Restricted Stock Award Agreement SOMERA COMMUNICATIONS, INC. NOTICE OF GRANT OF STOCK PURCHASE RIGHT
Exhibit 10.1
▇▇▇▇▇▇ COMMUNICATIONS, INC.
1999 STOCK PLAN
NOTICE OF GRANT OF STOCK PURCHASE RIGHT
Unless otherwise defined herein, the terms defined in the Plan shall have the same defined
meanings in this Notice of Grant.
Name:
Address:
You have been granted the right to purchase Common Stock of the Company, subject to the
Company’s Repurchase Option and your ongoing status as a Service Provider (as described in the Plan
and the attached Restricted Stock Purchase Agreement), as follows:
Grant Number
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Date of ▇▇▇▇▇
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▇▇▇▇▇ Per Share
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$ |
Total Number of Shares Subject to this Stock Purchase Right |
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Release of Shares
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__________________of the Shares shall be released from the Company’s Repurchase Option at the end of the |
| __________________after the Date of
Grant and __________________of the Shares at the end of each |
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| __________________thereafter], provided that you do not cease to be a Service Provider prior to the date of any such release. | |
Change of Control Conditions (4(d))
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Expiration Date:
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YOU MUST EXERCISE THIS STOCK PURCHASE RIGHT BEFORE THE EXPIRATION DATE OR IT WILL TERMINATE
AND YOU WILL HAVE NO FURTHER RIGHT TO PURCHASE THE SHARES. By your signature and the
signature of the Company’s representative below, you and the Company agree that this Stock
Purchase Right is granted under and governed by the terms and conditions of the 1999 Stock
Plan and the Restricted Stock Purchase
Agreement, attached hereto as Exhibit A-1, both of which are made a part of this
document. You further agree to execute the attached Restricted Stock Purchase Agreement as
a condition to purchasing any shares under this Stock Purchase Right.
GRANTEE:
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▇▇▇▇▇▇ COMMUNICATIONS, INC. |
By:
________________________ |
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| Title:___________________________ |
EXHIBIT A-1
▇▇▇▇▇▇ COMMUNICATIONS, INC.
1999 STOCK PLAN
RESTRICTED STOCK PURCHASE AGREEMENT
Unless otherwise defined herein, the terms defined in the Plan shall have the same defined
meanings in this Restricted Stock Purchase Agreement.
WHEREAS the Purchaser named in the Notice of Grant, (the “Purchaser”) is a Service Provider,
and the Purchaser’s continued participation is considered by the Company to be important for the
Company’s continued growth; and
WHEREAS in order to give the Purchaser an opportunity to acquire an equity interest in the
Company as an incentive for the Purchaser to participate in the affairs of the Company, the
Administrator has granted to the Purchaser a Stock Purchase Right subject to the terms and
conditions of the Plan and the Notice of Grant, which are incorporated herein by reference, and
pursuant to this Restricted Stock Purchase Agreement (the “Agreement”).
NOW THEREFORE, the parties agree as follows:
1. Sale of Stock. The Company hereby agrees to sell to the Purchaser and the
Purchaser hereby agrees to purchase shares of the Company’s Common Stock (the “Shares”), at the per
Share purchase price and as otherwise described in the Notice of Grant.
2. Payment of Purchase Price. The purchase price for the Shares may be paid by
delivery to the Company at the time of execution of this Agreement of cash, a check, or some
combination thereof.
3. Repurchase Option.
(a) In the event the Purchaser ceases to be a Service Provider for any or no reason (including
death or disability) before all of the Shares are released from the Company’s Repurchase Option
(see Section 4), the Company shall, upon the date of such termination (as reasonably fixed and
determined by the Company) have an irrevocable, exclusive option (the “Repurchase Option”) for a
period of sixty (60) days from such date to repurchase up to that number of shares which constitute
the Unreleased Shares (as defined in Section 4) at the original purchase price per share (the
“Repurchase Price”). The Repurchase Option shall be exercised by the Company by delivering written
notice to the Purchaser or the Purchaser’s executor (with a copy to the Escrow Holder) AND, at the
Company’s option, (i) by delivering to the Purchaser or the Purchaser’s executor a check in the
amount of the aggregate Repurchase Price, or (ii) by canceling an amount of the Purchaser’s
indebtedness to the Company equal to the aggregate Repurchase Price, or (iii) by a combination of
(i) and (ii) so that the combined payment and cancellation of indebtedness equals the aggregate
Repurchase Price. Upon delivery of such notice and the payment of the aggregate Repurchase Price,
the Company shall become the legal and beneficial owner of the Shares being repurchased and all
rights and interests therein or relating thereto, and the Company shall have the right to retain
and transfer to its own name the number of Shares being repurchased by the Company.
