LIBERTY GLOBAL, INC. 2005 INCENTIVE PLAN STOCK APPRECIATION RIGHTS AGREEMENT
Exhibit
(d)(2)
[Series __]
LIBERTY GLOBAL, INC.
2005 INCENTIVE PLAN
2005 INCENTIVE PLAN
THIS STOCK APPRECIATION RIGHTS AGREEMENT (“Agreement”) is made as of , 2009 (the
“Grant Date”), by and between LIBERTY GLOBAL, INC., a Delaware corporation (the “Company”), and the
individual whose name, address and employee number appear on the signature page hereto (the
“Grantee”).
The Grantee, an employee of the Company or its Subsidiaries, has elected to accept the
Company’s offer to exchange (the “Exchange Offer”) some or all of his or her stock options and/or
stock appreciation rights for shares of LBTY___(“Eligible Awards”), which awards were granted in
2007 and/or 2008 pursuant to the Liberty Global, Inc. 2005 Incentive Plan, as amended and restated
(the “Plan”). The Exchange Offer expired on the date hereof.
In accordance with the terms of the Exchange Offer, as set forth in the Company’s offer to
exchange document dated the launch date for the Exchange Offer, as amended or supplemented, the
Compensation Committee (the “Committee”) has determined to award a stock appreciation right to
Grantee, subject to the conditions and restrictions set forth herein and in the Plan, in exchange
for the cancellation of the Eligible Awards. The purpose of this award is to provide the Grantee
additional remuneration for services rendered, to encourage the Grantee to continue to provide
services to the Company or its Subsidiaries and to increase the Grantee’s personal interest in the
continued success and progress of the Company.
Capitalized terms used and not otherwise defined herein will have the meaning given thereto in
the Plan. [CLICK HERE TO READ THE PLAN.]
The Company and the Grantee therefore agree as follows:
1. Definitions. The following terms, when used in this Agreement, have the following
meanings:
“Base Price” means $ per LBTY___share.
“Business Day” means any day other than Saturday, Sunday or a day on which banking
institutions in Denver, Colorado, are required or authorized to be closed.
“Cause” has the meaning specified for “cause” in Section 11.2(b) of the Plan.
“Close of Business” means, on any day, 5:00 p.m., Denver, Colorado time.
“Code” means the Internal Revenue Code of 1986, as it may be amended from time to time.
“Committee” has the meaning specified in the recitals to this Agreement.
“Company” has the meaning specified in the preamble to this Agreement.
“Grant Date” has the meaning specified in the preamble to this Agreement.
“Grantee” has the meaning specified in the preamble to this Agreement.
“LBTY___” means the Series ___common stock, par value $.01 per share, of the Company.
“Plan” has the meaning specified in the recitals of this Agreement.
“Required Withholding Amount” has the meaning specified in Section 5 of this Agreement.
“SAR” has the meaning specified in Section 2 of this Agreement.
“Special Termination Period” has the meaning specified in Section 7(d) of this Agreement.
“Term” has the meaning specified in Section 2 of this Agreement.
“Termination of Service” means the Grantee’s provision of services to the Company and its
Subsidiaries as an officer, employee or independent contractor, terminates for any reason.
“Third Party Administrator” means the company that has been selected by the Company to
maintain the database of the Plan and to provide related services, including but not limited to
equity grant information, transaction processing and grantee interface.
“Year of Continuous Service” has the meaning specified in Section 7(d) of this Agreement.
2. Grant of Stock Appreciation Right. Subject to the terms and conditions herein, pursuant to
the Plan, the Company grants to the Grantee a Free-Standing SAR with respect to the number of
shares of LBTY___set forth on the signature page hereto (each a “SAR” and collectively the “SARs”).
