank or any Affiliate, an amount sufficient
to satisfy federal, state, and local taxes, domestic or foreign (including the Participant's FICA obligation), required by law
or regulation to be withheld with respect to any taxable event resulting or arising from this Plan. The Committee may provide for
Participants to satisfy withholding requirements by having the Bank withhold Shares or the Participant making such other arrangements,
in either case on such conditions as the Committee specifies.

 

ARTICLE 12

SUCCESSORS

 

Any obligations of the Bank or an Affiliate
under the Plan with respect to Awards granted hereunder, shall be binding on any successor to the Bank or Affiliate, respectively,
whether the existence of such successor is the result of a direct or indirect purchase, merger, consolidation, or otherwise, of
all or substantially all of the business and/or assets of the Bank or Affiliate, as applicable.

 

ARTICLE 13

GENERAL PROVISIONS

 

13.1        FORFEITURE
EVENTS. Without limiting in any way the generality of the Committee's power to specify any terms and conditions of an Award
consistent with law, and for greater clarity, the Committee may specify in an Award Agreement that the Participant's rights, payments,
and benefits with respect to an Award shall be subject to reduction, cancellation, forfeiture, or recoupment upon the occurrence
of certain specified events, in addition to any otherwise applicable vesting of an Award. Such events shall include, but shall
not be limited to, failure to accept the terms of the Award Agreement, termination of employment or service under certain or all
circumstances, violation of material Bank and Affiliate policies, breach of noncompetition, confidentiality, nonsolicitation, noninterference,
corporate property protection, or other agreement that may apply to the Participant, or other conduct by the Participant that is
detrimental to the business or reputation of the Bank and Affiliates.

 

13.2        LEGEND.
The certificates for Shares may include any legend that the Committee deems appropriate to reflect any restrictions on transfer
of such Shares.

 

13.3        DELIVERY
OF TITLE. The Bank shall have no obligation to issue or deliver evidence of title for Shares issued under the Plan prior to:

 

		(a)	Obtaining any approvals from governmental agencies that the Bank determines are necessary or advisable; and

 

    	 	10	 

     

    

 

		(b)	Completion of any registration or other qualification of the Shares under any applicable national or foreign law or ruling
of any governmental body that the Bank determines to be necessary or advisable.

 

13.4        INVESTMENT
REPRESENTATIONS. The Committee may require each Participant receiving Shares pursuant to an Award under this Plan to represent
and warrant in writing that the Participant is acquiring the Shares for investment and without any present intention to sell or
distribute such Shares.

 

13.5        UNCERTIFICATED
SHARES. To the extent that the Plan provides for issuance of certificates to reflect the transfer of Shares, the transfer of
such Shares may be effected on a noncertificated basis to the extent not prohibited by applicable law or the rules of any stock
exchange.

 

13.6        UNFUNDED
PLAN. Participants shall have no right, title, or interest whatsoever in or to any investments that the Bank or an Affiliate
may make to aid it in meeting its obligations under the Plan. Nothing contained in the Plan, and no action taken pursuant to its
provisions, shall create or be construed to create a trust of any kind, or a fiduciary relationship between the Bank or an Affiliate
and any Participant, beneficiary, legal representative, or any other person. Awards shall be general, unsecured obligations of
the Bank, except that if an Affiliate executes an Award Agreement instead of the Bank the Award shall be a general, unsecured obligation
of the Affiliate and not any obligation of the Bank. To the extent that any individual acquires a right to receive payments from
the Bank or an Affiliate, such right shall be no greater than the right of an unsecured general creditor of the Bank or Affiliate,
as applicable. All payments to be made hereunder shall be paid from the general funds of the Bank or Affiliate, as applicable,
and no special or separate fund shall be established and no segregation of assets shall be made to assure payment of such amounts
except as expressly set forth in the Plan. The Plan is not intended to be subject to ERISA.

 

13.7        NO
FRACTIONAL SHARES. No fractional Shares shall be issued or delivered pursuant to the Plan or any Award Agreement. In such an
instance, unless the Committee determines otherwise, fractional Shares and any rights thereto shall be forfeited or otherwise eliminated.

 

13.8        OTHER
COMPENSATION AND BENEFIT PLANS. Nothing in this Plan shall be construed to limit the right of the Bank or an Affiliate to establish
other compensation or benefit plans, programs, policies, or arrangements. Except as may be otherwise specifically stated in any
other benefit plan, policy, program, or arrangement, no Award shall be treated as compensation for purposes of calculating a Participant's
rights under any such other plan, policy, program, or arrangement.

 

13.9        NO
CONSTRAINT ON CORPORATE ACTION. Nothing in this Plan shall be construed (i) to limit, impair or otherwise affect the Bank's
or an Affiliate's right or power to make adjustments, reclassifications, reorganizations or changes of its capital or business
structure, or to merge or consolidate, or dissolve, liquidate, sell, or transfer all or any part of its business or assets, or
(ii) to limit the right or power of the Bank or an Affiliate to take any action which such entity deems to be necessary or appropriate.

 

ARTICLE 14

LEGAL CONSTRUCTION

 

14.1        GENDER
AND NUMBER. Except where otherwise indicated by the context, any masculine term used herein also shall include the feminine,
the plural shall include the singular, and the singular shall include the plural.

 

    	 	11	 

     

    

 

14.2        SEVERABILITY.
In the event any provision of the Plan shall be held illegal or invalid for any reason, the illegality or invalidity shall
not affect the remaining parts of the Plan, and the Plan shall be construed and enforced as if the illegal or invalid provision
had not been included.

 

14.3        REQUIREMENTS
OF LAW. The granting of Awards and the issuance of Shares under the Plan shall be subject to all applicable laws, rules, and
regulations, and to such approvals by any governmental agencies or national securities exchanges as may be required. The Bank or
an Affiliate shall receive the consideration required by law for the issuance of Awards under the Plan.

 

The inability of the Bank or an Affiliate
to obtain authority from any regulatory body having jurisdiction, which authority is deemed by the Bank's or the Affiliate's counsel
to be necessary to the lawful issuance and sale of any Shares hereunder, shall relieve the Bank or Affiliate of any liability in
respect of the failure to issue or sell such Shares as to which such requisite authority shall not have been obtained.

 

14.4        GOVERNING
LAW. The Plan and each Award Agreement shall be governed by the laws of the State of Maryland, excluding any conflicts or choice
of law rule or principle that might otherwise refer construction or interpretation of the Plan to the substantive law of another
jurisdiction.

 

    	 	12Exhibit 4.2

 

Execution Version

 

SIXTH SUPPLEMENTAL INDENTURE

by and among

Ventas Realty, Limited Partnership, as Issuer,

Ventas, Inc., as Guarantor

and

U.S. Bank National Association,

as Trustee

$500,000,000

4.750% Senior Notes due 2030

 

 

 

Dated as of April 1, 2020

 

Supplement to Indenture dated as of February
23, 2018 (Senior Debt Securities)

 

     

     

    

 

TABLE OF CONTENTS

 

	 	 	Page
	ARTICLE I CREATION OF THE SECURITIES 	2
	 	 
	Section 1.01	 	Designation of the Series; Securities Guarantee	2
	Section 1.02	 	Form of Notes	2
	Section 1.03	 	No Limit on Amount of Notes	2
	Section 1.04	 	Ranking	2
	Section 1.05	 	Certificate of Authentication	2
	Section 1.06	 	No Sinking Fund	2
	Section 1.07	 	No Additional Amounts	2
	Section 1.08	 	Definitions	2
	 	 	 	 
	ARTICLE II THE SECURITIES	8
	 	 
	Section 2.01	 	Amendment to Article 2	8
	 	 	 	 
	ARTICLE III REDEMPTION	8
	 	 
	Section 3.01	 	Amendment to Article 3	8
	 	 	 
	ARTICLE IV COVENANTS	9
	 	 
	Section 4.01	 	Amendments to Article 4	9
	 	 	 
	ARTICLE V SUCCESSORS	12
	 	 
	Section 5.01	 	Amendments to Article 5	12
	 	 	 
	ARTICLE VI DEFAULTS AND REMEDIES	13
	 	 
	Section 6.01	 	Amendments to Article 6	13
	 	 	 
	ARTICLE VII TRUSTEE	15
	 	 
	Section 7.01	 	Amendments to Article 7	15
	 	 	 
	ARTICLE VIII LEGAL DEFEASANCE AND COVENANT DEFEASANCE	15
	 	 
	Section 8.01	 	Applicability of Defeasance Provisions	15
	Section 8.02	 	Determinations Under Section 8.03	15
	Section 8.03	 	Determination Under Section 8.07	15
	Section 8.04	 	Amendments to Article 8	15
	 	 
	ARTICLE IX GUARANTEES	15
	 	 
	Section 9.01	 	Applicability of Guarantee Provisions	15
	 	 
	ARTICLE X MISCELLANEOUS	16
	 	 
	Section 10.01	 	Determination Under Section 13.10	16
	Section 10.02	 	Application of Sixth Supplemental Indenture; Ratification	16
	Section 10.03	 	Benefits of Sixth Supplemental Indenture	16
	Section 10.04	 	Effective Date	16
	Section 10.05	 	Governing Law	16
	Section 10.06	 	Counterparts	16
	 	 	 	 
	SCHEDULE 1	 	Real Estate Revenues	 
	 	 	 	 
	EXHIBIT A	 	Form of Note	 
	 	 	 	 	 	 	 	 	 	 

     

     

    

 

THIS SIXTH SUPPLEMENTAL INDENTURE, dated as
of April 1, 2020 (the “Sixth Supplemental Indenture”), is by and among Ventas Realty, Limited Partnership, a
Delaware limited partnership (the “Issuer”), Ventas, Inc., a Delaware corporation, and U.S. Bank National Association,
having a Corporate Trust Office at 425 Walnut ML CN WN 06 CT, Cincinnati, Ohio 45202, as Trustee (the “Trustee”),
under the Indenture (as defined below).

