Incentive Election. 2. If you elect Incentive Election #2, you will receive an amount equal to the Closing Cash Amount within two business days after the Closing. In addition, you will receive 69,949 shares of restricted stock under the La Jolla Pharmaceutical Company 2004 Equity Incentive Plan (the "Plan"). The shares will be issued as soon as practicable after the Closing and, subject to Section 8, the Company's repurchase right with respect to such shares will lapse with respect to all of the shares on the one year anniversary of the Closing.
Incentive Election. In order to receive the 2019 Waiver Incentive of $750, I have provided proof of other non- Juniata coverage and have attached the documentation to this form. I would like to have this incentive disbursed in the following way (check one): $750 paid in equal monthly installments through payroll I was given an opportunity to participate but I wish to waive coverage without payment of incentive Signature Date
