Document:

Exhibit 10.2

 

OFFERING DEPOSIT ACCOUNT AGENCY AGREEMENT

 

This OFFERING DEPOSIT
ACCOUNT AGENCY AGREEMENT (this “Agreement”) dated as of this [], by and among FUQIN FINTECH LIMITED,
a Cayman Islands company (the “Company”), having an address at No.8 Guanghua Dongli, Zhonghai Guangchang, South
Tower, 7th Floor, Chaoyang District, Beijing, PRC 100020 and BOUSTEAD SECURITIES, LLC, serving as the representative of
the underwriters (the “Underwriter”), having an address at 6 Venture, Suite 265, Irvine, CA 92618 USA, and FinTech
Clearing, LLC (the “Deposit Account Agent”), a broker-dealer registered with the Securities and Exchange
Commission (“SEC”), having an office at 6 Venture, Suite 265, Irvine, CA 92618 USA. All capitalized terms not
herein defined shall have the meaning ascribed to them in that certain prospectus filed with the United States SEC dated August
31, 2018, under File Number 333-227131, including all attachments, schedules and exhibits thereto, as amended from time to time
(the “Prospectus”).

 

W I T N E S S E T H:

 

WHEREAS, pursuant
to the terms of the Prospectus the Company desires to sell (the “Offering”) a minimum of $10,000,000.00 (the
“Minimum Amount”) and a maximum of $20,000,000.00 (the “Maximum Amount”) of its ordinary
shares (the “Shares”). The minimum investment per subscriber is $500.00 (which minimum investment may be waived
by Company); and

 

WHEREAS, unless
the Minimum Amount is sold by December 31, 2018 (the “Final Termination Date”), unless extended by an Extension
Notice (defined below in Section 2(b)), the Offering shall terminate, and all funds shall be returned to the subscribers in the
Offering, and if the Minimum Amount is met, the Offering may continue until the Final Termination Date, and one or more closings
may be conducted on or prior to the Final Termination Date; and

 

WHEREAS, the
Company and Underwriter desire to establish a deposit account with the Deposit Account Agent into which the Company and Underwriter
shall instruct investors introduced to the Company by Underwriter (the “Investors”) to deposit checks and other
instruments for the payment of money made payable to the order of “FinTech Clearing as Agent for the Investors in Fuqin Fintech
Limited” and Deposit Account Agent is willing to accept said checks and other instruments for the payment of money in accordance
with the terms hereinafter set forth; and

 

WHEREAS, the
Company, as issuer, and Underwriter, as an introducing broker-dealer, represent and warrant to the Deposit Account Agent that they
will comply with all of their respective obligations under applicable state and federal securities laws and regulations with respect
to sale of the Offering; and

 

WHEREAS, the
Company and Underwriter represent and warrant to the Deposit Account Agent that they have not stated to any individual or entity
that the Deposit Account Agent’s duties will include anything other than those duties stated in this Agreement; and

 

     

     

    

 

WHEREAS, the
Company and Underwriter warrant to the Deposit Account Agent that a copy of each document that has been delivered to Investors
and third parties that include Deposit Account Agent’s name and duties, has been attached hereto as Schedule I.

 

NOW, THEREFORE,
IT IS AGREED as follows:

 

1. Delivery
of Deposit Funds.

 

(a) Underwriter
and the Company shall instruct Investors to deliver to Deposit Account Agent checks made payable to the order of “FinTech
Clearing, as Agent for the Investors in Fuqin Fintech Limited,” or wire transfer to FinTech Clearing, 6 Venture, Suite 265,
Irvine, CA 92618, ABA No.[], Attention: Brian Park, President, for credit to FinTech Clearing, as Agent for the Investors in
Fuqin Fintech Limited Account No. 122242869, in each case, with the name and address of the individual or entity making payment.
In the event any Investor’s address is not provided to Deposit Account Agent by the Investor, then Underwriter and/or the
Company agree to promptly provide Deposit Account Agent with such information in writing. The checks or wire transfers shall be
deposited into a non-interest-bearing account at 45712427 entitled “FinTech Clearing, as Agent for the Investors in Fuqin
Fintech Limited” (the “Deposit Account”).

 

(b) The
collected funds deposited into the Deposit Account are referred to as the “Deposit Funds.”

 

(c) The
Deposit Account Agent shall have no duty or responsibility to enforce the collection or demand payment of any funds deposited into
the Deposit Account. If, for any reason, any check deposited into the Deposit Account shall be returned unpaid to the Deposit Account
Agent, the sole duty of the Deposit Account Agent shall be to return the check to the Investor and advise the Company and Underwriter
promptly thereof.

 

2. Release
of Deposit Funds. The Deposit Funds shall be paid by the Deposit Account Agent in accordance with the following:

 

(a) In
the event that the Company and Underwriter advise the Deposit Account Agent in writing that the Offering has been terminated (the
“Termination Notice”), the Deposit Account Agent shall promptly return the funds paid by each Investor to said
Investor without interest or offset within five (5) business days.

 

(b) If prior to
3:00 P.M. Pacific time on the Final Termination Date, the Deposit Account Agent receives written notice, in the form of Exhibit
A, attached hereto and made a part hereof, and signed by the Company and Underwriter, stating that the Final Termination Date has
been extended (the “Extension Notice”), then the Final Termination Date shall be so extended and such date shall
be the new “Final Termination Date”. 

 

(c)  Provided
that the Deposit Account Agent does not receive the Termination Notice in accordance with Section 2(a) and there is the Minimum
Amount deposited into the Deposit Account on or prior to the Final Termination Date or the date stated in the Extension Notice,
if any, received by the Deposit Account Agent in accordance with Section 2(b) above, the Deposit Account Agent shall, upon receipt
of written instructions, in the form of Exhibit B, attached hereto and made a part hereof, or in a form and substance satisfactory
to the Deposit Account Agent, received from the Company and Underwriter, pay the Deposit Funds in accordance with such written
instructions, such payment or payments to be made by wire transfer within one (1) business day of receipt of such written instructions.
Such instructions must be received by the Deposit Account Agent no later than 3:00 PM Pacific Time on a Business Day for the Deposit
Account Agent to process such instructions that Business Day.