 

WHEREAS, Ventas, Inc., the Issuer and the
Trustee are parties to that certain indenture dated as of February 23, 2018 (the “Base Indenture” and, together
with this Sixth Supplemental Indenture, as amended and supplemented from time to time, the “Indenture”), providing
for the issuance by Ventas, Inc. or by the Issuer together from time to time of their respective senior debt securities in one
or more series (the “Securities”);

 

WHEREAS, Sections 2.01, 2.02 and 9.01 of the
Base Indenture provide, among other things, that, without the consent of the Holders of the Securities, one or more indentures
supplemental to the Base Indenture may be entered into to establish the form or terms of Securities of any series or to change
or eliminate any of the provisions of the Base Indenture; provided that any such change or elimination shall become effective
only when there is no Security Outstanding of any series created prior to the execution of such supplemental indenture which is
entitled to the benefit of such provisions;

 

WHEREAS, the Issuer, acting in its capacity
as issuer under the Base Indenture, desires to issue a series of its Securities under the Base Indenture, and has duly authorized
the creation and issuance of such series of Securities and the execution and delivery of this Sixth Supplemental Indenture to establish
such series of Securities, to modify certain terms of the Base Indenture as they apply to such series of Securities and to provide
certain additional provisions in respect of such Securities as hereinafter described;

 

WHEREAS, the Issuer desires to issue such
Securities with the benefit of a Securities Guarantee provided by Ventas, Inc. on the terms set forth in the Indenture;

 

WHEREAS, the Issuer, Ventas, Inc. and the
Trustee deem it advisable to enter into this Sixth Supplemental Indenture for the purposes of establishing the terms of such series
of Securities and the related Securities Guarantee, and providing for the rights, obligations and duties of the Trustee with respect
to such Securities;

 

WHEREAS, concurrently with the execution hereof,
the Issuer has delivered to the Trustee an Officers’ Certificate and has caused its counsel to deliver to the Trustee an
Opinion of Counsel or a reliance letter upon an Opinion of Counsel satisfying the requirements of Section 2.03 of the Base Indenture;
and

 

WHEREAS, all conditions and requirements of
the Base Indenture necessary to make this Sixth Supplemental Indenture a valid, binding and legal instrument, enforceable in accordance
with its terms, have been performed and fulfilled by the parties hereto, and the execution and delivery hereof have been in all
respects duly authorized by the parties hereto.

 

NOW, THEREFORE, for and in consideration of
the premises and agreements herein contained, it is mutually covenanted and agreed, for the equal and proportionate benefit of
all Holders of the Securities of such series established hereby, as follows:

 

    1

     

    

 

ARTICLE I

 

CREATION OF THE SECURITIES

 

Section 1.01 Designation of the Series;
Securities Guarantee.

 

(a)       The
changes, modifications and supplements to the Base Indenture effected by this Sixth Supplemental Indenture shall be applicable
only with respect to, and govern the terms of, the Notes (as defined below), which shall not apply to any other Securities that
have been or may be issued under the Base Indenture, unless a supplemental indenture with respect to such other Securities specifically
incorporates such changes, modifications and supplements. Pursuant to the terms hereof and Sections 2.01 and 2.02 of the Base Indenture,
the Issuer hereby creates a series of Securities designated as the “4.750% Senior Notes due 2030” (the “Notes”),
which Notes shall be deemed “Securities” for all purposes under the Base Indenture. Except as otherwise provided
in the Base Indenture, the Notes shall form their own series for voting purposes and shall not be part of the same class or series
as any other Securities issued by the Issuer or by Ventas, Inc.

 

(b)       Each
of the Notes will be guaranteed by the Guarantor in accordance with Article 10 of the Base Indenture and Article IX of this Sixth
Supplemental Indenture.

 

Section 1.02 Form of Notes. The
Notes will be issued in permanent global form as one or more Global Securities substantially in the form set forth in Exhibit
A attached hereto, which is incorporated herein and made a part hereof. The Notes shall bear interest, be payable and have
such other terms as are stated in such form of global Note or in the Indenture. The stated maturity of the principal of the Notes
shall be November 15, 2030.

 

Section 1.03 No Limit on Amount of
Notes. The Trustee shall authenticate and deliver on the Issue Date under the Indenture Notes for original issue in an
aggregate principal amount of up to $500,000,000. Notwithstanding the foregoing, the aggregate principal amount of the Notes
that may be authenticated and delivered under the Indenture shall be unlimited, subject to the covenants set forth in the
Indenture, including under Section 4.10 hereof; provided, that the terms of all Notes issued under this Sixth
Supplemental Indenture (other than the date of issuance, the issuance price, and the initial Interest Payment Date) shall be
the same. The Issuer may, upon the execution and delivery of this Sixth Supplemental Indenture or from time to time
thereafter, execute and deliver the Notes to the Trustee for authentication, and the Trustee shall thereupon authenticate and
deliver said Notes upon an Authentication Order and delivery of an Officers’ Certificate and Opinion of Counsel as
contemplated by Section 2.03 of the Base Indenture, without further action by the Issuer.

 

Section 1.04 Ranking. The Notes
will be the Issuer’s unsecured and unsubordinated obligations and rank equal in right of payment with all of the Issuer’s
existing and future unsecured and unsubordinated indebtedness.

 

Section 1.05 Certificate of
Authentication. The Trustee shall authenticate the Notes by executing the Global Security substantially as provided in
the form of Note attached hereto as Exhibit A.

 

Section 1.06 No Sinking Fund. No
sinking fund will be provided with respect to the Notes (notwithstanding any provisions of the Base Indenture with respect to
sinking fund obligations).

 

Section 1.07 No Additional
Amounts. No Additional Amounts will be payable with respect to the Notes (notwithstanding any provisions of the Base
Indenture with respect to Additional Amount obligations).

 

Section 1.08 Definitions.

 

(a)       Capitalized
terms used herein and not otherwise defined herein shall have the respective meanings assigned thereto in the Base Indenture.

 

(b)       Solely
for purposes of this Sixth Supplemental Indenture and the Notes, the following definitions in Section 1.01 of the Base Indenture
are hereby amended in their entirety to read as follows:

 

    2

     

    

 

“Business Day” means any
day other than a Saturday or Sunday or a day on which banking institutions in The City of New York are required or authorized to
close.

 

(c)       Solely
for purposes of this Sixth Supplemental Indenture and the Notes, the following terms shall have the indicated meanings:

 

“Consolidated EBITDA” means,
for any period of time, the net income (loss) of Ventas, Inc. and its Subsidiaries, determined on a consolidated basis in accordance
with GAAP for such period, before deductions for (without duplication):

 

(1)       Interest
Expense;

 

(2)       taxes;

 

(3)       depreciation,
amortization and all other non-cash items, as determined reasonably and in good faith by Ventas, Inc., deducted in arriving at
net income (loss);

 

(4)       extraordinary
items;

 

(5)       non-recurring
items or other unusual items, as determined reasonably and in good faith by Ventas, Inc. (including, without limitation, all prepayment
penalties and all costs or fees incurred in connection with any debt financing or amendment thereto, acquisition, disposition,
recapitalization or similar transaction (regardless of whether such transaction is completed));

 

(6)       noncontrolling
interests;

 

(7)       income
or expense attributable to transactions involving derivative instruments that do not qualify for hedge accounting in accordance
with GAAP; and

 

(8)       gains
or losses on dispositions of depreciable real estate investments, property valuation losses and impairment charges.

 

For purposes of calculating Consolidated EBITDA,
all amounts shall be as determined reasonably and in good faith by Ventas, Inc. and in accordance with GAAP, except to the extent
that GAAP is not applicable with respect to the determination of all non-cash and non-recurring items.

 

“Consolidated Financial Statements”
means, with respect to any Person, collectively, the consolidated financial statements and notes to those financial statements,
of that Person and its Subsidiaries prepared in accordance with GAAP.

 

“Contingent Liabilities of Ventas,
Inc. and Subsidiaries” means, as of any date, those liabilities of Ventas, Inc. and its Subsidiaries consisting of (without
duplication) indebtedness for borrowed money, as determined in accordance with GAAP, that are or would be stated and quantified
as contingent liabilities in the notes to the Consolidated Financial Statements of Ventas, Inc. as of the date of determination.

