Exhibit 10.4
MAIA BIOTECHNOLOGY, INC.
Stock Option Award Agreement
Name of Grantee: |
|
Date of Grant: |
|
Vesting Commencement Date: |
|
Number of Option Shares: |
|
Option Price: | $ |
Type of Option: | Incentive Stock Option |
Applicable Plan: | The 2021 Equity Incentive Plan (the “Plan”) |
Vesting: |
|
Purpose: |
|
|
|
DOCPROPERTY "DocID" \* MERGEFORMAT 22519773.2 |
|
|
MAIA BIOTECHNOLOGY, INC.
2021 EQUITY INCENTIVE PLAN
INCENTIVE STOCK OPTION AGREEMENT
THIS AGREEMENT made as of ___________ __, 2021 [insert date on which Committee grants the Option] (the “Grant Date”), by and between Maia Biotechnology, Inc. (the “Company”), and ____________________ (the “Optionee”).
WITNESSETH:
WHEREAS, the Company has adopted and maintains the Maia Biotechnology, Inc. 2021 Equity Incentive Plan, effective August 1, 2022 (the “Plan”), and
WHEREAS, the Committee has authorized the grant to the Optionee of an Option under the Plan, on the terms and conditions set forth in the Plan and as hereinafter provided,
NOW, THEREFORE, in consideration of the premises contained herein, the Company and the Optionee hereby agree as follows:
DOCPROPERTY "DocID" \* MERGEFORMAT 22519773.2 | 2 |
|
DOCPROPERTY "DocID" \* MERGEFORMAT 22519773.2 | 3 |
|
DOCPROPERTY "DocID" \* MERGEFORMAT 22519773.2 | 4 |
|
| MAIA BIOTECHNOLOGY, INC. | |
| By:______________________________ Title:____________________________
|
|
| OPTIONEE By:______________________________ Title:____________________________
|
|
DOCPROPERTY "DocID" \* MERGEFORMAT 22519773.2 | 5 |
|
SAMPLE
NOTICE OF EXERCISE
Maia Biotechnology, Inc. | Date of Exercise: | |
|
|
|
Ladies and Gentlemen:
This constitutes notice under my stock Option that I elect to purchase the number of Shares for the price set forth below.
Type of Option: | Incentive Stock Option |
|
|
|
|
Grant Date: |
|
|
|
|
|
Number of Shares as |
|
|
|
|
|
Certificates to be |
|
|
|
|
|
Total exercise price: | $ |
|
|
|
|
Cash payment delivered | $ |
|
By this exercise, I agree (i) to execute or provide such additional documents as Maia Biotechnology, Inc. (“Company”) may reasonably require pursuant to the terms of this Notice of Exercise and the Company’s 2021 Equity Incentive Plan (the “Plan”), and (ii) to provide for the payment by me to the Company (in the manner designated by the Company) of the Company’s withholding obligation, if any, relating to the exercise of this Option.
Very truly yours,
___________________________________
Optionee
DOCPROPERTY "DocID" \* MERGEFORMAT 22519773.2 | 6 |
|