 

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(d) If
by 3:00 P.M. Pacific time on the later of the Final Termination Date or the date stated in the Extension Notice, if any, that the
Deposit Account Agent has received in accordance with Section 2(b) above, the Deposit Account Agent has not received written instructions
from the Company and Underwriter regarding the disbursement of the Deposit Funds or the total amount of the Deposit Funds is less
than the Minimum Amount, then the Deposit Account Agent shall promptly return the Deposit Funds to the Investors without interest
or offset within five (5) business days. The Deposit Funds returned to each Investor shall be free and clear of any and all claims
of the Deposit Account Agent.

 

(e) The
Deposit Account Agent shall not be required to pay any uncollected funds or any funds that are not available for withdrawal.

 

(f) If
the Final Termination Date or any date that is a deadline under this Agreement for giving the Deposit Account Agent notice or instructions
or for the Deposit Account Agent to take action is not a Business Day, then such date shall be the Business Day that immediately
preceding that date. A “Business Day” is any day other than a Saturday, Sunday or a day that a SEC-registered
broker-dealer is not legally obligated to be opened.

 

3. Acceptance
by Deposit Account Agent. The Deposit Account Agent hereby accepts and agrees to perform its obligations hereunder, provided
that:

 

(a) The
Deposit Account Agent may act in reliance upon any signature believed by it to be genuine and may assume that any person who has
been designated by Underwriter or the Company to give any written instructions, notice or receipt, or make any statements in connection
with the provisions hereof has been duly authorized to do so. Deposit Account Agent shall have no duty to make inquiry as to the
genuineness, accuracy or validity of any statements or instructions or any signatures on statements or instructions. The names
and true signatures of each individual authorized to act singly on behalf of the Company and Underwriter are stated in Schedule
II, which is attached hereto and made a part hereof. The Company and Underwriter may each remove or add one or more of its
authorized signers stated on Schedule II by notifying the Deposit Account Agent of such change in accordance with this Agreement,
which notice shall include the true signature for any new authorized signatories.

 

(b) The
Deposit Account Agent may act relative hereto in reliance upon advice of counsel in reference to any matter connected herewith.
The Deposit Account Agent shall not be liable for any mistake of fact or error of judgment or law, or for any acts or omissions
of any kind, unless caused by its willful misconduct or gross negligence.

 

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(c) Underwriter
and the Company agree to indemnify and hold the Deposit Account Agent harmless from and against any and all claims, losses, costs,
liabilities, damages, suits, demands, judgments or expenses (including but not limited to reasonable attorney’s fees) claimed
against or incurred by Deposit Account Agent arising out of or related, directly or indirectly, to this Agreement unless caused
by the Deposit Account Agent’s gross negligence or willful misconduct.

 

(d) In
the event that the Deposit Account Agent shall be uncertain as to its duties or rights hereunder, the Deposit Account Agent shall
be entitled to (i) refrain from taking any action other than to keep safely the Deposit Funds until it shall be directed otherwise
by a court of competent jurisdiction, or (ii) deliver the Deposit Funds to a court of competent jurisdiction.

 

(e) The
Deposit Account Agent shall have no duty, responsibility or obligation to interpret or enforce the terms of any agreement other
than Deposit Account Agent’s obligations hereunder, and the Deposit Account Agent shall not be required to make a request
that any monies be delivered to the Deposit Account, it being agreed that the sole duties and responsibilities of the Deposit Account
Agent shall be to the extent not prohibited by applicable law (i) to accept checks or other instruments for the payment of money
and wire transfers delivered to the Deposit Account Agent for the Deposit Account and deposit said checks and wire transfers into
the non-interest bearing Deposit Account, and (ii) to disburse or refrain from disbursing the Deposit Funds as stated above, provided
that the checks received by the Deposit Account Agent have been collected and are available for withdrawal.

 

4. Term
of Deposits. This Agreement shall terminate upon the disbursement of all Deposit Funds in the Deposit Account pursuant
to Section 2(c), Section 2(d), Section 6 or Section 7 (except with respect to provisions hereof which are specifically intended
to survive such termination).

 

5. Deposit
Account Statements and Information. The Deposit Account Agent agrees to send to the Company and/or the Underwriter a copy of
the Deposit Account periodic statement, upon request and to also provide the Company and/or Underwriter, or their designee, upon
request other deposit account information, including Deposit Account balances, by telephone or by computer communication, to the
extent practicable. The Company and Underwriter agree to complete and sign all forms or agreements required by the Deposit Account
Agent for that purpose. The Company and Underwriter each consent to the Deposit Account Agent’s release of such Deposit Account
information to any of the individuals designated by Company or Underwriter, which designation has been signed in accordance with
Section 3(a) by any of the persons in Schedule II.  Further, the Company and Underwriter have an option to receive
e-mail notification of incoming and outgoing wire transfers. If this e-mail notification service is requested and subsequently
approved by the Deposit Account Agent, the Company and Underwriter agrees to provide a valid e-mail address and other information
necessary to set-up this service and sign all forms and agreements required for such service. The Company and Underwriter each
consent to the Deposit Account Agent’s release of wire transfer information to the designated e-mail address(es). The Deposit
Account Agent’s liability for failure to comply with this section shall not exceed the cost of providing such information.

 

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6. Resignation
and Termination of the Deposit Account Agent. The Deposit Account Agent may resign at any time by giving 30 days’ prior
written notice of such resignation to Underwriter and the Company. Upon providing such notice, the Deposit Account Agent shall
have no further obligation hereunder except to hold as depositary the Deposit Funds that it receives until the end of such 30-day
period. In such event, the Deposit Account Agent shall not take any action, other than receiving and depositing Investors’
checks and wire transfers in accordance with this Agreement, until the Company has designated a banking corporation, trust company,
attorney or other person as successor. Upon receipt of such written designation signed by Underwriter and the Company, the Deposit
Account Agent shall promptly deliver the Deposit Funds to such successor and shall thereafter have no further obligations hereunder.
If such instructions are not received within 30 days following the effective date of such resignation, then the Deposit Account
Agent may deposit the Deposit Funds held by it pursuant to this Agreement with a clerk of a court of competent jurisdiction pending
the appointment of a successor. In either case provided for in this Section, the Deposit Account Agent shall be relieved of all
further obligations and released from all liability thereafter arising with respect to the Deposit Funds.

