EXHIBIT A
NOTICE OF EXERCISE OF INCENTIVE STOCK OPTION (ISO)
I hereby exercise, all or part of, the incentive stock option (the “Option” or “ISO”) granted to me by CBM Bancorp, Inc. (the “Company”) or its affiliate, subject to all the terms and provisions set forth in the Stock Option Agreement (the “Agreement”) and the CBM Bancorp, Inc. 2019 Equity Incentive Plan (the “Plan”) referred to therein, and notify you of my desire to purchase shares of common stock of the Company (“Common Stock”) for a purchase price of $ per share.
I elect to pay the exercise price by:
| | Cash or personal, certified or cashier’s check in the sum of $ , in full/partial payment of the purchase price. |
| | Stock of the Company with a fair market value of $ in full/partial payment of the purchase price.* |
| | A net settlement of the Option, using a portion of the shares obtained on exercise in payment of the exercise price of the Option (and, if applicable, any required tax withholding). |
| | Selling shares from my Option shares through a broker in full/partial payment of the purchase price. |
I understand that after this exercise, shares of Common Stock remain subject to the Option, subject to all terms and provisions set forth in the Agreement and the Plan.
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Date of Exercise | | Participant’s signature | | | | |
* If I elect to exercise an Option by exchanging shares I already own, I willconstructively return shares that I already own to purchase the new option shares. If my shares are in certificate form, I must attach a separate statement indicating the certificate number of the shares I am treating as having exchanged. If the shares are held in “street name” by a registered broker, I must provide the Company with a statement attesting to the number of shares owned that will be treated as having been exchanged. I will keep the shares that I already own and treat them as if they are shares acquired by the option exercise. In addition, I will receive additional shares equal to the difference between the shares I constructively exchange and the total new option shares that I acquire. I certify that either (i) I have held the shares I am tendering for at least one year after acquiring such shares through the exercise of an ISO, or (ii) I have not obtained such shares through the exercise of an ISO. Further, I acknowledges that if I am exercising ISO options, failure to retain such shares for a minimum of one year from the date of exercise will result in a disqualified disposition and immediate taxation at ordinary income tax rates.
BY THE COMPANY
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Date Received: | | | | Company Representative: | | |