Upon exercise of a SAR in accordance with this Agreement, the Company will, subject to Section 5
below, pay to the Grantee consideration equal to the amount, if any, by which the Fair Market Value
of a share of LBTY___as of the date on which such exercise is considered to occur pursuant to
Section 4 exceeds the Base Price of such SAR. The SARs, to the extent they have become exercisable
in accordance with Section 3, will be exercisable during the period commencing on the Grant Date
and expiring at the Close of Business on May 1, 2016 (the “Term”), subject to earlier termination
as provided in Section 7. The Base Price and number of SARs are subject to adjustment pursuant to
Section 11.
3. Conditions of Exercise. Unless otherwise determined by the Committee in its sole
discretion, the SARs will be exercisable only in accordance with the conditions stated in this
Section 3.
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(a) Except as otherwise provided in Section 11.1(b) of the Plan or in the last sentence
of this Section 3(a), the SARs will not be exercisable until November 1, 2009, and may be
exercised thereafter only to the extent they have become exercisable in accordance with the
following schedule:
| (i) | On November 1, 2009, 12.5% of the SARs will be exercisable; | ||
| (ii) | On February 1, 2010, and on the first day of the month in each third month thereafter, an additional 6.25% of the SARs will become exercisable; and | ||
| (iii) | On May 1, 2013, 100% of the SARs will be exercisable. |
[Please refer to the website of the Third Party Administrator for the specific vesting
schedule related to the exercisability of the SAR (click on the specific grant under the tab
labeled “Grants/Award/Units”).]
Notwithstanding the foregoing, (x) all SARs will become exercisable on the date of
Termination of Service if the Termination of Service occurs by reason of Grantee’s death or
Disability, and (y) if the Termination of Service is by the Company or a Subsidiary without
Cause (as determined in the sole discretion of the Committee) more than six months after the
Grant Date, the Grantee will be entitled to exercise all SARs that had previously become
exercisable, plus the product of (x) one-third (1/3) of the additional number of SARs that
would have become exercisable on the next following vesting date in accordance with the
above schedule, times (y) the number of full months of employment completed since the most
recent date of vesting in accordance with the foregoing schedule.
(b) To the extent the SARs become exercisable, all or any of such SARs may be exercised
(at any time or from time to time, except as otherwise provided herein) until expiration of
the Term or earlier termination thereof.
(c) The Grantee acknowledges and agrees that the Committee, in its discretion and as
contemplated by Section 3.3 of the Plan, may adopt rules and regulations from time to time
after the date hereof with respect to the exercise of the SARs and that the exercise by the
Grantee of SARs will be subject to the further condition that such exercise is made in
accordance with all such rules and regulations as the Committee may determine are applicable
thereto.
4. Manner of Exercise. The SARs will be considered exercised (as to the number of SARs
specified in the notice referred to in Section 4(a) below) on the latest of (i) the date of
exercise designated in the written notice referred to in Section 4(a) below, (ii) if the date so
designated is not a Business Day, the first Business Day following such date or (iii) the earliest
Business Day by which the following have occurred:
(a) The Grantee has either (i) notified the Third Party Administrator through its
website or by telephone (see Section 12) of the exercise, or (ii) submitted to the
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Company a properly executed written notice of exercise in such form as the Committee
may require containing such representations and warranties as the Committee may require and
designating, among other things, the date of exercise and the number of SARs to be
exercised; and
(b) The Company has received such other documentation, if any, that the Committee may
reasonably require.
5. Mandatory Withholding for Taxes. The Grantee acknowledges and agrees that the Company will
deduct from the cash or shares of LBTY___otherwise payable or deliverable upon exercise of any
SARs, an amount of cash, a number of shares of LBTY___(valued at their Fair Market Value on the
date of exercise) or a combination of the foregoing that is equal to the amount, if any, of all
national, state and local taxes required to be withheld by the Company upon such exercise, as
determined by the Committee (the “Required Withholding Amount”).