(b) Whenever the Company shall have the right to repurchase Shares hereunder, the Company may
designate and assign one or more employees, officers, directors or shareholders of the Company or
other persons or organizations to exercise all or a part of the Company’s purchase rights under
this Agreement and purchase all or a part of such Shares.
4. Release of Shares From Repurchase Option.
(a) Shares shall be released from the Company’s Repurchase Option on the dates set forth in
the Notice of Grant, provided that the Purchaser does not cease to be a Service Provider prior to
the date of any such release.
(b) Any of the Shares that have not yet been released from the Repurchase Option are referred
to herein as “Unreleased Shares.”
(c) The Shares that have been released from the Repurchase Option shall be delivered to the
Purchaser at the Purchaser’s request (see Section 6).
(d) Subject to any conditions set forth in the Notice of Grant, all Shares that have not yet
been released from the Repurchase Option shall be released from the Company’s Repurchase Option on
the date on which a Change of Control occurs, provided that the Purchaser does not cease to be a
Service Provider prior to the date of such release. For purposes of this Agreement, “Change of
Control” is defined as: (i) any “person” (as such term is used in Sections 13(d) and 14(d) of the
Securities Exchange Act of 1934, as amended) is or becomes the “beneficial owner” (as defined in
Rule 13d-3 under said Act), directly or indirectly, of securities of the Company representing 50%
or more of the total voting power represented by the Company’s then outstanding voting securities;
or (ii) a change in the composition of the Board occurring within a two-year period, as a result of
which fewer than a majority of the directors are Incumbent Directors; (iii) the date of the
consummation of a merger or consolidation of the Company with any other corporation that has been
approved by the stockholders of the Company, other than a merger or consolidation which would
result in the voting securities of the Company outstanding immediately prior thereto continuing to
represent (either by remaining outstanding or by being converted into voting securities of the
surviving entity) more than fifty percent (50%) of the total voting power represented by the
voting securities of the Company or such surviving entity outstanding immediately after such merger
or consolidation, or the stockholders of the Company approve a plan of complete liquidation of the
Company; or (iv) the date of the consummation of the sale or disposition by the Company of all or
substantially all the Company’s assets. “Incumbent Directors” will 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 will 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).
5. Restriction on Transfer. Except for the escrow described in Section 6 or the
transfer of the Shares to the Company or its assignees contemplated by this Agreement, none of the
Shares or any beneficial interest therein shall be transferred, encumbered or otherwise disposed of
in any way until such Shares are released from the Company’s Repurchase Option in accordance with
the provisions of this Agreement, other than by will or the laws of descent and distribution.
6. Escrow of Shares.
(a) To ensure the availability for delivery of the Purchaser’s Unreleased Shares upon
repurchase by the Company pursuant to the Repurchase Option, the Purchaser shall, upon execution of
this Agreement, deliver and deposit with an escrow holder designated by the Company (the “Escrow
Holder”) the share certificates representing the Unreleased Shares, together with the stock
assignment duly endorsed in blank, attached hereto as Exhibit A-2. The Unreleased Shares
and stock assignment shall be held by the Escrow Holder, pursuant to the Joint Escrow Instructions
of the Company and Purchaser attached hereto as Exhibit A-3, until such time as the
Company’s Repurchase Option expires.
(b) The Escrow Holder shall not be liable for any act it may do or omit to do with respect to
holding the Unreleased Shares in escrow while acting in good faith and in the exercise of its
judgment.