 

“Debt” means, as of
any date (without duplication), (1) all indebtedness and liabilities for borrowed money, secured or unsecured, of Ventas,
Inc. and its Subsidiaries, including mortgages and other notes payable (including the Notes to the extent outstanding from
time to time), but excluding any indebtedness, including mortgages and other notes payable, which is secured by cash, cash
equivalents or marketable securities or defeased (it being understood that cash collateral shall be deemed to include cash
deposited with a trustee with respect to third-party indebtedness) and (2) all Contingent Liabilities of Ventas, Inc. and its
Subsidiaries, excluding in each of clauses (1) and (2) Intercompany Debt and all liabilities associated with customary
exceptions to Non-Recourse Debt, such as for fraud, misapplication of funds, environmental indemnities, voluntary bankruptcy,
collusive involuntary bankruptcy and other similar exceptions.

 

    3

     

    

 

It is understood that Debt shall not include
any redeemable equity interest in Ventas, Inc.

 

“Sixth Supplemental Indenture”
has the meaning stated in the preamble.

 

“Guarantor” means Ventas,
Inc. and its successors and assigns; provided, however, that any Person constituting a Guarantor as described above
shall cease to constitute a Guarantor when its Guarantee of the Notes is released in accordance with the terms of the Indenture.

 

“Intercompany Debt” means,
as of any date, Debt to which the only parties are Ventas, Inc. and any of its Subsidiaries as of such date; provided, however,
that with respect to any such Debt of which the Issuer or the Guarantor is the borrower, such Debt is subordinate in right of payment
to the Notes.

 

“Interest Expense” means,
for any period of time, the aggregate amount of interest recorded in accordance with GAAP for such period by Ventas, Inc. and its
Subsidiaries, but excluding (i) interest reserves funded from the proceeds of any loan, (ii) prepayment penalties, (iii) amortization
of deferred financing costs and (iv) non-cash swap ineffectiveness charges, in all cases as reflected in the applicable Consolidated
Financial Statements.

 

“Issue Date” means April
1, 2020.

 

“Issuer” has the meaning
stated in the preamble.

 

“Latest Completed Quarter”
means, as of any date, the then most recently ended fiscal quarter of Ventas, Inc. for which Consolidated Financial Statements
of Ventas, Inc. have been completed, it being understood that at any time when Ventas, Inc. is subject to the informational requirements
of the Exchange Act, and in accordance therewith files annual and quarterly reports with the Commission, the term “Latest
Completed Quarter” shall be deemed to refer to the fiscal quarter covered by Ventas, Inc.’s most recently filed Quarterly
Report on Form 10-Q, or, in the case of the last fiscal quarter of the year, Ventas, Inc.’s Annual Report on Form 10-K.

 

“Make-Whole Amount” means,
in connection with any optional redemption of the Notes, the excess, if any, of:

 

(1)       the
aggregate present value as of the date of such redemption of each dollar of principal of the Notes being redeemed or paid and the
amount of interest (exclusive of interest accrued to the date of redemption or accelerated payment) that would have been payable
in respect of each such dollar if such redemption or accelerated payment had been made on August 15, 2030, determined by discounting,
on a semi-annual basis, such principal and interest at the Reinvestment Rate (determined on the third Business Day preceding the
date a notice of redemption is given or declaration of acceleration is made) from the respective dates on which such principal
and interest would have been payable if such redemption or payment had been made on August 15, 2030, over

 

(2)       the
aggregate principal amount of the Notes being redeemed or paid.

 

“Notes” has the meaning
stated in Section 1.01 hereof.

 

“Obligations” means any
principal, interest, penalties, fees, indemnifications, reimbursements, damages and other liabilities payable under the documentation
governing any Debt.

 

“Property EBITDA” means,
for any property owned by Ventas, Inc. or any of its Subsidiaries as of the date of determination, for any period of time (without
duplication), the net income (loss) derived from such property for such period, before deductions for:

 

    4

     

    

 

(1)       Interest
Expense;

 

(2)       taxes;

 

(3)       depreciation,
amortization and all other non-cash items, as determined reasonably and in good faith by Ventas, Inc., deducted in arriving at
net income (loss);

 

(4)       general
and administrative expenses that are not allocated by management to a property segment, as reflected in Ventas, Inc.’s Consolidated
Financial Statements available for the four (4) consecutive fiscal quarters ending with the Latest Completed Quarter;

 

(5)       extraordinary
items;

 

(6)       non-recurring
items or other unusual items, as determined reasonably and in good faith by Ventas, Inc. (including, without limitation, all prepayment
penalties and all costs or fees incurred in connection with any debt financing or amendment thereto, acquisition, disposition,
recapitalization or similar transaction (regardless of whether such transaction is completed));

 

(7)       noncontrolling
interests;

 

(8)       income
or expense attributable to transactions involving derivative instruments that do not qualify for hedge accounting in accordance
with GAAP; and

 

(9)       property
valuation losses and impairment charges;

 

in each case, attributable to such property.

 

For purposes of calculating Property EBITDA,
all amounts shall be determined reasonably and in good faith by Ventas, Inc. and in accordance with GAAP except to the extent that
GAAP is not applicable with respect to the determination of all non-cash and non-recurring items.

 

Property EBITDA shall be adjusted (without
duplication) to give pro forma effect:

 

(x)       in
the case of any assets having been placed-in-service or removed from service since the first day of the period to the date of determination,
to include or exclude, as the case may be, any Property EBITDA earned or eliminated as a result of the placement of such assets
in service or removal of such assets from service as if the placement of such assets in service or removal of such assets from
service occurred as of the first day of the period; and

 

(y)       in
the case of any acquisition or disposition of any asset or group of assets since the first day of the period to the date of determination,
including, without limitation, by merger, or stock or asset purchase or sale, to include or exclude, as the case may be, any Property
EBITDA earned or eliminated as a result of the acquisition or disposition of those assets as if the acquisition or disposition
occurred as of the first day of the period.

 

“Reinvestment Rate”
means 0.500% plus the arithmetic mean of the yields under the respective heading Day Ending published in the most recent
Statistical Release under Treasury Constant Maturities for the maturity (rounded to the nearest month) corresponding to the
remaining life to maturity of the principal of the Notes being redeemed or paid as of such redemption or payment date, which
maturity shall be deemed to be August 15, 2030. If no maturity exactly corresponds to such deemed maturity, yields for the
two published maturities most closely corresponding to such maturity shall be calculated pursuant to the immediately
preceding sentence and the Reinvestment Rate in respect of the Notes shall be interpolated or extrapolated from such yields
on a straight-line basis, rounding in each of such relevant periods to the nearest month. For the purpose of calculating the
Reinvestment Rate in respect of the Notes, the most recent Statistical Release published prior to the date of determination
of the Make-Whole Amount shall be used.

 

    5

     

    

 

“Secured Debt” means, as
of any date, that portion of the aggregate principal amount of all outstanding Debt of Ventas, Inc. and its Subsidiaries as of
that date that is secured by a Lien on properties or other assets of Ventas, Inc. or any of its Subsidiaries.

 

“Stabilized Development Asset”
means, as of any date, a new construction or development Real Estate Asset at such date that, following the first four (4) consecutive
fiscal quarters occurring after substantial completion of construction or development, either (i) an additional six (6) consecutive
fiscal quarters have occurred or (ii) such Real Estate Asset is at least 90% leased, whichever shall first occur.

 

“Statistical Release” means
that statistical release that is published by the Federal Reserve System and that establishes annual yields on actively traded
United States government securities adjusted to constant maturities, or, if such statistical release is not published at the time
of any determination under the Indenture, then such other reasonably comparable index the Issuer designates.

 

“Subsidiary” means, with
respect to any Person, a corporation, partnership association, joint venture, trust, limited liability company or other business
entity which is required to be consolidated with such Person in accordance with GAAP.

 

“Total Assets” means,
as of any date, in each case as determined reasonably and in good faith by Ventas, Inc., the sum of (without duplication):

 

(1)       with
respect to Real Estate Assets that were owned by Ventas, Inc. and its Subsidiaries as of April 17, 2002 and that continue to be
owned as of the date of determination, the annualized rental revenues specified for such Real Estate Assets on Schedule 1 attached
to this Sixth Supplemental Indenture, divided by 0.0900, plus any annualized incremental rental revenue generated by such Real
Estate Assets as a result of, arising out of or in connection with annual rent escalations or rent reset rights of Ventas, Inc.
and its Subsidiaries with respect to such Real Estate Assets (whether by agreement or exercise of such right or otherwise), divided
by 0.0900; for the purpose of this clause (1), “annualized incremental rental revenue” in respect of a Real Estate
Asset shall mean the increase in daily rental revenue generated by such Real Estate Asset as a result of, arising out of or in
connection with such annual rent escalations or rent reset rights over the daily rental revenue generated by such Real Estate Asset
immediately prior to the effective date of such increase, annualized by multiplying such daily increase by 365;

 

(2)       with
respect to all other Real Estate Assets owned by Ventas, Inc. and its Subsidiaries as of the date of determination (except as set
forth in clause (3) below), the cost (original cost plus capital improvements before depreciation and amortization) thereof, determined
in accordance with GAAP;

 

(3)       with
respect to Stabilized Development Assets owned by Ventas, Inc. and its Subsidiaries as of the date of determination, the aggregate
sum of all Property EBITDA for such Stabilized Development Assets for the four (4) consecutive fiscal quarters ending with the
Latest Completed Quarter divided by (i) 0.0900, in the case of a government reimbursed property and (ii) 0.0700 in all other cases;
provided, however, that if the value of a particular Stabilized Development Asset calculated pursuant to this clause (3)
is less than the cost (original cost plus capital improvements before depreciation and amortization) of such Real Estate Asset,
as determined in accordance with GAAP, such cost shall be used in lieu thereof with respect to such Real Estate Asset;

 

    6

     

    

 

(4)       the
proceeds of the Debt, or the assets to be acquired in exchange for such proceeds, as the case may be, incurred since the end of
the Latest Completed Quarter;

 

(5)       mortgages
and other notes receivable of Ventas, Inc. and its Subsidiaries, determined in accordance with GAAP;

 

(6)       cash,
cash equivalents and marketable securities of Ventas, Inc. and its Subsidiaries but excluding all cash, cash equivalents and marketable
securities securing, or applied to defease or discharge, in each case as of that date, any indebtedness, including mortgages and
other notes payable (including cash deposited with a trustee with respect to third-party indebtedness), all determined in accordance
with GAAP; and

 

(7)       all
other assets of Ventas, Inc. and its Subsidiaries (excluding goodwill), determined in accordance with GAAP.