6. Payment or Delivery by the Company. As soon as practicable after receipt of all items
referred to in Section 4, and subject to the withholding referred to in Section 5, the Company will
deliver or cause to be delivered to or at the direction of the Grantee the amount of consideration
determined under the second sentence of Section 2 above, which consideration shall consist of
shares of LBTY___(valued at their Fair Market Value on the date of exercise) or, at the discretion
of the Committee, if Grantee is not subject to U.S. federal income tax, cash or a combination of
cash and shares. Any delivery of shares of LBTY___will be deemed effected for all purposes when
(i) a certificate representing such shares or statement of holdings reflecting such shares held for
the benefit of Grantee in uncertificated form by a third party service provider designated by the
Company has been delivered personally to the Grantee or, if delivery is by mail, when the
certificate or statement of holdings has been deposited in the United States mail, addressed to the
Grantee, or (ii) confirmation of deposit into the designated broker’s account of such shares, in
written or electronic format, is first made available to Grantee. Any cash payment will be deemed
effected when the Company or a Subsidiary makes the payment by any of the following means: (i) by
check , payable to or at the direction of the Grantee and in the amount equal to the amount of the
cash payment, delivered personally to or at the direction of the Grantee or deposited in the United
States mail, addressed to the Grantee or his or her nominee, or (ii) by delivery of the amount of
such cash payment by electronic transfer to Grantee’s designated account.
7. Early Termination of the SARs. Unless otherwise determined by the Committee in its sole
discretion, the SARs will terminate, prior to the expiration of the Term, at the time specified
below:
(a) Subject to Section 7(b), if Termination of Service occurs other than (i) by the
Company or a Subsidiary (whether for Cause or without Cause) or (ii) by reason of Grantee’s
death or Disability, then the SARs will terminate at the Close of Business on the first
Business Day following the expiration of the 90-day period which began on the date of
Termination of Service.
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(b) If the Grantee dies (i) prior to Termination of Service or prior to the expiration
of a period of time following Termination of Service during which the SARs remain
exercisable as provided in Section 7(a) or Section 7(c), as applicable, the SARs will
terminate at the Close of Business on the first Business Day following the expiration of the
one-year period which began on the date of the Grantee’s death, or (ii) prior to the
expiration of a period of time following Termination of Service during which the SARs remain
exercisable as provided in Section 7(d), the SARs will terminate at the Close of Business on
the first Business Day following the expiration of (A) the one-year period which began on
the date of the Grantee’s death or (B) the Special Termination Period, whichever period is
longer.
(c) Subject to Section 7(b), if Termination of Service occurs by reason of Disability,
then the SARs will terminate at the Close of Business on the first Business Day following
the expiration of the one-year period which began on the date of Termination of Service.
(d) If Termination of Service is by the Company or a Subsidiary without Cause (as
determined in the sole discretion of the Committee), the SARs will terminate at the Close of
Business on the first Business Day following the expiration of the Special Termination
Period. The Special Termination Period is the period of time beginning on the date of
Termination of Service and continuing for the number of days that is equal to the sum of (a)
90, plus (b) 180 multiplied by the Grantee’s total Years of Continuous Service, provided
that the Special Termination Period will in any event expire on the second anniversary of
the date of Termination of Service. A Year of Continuous Service means a consecutive
12-month period, measured by the Grantee’s hire date (as reflected in the payroll records of
the Company or a Subsidiary) and the anniversaries of that date, during which the Grantee is
employed by the Company or a Subsidiary without interruption. For purposes of determining
the Grantee’s Years of Continuous Service, Grantee’s employment with the Company’s former
parent, Liberty Media Corporation (“LMC”), and any predecessor of the Company or LMC will be
included, provided that the Grantee’s hire date with the Company or a Subsidiary occurred
within 30 days following the Grantee’s termination of employment with LMC or such
predecessor. If the Grantee was employed by a Subsidiary at the time of such Subsidiary’s
acquisition by the Company, the Grantee’s employment with the Subsidiary prior to the
acquisition date will not be included in determining the Grantee’s Years of Continuous
Service unless the Committee, in its sole discretion, determines that such prior employment
will be included. Notwithstanding the foregoing, the business combination in which Liberty
Media International, Inc. and UnitedGlobalCom, Inc. and their respective Subsidiaries became
Subsidiaries of the Company on June 15, 2005 shall not be deemed an acquisition of any such
Subsidiary by the Company for purpose of the preceding sentence.