(c) If the Company or any assignee exercises the Repurchase Option hereunder, the Escrow
Holder, upon receipt of written notice of such exercise from the proposed transferee, shall take
all steps necessary to accomplish such transfer.
(d) When the Repurchase Option has been exercised or expires unexercised or a portion of the
Shares has been released from the Repurchase Option, upon request the Escrow Holder shall promptly
cause a new certificate to be issued for the released Shares and shall deliver the certificate to
the Company or the Purchaser, as the case may be.
(e) Subject to the terms hereof, the Purchaser shall have all the rights of a shareholder with
respect to the Shares while they are held in escrow, including without limitation, the right to
vote the Shares and to receive any cash dividends declared thereon. If, from time to time during
the term of the Repurchase Option, there is (i) any stock dividend, stock split or other change in
the Shares, or (ii) any merger or sale of all or substantially all of the assets or other
acquisition of the Company, any and all new, substituted or additional securities to which the
Purchaser is entitled by reason of the Purchaser’s ownership of the Shares shall be immediately
subject to this escrow, deposited with the Escrow Holder and included thereafter as “Shares” for
purposes of this Agreement and the Repurchase Option.
7. Legends. The share certificate evidencing the Shares, if any, issued hereunder
shall be endorsed with the following legend (in addition to any legend required under applicable
state securities laws):
THE SHARES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO CERTAIN RESTRICTIONS UPON
TRANSFER AND RIGHTS OF REPURCHASE AS SET FORTH IN AN AGREEMENT BETWEEN THE COMPANY
AND THE SHAREHOLDER, A COPY OF WHICH IS ON FILE WITH THE SECRETARY OF THE COMPANY.
8. Adjustment for Stock Split. All references to the number of Shares and the
purchase price of the Shares in this Agreement shall be appropriately adjusted to reflect any stock
split, stock dividend or other change in the Shares that may be made by the Company after the date
of this Agreement.
9. Tax Consequences. The Purchaser has reviewed with the Purchaser’s own tax advisors
the federal, state, local and foreign tax consequences of this investment and the transactions
contemplated by this Agreement. The Purchaser is relying solely on such advisors and not on any
statements or representations of the Company or any of its agents. The Purchaser understands that
the Purchaser (and not the Company) shall be responsible for the Purchaser’s own tax liability that
may arise as a result of the transactions contemplated by this Agreement. The Purchaser
understands that Section 83 of the Internal Revenue Code of 1986, as amended (the “Code”), taxes as
ordinary income the difference between the purchase price for the Shares and the Fair Market Value
of the Shares as of the date any restrictions on the Shares lapse. In this context, “restriction”
includes the right of the Company to buy back the Shares pursuant to the Repurchase Option. The
Purchaser understands that the Purchaser may elect to be taxed at the time the Shares are purchased
rather than when and as the Repurchase Option expires by filing an election under Section 83(b) of
the Code with the IRS within 30 days from the date of purchase. The form for making this election
is attached as Exhibit A-4 hereto.
THE PURCHASER ACKNOWLEDGES THAT IT IS THE PURCHASER’S SOLE RESPONSIBILITY AND NOT
THE COMPANY’S TO FILE TIMELY THE
ELECTION UNDER SECTION 83(b), EVEN IF THE PURCHASER REQUESTS THE COMPANY OR ITS
REPRESENTATIVES TO MAKE THIS FILING ON THE PURCHASER’S BEHALF.
10. General Provisions.
(a) This Agreement shall be governed by the internal substantive laws, but not the choice of
law rules of California. This Agreement, subject to the terms and conditions of the Plan and the
Notice of Grant, represents the entire agreement between the parties with respect to the purchase
of the Shares by the Purchaser. Subject to Section 15(c) of the Plan, in the event of a conflict
between the terms and conditions of the Plan and the terms and conditions of this Agreement, the
terms and conditions of the Plan shall prevail. Unless otherwise defined herein, the terms defined
in the Plan shall have the same defined meanings in this Agreement.
(b) The rights of the Company under this Agreement shall be transferable to any one or more
persons or entities, and all covenants and agreements hereunder shall inure to the benefit of, and
be enforceable by the Company’s successors and assigns. The rights and obligations of the
Purchaser under this Agreement may only be assigned with the prior written consent of the Company.