 

“Unencumbered Assets” means,
as of any date, in each case as determined reasonably and in good faith by Ventas, Inc., the sum of (without duplication):

 

(1)       with
respect to Real Estate Assets that were owned by Ventas, Inc. and its Subsidiaries as of April 17, 2002 and that continue to be
owned as of the date of determination, but excluding any such Real Estate Assets that are serving as collateral for Secured Debt,
the annualized rental revenues specified for such Real Estate Assets on Schedule 1 attached to this Sixth Supplemental Indenture,
divided by 0.0900, plus any annualized incremental rental revenue generated by such Real Estate Assets as a result of, arising
out of or in connection with annual rent escalations or rent reset rights of Ventas, Inc. and its Subsidiaries with respect to
such Real Estate Assets (whether by agreement or exercise of such right or otherwise), divided by 0.0900; for the purpose of this
clause (1), “annualized incremental rental revenue” in respect of a Real Estate Asset shall mean the increase in daily
rental revenue generated by such Real Estate Asset as a result of, arising out of or in connection with such annual rent escalations
or rent reset rights over the daily rental revenue generated by such Real Estate Asset immediately prior to the effective date
of such increase, annualized by multiplying such daily increase by 365;

 

(2)       with
respect to all other Real Estate Assets owned by Ventas, Inc. and its Subsidiaries as of the date of determination (except as set
forth in clause (3) below), but excluding any such Real Estate Assets that are serving as collateral for Secured Debt, the cost
(original cost plus capital improvements before depreciation and amortization) thereof, determined in accordance with GAAP;

 

(3)       with
respect to Stabilized Development Assets owned by Ventas, Inc. and its Subsidiaries as of the date of determination, excluding
any such Stabilized Development Assets that are serving as collateral for Secured Debt, the aggregate sum of all Property EBITDA
for such Stabilized Development Assets for the four (4) consecutive fiscal quarters ending with the Latest Completed Quarter divided
by (i) 0.0900, in the case of a government reimbursed property and (ii) 0.0700 in all other cases; provided, however, that
if the value of a particular Stabilized Development Asset calculated pursuant to this clause (3) is less than the cost (original
cost plus capital improvements before depreciation and amortization) of such Real Estate Asset, as determined in accordance with
GAAP, such cost shall be used in lieu thereof with respect to such Real Estate Asset;

 

(4)       the
proceeds of the Debt, or the assets to be acquired in exchange for such proceeds, as the case may be, incurred since the end of
the Latest Completed Quarter;

 

(5)       mortgages
and other notes receivable of Ventas, Inc. and its Subsidiaries, except any mortgages or other notes receivable that are serving
as collateral for Secured Debt, determined in accordance with GAAP;

 

    7

     

    

 

(6)       cash,
cash equivalents and marketable securities of Ventas, Inc. and its Subsidiaries but excluding all cash, cash equivalents and marketable
securities securing, or applied to defease or discharge, in each case as of that date, any indebtedness, including mortgages and
other notes payable (including cash deposited with a trustee with respect to third-party indebtedness), all determined in accordance
with GAAP; and

 

(7)       all
other assets of Ventas, Inc. and its Subsidiaries (excluding goodwill), other than assets pledged to secure Debt, determined in
accordance with GAAP; provided, however, that Unencumbered Assets shall not include net real estate investments in unconsolidated
joint ventures of Ventas, Inc. and its Subsidiaries.

 

For the avoidance of doubt, cash held by a
 “qualified intermediary” in connection with proposed like-kind exchanges pursuant to Section 1031 of the Internal Revenue
Code of 1986, as amended, which may be classified as “restricted” for GAAP purposes shall nonetheless be included in
clause (6) above, so long as Ventas, Inc. or any of its Subsidiaries has the right to (i) direct the qualified intermediary to
return such cash to Ventas, Inc. or such Subsidiary if and when Ventas, Inc. or such Subsidiary fails to identify or acquire the
proposed like-kind property or at the end of the 180-day replacement period or (ii) direct the qualified intermediary to use such
cash to acquire like-kind property.

 

“Unsecured Debt” means,
as of any date, that portion of the aggregate principal amount of all outstanding Debt of Ventas, Inc. and its Subsidiaries as
of that date that is neither Secured Debt nor Contingent Liabilities of Ventas, Inc. and its Subsidiaries.

 

“Ventas Capital” means
Ventas Capital Corporation, a Delaware corporation.

 

ARTICLE II

 

THE SECURITIES

 

Section 2.01 Amendment to Article 2.

 

(a)       The
first sentence of Section 2.03 of the Base Indenture is hereby amended with respect to the Notes by replacing the reference to
 “Two Officers” therein with “One Officer.”

 

ARTICLE III

 

REDEMPTION

 

Section 3.01 Amendment to Article 3.

 

(a)       Pursuant
to Section 2.02(7) of the Base Indenture, the first sentence of Section 3.04 of the Base Indenture is hereby amended with respect
to the Notes by replacing the reference to “30 days” therein with “15 days”.

 

(b)       Pursuant
to Sections 2.02(7) and 2.02(8) of the Base Indenture, Article 3 of the Base Indenture is hereby amended with respect to the Notes
by adding to the end the following new Sections 3.09 and 3.10, in each case to read as follows:

 

“Section 3.09 Optional
Redemption.

 

(a)       The
Issuer may, at its option, redeem the Notes at any time prior to maturity, in whole or from time to time in part.

 

    8

     

    

 

(b)       The
redemption price for any redemption of the Notes before August 15, 2030 shall be equal to the sum of (1) the principal amount of
the Notes being redeemed, (2) accrued and unpaid interest thereon, if any, to (but excluding) the redemption date and (3) the Make-Whole
Amount, if any (subject to the right of holders of record on the relevant Record Date to receive interest due on the relevant Interest
Payment Date). The calculation of the Make-Whole Amount shall be the responsibility of the Issuer or such other party appointed
by the Issuer. The redemption price for any redemption of the Notes on or after August 15, 2030 shall be equal to the sum of (1)
the principal amount of the Notes being redeemed and (2) accrued and unpaid interest thereon, if any, to (but excluding) the redemption
date.

 

(c) Any redemption pursuant to this
Section 3.09 shall be made pursuant to the provisions of Sections 3.01 through 3.07 of the Indenture.

 

Section 3.10 Mandatory Redemption.
The Issuer is not required to make mandatory redemption payments with respect to the Notes.”

 

ARTICLE IV

 

COVENANTS

 

Section 4.01 Amendments to Article 4.

 

(a)       Pursuant
to Section 2.02(14) of the Base Indenture, Section 4.03 of the Base Indenture is hereby amended with respect to the Notes by deleting
the text thereof in its entirety and inserting in its place the following:

 

“Section 4.03 Reports.
Whether or not required by the Commission, so long as any Notes are outstanding, Ventas, Inc. shall file with the Trustee, within
15 days after it files the same with the Commission (or if not subject to the periodic reporting requirements of the Exchange Act,
within 15 days after it would have been required to file the same with the Commission had it been so subject):

 

(1)       all
quarterly and annual financial information that is required to be contained in filings with the Commission on Forms 10-Q and 10-K,
including a “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and, with
respect to the annual information only, a report on the annual financial statements by Ventas, Inc.’s certified independent
accountants; and

 

(2)       all
current reports that are required to be filed with the Commission on Form 8-K.

 

For so long as any Notes remain
Outstanding, if at any time Ventas, Inc. is not required to file with the Commission the reports required by the preceding paragraph
of this Section 4.03, Ventas, Inc. shall furnish to the Holders and to securities analysts and prospective investors, upon their
request, the information required to be delivered pursuant to Rule 144A(d)(4) under the Securities Act.

 

The availability of the
foregoing materials on the Commission’s website or on Ventas, Inc.’s website shall be deemed to satisfy the
foregoing delivery obligations. In the event that the rules and regulations of the Commission permit Ventas, Inc. and any
direct or indirect parent of Ventas, Inc. to report at such parent entity’s level on a consolidated basis,
consolidating reporting at the parent entity’s level in a manner consistent with that described in this Section 4.03
for Ventas, Inc. will satisfy this Section 4.03, and the obligations in this Section 4.03 with respect to financial
information relating to Ventas, Inc. shall be deemed to be satisfied by furnishing financial information relating to such
direct or indirect parent; provided that such financial information is accompanied by consolidating information that explains
in reasonable detail the differences between the information relating to such direct or indirect parent and any of its
Subsidiaries other than Ventas, Inc. and its Subsidiaries, on the one hand, and the information relating to Ventas, Inc. and
its Subsidiaries on a standalone basis, on the other hand.”