 

7. Termination.
The Company and Underwriter may terminate the appointment of the Deposit Account Agent hereunder upon written notice specifying
the date upon which such termination shall take effect, which date shall be at least 30 days from the date of such notice. In the
event of such termination, the Company and Underwriter shall, within 30 days of such notice, appoint a successor deposit account
agent and the Deposit Account Agent shall, upon receipt of written instructions signed by the Company and Underwriter, turn over
to such successor deposit account agent all of the Deposit Funds; provided, however, that if the Company and Underwriter
fail to appoint a successor deposit account agent within such 30-day period, such termination notice shall be null and void and
the Deposit Account Agent shall continue to be bound by all of the provisions hereof. Upon receipt of the Deposit Funds, the successor
deposit account agent shall become the deposit account agent hereunder and shall be bound by all of the provisions hereof and Deposit
Account Agent shall be relieved of all further obligations and released from all liability thereafter arising with respect to the
Deposit Funds and under this Agreement.

 

8. Investment.
All funds received by the Deposit Account Agent shall be held only in non-interest-bearing accounts at Pacific Mercantile Bank.

 

9. Compensation.
Deposit Account Agent shall be entitled, for the duties to be performed by it hereunder, to a fee as set forth on Schedule III.
In addition, the Company shall be obligated to reimburse Deposit Account Agent for all fees, costs and expenses incurred or that
become due in connection with this Agreement or the Deposit Account, including reasonable attorney’s fees. Neither the modification,
cancellation, termination or rescission of this Agreement nor the resignation or termination of the Deposit Account Agent shall
affect the right of Deposit Account Agent to retain the amount of any fee which has been paid, or to be reimbursed or paid any
amount which has been incurred or becomes due, prior to the effective date of any such modification, cancellation, termination,
resignation or rescission. To the extent the Deposit Account Agent has incurred any such expenses, or any such fee becomes due,
prior to any closing, the Deposit Account Agent shall advise the Company and the Company shall direct all such amounts to be paid
directly at any such closing.

 

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10. Notices.
All notices, requests, demands and other communications required or permitted to be given hereunder shall be in writing and shall
be deemed to have been duly given if sent by hand-delivery, by facsimile (followed by first-class mail), by nationally recognized
overnight courier service or by prepaid registered or certified mail, return receipt requested, to the addresses set forth below:

 

If to Underwriter:

 

Boustead Securities,
LLC

6 Venture,
Suite 265

Irvine, CA
92618

Attention:
Keith Moore, CEO

Fax: +1 815
301 8099

 

With copy to:

 

Mei & Mark LLP

818 18th
Street NW, Suite 410

Washington,
DC 20006

Attention:
Fang Liu, Esq.

Fax: (888)
706-1173

 

If to the Company:

Fuqin Fintech
Limited

No.8 Guanghua
Dongli, Zhonghai Guangchang, South Tower, 7th Floor

Chaoyang
District, Beijing, PRC 100020

Attention:
Xingliang Li, Chief Executive Officer

 

With copy to: 

 

Ortoli Rosenstadt
LLP

366 Madison
Avenue, 3rd Floor

New York,
NY 10017

Attention:
William S. Rosenstadt, Esq.

Mengyi “Jason”
Ye, Esq.

Fax: (212)
826-9307

 

If to Deposit Account
Agent:

 

FinTech Clearing, LLC

6 Venture,
Suite 265

Irvine, CA
92618

Attention:
Brian Park, President

Fax: +1 310
504 3704

 

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11. General.

 

(a) This
Agreement shall be governed by and construed and enforced in accordance with the laws of the State of Delaware applicable to agreements
made and to be entirely performed within such State, without regard to choice of law principles and any action brought hereunder
shall be brought in the courts of the State of California, located in the County of Orange. Each party hereto irrevocably waives
any objection on the grounds of venue, forum nonconveniens or any similar grounds and irrevocably consents to service of process
by mail or in any manner permitted by applicable law and consents to the jurisdiction of said courts. EACH OF THE PARTIES HERETO
HEREBY WAIVES ALL RIGHT TO TRIAL BY JURY IN ANY ACTION, PROCEEDING OR COUNTERCLAIM ARISING OUT OF THE TRANSACTIONS CONTEMPLATED
BY THIS AGREEMENT.

 

(b) This
Agreement sets forth the entire
agreement and understanding of the parties with respect to the matters contained herein and supersedes all prior agreements, arrangements
and understandings relating thereto.

 

(c) All
of the terms and conditions of this Agreement shall be binding upon, and inure to the benefit of and be enforceable by, the parties
hereto, as well as their respective successors and assigns.

 

(d) This
Agreement may be amended, modified, superseded or canceled, and any of the terms or conditions hereof may be waived, only by a
written instrument executed by each party hereto or, in the case of a waiver, by the party waiving compliance. The failure of any
party at any time or times to require performance of any provision hereof shall in no manner affect its right at a later time to
enforce the same. No waiver of any party of any condition, or of the breach of any term contained in this Agreement, whether by
conduct or otherwise, in any one or more instances shall be deemed to be or construed as a further or continuing waiver of any
such condition or breach or a waiver of any other condition or of the breach of any other term of this Agreement. No party may
assign any rights, duties or obligations hereunder unless all other parties have given their prior written consent.

 

(e) If
any provision included in this Agreement proves to be invalid or unenforceable, it shall not affect the validity of the remaining
provisions.

 

(f) This
Agreement and any modification or amendment of this Agreement may be executed in several counterparts or by separate instruments
and all of such counterparts and instruments shall constitute one agreement, binding on all of the parties hereto.

 

12. Form
of Signature. The parties hereto agree to accept a facsimile transmission copy of their respective actual signatures as evidence
of their actual signatures to this Agreement and any modification or amendment of this Agreement; provided, however,
that each party who produces a facsimile signature agrees, by the express terms hereof, to place, promptly after transmission of
his or her signature by fax, a true and correct original copy of his or her signature in overnight mail to the address of the other
party.

 

13.  No
Third-Party Beneficiaries.  This Agreement is solely for the benefit of the parties and their respective successors
and permitted assigns, and no other person has any right, benefit, priority, or interest under or because of the existence of this
Agreement.

 

[SIGNATURE PAGE FOLLOWS]

 

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IN WITNESS WHEREOF, the parties
have duly executed this Agreement as of the date first set forth above.

  

	Fuqin Fintech Limited	 	Boustead Securities, LLC
	 	 	 	 	 
	By:	 	 	By:	 
	 	Name: Xingliang Li	 	 	Name: Keith Moore
	 	Title:  CEO	 	 	Title:   CEO

 

	FinTech Clearing, LLC	 
	 	 	 
	By:	 	 
	 	Name:  Brian Park	 
	 	Title:  President	 

 

     8

     

    

 

Schedule
I

 

OFFERING DOCUMENTS

 

As attached.