(c) Either party’s failure to enforce any provision of this Agreement shall not in any way be
construed as a waiver of any such provision, nor prevent that party from thereafter enforcing any
other provision of this Agreement. The rights granted both parties hereunder are cumulative and
shall not constitute a waiver of either party’s right to assert any other legal remedy available to
it.
(d) The Purchaser agrees upon request to execute any further documents or instruments
necessary or desirable to carry out the purposes or intent of this Agreement.
(e) PURCHASER ACKNOWLEDGES AND AGREES THAT THE VESTING OF SHARES PURSUANT TO SECTION 4 HEREOF
IS EARNED ONLY BY CONTINUING SERVICE AS A SERVICE PROVIDER AT THE WILL OF THE COMPANY (AND NOT
THROUGH THE ACT OF BEING HIRED OR PURCHASING SHARES HEREUNDER). PURCHASER FURTHER ACKNOWLEDGES AND
AGREES THAT THIS AGREEMENT, THE TRANSACTIONS CONTEMPLATED HEREUNDER AND THE VESTING SCHEDULE SET
FORTH HEREIN DO NOT CONSTITUTE AN EXPRESS OR IMPLIED PROMISE OF CONTINUED ENGAGEMENT AS A SERVICE
PROVIDER FOR THE VESTING PERIOD, FOR ANY PERIOD, OR AT ALL, AND SHALL NOT INTERFERE WITH
PURCHASER’S RIGHT OR THE COMPANY’S RIGHT TO TERMINATE PURCHASER’S RELATIONSHIP AS A SERVICE
PROVIDER AT ANY TIME, WITH OR WITHOUT CAUSE.
By ▇▇▇▇▇▇▇▇▇’s signature below, Purchaser represents that he or she is familiar with the terms
and provisions of the Plan, and hereby accepts this Agreement subject to all of the terms and
provisions thereof. Purchaser has reviewed the Plan and this Agreement in their entirety, has had
an opportunity to obtain the advice of counsel prior to executing this Agreement and fully
understands all provisions of this
Agreement. Purchaser agrees to accept as binding, conclusive and final all decisions or
interpretations of the Administrator upon any questions arising under the Plan or this Agreement.
Purchaser further agrees to notify the Company upon any change in the residence indicated in the
Notice of Grant.
DATED:
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| PURCHASER: | ▇▇▇▇▇▇ COMMUNICATIONS, INC. | |||||
| Signature | By | |||||
| Print Name | Title | |||||
EXHIBIT A-2
ASSIGNMENT SEPARATE FROM CERTIFICATE
FOR VALUE RECEIVED I, , hereby sell, assign and transfer unto ▇▇▇▇▇▇
Communications, Inc. shares of the Common Stock of ▇▇▇▇▇▇ Communications, Inc., standing in
my name of the books of said corporation represented by Certificate No. herewith and do
hereby irrevocably constitute and appoint to transfer the said stock on the
books of the within named corporation with full power of substitution in the premises.
This Stock Assignment may be used only in accordance with the Restricted Stock Purchase
Agreement (the “Agreement”) between and the undersigned dated
, .
Dated: ,
Signature:
Print:
INSTRUCTIONS: Please do not fill in any blanks other than the signature line. The purpose of this
assignment is to enable the Company to exercise the Repurchase Option, as set forth in the
Agreement, without requiring additional signatures on the part of the Purchaser.
EXHIBIT A-3
JOINT ESCROW INSTRUCTIONS
Effective: December 1, 2005
▇▇. ▇▇▇▇ ▇▇▇▇▇
Corporate Secretary
▇▇▇▇▇▇ Communications, Inc.
▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇
Corporate Secretary
▇▇▇▇▇▇ Communications, Inc.
▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇
Dear ▇▇. ▇▇▇▇▇:
As Escrow Agent for both ▇▇▇▇▇▇ Communications, Inc., a Delaware corporation (the “Company”),
and the undersigned purchaser of stock of the Company (the “Purchaser”), you are hereby authorized
and directed to hold the documents delivered to you pursuant to the terms of that certain
Restricted Stock Purchase Agreement (“Agreement”) between the Company and the undersigned, in
accordance with the following instructions:
11. In the event the Company and/or any assignee of the Company (referred to collectively as
the “Company”) exercises the Company’s Repurchase Option set forth in the Agreement, the Company
shall give to Purchaser and you a written notice specifying the number of shares of stock to be
purchased, the purchase price, and the time for a closing hereunder at the principal office of the
Company. Purchaser and the Company hereby irrevocably authorize and direct you to close the
transaction contemplated by such notice in accordance with the terms of said notice.
| 1. | At the closing, you are directed (a) to date the stock assignments necessary for the transfer in question, (b) to fill in the number of shares being transferred, and (c) to deliver same, together with the certificate evidencing the shares of stock to be transferred, to the Company or its assignee, against the simultaneous delivery to you of the purchase price (by cash, a check, or some combination thereof) for the number of shares of stock being purchased pursuant to the exercise of the Company’s Repurchase Option. | ||
| 2. | Purchaser irrevocably authorizes the Company to deposit with you any certificates evidencing shares of stock to be held by you hereunder and any additions and substitutions to said shares as defined in the Agreement. Purchaser does hereby irrevocably constitute and appoint you as Purchaser’s attorney-in-fact and agent for the term of this escrow to execute with respect to such securities all documents necessary or appropriate to make such securities negotiable and to complete any transaction herein contemplated, including but not limited to the filing with any applicable state blue sky authority of any required applications for consent to, or notice of transfer of, the securities. Subject to the provisions of this paragraph 3, Purchaser shall exercise all rights and privileges of a shareholder of the Company while the stock is held by you. |
| 3. | Upon written request of the Purchaser, but no more than once per calendar year, unless the Company’s Repurchase Option has been exercised, you shall deliver to Purchaser a certificate or certificates representing so many shares of stock as are not then subject to the Company’s Repurchase Option. Within 90 days after Purchaser ceases to be a Service Provider, you shall deliver to Purchaser a certificate or certificates representing the aggregate number of shares held or issued pursuant to the Agreement and not purchased by the Company or its assignees pursuant to exercise of the Company’s Repurchase Option. | ||
| 4. | If at the time of termination of this escrow you should have in your possession any documents, securities, or other property belonging to Purchaser, you shall deliver all of the same to Purchaser and shall be discharged of all further obligations hereunder. | ||
| 5. | Your duties hereunder may be altered, amended, modified or revoked only by a writing signed by all of the parties hereto. | ||
| 6. | You shall be obligated only for the performance of such duties as are specifically set forth herein and may rely and shall be protected in relying or refraining from acting on any instrument reasonably believed by you to be genuine and to have been signed or presented by the proper party or parties. You shall not be personally liable for any act you may do or omit to do hereunder as Escrow Agent or as attorney-in-fact for Purchaser while acting in good faith, and any act done or omitted by you pursuant to the advice of your own attorneys shall be conclusive evidence of such good faith. | ||
| 7. | You are hereby expressly authorized to disregard any and all warnings given by any of the parties hereto or by any other person or corporation, excepting only orders or process of courts of law, and are hereby expressly authorized to comply with and obey orders, judgments or decrees of any court. In case you obey or comply with any such order, judgment or decree, you shall not be liable to any of the parties hereto or to any other person, firm or corporation by reason of such compliance, notwithstanding any such order, judgment or decree being subsequently reversed, modified, annulled, set aside, vacated or found to have been entered without jurisdiction. | ||
| 8. | You shall not be liable in any respect on account of the identity, authorities or rights of the parties executing or delivering or purporting to execute or deliver the Agreement or any documents or papers deposited or called for hereunder. | ||
