SEC Contract Filing

Filing Date: 2021-08-30

Document Content:
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<TYPE>EX-10.4(1)
<SEQUENCE>5
<FILENAME>tm2126013d1_ex10-4d1.htm
<DESCRIPTION>EXHIBIT 10.4(1)
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: right"><B>Exhibit 10.4.1</B></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"><B><U>STOCK OPTION GRANT NOTICE</U></B></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"><B>UNDER THE HUMACYTE,&nbsp;INC.<BR>
2021 LONG-TERM INCENTIVE PLAN</B></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 1in">Humacyte,&nbsp;Inc. (the &ldquo;<U>Company</U>&rdquo;)
hereby grants to Grantee, as of the Grant Date, an option (this &ldquo;<U>Option</U>&rdquo;) to purchase shares of the Company&rsquo;s
Common Stock pursuant to the Humacyte,&nbsp;Inc. 2021 Long-Term Incentive Plan (as amended from time to time, the &ldquo;<U>Plan</U>&rdquo;).
Capitalized terms not otherwise defined herein will have the meanings set forth in the Plan or the attached Stock Option Agreement (the
 &ldquo;<U>Award Agreement</U>&rdquo;).</P>

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 <TR STYLE="vertical-align: top">
 <TD STYLE="width: 30%"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Grantee:</B></FONT></TD>
 <TD STYLE="width: 70%"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">[Full Name]</FONT></TD></TR>
 <TR STYLE="vertical-align: top">
 <TD>&nbsp;</TD>
 <TD>&nbsp;</TD></TR>
 <TR STYLE="vertical-align: top">
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Grant Date:</B></FONT></TD>
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">[Month Day, Year]</FONT></TD></TR>
 <TR STYLE="vertical-align: top">
 <TD>&nbsp;</TD>
 <TD>&nbsp;</TD></TR>
 <TR STYLE="vertical-align: top">
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Maximum Number of<BR>
 Shares Subject to Option:</B></FONT></TD>
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">[Number]</FONT></TD></TR>
 <TR STYLE="vertical-align: top">
 <TD>&nbsp;</TD>
 <TD>&nbsp;</TD></TR>
 <TR STYLE="vertical-align: top">
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Exercise Price Per Share:</B></FONT></TD>
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">USD [Exercise Price]</FONT></TD></TR>
 <TR STYLE="vertical-align: top">
 <TD>&nbsp;</TD>
 <TD>&nbsp;</TD></TR>
 <TR STYLE="vertical-align: top">
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Type of Option:</B></FONT></TD>
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">[Nonqualified Stock Option][Incentive Stock Option]</FONT></TD></TR>
 <TR STYLE="vertical-align: top">
 <TD>&nbsp;</TD>
 <TD>&nbsp;</TD></TR>
 <TR STYLE="vertical-align: top">
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Vesting Commencement Date:</B></FONT></TD>
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">[Month Day, Year]</FONT></TD></TR>
 <TR STYLE="vertical-align: top">
 <TD>&nbsp;</TD>
 <TD>&nbsp;</TD></TR>
 <TR STYLE="vertical-align: top">
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Expiration Date:</B></FONT></TD>
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">The date [ten (10)] years after the Grant Date set
 forth above, subject to earlier expiration as provided in Section&nbsp;4 of the Award Agreement.</FONT></TD></TR>
 <TR STYLE="vertical-align: top">
 <TD>&nbsp;</TD>
 <TD>&nbsp;</TD></TR>
 <TR STYLE="vertical-align: top">
 <TD><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>Vesting Schedule:</B></FONT></TD>
 <TD STYLE="text-align: justify"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">The Option shall vest as
 follows, subject to Grantee&rsquo;s continued employment or services through such date: [</FONT><FONT STYLE="font-size: 10pt">(i)&nbsp;25%
 of the Shares subject to the Option on the Grant Date shall vest on the one-year anniversary of the Vesting Commencement Date, and
 (ii)&nbsp;1/48th of the Shares subject to the Option on the Grant Date shall vest each month after the one-year anniversary of the
 Vesting Commencement Date on the same day of the month as the Vesting Commencement Date (or if there is no corresponding day, on
 the last day of such month) over a period of 36 months, such that all of the Shares subject to the Option on Grant Date shall be
 fully vested on the four-year anniversary of the Vesting Commencement Date].</FONT></TD></TR>
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 <TD STYLE="width: 30%"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><B>A