 

    9

     

    

 

(b)       Pursuant
to Section 2.02(14) of the Base Indenture, Section 4.04 of the Base Indenture is hereby amended with respect to the Notes by deleting
the text thereof in its entirety and inserting in its place the following:

 

“Section 4.04 Compliance
Certificate. “Ventas, Inc. shall deliver to the Trustee, within 120 days after the end of each fiscal year, an Officers’
Certificate stating that a review of the activities of Ventas, Inc. and its Subsidiaries during the preceding fiscal year has been
made under the supervision of the signing Officers with a view to determining whether Ventas, Inc. has kept, observed, performed
and fulfilled its obligations under the Indenture, and further stating, as to each such Officer signing such certificate, that
to the best of his or her knowledge, Ventas, Inc. has kept, observed, performed and fulfilled each and every covenant contained
in the Indenture and is not in default in the performance or observance of any of the terms, provisions and conditions of the Indenture
(or, if a Default or Event of Default has occurred, describing all such Defaults or Events of Default of which he or she may have
knowledge and what action Ventas, Inc. is taking or proposes to take with respect thereto) and that to the best of his or her knowledge,
no event has occurred and remains in existence by reason of which payments on account of the principal of or interest, if any,
on the Securities of any series is prohibited or if such event has occurred, a description of the event and what action Ventas,
Inc. is taking or proposes to take with respect thereto. For purposes of this Section 4.04, such compliance shall be determined
without regard to any period of grace or requirement of notice under the Indenture.”

 

(c)       Pursuant
to Section 2.02(14) of the Base Indenture, Section 4.06 of the Base Indenture is hereby amended with respect to the Notes by deleting
the text thereof in its entirety and inserting in its place the following:

 

“Section 4.06 Corporate
Existence. Except as permitted by Article 5 and Section 10.04, Ventas, Inc. and the Issuer shall do all things necessary to
preserve and keep their existence, rights and franchises, except that neither Ventas, Inc. nor the Issuer shall be required to
preserve any such right or franchise if Ventas, Inc. or the Issuer, as applicable, shall determine reasonably and in good faith
that the preservation thereof is no longer desirable in the conduct of its business.”

 

(d)       Pursuant
to Section 2.02(14) of the Base Indenture, Article 4 of the Base Indenture is hereby amended with respect to the Notes by adding
to the end the following new Sections 4.07 through 4.11, in each case to read as follows:

 

“Section 4.07 Taxes.
Ventas, Inc. will pay, and will cause each of its Subsidiaries to pay, prior to delinquency, all material taxes, assessments, and
governmental levies except such as are contested in good faith and by appropriate proceedings or where the failure to effect such
payment is not adverse in any material respect to the Holders of the Notes.

 

Section 4.08 Stay,
Extension and Usury Laws. Each of Ventas, Inc. and the Issuer covenants (to the extent that it may lawfully do so) that:
(1) it will not at any time insist upon, plead, or in any manner whatsoever claim or take the benefit or advantage of, any
stay, extension or usury law wherever enacted, now or at any time hereafter in force, that may affect the covenants or the
performance of the Indenture; and (2) it hereby expressly waives all benefit or advantage of any such law; and (3) it will
not, by resort to any such law, hinder, delay or impede the execution of any power herein granted to the Trustee, but will
suffer and permit the execution of every such power as though no such law has been enacted.

 

    10

     

    

 

Section 4.09 Restrictions on
Activities of Ventas Capital. Neither Ventas, Inc. nor the Issuer shall permit Ventas Capital to hold any material assets,
become liable for any material obligations or engage in any significant business activities, except that Ventas Capital may be
a co-obligor with respect to Debt if the Issuer is a primary obligor of such Debt and the net proceeds of such Debt are received
by the Issuer or one or more of its Subsidiaries other than Ventas Capital.

 

Section 4.10 Limitations on Incurrence
of Debt.

 

(a)       Ventas,
Inc. shall not, and shall not permit any of its Subsidiaries to, Incur any Debt if, immediately after giving effect to the Incurrence
of such additional Debt and any other Debt Incurred since the end of the Latest Completed Quarter and the application of the net
proceeds therefrom, the aggregate principal amount of all outstanding Debt would exceed 60% of the sum of (without duplication)
(i) Total Assets as of the end of the Latest Completed Quarter and (ii) the purchase price of any Real Estate Assets or mortgages
receivable acquired, and the amount of any securities offering proceeds received (to the extent such proceeds were not used to
acquire Real Estate Assets or mortgages receivable or to reduce Debt), since the end of the Latest Completed Quarter.

 

(b)       Ventas,
Inc. shall not, and shall not permit any of its Subsidiaries to, Incur any Secured Debt if, immediately after giving effect to
the Incurrence of such additional Secured Debt and any other Secured Debt Incurred since the end of the Latest Completed Quarter
and the application of the net proceeds therefrom, the aggregate principal amount of all outstanding Secured Debt would exceed
50% of the sum of (without duplication) (i) Total Assets as of the end of the Latest Completed Quarter and (ii) the purchase price
of any Real Estate Assets or mortgages receivable acquired, and the amount of any securities offering proceeds received (to the
extent such proceeds were not used to acquire Real Estate Assets or mortgages receivable or to reduce Debt), since the end of the
Latest Completed Quarter.

 

(c)       Ventas,
Inc. shall not, and shall not permit any of its Subsidiaries to, Incur any Debt if, immediately after giving effect to the Incurrence
of such additional Debt and any other Debt Incurred since the end of the Latest Completed Quarter and the application of the net
proceeds therefrom, the ratio of Consolidated EBITDA to Interest Expense for the four (4) consecutive fiscal quarters ending with
the Latest Completed Quarter would be less than 1.50 to 1.00 on a pro forma basis and calculated on the assumption (without duplication)
that:

 

(i)       the
additional Debt and any other Debt Incurred by Ventas, Inc. or any of its Subsidiaries since the first day of such four-quarter
period to the date of determination, which was outstanding at the date of determination, had been Incurred at the beginning of
that period and continued to be outstanding throughout that period, and the application of the net proceeds of such Debt, including
to refinance other Debt, had occurred at the beginning of such period, except that in determining the amount of Debt so Incurred,
the amount of Debt under any revolving credit facility shall be computed based upon the average daily balance of such Debt during
such period;

 

    11

     

    

 

(ii)       the
repayment or retirement of any other Debt repaid or retired by Ventas, Inc. or any of its Subsidiaries since the first day of such
four-quarter period to the date of determination had occurred at the beginning of that period, except that in determining the amount
of Debt so repaid or retired, the amount of Debt under any revolving credit facility shall be computed based upon the average daily
balance of such Debt during such period; and

 

(iii)       in
the case of any acquisition or disposition of any asset or group of assets (including, without limitation, by merger, or stock
or asset purchase or sale) or the placement of any assets in service or removal of any assets from service by Ventas, Inc. or any
of its Subsidiaries since the first day of such four-quarter period to the date of determination, the acquisition, disposition,
placement in service or removal from service and any related repayment or refinancing of Debt had occurred as of the first day
of such period, with the appropriate adjustments to Consolidated EBITDA and Interest Expense with respect to the acquisition, disposition,
placement in service or removal from service being included in that pro forma calculation.

 

Section 4.11 Maintenance of Unencumbered
Assets. Ventas, Inc. and its Subsidiaries shall maintain at all times Unencumbered Assets of not less than 150% of the aggregate
principal amount of all outstanding Unsecured Debt.”

 

ARTICLE V

 

SUCCESSORS

 

Section 5.01 Amendments to Article 5.

 

(a)       Pursuant
to Section 2.02(23) of the Base Indenture, Section 5.01 of the Base Indenture is hereby amended with respect to the Notes by deleting
the text thereof in its entirety and inserting in its place the following:

 

“Section 5.01 Merger, Consolidation,
or Sale of Assets.

 

Ventas, Inc. may not, directly
or indirectly: (a) consolidate or merge with or into another Person (whether or not Ventas, Inc. is the surviving corporation);
or (b) sell, assign, transfer, convey, lease (other than to an unaffiliated operator in the ordinary course of business) or otherwise
dispose of all or substantially all of the properties or assets of Ventas, Inc. and its Subsidiaries taken as a whole, in one or
more related transactions, to another Person, unless:

 

(1)       either:

 

(i)       Ventas,
Inc. is the surviving corporation; or

 

(ii)       the
Person formed by or surviving any such consolidation or merger (if other than Ventas, Inc.) or to which such sale, assignment,
transfer, conveyance or other disposition has been made is a corporation organized or existing under the laws of the United States,
any state of the United States or the District of Columbia;

 

(2)       the
Person formed by or surviving any such consolidation or merger (if other than Ventas, Inc.) or the Person to which such sale, assignment,
transfer, conveyance or other disposition has been made assumes all of Ventas, Inc.’s obligations under the Notes and the
Indenture pursuant to agreements reasonably satisfactory to the Trustee; and

 

    12

     

    

 

(3)       immediately
after such transaction, on a pro forma basis giving effect to such transaction or series of transactions (and treating any obligation
of Ventas, Inc. or any Subsidiary incurred in connection with or as a result of such transaction or series of transactions as having
been incurred at the time of such transaction), no Default or Event of Default exists under the Indenture.