| 9. | You shall not be liable for the outlawing of any rights under the statute of limitations with respect to these Joint Escrow Instructions or any documents deposited with you. | ||
| 10. | You shall be entitled to employ such legal counsel and other experts as you may deem necessary properly to advise you in connection with your obligations hereunder, may rely upon the advice of such counsel, and may pay such counsel reasonable compensation therefore. |
| 11. | Your responsibilities as Escrow Agent hereunder shall terminate if you shall cease to be an officer or agent of the Company or if you shall resign by written notice to each party. In the event of any such termination, the Company shall appoint a successor ▇▇▇▇▇▇ Agent. | ||
| 12. | If you reasonably require other or further instruments in connection with these Joint Escrow Instructions or obligations in respect hereto, the necessary parties hereto shall join in furnishing such instruments. | ||
| 13. | It is understood and agreed that should any dispute arise with respect to the delivery and/or ownership or right of possession of the securities held by you hereunder, you are authorized and directed to retain in your possession without liability to anyone all or any part of said securities until such disputes shall have been settled either by mutual written agreement of the parties concerned or by a final order, decree or judgment of a court of competent jurisdiction after the time for appeal has expired and no appeal has been perfected, but you shall be under no duty whatsoever to institute or defend any such proceedings. | ||
| 14. | Any notice required or permitted hereunder shall be given in writing and shall be deemed effectively given upon personal delivery or upon deposit in the United States Post Office, by registered or certified mail with postage and fees prepaid, addressed to each of the other parties thereunto entitled at the following addresses or at such other addresses as a party may designate by ten days’ advance written notice to each of the other parties hereto. |
| COMPANY: | ▇▇▇▇▇▇ COMMUNICATIONS, INC. ▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇ |
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| PURCHASER: | ||||||||
| 1. | ||||||||
| 2. | ESCROW AGENT: ▇▇▇▇ ▇▇▇▇▇ | |||||||
| 3. Corporate Secretary ▇▇▇▇▇▇ Communications, Inc. ▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇ |
| 15. | By signing these Joint Escrow Instructions, you become a party hereto only for the purpose of said Joint Escrow Instructions; you do not become a party to the Agreement. | ||
| 16. | This instrument shall be binding upon and inure to the benefit of the parties hereto, and their respective successors and permitted assigns. |
| 17. | These Joint Escrow Instructions shall be governed by, and construed and enforced in accordance with, the internal substantive laws, but not the choice of law rules, of California. |
| Very truly yours, | ||||||
| ▇▇▇▇▇▇ COMMUNICATIONS, INC. | ||||||
| By: | ||||||
| Title: | ||||||
| PURCHASER: | ||||||
| Signature | ||||||
| Print Name | ||||||
ESCROW AGENT:
Corporate Secretary
EXHIBIT A-4
ELECTION UNDER SECTION 83(b)
OF THE INTERNAL REVENUE CODE OF 1986
The undersigned taxpayer hereby elects, pursuant to Section 83(b) of the Internal Revenue Code of
1986, as amended, to include in taxpayer’s gross income for the current taxable year the amount of
any compensation taxable to taxpayer in connection with his or her receipt of the property
described below:
The name, address, taxpayer identification number and taxable year of the undersigned are as
follows:
| NAME: | TAXPAYER: | SPOUSE: | ||||
| ADDRESS: | ||||||
| IDENTIFICATION NO.: | TAXPAYER: | SPOUSE: | ||||
| TAXABLE YEAR: |
| 1. | The property with respect to which the election is made is described as follows: shares (the “shares”)of the Common Stock of ▇▇▇▇▇▇ Communications, Inc. (the “Company”). | |
| 2. | The date on which the property was transferred is: , . | |
| 3. | The property is subject to the following restrictions: |
The Shares may be repurchased by the Company, or its assignee, upon certain events. This
right lapses with regard to a portion of the Shares based on the continued performance of
services by the taxpayer over time.
| 4. | The fair market value at the time of transfer, determined without regard to any restriction other than a restriction which by its terms will never lapse, of such property is: $ . | |
| 5. | The amount (if any) paid for such property is: $ . |
The undersigned has submitted a copy of this statement to the person for whom the services were
performed in connection with the undersigned’s receipt of the above-described property. The
transferee of such property is the person performing the services in connection with the transfer
of said property.
The undersigned understands that the foregoing election may not be revoked except with the
consent of the Commissioner.
Dated:
|
, | |||
| Taxpayer |
The undersigned spouse of taxpayer joins in this election.
Dated:
|
, | Spouse of Taxpayer |