  

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Schedule
II

 

The Deposit Account
Agent is authorized to accept instructions signed or believed by the Deposit Account Agent to be signed by any one of the following
on behalf of the Company and Underwriter.

 

Fuqin Fintech Limited

 

	Name	 	True
                           Signature

	 	 	 
	Huaishan Cao	 	 
	 	 	 
	Xingliang Li
	 	 

 

Boustead Securities, LLC

 

	Name	 	True Signature
	 	 	 
	Keith Moore, CEO	 	 
	 	 	 
	Dan McClory, Managing Director	 	 

 

     10

     

    

 

Schedule
III

Fee Schedule

 

	Service	 	Fee	 
	Cash Management Fee (one-time fee)	 	$	4,500.00	 

 

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Exhibit A

 

EXTENSION NOTICE

 

Date:

 

FinTech Clearing, LLC

6 Venture, Suite 265 Irvine, CA 92618

Attention: Brian Park, President

 

Dear Mr. Park:

 

In accordance with the terms of Section
2(b) of a Deposit Account Agreement dated ___ _______, by and among Fuqin Fintech Limited. (the “Company”), Boustead
Securities, LLC (the “Underwriter”), and FinTech Clearing, LLC (the “Deposit Account Agent”), the Company
and Underwriter hereby notifies the Deposit Account Agent that the Termination Date has been extended to ____________, 2018, the
Final Termination Date.

 

Very truly yours,

 

	Fuqin Fintech Limited	 
	 	 	 
	By:	 	 
	 	Name: 	 
	 	Title:  	 

 

	Boustead Securities, LLC	 
	 	 	 
	By:	 	 
	 	Name: Keith Moore	 
	 	Title:   CEO	 

   

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Exhibit B

 

FORM OF DEPOSIT RELEASE NOTICE

 

Date:

 

FinTech Clearing, LLC

6 Venture, Suite 265

Irvine, CA 92618Attention: Brian
Park, President

 

Dear Mr. Park:

 

In accordance with the terms of Section
2(c) of a Deposit Account Agreement dated as of __________, 2018 (the “Deposit Account Agreement”), by and between Fuqin
Fintech Limited (the “Company”), FinTech Clearing, LLC (the “Deposit Account Agent”) and Boustead Securities,
LLC (the “Underwriter”), the Company and Underwriter hereby notify the Deposit Account Agent that the ________ closing
will be held on ___________ for gross proceeds of $_________.

 

PLEASE DISTRIBUTE FUNDS BY WIRE TRANSFER
AS FOLLOWS (wire instructions attached):

 

	 	:	$	 
	 	 	 	 
	 	:	$	 
	 	 	 	 
	 	:	$	 

  

Very truly yours,

 

	Fuqin Fintech Limited	 
	 	 	 
	By:	 	 
	 	Name: 	 
	 	Title:  	 

 

	Boustead Securities, LLC	 
	 	 	 
	By:	 	 
	 	Name: Keith Moore	 
	 	Title:   CEO	 

   

     13Exhibit

Exhibit 10.1

CYPRESS SEMICONDUCTOR CORPORATION
AMENDED AND RESTATED
CHANGE OF CONTROL SEVERANCE AGREEMENT  
This Amended and Restated Change of Control Severance Agreement (the “Agreement”) is made and entered into by and between _______ (the “Employee”) and Cypress Semiconductor Corporation, a Delaware corporation (the “Company”), as of ________, 2018 (the “Effective Date”).
RECITALS
1. It is expected that the Company from time to time will consider the possibility of an acquisition by another company or other change of control transaction. The Board of Directors of the Company (the “Board”) recognizes that such consideration may be a distraction to the Employee and may cause the Employee to consider alternative employment opportunities. The Board has determined that it is in the best interests of the Company and its stockholders to assure that the Company will have the continued dedication and objectivity of the Employee, notwithstanding the possibility, threat or occurrence of a “Change of Control” (as defined herein) of the Company. 
2. The Board believes that it is in the best interests of the Company and its stockholders to provide the Employee with an incentive to continue his or her employment and to motivate the Employee to maximize the value of the Company upon a Change of Control for the benefit of its stockholders. 
3. The Board believes that it is imperative to provide the Employee with certain severance benefits upon the Employee’s termination of employment in connection with a Change of Control. This Agreement is intended to provide the Employee with enhanced financial security and incentive and encouragement to remain with the Company notwithstanding the possibility of a Change of Control. 
AGREEMENT 
NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties hereto agree as follows: 
1.Term of Agreement. This Agreement will have an initial term of two (2) years commencing on the Effective Date (the “Initial Term”).  Commencing on the two (2) year anniversary of the Effective Date and on each one (1) year anniversary thereafter, this Agreement will renew automatically for additional, one (1) year terms (each, an “Additional Term”) unless either party provides the other party with written notice of nonrenewal at least four (4) months prior to the date of automatic renewal.  Notwithstanding the foregoing, if a Change of Control occurs (i)  during the Initial Term or (b) during an Additional Term, the term of this Agreement will extend automatically through the date that is twenty-four (24) months following the date of the Change of Control.  If Executive becomes entitled to the benefits under Section 4  of this Agreement, then the Agreement will not terminate until all of the obligations of the parties hereto with respect to this Agreement have been satisfied.
2.At-Will Employment. The Company and the Employee acknowledge that the Employee’s employment is and shall continue to be at-will, as defined under applicable law, except as may otherwise be specifically provided under the terms of any written formal employment agreement or offer letter agreement between the Company and the Employee (an “Employment Agreement”). If the Employee’s employment terminates for any reason, including (without limitation) any termination outside of the Change of Control Period, the Employee shall not be entitled to any payments, benefits, damages, awards or compensation other than as provided by this Agreement or under his or her Employment Agreement. 