(e) If Termination of Service is by the Company or a Subsidiary for Cause, then the
SARs will terminate immediately upon such Termination of Service.
In any event in which the SARs remain exercisable for a period of time following the date of
Termination of Service as provided above, the SARs may be exercised during such
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period of time only to the extent the same were exercisable as provided in Section 3 above on
such date of Termination of Service. Unless the Committee otherwise determines, neither a change of
the Grantee’s employment from the Company to a Subsidiary or from a Subsidiary to the Company or
another Subsidiary, nor a change in Grantee’s status from an independent contractor to an employee,
will be a Termination of Service for purposes of this Agreement if such change of employment or
status is made at the request or with the express consent of the Company. Unless the Committee
otherwise determines, however, any such change of employment or status that is not made at the
request or with the express consent of the Company and any change in Grantee’s status from an
employee to an independent contractor will be a Termination of Service within the meaning of this
Agreement. Notwithstanding any period of time referenced in this Section 7 or any other provision
of this Section 7 that may be construed to the contrary, the SARs will in any event terminate upon
the expiration of the Term.
8. Automatic Exercise of SARs. Immediately prior to the termination of SARs, as provided in
Section 7(a), 7(b), 7(c) or 7(d) above or upon expiration of the Term, all remaining SARs then
exercisable will be deemed to have been exercised by the Grantee. Notwithstanding any other
provision of this Agreement, no exercise of SARs will be deemed to occur upon Termination of
Service for Cause.
9. Nontransferability. During the Grantee’s lifetime, the SARs are not transferable
(voluntarily or involuntarily) other than pursuant to a Domestic Relations Order and, except as
otherwise required pursuant to a Domestic Relations Order, are exercisable only by the Grantee or
the Grantee’s court appointed legal representative. The Grantee may designate a beneficiary or
beneficiaries to whom the SARs will pass upon the Grantee’s death and may change such designation
from time to time by filing a written designation of beneficiary or beneficiaries with the
Committee on such form as may be prescribed by the Committee, provided that no such designation
will be effective unless so filed prior to the death of the Grantee. If no such designation is
made or if the designated beneficiary does not survive the Grantee’s death, the SARs will pass by
will or the laws of descent and distribution. Following the Grantee’s death, the SARs, if
otherwise exercisable, may be exercised by the person to whom such right passes according to the
foregoing and such person will be deemed the Grantee for purposes of any applicable provisions of
this Agreement. [CLICK HERE TO ACCESS THE DESIGNATION OF BENEFICIARY FORM.]
10. No Stockholder Rights. The Grantee will not, by reason of the Award granted under this
Agreement, be deemed for any purpose to be, or to have any of the rights of, a stockholder of the
Company with respect to any shares of LBTY___, nor will the existence of this Agreement affect in
any way the right or power of the Company or its stockholders to accomplish any corporate act,
including, without limitation, the acts referred to in Section 11.16 of the Plan.
11. Adjustments. The SARs will be subject to adjustment (including, without limitation, as to
the number of SARs and the Base Price per share) in the sole discretion of the Committee and in
such manner as the Committee may deem equitable and appropriate in connection with the occurrence
of any of the events described in Section 4.2 of the Plan following the Grant Date.
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12. Restrictions Imposed by Law. Without limiting the generality of Section 11.8 of the Plan,
the Grantee will not exercise any SARs, and the Company will not be obligated to make any cash
payment or issue or cause to be issued any shares of LBTY___, if counsel to the Company determines
that such exercise, payment or issuance would violate any applicable law or any rule or regulation
of any governmental authority or any rule or regulation of, or agreement of the Company with, any
securities exchange or association upon which shares of LBTY___are listed or quoted. The Company
will in no event be obligated to take any affirmative action in order to cause the exercise of the
SARs or the resulting payment of cash or issuance of shares of LBTY___to comply with any such law,
rule, regulation or agreement.