 

Notwithstanding anything to the
contrary in this Section 5.01, the Guarantor may consolidate or merge with or into the Issuer, or sell and/or transfer to the Issuer
all or substantially all of its assets, in each case, without compliance with any of the requirements set forth in this Article
5.”

 

ARTICLE VI

 

DEFAULTS AND REMEDIES

 

Section 6.01 Amendments to Article 6.

 

(a)       Pursuant
to Section 2.02(14) of the Base Indenture, Section 6.01 of the Base Indenture is hereby amended with respect to the Notes by deleting
the text thereof in its entirety and inserting in its place the following:

 

“Section 6.01 Events of Default.

 

Each of the following is an “Event
of Default”:

 

(1)       Ventas,
Inc. or the Issuer does not pay the principal or any premium on any Note when due and payable;

 

(2)       Ventas,
Inc. or the Issuer does not pay interest on any Note within 30 days after the applicable due date;

 

(3)       Ventas,
Inc. or its Subsidiaries remain in breach of any other term of the Indenture for 90 days after they receive a notice of Default
stating they are in breach. Either the Trustee or the Holders of more than 25% in aggregate principal amount of the Notes then
Outstanding may send the notice;

 

(4)       except
as permitted by the Indenture and the Notes, the Securities Guarantee by the Guarantor shall cease to be in full force and effect
or the Guarantor shall deny or disaffirm its obligations with respect thereto;

 

(5)       the
Issuer, Ventas, Inc. or any of its Significant Subsidiaries default under any of their indebtedness (including a default with respect
to Securities of any series issued under the Base Indenture other than the Notes) in an aggregate principal amount exceeding $50.0
million after the expiration of any applicable grace period, which default results in the acceleration of the maturity of such
indebtedness. Such default is not an Event of Default if the other indebtedness is discharged, or the acceleration is rescinded
or annulled, within a period of 30 days after the Issuer, Ventas, Inc. or any such Significant Subsidiary, as the case may be,
receives notice specifying the default and requiring that they discharge the other indebtedness or cause the acceleration to be
rescinded or annulled. Either the Trustee or the Holders of more than 25% in aggregate principal amount of the Notes then Outstanding
may send the notice;

 

(6)       the
Issuer, Ventas, Inc. or any of its Significant Subsidiaries, or any group of Subsidiaries that, taken as a whole, would
constitute a Significant Subsidiary:

 

    13

     

    

 

(i)       commence
a voluntary case;

 

(ii)       consent
to the entry of an order for relief against them in an involuntary case;

 

(iii)       consent
to the appointment of a custodian of them or for all or substantially all of their property;

 

(iv)       make
a general assignment for the benefit of their creditors; or

 

(v)       generally
are not paying their debts as they become due; or

 

(7)       a
court of competent jurisdiction enters an order or decree under any Bankruptcy Law that:

 

(i)       is
for relief against the Issuer, Ventas, Inc. or any of its Significant Subsidiaries, or any group of Subsidiaries that, taken as
a whole, would constitute a Significant Subsidiary, in an involuntary case;

 

(ii)       appoints
a custodian of the Issuer, Ventas, Inc. or any of its Significant Subsidiaries, or any group of Subsidiaries that, taken as a whole,
would constitute a Significant Subsidiary, or for all or substantially all of the property of the Issuer, Ventas, Inc. or any of
its Significant Subsidiaries, or any group of Subsidiaries that, taken as a whole, would constitute a Significant Subsidiary; or

 

(iii)       orders
the liquidation of the Issuer, Ventas, Inc. or any of its Significant Subsidiaries, or any group of Subsidiaries that, taken as
a whole, would constitute a Significant Subsidiary;

 

and the order or decree remains unstayed and in effect
for 60 consecutive days.”

 

(b)       Pursuant
to Section 2.02(14) of the Base Indenture, Section 6.02 of the Base Indenture is hereby amended with respect to the Notes by (i)
deleting the first sentence thereof in its entirety and inserting in its place the following:

 

“In the case of an Event
of Default specified in clause (6) or (7) of Section 6.01, with respect to the Issuer, Ventas, Inc. or any of its Significant Subsidiaries
or any group of Subsidiaries that, taken as a whole, would constitute a Significant Subsidiary, all Outstanding Notes will become
due and payable immediately without further action or notice.”

 

and (ii) adding to the end of Section 6.02 the following:

 

“Notwithstanding anything
to the contrary contained in the Indenture, the sole remedy for an Event of Default relating to a failure to comply with any of
the provisions of Section 4.03 hereof shall consist exclusively of the right to receive additional interest on the Notes at an
annual rate equal to 0.25% of the outstanding principal amount of the Notes. This additional interest will be payable in the same
manner and on the same dates as the stated interest payable on the Notes and will accrue on all Outstanding Notes from and including
the date on which such Event of Default first occurs to, but not including, the date on which such Event of Default shall have
been cured or waived.”

 

    14

     

    

 

(c)       Pursuant
to Section 2.02(14) of the Base Indenture, Section 6.08 of the Base Indenture is hereby amended with respect to the Notes by deleting
from the first line thereof the reference to clause (3) of Section 6.01 of the Base Indenture.

 

ARTICLE VII

 

TRUSTEE

 

Section 7.01 Amendments to Article 7.
Pursuant to Section 2.02(14) of the Base Indenture, Section 7.07(e) of the Base Indenture is hereby amended with respect to the
Notes by changing the references to Section 6.01(7) or (8) therein to Section 6.01(6) or (7).

 

ARTICLE VIII

 

LEGAL DEFEASANCE AND COVENANT DEFEASANCE

 

Section 8.01 Applicability of Defeasance
Provisions. Pursuant to Sections 2.02(17) and 8.01 of the Base Indenture, so long as any of the Notes are Outstanding, Sections
8.02 and 8.03 of the Base Indenture shall be applicable to the Notes.

 

Section 8.02 Determinations Under Section
8.03. For the purposes of Sections 2.02(17) and 8.03 of the Base Indenture, Section 8.03 of the Base Indenture shall apply
to Sections 4.09 through 4.11, inclusive.

 

Section 8.03 Determination Under Section
8.07. For the purposes of Sections 8.07 and 11.02 of the Base Indenture, the provisions of Section 8.07 of the Base Indenture
shall apply to the Notes.

 

Section 8.04 Amendments to Article 8.

 

(a) Pursuant to Section 2.02(17) of the Base
Indenture, the last sentence of Section 8.03 of the Base Indenture is hereby amended with respect to the Notes by changing the
references to Sections 6.01(4) through 6.01(6) therein to Sections 6.01(3) through 6.01(5).

 

ARTICLE IX

 

GUARANTEES

 

Section 9.01 Applicability of Guarantee
Provisions.

 

(a)       Pursuant
to Sections 2.02(1) and 10.01 of the Base Indenture, so long as any of the Notes are Outstanding, Article 10 shall be applicable
to the Notes.

 

(b)       Pursuant
to Section 2.02(23) of the Base Indenture, Section 10.03 of the Base Indenture is hereby amended with respect to the Notes by deleting
the text thereof in its entirety and inserting in its place the following:

 

“To evidence its Securities
Guarantee as set forth in Section 10.01 in respect of the Notes, an Officer of the Guarantor shall execute the Indenture on behalf
of such Guarantor, and the Guarantor hereby agrees that such Securities Guarantee shall become effective upon such execution and
shall remain in full force and effect thereafter, subject to the terms of the Indenture.”

 

If an Officer whose signature is
on this Indenture no longer holds that office at the time the Trustee authenticates the Notes, such Securities Guarantee will be
valid nonetheless.

 

    15

     

    

 

The delivery of any Note by the
Trustee after the authentication thereof hereunder will constitute the delivery of the Securities Guarantee set forth in this Indenture
on behalf of the Guarantor.”

 

ARTICLE X

 

MISCELLANEOUS

 

Section 10.01 Determination Under Section
13.10. For the purposes of Section 13.10 of the Base Indenture, the agreements of the Guarantor will bind its successors except
as otherwise provided in Article 10 of the Base Indenture.

 

Section 10.02 Application of Sixth Supplemental
Indenture; Ratification.

 

(a)       Each
and every term and condition contained in this Sixth Supplemental Indenture that modifies, amends or supplements the terms and
conditions of the Base Indenture shall apply only to the Notes created hereby and not to any future series of Securities established
under the Indenture.

 

(b)       The
Base Indenture, as supplemented and amended by this Sixth Supplemental Indenture, is in all respects ratified and confirmed, and
the Base Indenture and this Sixth Supplemental Indenture shall be read, taken and construed as the same instrument.

 

(c)       In
the event of any conflict between this Sixth Supplemental Indenture and the Base Indenture, the provisions of this Sixth Supplemental
Indenture shall prevail.

 

Section 10.03 Benefits of Sixth Supplemental
Indenture. Nothing contained in this Sixth Supplemental Indenture shall or shall be construed to confer upon any Person other
than a Holder of the Notes, the Issuer, the Guarantor or the Trustee any right or interest to avail itself of any benefit under
any provision of the Base Indenture or this Sixth Supplemental Indenture.