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3.Termination of Employment. In the event Employee’s employment with the Company terminates for any reason, Employee will be entitled to any: (a) unpaid base salary accrued up to the effective date of termination, (b) unpaid, but earned and accrued annual incentive for any completed fiscal year as of his or her termination of employment, (c) pay for accrued but unused vacation, (d) benefits or compensation as provided under the terms of any employee benefit and compensation agreements or plans applicable to Employee, (e) unreimbursed business expenses required to be reimbursed to Employee, and (f) rights to indemnification Employee may have under the Company’s Articles of Incorporation, Bylaws, or separate indemnification agreement, as applicable.  In addition, if the termination is by the Company other than for Cause, death or Disability (as defined herein), or Employee terminates his or her employment with the Company (or any parent or subsidiary of the Company) for Good Reason, Employee may be entitled to the amounts and benefits specified in Section 4.
4.Severance Benefits. 
(a) Involuntary Termination Other than for Cause outside of the Change of Control Period.  If, outside of the Change of Control Period, the Company (or any parent or subsidiary of the Company) terminates the Employee’s employment for other than Cause, death or Disability, then the Employee shall receive from the Company the severance payments and benefits described in this Section 4(a), subject to the Employee signing and not revoking a standard release of claims with the Company in a form reasonably acceptable to the Company (but which form does not impose post-employment obligations on the Employee other than those contained in this Agreement) (the “Release”) within the period required by the Release and in no event later than sixty (60) days following the Employee’s termination of employment, inclusive of any revocation period set forth in the Release (collectively, the “Release Deadline Date”), provided that the Release shall not be required in the event of Employee’s death. 
(i) Severance Payment. The Employee shall be entitled to receive a lump-sum severance payment (less applicable withholdings) equal to nine (9) months of the Employee’s annual base salary (as in effect immediately prior to the Employee’s termination).  
(ii) Additional Cash Payment. The Employee shall be entitled to receive an additional lump-sum severance payment (less applicable withholdings) equal to the result of (A) times (B).  For this purpose, “A” will equal nine (9), and “B” will equal the amount of the monthly premium that would be required for the first month of coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended and all applicable regulations (referred to collectively as “COBRA”), with the premium calculated on the assumption that the Employee in fact elects coverage for himself or herself, and any eligible spouse and/or dependents of the Employee that were enrolled in the applicable Company health plan immediately prior to the date of termination.  However, the Employee will be eligible for this taxable payment without regard to whether he or she actually elects COBRA continuation coverage.
(b) Involuntary Termination Other than for Cause or Voluntary Termination for Good Reason within the Change of Control Period. If, within the Change of Control Period, (i) the Employee terminates his or her employment with the Company (or any parent or subsidiary of the Company) for Good Reason or (ii) the Company (or any parent or subsidiary of the Company) terminates the Employee’s employment for other than Cause, death or Disability, then the Employee shall receive from the Company the severance payments and benefits described in this Section 4(b), subject to the Employee signing and not revoking the Release within the period required by the Release and in no event later than the Release Deadline Date, provided that the Release shall not be required in the event of Employee’s death. If the Release does not become effective by the Release Deadline Date, the Employee will forfeit any rights to severance payments and benefits in Section 4(b) and under this Agreement.  No severance will be paid or provided until the Release becomes effective. The Company must provide the form of Release to the Employee in a reasonable period of time following 

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termination of employment so that the Employee has a reasonable opportunity to have the Release become effective before the Release Deadline Date.
(i) Severance Payment. The Employee shall be entitled to receive a lump-sum severance payment (less applicable withholdings) equal to eighteen (18) months of the Employee’s annual base salary (as in effect immediately prior to (A) the Change of Control, or (B) the Employee’s termination, whichever is greater) plus eighteen (18) months of the Employee’s annual target bonus for the fiscal year in which the Change of Control or the Employee’s termination occurs, whichever is greater.  
(ii) Acceleration of Vesting of Equity-Based Compensation Awards. One-hundred percent (100%) of the then-unvested portion of all of Employee’s then-outstanding equity-based compensation awards shall become vested, at the 100% target level in the case of equity-based compensation awards the vesting of which is conditioned on the attainment of performance targets (and not solely on the continued service of Employee) (such awards, “Performance Vesting Awards”); provided, however, that, if the terms of any Performance Vesting Award include a different severance acceleration formula that applies in the circumstances of the employment termination, then such formula will control the vesting of such award; and provided further, however, that in the absence of such a formula if the employment termination occurs after the completion of a performance period but prior to the scheduled vesting date for such period (such as a termination in January or February of a typical year) then the Employee shall vest at the 100% target level or at the amount actually earned based on performance for the completed period, whichever is greater. Notwithstanding the foregoing, to the extent required to avoid imposition of any additional tax or income recognition under Section 409A of the Internal Revenue Code of 1986, as amended (the “Code”), equity-based compensation awards shall be paid or settled at the same time or times that the awards otherwise would have been paid or settled in the absence of this Section 4(b)(ii).  
(iii) Additional Cash Payment. The Employee shall be entitled to receive an additional lump-sum severance payment (less applicable withholdings) equal to the result of (A) times (B).  For this purpose, “A” will equal eighteen (18), and “B” will equal the amount of the monthly premium that would be required for the first month of coverage under COBRA, with the premium calculated on the assumption that the Employee in fact elects coverage for himself or herself, and any eligible spouse and/or dependents of the Employee that were enrolled in the applicable Company health plan immediately prior to the Change of Control.  However, the Employee will be eligible for this taxable payment without regard to whether he or she actually elects COBRA continuation coverage.
(c) Release/Timing of Severance Payments. If the Release required under Section 4(a) or Section 4(b) does not become effective by the Release Deadline Date, the Employee will forfeit any rights to severance payments and benefits in Section 4(a) or Section 4(b), as applicable, and under this Agreement.  No severance will be paid or provided under this Agreement until such Release becomes effective. The Company must provide the form of Release to the Employee in a reasonable period of time following termination of employment so that the Employee has a reasonable opportunity to have the Release become effective before the Release Deadline Date.  If the Release required by Section 4(a) or Section 4(b), as applicable, becomes effective by the Release Deadline Date, severance payments and benefits under this Agreement will be paid in a lump sum payment (less any applicable withholdings) on the first business day after the Release Deadline Date, but in no event later than March 15th of the calendar year immediately following the calendar year of the Employee’s termination of employment, except as required by Section 4(f).  If the Employee should die before all amounts have been paid, such unpaid amounts shall be paid in a lump sum payment (less any applicable withholding taxes) to the Employee’s designated beneficiary, if living, or otherwise to the personal representative of the Employee’s estate, as described in Section 4(f) below. 