13. Notice. Unless the Company notifies the Grantee in writing of a different procedure:
(a) any notice or other communication to the Company with respect to this Agreement
(other than a notice of exercise pursuant to Section 4 of this Agreement) will be in writing
and will be delivered personally or sent by United States first class mail, postage prepaid,
overnight courier, freight prepaid or sent by facsimile and addressed as follows:
Liberty Global, Inc.
00000 Xxxxxxx Xxxxxxxxx
Xxxxxxxxx, Xxxxxxxx 00000
Attn: General Counsel
Fax: 000-000-0000
00000 Xxxxxxx Xxxxxxxxx
Xxxxxxxxx, Xxxxxxxx 00000
Attn: General Counsel
Fax: 000-000-0000
(b) any notice of exercise pursuant to Section 4 will be made to the Third Party
Administrator, UBS Financial Services Inc., either through its UBS One Source website at
xxx.xxx.xxx/xxxxxxxxx/XXXX___xx by telephone at 0-000-000-0000.
Any notice or other communication to the Grantee with respect to this Agreement will be in writing
and will be delivered personally, or will be sent by United States first class mail, postage
prepaid, to the Grantee’s address as listed in the records of the Company on the Grant Date, unless
the Company has received written notification from the Grantee of a change of address.
14. Amendment. Notwithstanding any other provision hereof, this Agreement may be supplemented
or amended from time to time as approved by the Committee. Without limiting the generality of the
foregoing, without the consent of the Grantee,
(a) this Agreement may be amended or supplemented from time to time as approved by the
Committee (i) to cure any ambiguity or to correct or supplement any provision herein which
may be defective or inconsistent with any other provision herein, or (ii) to add to the
covenants and agreements of the Company for the benefit of the Grantee or surrender any
right or power reserved to or conferred upon the Company in this Agreement, subject to any
required approval of the Company’s stockholders and, provided, in each case, that such
changes will not adversely affect the rights of the Grantee with respect to the Award
evidenced hereby, or (iii) to reform the Award made hereunder as contemplated by Section
11.18 of the Plan or to exempt the Award made
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hereunder from coverage under Section 409A, or (iv) to make such other changes as the
Company, upon advice of counsel, determines are necessary or advisable because of the
adoption or promulgation of, or change in or of the interpretation of, any law or
governmental rule or regulation, including any applicable federal or state securities laws;
and
(b) subject to any required action by the Board or the stockholders of the Company, the
SARs granted under this Agreement may be canceled by the Company and a new Award made in
substitution therefor, provided that the Award so substituted will satisfy all of the
requirements of the Plan as of the date such new Award is made and no such action will
adversely affect any SARs to the extent then exercisable.
15. Grantee Employment.
(a) Nothing contained in this Agreement, and no action of the Company or the Committee with
respect hereto, will confer or be construed to confer on the Grantee any right to continue in the
employ or service of the Company or any of its Subsidiaries or interfere in any way with any right
of the Company or any Subsidiary, subject to the terms of any separate employment agreement to the
contrary, to terminate the Grantee’s employment or service at any time, with or without cause.
(b) The Award hereunder is special incentive compensation that will not be taken into account,
in any manner, as salary, earnings, compensation, bonus or benefits, in determining the amount of
any payment under any pension, retirement, profit sharing, 401(k), life insurance, salary
continuation, severance or other employee benefit plan, program or policy of the Company or any of
its Subsidiaries or any employment agreement or arrangement with the Grantee.
(c) It is a condition of the Grantee’s Award that, in the event of Termination of Service for
whatever reason, whether lawful or not, including in circumstances which could give rise to a claim
for wrongful and/or unfair dismissal (whether or not it is known at the time of Termination of
Service that such a claim may ensue), the Grantee will not by virtue of such Termination of
Service, subject to Section 3 of this Agreement, become entitled to any damages or severance or any
additional amount of damages or severance in respect of any rights or expectations of whatsoever
nature the Grantee may have hereunder or under the Plan. Notwithstanding any other provision of
the Plan or this Agreement, the Award hereunder will not form part of the Grantee’s entitlement to
remuneration or benefits pursuant to the Grantee’s employment agreement or arrangement, if any.