 

Section 10.04 Effective Date. This
Sixth Supplemental Indenture shall be effective as of the date first above written and upon the execution and delivery hereof by
each of the parties hereto.

 

Section 10.05 Governing Law. This Sixth
Supplemental Indenture shall be governed by, and construed in accordance with, the laws of the State of New York, without regard
to conflicts of laws principles thereof.

 

Section 10.06 Counterparts. This Sixth
Supplemental Indenture may be executed in any number of counterparts, each of which so executed shall be deemed to be an original,
but all such counterparts shall together constitute but one and the same instrument.

 

[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

 

    16

     

    

 

IN WITNESS WHEREOF, the parties hereto have
caused this Sixth Supplemental Indenture to be duly executed by their respective officers hereunto duly authorized, all as of the
day and year first above written.

	 	
         

         

        ISSUER

	 	 
	 	VENTAS REALTY, LIMITED PARTNERSHIP
	 	 
	 	 	By:	Ventas, Inc., its General Partner
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	By:	/s/ Robert F. Probst
	 	 	 	 	Name: 	Robert F. Probst
	 	 	 	 	Title: 	Executive Vice President and Chief Financial Officer
	 	 	 	 
	 	GUARANTOR
	 	 
	 	VENTAS, INC.
	 	 
	 	 	By:	/s/ Robert F. Probst
	 	 	 	Name:	Robert F. Probst
	 	 	 	Title: 	Executive Vice President and Chief Financial Officer

 

[Signature Page
to Sixth Supplemental Indenture]

 

     

     

    

 

	 	TRUSTEE
	 	 
	 	U.S. BANK NATIONAL ASSOCIATION
	 	 	 
	 	 	By:	/s/ Daniel Boyers
	 	 	 	Name: Daniel Boyers
	 	 	 	Title: Vice President

 

[Signature Page
to Sixth Supplemental Indenture]

 

     

     

    

 

SCHEDULE 1

 

Real Estate Revenues

 

[See attached.]

 

     

     

    

 

Exhibit A

 

Form of Note

 

[See attached.]

 

     

     

    

 

FORM OF NOTE

 

[Front of Note]

 

CUSIP #92277G AV9

 

4.750% Senior Note due 2030

 

	No.	___	$ _______________

 

VENTAS REALTY, LIMITED PARTNERSHIP

 

promises to pay to CEDE & CO. or registered assigns, the
principal sum of ________________ Dollars on November 15, 2030.

 

Interest Payment Dates: May 15 and November 15

 

Record Dates: May 1 and November 1

 

Dated: ____________, 20___

 

THIS GLOBAL SECURITY IS HELD BY THE DEPOSITARY (AS DEFINED IN
THE INDENTURE GOVERNING THIS SECURITY) OR ITS NOMINEE IN CUSTODY FOR THE BENEFIT OF THE BENEFICIAL OWNERS HEREOF, AND IS NOT TRANSFERABLE
TO ANY PERSON UNDER ANY CIRCUMSTANCES EXCEPT THAT (1) THE TRUSTEE MAY MAKE SUCH NOTATIONS HEREON AS MAY BE REQUIRED PURSUANT
TO SECTION 2.07 OF THE INDENTURE, (2) THIS GLOBAL SECURITY MAY BE EXCHANGED IN WHOLE BUT NOT IN PART PURSUANT TO SECTION
2.07(a) OF THE INDENTURE, (3) THIS GLOBAL SECURITY MAY BE DELIVERED TO THE TRUSTEE FOR CANCELLATION PURSUANT TO SECTION
2.12 OF THE INDENTURE AND (4) THIS GLOBAL SECURITY MAY BE TRANSFERRED TO A SUCCESSOR DEPOSITARY WITH THE PRIOR WRITTEN CONSENT
OF THE ISSUER.

 

UNLESS AND UNTIL IT IS EXCHANGED IN WHOLE OR IN PART FOR SECURITIES
IN DEFINITIVE FORM, THIS SECURITY MAY NOT BE TRANSFERRED EXCEPT AS A WHOLE BY THE DEPOSITARY TO A NOMINEE OF THE DEPOSITARY OR
BY A NOMINEE OF THE DEPOSITARY TO THE DEPOSITARY OR ANOTHER NOMINEE OF THE DEPOSITARY OR BY THE DEPOSITARY OR ANY SUCH NOMINEE
TO A SUCCESSOR DEPOSITARY OR A NOMINEE OF SUCH SUCCESSOR DEPOSITARY. UNLESS THIS CERTIFICATE IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE
OF THE DEPOSITORY TRUST COMPANY (55 WATER STREET, NEW YORK, NEW YORK) (“DTC”), TO THE ISSUER OR ITS AGENT FOR
REGISTRATION OF TRANSFER, EXCHANGE OR PAYMENT, AND ANY CERTIFICATE ISSUED IS REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER
NAME AS MAY BE REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF DTC (AND ANY PAYMENT IS MADE TO CEDE & CO. OR SUCH OTHER ENTITY
AS MAY BE REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF DTC), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY
OR TO ANY PERSON IS WRONGFUL INASMUCH AS THE REGISTERED OWNER HEREOF, CEDE & CO., HAS AN INTEREST HEREIN.

 

    A-1

     

    

 

	 	VENTAS REALTY, LIMITED PARTNERSHIP
	 	 
	 	By: Ventas, Inc., its General
    Partner
	 	 
	 	By:	                 
	 	     Name:  
	 	     Title:       

 

    A-2

     

    

 

This is one of the Securities of the

series designated therein referred to

in the within-mentioned Indenture:

 

U.S. BANK NATIONAL ASSOCIATION,

as Trustee

 

	By:	 	 

Authorized
Signatory

 

    A-3

     

    

 

[Back
of Note]

 

4.750% Senior Notes due 2030

 

Capitalized terms used herein have the meanings assigned to
them in the Indenture referred to below unless otherwise indicated.

 

(1)       Interest.
Ventas Realty, Limited Partnership (the “Issuer”) promises to pay interest on the principal amount of this Note
at 4.750% per annum from April 1, 2020 until maturity. The Issuer will pay interest semi-annually in arrears on May 15 and November
15 of each year, or if any such day is not a Business Day, on the next succeeding Business Day (each, an “Interest Payment
Date”). Interest on the Notes will accrue from the most recent date to which interest has been paid or, if no interest
has been paid, from April 1, 2020; provided, that if there is no existing Default in the payment of interest, and if this
Note is authenticated between a record date referred to on the face hereof and the next succeeding Interest Payment Date, interest
shall accrue from such next succeeding Interest Payment Date; provided, further, that the first Interest Payment
Date shall be November 15, 2020. The Issuer will pay interest (including post-petition interest in any proceeding under any Bankruptcy
Law) on overdue principal and premium, if any, from time to time on demand at a rate that is 1% per annum in excess of the rate
then in effect; the Issuer will pay interest (including post-petition interest in any proceeding under any Bankruptcy Law) on overdue
installments of interest (without regard to any applicable grace periods) from time to time on demand at the same rate to the extent
lawful. Interest will be computed on the basis of a 360-day year of twelve 30-day months.

 

(2)       Method
of Payment. The Issuer will pay interest on the Notes (except defaulted interest) to the Persons who are registered Holders
of Notes at the close of business on the May 1 or November 1 (each, a “Record Date”) preceding the next Interest
Payment Date, even if such Notes are canceled after such record date and on or before such Interest Payment Date, except as provided
in Section 2.13 of the Indenture with respect to defaulted interest. The Notes will be payable as to principal, premium, if any,
and interest at the office or agency of the Issuer maintained for such purpose within or without the City and State of New York,
or, at the option of the Issuer, payment of interest may be made by check mailed to the Holders at their addresses set forth in
the register of Holders; provided, that payment by wire transfer of immediately available funds will be required with respect
to principal of and interest and premium, if any, on all Global Notes and all other Notes the Holders of which will have provided
wire transfer instructions to the Issuer or the Paying Agent. Such payment will be in such coin or currency of the United States
of America as at the time of payment is legal tender for payment of public and private debts.

 

(3)       Paying
Agent and Registrar. Initially, U.S. Bank National Association, the Trustee under the Indenture, will act as Paying Agent and
Registrar. The Issuer may change any Paying Agent or Registrar without notice to any Holder. The Issuer or any of its Subsidiaries
may act in any such capacity.

 

(4)       Indenture.
The Issuer issued the Notes under an indenture, dated as of February 23, 2018 (the “Base Indenture”), as amended
by the Sixth Supplemental Indenture, dated as of April 1, 2020 (the “Sixth Supplemental Indenture” and, together
with the Base Indenture and as the Base Indenture and the Sixth Supplemental Indenture may be further amended and supplemented
from time to time, the “Indenture”), among the Issuer, the Guarantor named therein and the Trustee. The terms
of the Notes include those stated in the Indenture and those made part of the Indenture by reference to the Trust Indenture Act
of 1939, as amended (15 U.S. Code §§ 77aaa-77bbbb). The Notes are subject to all such terms, and Holders are referred
to the Indenture and such Act for a statement of such terms. To the extent any provision of this Note conflicts with the express
provisions of the Indenture, the provisions of the Indenture shall govern and be controlling. The Notes are unsecured obligations
of the Issuer.