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(d) Voluntary Resignation other than for Good Reason; Voluntary Resignation for Good Reason outside of Change of Control Period; Termination for Cause, Death or Disability. If the Employee’s employment with the Company terminates (i) voluntarily by the Employee other than for Good Reason at any time, (ii) voluntarily by the Employee for Good Reason outside of the Change of Control Period, (iii) for Cause by the Company or (iv) due to Employee’s death or Disability, then the Employee shall not be entitled to receive severance or other benefits except for those (if any) as may then be established under the Company’s then existing severance and benefits plans and practices or pursuant to other written agreements with the Company, including, without limitation, any Employment Agreement. 
(e) Exclusive Remedy. In the event of a termination of Employee’s employment, the provisions of this Section 4 are intended to be and are exclusive and in lieu of any other rights or remedies to which the Employee or the Company may otherwise be entitled, whether at law, tort or contract, in equity, or under this Agreement. The Employee shall be entitled to no benefits, compensation or other payments or rights upon termination of employment other than those benefits expressly set forth in this Section 4. 
(f) Section 409A. 
(i) Six-Month Delay. Notwithstanding anything to the contrary in this Agreement, no Deferred Compensation Separation Benefits (as defined below) payable under this Agreement will be considered due or payable until the Employee has incurred a “separation from service” within the meaning of Section 409A of the Internal Revenue Code of 1986, as amended and the final regulations and any guidance promulgated thereunder (together, “Section 409A”).  In addition, if the Employee is a “specified employee” within the meaning of Section 409A at the time of the Employee’s separation from service (other than due to death), then the severance benefits payable to the Employee under this Agreement, if any, and any other severance payments or separation benefits that may be considered deferred compensation under Section 409A (together, the “Deferred Compensation Separation Benefits”) otherwise due to the Employee on or within the six (6) month period following the Employee’s separation from service will accrue during such six (6) month period and will become payable in a lump sum payment (less any applicable withholding taxes) on the date six (6) months and one (1) day following the date of the Employee’s separation from service. All subsequent payments, if any, will be payable in accordance with the payment schedule applicable to each payment or benefit. In no event will the Employee have discretion to determine the taxable year of payment of any Deferred Compensation Separation Benefits.  Notwithstanding anything herein to the contrary, if the Employee dies following his or her separation from service but prior to the six (6) month anniversary of his or her date of separation, then any payments delayed in accordance with this paragraph will be payable in a lump sum (less any applicable withholding taxes) to the Employee’s estate as soon as administratively practicable after the date of the Employee’s death and all other Deferred Compensation Separation Benefits will be payable in accordance with the payment schedule applicable to each payment or benefit. 
(ii) Amendments to this Agreement to Comply with Section 409A. This provision is intended to comply with the requirements of Section 409A so that none of the severance payments and benefits to be provided hereunder will be subject to the additional tax imposed under Section 409A, and any ambiguities herein will be interpreted to so comply. Each payment and benefit payable under this Agreement is intended to constitute a separate payment under Section 1.409A‐2(b)(2) of the Treasury Regulations. The Company and the Employee agree to work together in good faith to consider amendments to this Agreement and to take such reasonable actions, which are necessary, appropriate or desirable to avoid imposition of any additional tax or income recognition prior to actual payment to the Employee under Section 409A. Notwithstanding anything to the contrary in this Agreement, in no event will the Company reimburse Employee for any taxes imposed or other costs incurred as a result of Section 409A.

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(g) Non-disparagement & Non-solicitation. Employee agrees to the following covenants, to the extent permitted by applicable law, in the event Employee receives severance payments and benefits under Section 4 of this Agreement.  Employee further acknowledges and agrees that the Company is relying on Employee’s compliance with this Section 4(g) as an essential term of this Agreement. The Company’s rights pursuant to this Section 4(g) are in addition to any remedies it may have for breach of contract or otherwise; further, the remaining terms of this Agreement, as well as the Release contemplated by Section 4(a) or Section 4(b), as applicable, will remain in full force and effect.
(i) Non-disparagement. For a period of nine (9) months immediately following the date of termination of employment that occurs outside of the Change of Control Period or eighteen (18) months immediately following the date of termination of Employee’s employment that occurs within the Change of Control Period, as applicable, Employee will refrain, in Employee’s capacity as a former executive officer, from any disparaging statements about the Company and its officers, directors and affiliates, including, without limitation, the business, products, intellectual property, financial standing, future, or employment/compensation/benefit practices of the Company; provided, however, that (a) nothing shall restrict Employee’s ability to make any statements of any nature as a stockholder or a director of the Company, (b) none of these restrictions shall apply to statements made in connection with legal proceedings, and (c) the foregoing requirements under this Section 4(g) will not apply to any statements that Employee makes in addressing any statements made by the Company, its officers and/or its directors regarding Employee or Employee’s performance as an employee of the Company so long as Employee’s statements are, in the good faith judgment of Employee, truthful; and
(ii) Non-solicitation. For a period of nine (9) months immediately following the date of termination of employment that occurs outside of the Change of Control Period or eighteen (18) months immediately following the date of termination of Employee’s employment that occurs within the Change of Control Period, as applicable, Employee will not, either directly or indirectly, solicit, induce, recruit or encourage any of the Company’s employees to leave their employment, or hire or take away such employees, or attempt to solicit, induce, recruit, encourage, hire or take away employees of the Company, either for Employee’s own purposes, or for any other person or entity.  
5.Limitation on Payments. In the event that the severance and other benefits provided for in this Agreement or otherwise payable to the Employee (a) constitute “parachute payments” within the meaning of Section 280G of the Code and (b) but for this Section 5, would be subject to the excise tax imposed by Section 4999 of the Code, then the Employee’s severance benefits under Section 4(a) or Section 4(b) or other benefits shall be either: 
(i) delivered in full, or 
(ii) delivered as to such lesser extent which would result in no portion of such severance benefits being subject to excise tax under Section 4999 of the Code, 
whichever of the foregoing amounts, taking into account the applicable federal, state and local income taxes and the excise tax imposed by Section 4999, results in the receipt by the Employee on an after-tax basis, of the greatest amount of severance benefits, notwithstanding that all or some portion of such severance benefits and other benefits may be taxable under Section 4999 of the Code. 
In the event of a reduction in accordance with Section 5(ii), the reduction will occur, with respect to such severance and other benefits considered “parachute payments” within the meaning of Section 280G of the Code, in the following order: (i) reduction of cash payments in reverse chronological order (that is, the cash payment owed on the latest date following the occurrence of the event triggering the excise tax will be the first cash payment to be reduced; (ii) cancellation of awards granted “contingent on a change in ownership or control” (within the meaning of Section 280G of the Code), (iii) cancellation of accelerated vesting of 

