EXHIBIT 4.3
EP MEDSYSTEMS, Inc.
Form of 1995 Long Term Incentive Plan Award Agreement
EP MedSystems
000 Xxxxxxx Xxxxx
Xxxxx 000
Xx. Arlington, NJ 07856
Tel: 000-000-0000
Fax: 000-000-0000
[FORM OF INCENTIVE STOCK OPTION AWARD]
[Recipient]
Re: Incentive Stock Option
Dear [ Recipient]
This letter confirms that you have been granted an incentive stock option
representing an aggregate of [insert quantity] shares of common stock of EP
MedSystems, Inc. (the "Company") dated as of [insert date of grant], pursuant to
the Amended 1995 Long Term Incentive Plan (the "Plan"). A copy of the Plan is
attached and made a part hereof. This option is subject to the terms of such
Plan, and the terms of the Plan shall control in the event of any conflict with
this letter.
You may exercise purchase rights for [insert quantity] shares under this option
[insert vesting schedule]. The exercise price for the shares covered by this
option is [insert exercise price] per share and the exercise period for this
option is [insert exercise term] from the date of grant.
NEITHER THE OPTION GRANTED HEREUNDER, NOR THE SHARES OF COMMON STOCK TO BE
ISSUED UPON EXERCISE OF SUCH OPTION, HAVE BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933, AS AMENDED, OR STATE SECURITIES LAWS AND MAY NEITHER BE REOFFERED
OR SOLD UNLESS REGISTERED OR UNLESS AN EXEMPTION FROM SUCH REGISTRATION IS
AVAILABLE. THE CERTIFICATES FOR SHARES OF COMMON STOCK TO BE ISSUED UPON
EXERCISE OF THIS OPTION WILL BE APPROPRIATELY DESIGNATED WITH A RESTRICTIVE
LEGEND SIMILAR TO THAT SET FORTH ABOVE.
Sincerely,
Xxxxx X. Xxxxxxx,
President
Accepted and agreed to:
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