 

(5)       Optional
Redemption. (a) The Issuer may, at its option, redeem the Notes at any time prior to maturity, in whole or from time to time
in part.

 

(b)       The redemption
price for any redemption of the Notes before August 15, 2030 shall be equal to the sum of (i) the principal amount of the
Notes being redeemed, (ii) accrued and unpaid interest thereon, if any, to (but excluding) the redemption date, and (iii)
the Make-Whole Amount, if any (subject to the right of holders of record on the relevant Record Date to receive interest due on
the relevant Interest Payment Date). The redemption price for any redemption of the Notes on or after August 15, 2030 shall be
equal to the sum of (i) the principal amount of the Notes being redeemed and (ii) accrued and unpaid interest thereon,
if any, to (but excluding) the redemption date.

 

(c)       Any redemption
of the Notes shall be made pursuant to the provisions of Sections 3.01 through 3.07 of the Indenture.

 

(6)       Mandatory
Redemption. The Issuer will not be required to make mandatory redemption payments with respect to the Notes.

 

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(7)       Notice
of Redemption. Notice of redemption will be mailed at least 15 days but not more than 60 days before the redemption date to
each Holder whose Notes are to be redeemed at its registered address. Notes in denominations larger than $2,000 may be redeemed
in part but only in whole multiples of $1,000, unless all of the Notes held by a Holder are to be redeemed. On and after the redemption
date interest ceases to accrue on Notes or portions thereof called for redemption.

 

(8)       Denominations,
Transfer, Exchange. The Notes are in registered form without coupons in denominations of $2,000 and integral multiples of $1,000.
The transfer of Notes may be registered and Notes may be exchanged as provided in the Indenture. The Registrar and the Trustee
may require a Holder, among other things, to furnish appropriate endorsements and transfer documents and the Issuer may require
a Holder to pay any taxes and fees required by law or permitted by the Indenture. The Issuer need not exchange or register the
transfer of any Note or portion of a Note selected for redemption, except for the unredeemed portion of any Note being redeemed
in part. Also, the Issuer need not exchange or register the transfer of any Notes for a period of 15 days before a selection of
Notes to be redeemed or during the period between a Record Date and the corresponding Interest Payment Date.

 

(9)       Persons
Deemed Owners. The registered Holder of a Note may be treated as its owner for all purposes.

 

(10)       Amendment,
Supplement and Waiver. Subject to certain exceptions, the Indenture, the Securities Guarantee or the Notes may be amended or
supplemented with the consent of the Holders of at least a majority in principal amount of the then Outstanding Securities affected
by such amendment or supplemental indenture voting as a single class, and any existing Default or Event of Default or compliance
with any provision of the Indenture, the Securities Guarantee or the Notes may be waived with the consent of the Holders of a majority
in principal amount of the then Outstanding Securities affected thereby voting as a single class. Without the consent of any Holder
of a Note, the Indenture, the Securities Guarantee or the Notes may be amended or supplemented to, among other things, cure any
ambiguity, defect or inconsistency; to provide for uncertificated Notes in addition to or in place of certificated Notes; to provide
for the assumption of the Issuer’s obligations to Holders of Notes in the case of a merger or consolidation or sale of all
or substantially all of the Issuer’s assets; to add additional Securities Guarantees with respect to the Notes; to secure
the Notes; to make any other change that would provide any additional rights or benefits to the Holders of Notes or that does not
adversely affect the legal rights under the Indenture of any such Holder; or to comply with requirements of the Commission in order
to effect or maintain the qualification of the applicable Indenture under the Trust Indenture Act.

 

(11)       Defaults
and Remedies. Events of Default with respect to the Notes include: (i) default in the payment of principal or any premium on
the Notes when due and payable; (ii) default in the payment of interest on the Notes within 30 days after the applicable due date;
(iii) breach of any other term of the Indenture for 90 days after receipt of a notice of Default stating the Issuer is in breach;
(iv) default under any of certain Debt of the Issuer, Ventas, Inc. and its Significant Subsidiaries, which default results in the
acceleration of the maturity of such indebtedness, unless such other Debt is discharged, or the acceleration is rescinded or annulled,
within 30 days after the Issuer, Ventas, Inc. or any of its Significant Subsidiaries, as applicable, receive notice of the default;
and (v) certain events in bankruptcy, insolvency or reorganization occur with respect to the Issuer, Ventas, Inc. or any of its
Significant Subsidiaries or any group of Subsidiaries that, taken as a whole, would constitute a Significant Subsidiary. If any
Event of Default occurs and is continuing, the Trustee or the Holders of at least 25% in principal amount of the then Outstanding
Notes may declare the entire principal amount of the Notes to be due and payable; provided, that the sole remedy for an
Event of Default relating to a failure to comply with any of the provisions of Section 4.03 of the Indenture shall consist exclusively
of the right to receive additional interest on the Notes in accordance with the terms set forth in the Indenture. Notwithstanding
the foregoing, in the case of an Event of Default arising from certain events of bankruptcy or insolvency, all Outstanding Notes
will become due and payable without further action or notice. Holders may not enforce the Indenture or the Notes except as provided
in the Indenture. Subject to certain limitations, the Holders of a majority in principal amount of the then Outstanding Notes may
direct the Trustee in its exercise of any trust or power. The Trustee may withhold from Holders of the Notes notice of any continuing
Default or Event of Default (except a Default or Event of Default in the payment of principal or interest) if and so long as it
in good faith determines that withholding notice is in the interest of the Holders of the Notes. Subject to certain exceptions,
the Holders of a majority in aggregate principal amount of the then Outstanding Notes by notice to the Trustee may on behalf of
the Holders of all of the Notes waive any existing Default or Event of Default and its consequences under the Indenture except
a continuing Default or Event of Default in the payment of principal of, premium, if any, or interest on the Notes. The Issuer
is required to deliver to the Trustee annually a statement regarding compliance with the Indenture.

 

(12)       Trustee
Dealings with Issuer. The Trustee, in its individual or any other capacity, may make loans to, accept deposits from, and perform
services for the Issuer or its Affiliates, and may otherwise deal with the Issuer or its Affiliates as if it were not the Trustee.

 

(13)       No
Recourse Against Others. No director, officer, employee or stockholder of Ventas, Inc. or any of its Subsidiaries, as
such, will have any liability for any obligations of Ventas, Inc. or any of its Subsidiaries under the Notes or the Indenture
based on, in respect of, or by reason of such obligations or their
creation. Each Holder by accepting a Note waives and releases all such liability. The foregoing waiver and release are an
integral part of the consideration for the issuance of the Notes.

 

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(14)       Authentication.
This Note will not be valid until authenticated by the manual signature of the Trustee or an authenticating agent.

 

(15)       Abbreviations.
Customary abbreviations may be used in the name of a Holder or an assignee, such as: TEN COM (= tenants in common), TEN ENT (=
tenants by the entireties), JT TEN (= joint tenants with right of survivorship and not as tenants in common), CUST (= Custodian),
and U/G/M/A (= Uniform Gifts to Minors Act).

 

(16)       CUSIP
Numbers. Pursuant to a recommendation promulgated by the Committee on Uniform Security Identification Procedures, the Issuer
has caused CUSIP numbers to be printed on the Notes and the Trustee may use CUSIP numbers in notices of redemption as a convenience
to Holders. No representation is made as to the accuracy of such numbers either as printed on the Notes or as contained in any
notice of redemption and reliance may be placed only on the other identification numbers placed thereon.

 

(17)       The
due and punctual payment of principal and interest and premium, if any, on the Notes is unconditionally guaranteed on an unsecured
senior basis by the Guarantor to the extent set forth in, and subject to the provisions of, the Indenture.

 

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The Issuer will furnish to any Holder upon written request and
without charge a copy of the Indenture. Requests may be made to:

 

Ventas Realty, Limited Partnership

c/o Ventas, Inc.

353 North Clark Street, Suite 3300

Chicago, Illinois 60654

Attention: General Counsel

 

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Assignment Form

 

To assign this Note, fill in the form below:

 

	(I) or (we) assign and transfer this Note to:	 
	 	(Insert assignee’s legal name)
	(Insert assignee’s Soc. Sec. or Tax I.D. No.)
	 
	 
	 
	(Print or type assignee’s name, address and zip code)
	and irrevocably appoint	             
	to transfer this Note on the books of the Issuer.  The agent may substitute another to act for him.
	Date:  _______________	
         

        Your Signature: ______________________

        (Sign exactly as your name appears on the face

        of this Note)

         

	Signature Guarantee*:  _______________	 
	 	 	 

 

		*	Participant in a recognized Signature Guarantee Medallion
Program (or other signature guarantor acceptable to the Trustee).

 

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SCHEDULE OF EXCHANGES OF INTERESTS IN
THE GLOBAL NOTE

 

The following exchanges of a part of this Global Note for an
interest in another Global Note or for a Definitive Note, or exchanges of a part of another Global Note or Definitive Note for
an interest in this Global Note, have been made:

 

	
        Date of
        Exchange
	
        Amount of

        decrease in

        Principal Amount

        of this Global Note
	
        Amount of
        increase

        in Principal

        Amount of this

        Global Note
	
        Principal
        Amount of this Global Note following

        such decrease

        (or increase)
	
        Signature
        of

        authorized

        officer of Trustee

        or Custodian

	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 

 

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