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equity-based compensation awards in the reverse order of date of grant of the awards (that is, the vesting of the most recently granted awards will be cancelled first); and (iv) reduction of employee benefits in reverse chronological order (that is, the benefit owed on the latest date following the occurrence of the event triggering the excise tax will be the first benefit to be reduced.  If two or more equity-based compensation awards are granted on the same date, each award will be reduced on a prorated basis.  In no event shall the Employee have any discretion with respect to the ordering of payment reductions.
Unless the Company and the Employee otherwise agree in writing, any determination required under this Section 5 shall be made in writing by a nationally recognized accounting or valuation firm selected by the Company (the “Accountants”), whose determination shall be conclusive and binding upon the Employee and the Company for all purposes.  For purposes of making the calculations required by this Section 5, the Accountants may make reasonable assumptions and approximations concerning applicable taxes and may rely on reasonable, good faith interpretations concerning the application of Sections 280G and 4999 of the Code.  The Company and the Employee shall furnish to the Accountants such information and documents as the Accountants may reasonably request in order to make a determination under this Section 5. The Company shall bear all costs for payment of the Accountants services in connection with any calculations contemplated by this Section 5.  
6.Definition of Terms. The following terms referred to in this Agreement shall have the following meanings: 
(a) Cause. “Cause” shall mean (i) any act of personal dishonesty taken by the Employee in connection with his or her responsibilities as an employee and intended to result in substantial personal enrichment of the Employee, (ii) Employee being convicted of, or pleading no contest to, a felony or misdemeanor that the Company reasonably believes has had or will have a material detrimental effect on the Company’s reputation or business, (iii) a willful act by the Employee which constitutes illegal or gross misconduct and which is injurious to the Company, or (iv) Employee’s intentional unauthorized or wrongful use or disclosure of proprietary or confidential information of the Company (or any other party to whom Employee owes an obligation of nonuse or nondisclosure as a result of Employee’s employment relationship with the Company), including but not limited to trade secrets and customer lists; or (v) Employee’s willful and continued failure to substantially perform the duties and responsibilities of his or her position (other than due to physical or mental illness) after there has been delivered to the Employee a written demand for performance from the Company that describes the basis for the Company’s belief that the Employee has not substantially performed his or her duties and the Employee has not corrected such failure within thirty (30) days of such written demand.
(b) Change of Control. “Change of Control” means the occurrence of any of the following: 
(i) Any “person” (as such term is used in Sections 13(d) and 14(d) of the Securities Exchange Act of 1934, as amended) (“Person”) becomes the “beneficial owner” (as defined in Rule 13d-3 under said Act), directly or indirectly, of securities of the Company representing more than fifty percent (50%) of the total voting power represented by the Company’s then outstanding voting securities; provided, however, that for purposes of this subsection, (1) the acquisition of additional stock by any Person, who is considered to own more than fifty percent (50%) of the total voting power of the stock of the Company will not be considered a Change of Control; and (2) if the stockholders of the Company immediately before such change in ownership continue to retain immediately after the change in ownership, in substantially the same proportions as their ownership of shares of the Company’s voting stock immediately prior to the change in ownership, direct or indirect beneficial ownership of more than fifty percent (50%) of the total voting power of the stock of the Company, such event shall not be considered a Change of Control under this subsection. For this purpose, indirect beneficial ownership shall include, without limitation, an interest resulting from ownership of the voting securities of one or more corporations or other business entities which own the Company, 

6

as the case may be, either directly or through one or more subsidiary corporations or other business entities; or
(ii) Any action or event occurring within a twelve (12) month period, as a result of which fewer than a majority of the directors are Incumbent Directors. “Incumbent Directors” shall mean directors who either (A) are directors of the Company as of the date hereof, or (B) are elected, or nominated for election, to the Board with the affirmative votes of at least a majority of the Incumbent Directors at the time of such election or nomination (but shall not include an individual whose election or nomination is in connection with an actual or threatened proxy contest relating to the election of directors to the Company); or 
(iii)  A change in the ownership of a substantial portion of the Company’s assets which occurs on the date that any Person acquires (or has acquired during the twelve (12) month period ending on the date of the most recent acquisition by such person or persons) assets from the Company that have a total gross fair market value equal to or more than fifty-percent (50%) of the total gross fair market value of all of the assets of the Company immediately prior to such acquisition or acquisitions; provided, however, that for purposes of this subsection (iii), the following will not constitute a change in the ownership of a substantial portion of the Company’s assets: (A) a transfer to an entity that is controlled by the Company’s stockholders immediately after the transfer, or (B) a transfer of assets by the Company to: (1) a stockholder of the Company (immediately before the asset transfer) in exchange for or with respect to the Company’s stock, (2) an entity, fifty-percent (50%) or more of the total value or voting power of which is owned, directly or indirectly, by the Company, (3) a Person, that owns, directly or indirectly, fifty-percent (50%) or more of the total value or voting power of all the outstanding stock of the Company, or (4) an entity, at least fifty-percent (50%) of the total value or voting power of which is owned, directly or indirectly, by a Person described in this subsection (iii)(B)(3).  For purposes of this subsection (iii), gross fair market value means the value of the assets of the Company, or the value of the assets being disposed of, determined without regard to any liabilities associated with such assets.
(c) Change of Control Period. “Change of Control Period” shall mean the period (i) commencing three (3) months before the occurrence of a Change of Control, and (ii) ending twenty-four (24) months after the Change of Control.
(d) Disability. “Disability” shall mean that the Employee has been unable to perform his or her Company duties as the result of his or her incapacity due to physical or mental illness, and such inability, at least twenty-six (26) weeks after its commencement, is determined to be total and permanent by a physician selected by the Company or its insurers and acceptable to the Employee or the Employee’s legal representative (such determination as to acceptability not to be unreasonably withheld). Termination resulting from Disability may only be effected after at least thirty (30) days’ written notice by the Company of its intention to terminate the Employee’s employment. In the event that the Employee resumes the performance of substantially all of his or her duties hereunder before the termination of his or her employment becomes effective, the notice of intent to terminate shall automatically be deemed to have been revoked. 

