SEC Contract Filing

Filing Date: 2017-11-06

Document Content:
<DOCUMENT>
<TYPE>EX-10.21(A)
<SEQUENCE>3
<FILENAME>tv477590_ex10-21a.htm
<DESCRIPTION>EXHIBIT 10.21(A)
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: right"><B>Exhibit 10.21a</B></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">Pursuant to the terms and conditions of
the Company&rsquo;s 2017 Incentive Plan (the &ldquo;Plan&rdquo;), you have been granted an Incentive Stock Option to purchase ________
shares of stock as outlined below.</P>

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<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="font: 10pt Times New Roman, Times, Serif; width: 100%; border-collapse: collapse">
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 <TD STYLE="width: 5%; text-align: justify">&nbsp;</TD>
 <TD STYLE="width: 35%; text-align: justify">Granted To: &nbsp;<I>Employee Name</I></TD>
 <TD STYLE="width: 60%; text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">Grant Date:&nbsp;&nbsp;<I>mm/dd/yyyy</I></TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">Granted:&nbsp;&nbsp;<I>##</I></TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">Grant Price:&nbsp;&nbsp;$##</TD>
 <TD STYLE="text-align: justify">Total Cost to Exercise:&nbsp;&nbsp;$##</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">Expiration Date:&nbsp;&nbsp;<I>mm/dd/yyy</I></TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="text-align: justify">&nbsp;</TD>
 <TD STYLE="text-align: justify">Vesting Schedule:</TD>
 <TD STYLE="text-align: justify">&nbsp;</TD></TR>
</TABLE>
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">By my signature below, I hereby acknowledge
receipt of this Grant on the date shown above, which has been issued to me under the terms and conditions of the Plan. I further
acknowledge receipt of the copy of the Plan and agree to conform to all of the terms and conditions of the Grant and the Plan.</P>

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 <TD STYLE="width: 45%; font-size: 10pt">Signature: _________________________________</TD>
 <TD STYLE="width: 20%; font-size: 10pt">&nbsp;</TD>
 <TD STYLE="width: 35%; font-size: 10pt">Date: _____________________________</TD></TR>
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