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(e) Good Reason. “Good Reason” means Employee’s resignation within thirty (30) days following the expiration of any Company cure period (discussed below) following the occurrence of one or more of the following, without Employee’s express written consent:  (i) a material reduction by the Company of Employee’s base salary in effect immediately prior to such reduction (other than a one-time reduction that is equal to or less than fifteen percent (15%) of Employee’s base salary that also applies to substantially all of the similarly situated employees of the Company); (ii) [for the Chief Financial Officer and Chief Legal Officer: a material reduction of Employee’s duties or responsibilities relative to Employee’s duties or responsibilities in effect immediately prior to such reduction] [for other executives:  a material reduction of Employee’s duties or responsibilities relative to Employee’s duties or responsibilities in effect immediately prior to such reduction; provided that “Good Reason” shall not exist under this Section 6(e)(ii) if following a Change of Control the Employee is employed by the Company with substantially the same responsibilities with respect to the Company’s business that he or she had immediately prior to the Change of Control regardless of whether his or her title is revised to reflect his or her placement within the overall corporate hierarchy or whether, following such Change of Control, he or she provides services to a subsidiary, affiliate, business unit or otherwise of the Company or its ultimate parent entity]; or (iii) Employee’s relocation at the Company’s direction to a facility or location more than thirty-five (35) miles from Employee’s then present location of providing services.  Employee’s resignation will not be deemed to be for Good Reason unless Employee has first provided the Company with written notice of the acts or omissions constituting the grounds for “Good Reason” within one hundred twenty (120) days of the initial existence of the grounds for “Good Reason” and a reasonable cure period of not less than thirty (30) days following the date the Company receives such notice, and such condition has not been cured during such period.
7.Successors. 
(a) The Company’s Successors. Any successor to the Company (whether direct or indirect and whether by purchase, merger, consolidation, liquidation or otherwise) to all or substantially all of the Company’s business and/or assets shall assume the obligations under this Agreement and agree expressly to perform the obligations under this Agreement in the same manner and to the same extent as the Company would be required to perform such obligations in the absence of a succession. For all purposes under this Agreement, the term “Company” shall include any successor to the Company’s business and/or assets which executes and delivers an agreement pursuant to a purchase, merger, consolidation, liquidation or otherwise as described in this Section 7(a) or which becomes bound by the terms of this Agreement by operation of law. 
(b) The Employee’s Successors. The terms of this Agreement and all rights of the Employee hereunder shall inure to the benefit of, and be enforceable by, the Employee’s personal or legal representatives, executors, administrators, successors, heirs, distributees, devisees and legatees. 
8.Notice. 
(a) General. All notices and other communications required or permitted hereunder shall be in writing, shall be effective when given, and shall in any event be deemed to be given upon receipt or, if earlier, (i) five (5) days after deposit with the U.S. Postal Service or other applicable postal service, if delivered by first class mail, postage prepaid, (ii) upon delivery, if delivered by hand, (iii) one (1) business day after the business day of deposit with Federal Express or similar overnight courier, freight prepaid or (iv) one (1) business day after the business day of facsimile transmission, if delivered by facsimile transmission with copy by first class mail, postage prepaid, and shall be addressed (A) if to Employee, at his or her last known residential address and (B) if to the Company, at the address of its principal corporate offices (attention: Secretary), or in any such case at such other address as a party may designate by ten (10) days’ advance written notice to the other party pursuant to the provisions above. 
(b) Notice of Termination. Any termination by the Company for Cause or by the Employee for Good Reason or as a result of any voluntary resignation shall be communicated by a notice of termination to the other party hereto given in accordance with this Section 8(b) of this Agreement. Such notice shall indicate the 

8

specific termination provision in this Agreement relied upon, shall set forth in reasonable detail the facts and circumstances claimed to provide a basis for termination under the provision so indicated, and shall specify the termination date (which shall be not more than thirty (30) days after the giving of such notice). The failure by the Employee to include in the notice any fact or circumstance which contributes to a showing of Good Reason shall not waive any right of the Employee hereunder or preclude the Employee from asserting such fact or circumstance in enforcing his or her rights hereunder. 
9.Miscellaneous Provisions. 
(a) No Duty to Mitigate. The Employee shall not be required to mitigate the amount of any payment contemplated by this Agreement, nor shall any such payment be reduced by any earnings that the Employee may receive from any other source. 
(b) Waiver. No provision of this Agreement shall be modified, waived or discharged unless the modification, waiver or discharge is agreed to in writing and signed by the Employee and by an authorized officer of the Company (other than the Employee). No waiver by either party of any breach of, or of compliance with, any condition or provision of this Agreement by the other party shall be considered a waiver of any other condition or provision or of the same condition or provision at another time. 
(c) Headings. All captions and section headings used in this Agreement are for convenient reference only and do not form a part of this Agreement. 
(d) Entire Agreement. This Agreement, together with any equity-based compensation award agreement, constitutes the entire agreement of the parties hereto and supersedes in their entirety all prior representations, understandings, undertakings or agreements (whether oral or written and whether expressed or implied) of the parties with respect to the subject matter hereof. With respect to equity-based compensation awards granted on or after the date hereof, the acceleration of vesting provided herein will apply to such awards except to the extent otherwise explicitly provided in the applicable equity-based compensation award agreement. 
(e) Choice of Law. The validity, interpretation, construction and performance of this Agreement shall be governed by the laws of the State of California. The Superior Court of Santa Clara County and/or the United States District Court for the Northern District of California shall have exclusive jurisdiction and venue over all controversies in connection with this Agreement. 
(f) Severability. The invalidity or unenforceability of any provision or provisions of this Agreement shall not affect the validity or enforceability of any other provision hereof, which shall remain in full force and effect. 
(g) Withholding. All payments made pursuant to this Agreement will be subject to withholding of applicable income and employment taxes. 
(h) Counterparts. This Agreement may be executed in counterparts, each of which shall be deemed an original, but all of which together will constitute one and the same instrument. 

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

	COMPANY
	 
	 
	 
	CYPRESS SEMICONDUCTOR CORPORATION

	 
	 
	 
	 
	 

	 
	 
	 
	 
	 
	 
	By:
	 
	 

	 
	 
	 
	 
	 

	 
	 
	 
	 
	 
	 
	Name:
	 
	 

	 
	 
	 
	 
	 
	 
	Title:
	 
	 
  

	 
	 
	 
	 
	 
	 
	Date:
	 
	 

	 
	 
	 
	 

	EMPLOYEE
	 
	 
	 
	By:
	 
	 

	 
	 
	 
	 
	 

	 
	 
	 
	 
	 
	 
	Name:
	 
	 

	 
	 
	 
	 
	 
	 
	Date:
	  
	 

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