The rights and obligations of the Grantee under the terms of his or her employment agreement, if
any, will not be enhanced hereby.
(d) In the event of any inconsistency between the terms hereof or of the Plan and any
employment, severance or other agreement with the Grantee, the terms hereof and of the Plan shall
control.
16. Nonalienation of Benefits. Except as provided in Section 9 of this Agreement, (i) no
right or benefit under this Agreement will be subject to anticipation, alienation, sale,
assignment, hypothecation, pledge, exchange, transfer, encumbrance or charge,
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and any attempt to anticipate, alienate, sell, assign, hypothecate, pledge, exchange,
transfer, encumber or charge the same will be void, and (ii) no right or benefit hereunder will in
any manner be liable for or subject to the debts, contracts, liabilities or torts of the Grantee or
other person entitled to such benefits
17. Data Privacy.
(a) The Grantee’s acceptance hereof shall evidence the Grantee’s explicit and unambiguous
consent to the collection, use and transfer, in electronic or other form, of the Grantee’s personal
data by and among, as applicable, the Grantee’s employer (the “Employer”) and the Company and its
subsidiaries and affiliates for the exclusive purpose of implementing, administering and managing
the Grantee’s participation in the Plan. The Grantee understands that the Company and the Employer
may hold certain personal information about the Grantee, including, but not limited to, the
Grantee’s name, home address and telephone number, date of birth, social insurance number or other
identification number, salary, bonus and employee benefits, nationality, job title and description,
any shares of stock or directorships or other positions held in the Company, its subsidiaries and
affiliates, details of all options, stock appreciation rights, restricted shares, restricted share
units or any other entitlement to shares of stock or other Awards granted, canceled, exercised,
vested, unvested or outstanding in the Grantee’s favor, annual performance objectives, performance
reviews and performance ratings, for the purpose of implementing, administering and managing Awards
under the Plan (“Data”).
(b) The Grantee understands that Data may be transferred to any third parties assisting in the
implementation, administration and management of the Plan, that these recipients may be located in
the Grantee’s country or elsewhere, and that the recipients’ country (e.g. the United States) may
have different data privacy laws and protections than the Grantee’s country. The Grantee
understands that the Grantee may request a list with the names and addresses of any potential
recipients of the Data by contacting the Grantee’s local human resources representative. The
Grantee authorizes the recipients to receive, possess, use, retain and transfer the Data, in
electronic or other form, for the sole purpose of implementing, administering and managing the
Grantee’s participation in the Plan, including any requisite transfer of such Data as may be
required to a broker or other third party with whom the Grantee may elect to deposit any shares of
stock acquired with respect to an Award.
(c) The Grantee understands that Data will be held only as long as is necessary to implement,
administer and manage the Grantee’s participation in the Plan. The Grantee understands that the
Grantee may at any time view Data, request additional information about the storage and processing
of Data, require any necessary amendments to Data or refuse or withdraw the consents herein, in any
case without cost, by contacting in writing the Grantee’s local human resources representative.
The Grantee understands, however, that refusing or withdrawing the Grantee’s consent may affect the
Grantee’s ability to participate in the Plan. For more information on the consequences of a
refusal to consent or withdrawal of consent, the Grantee may contact the Grantee’s local human
resources representative.
18. Governing Law. This Agreement will be governed by, and construed in accordance with, the
internal laws of the State of Colorado. Each party irrevocably submits to the general jurisdiction
of the state and federal courts located in the State of Colorado in any
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action to interpret or enforce this Agreement and irrevocably waives any objection to
jurisdiction that such party may have based on inconvenience of forum.
19. Construction. References in this Agreement to “this Agreement” and the words “herein,”
“hereof,” “hereunder” and similar terms include all Exhibits and Schedules appended hereto. This
Agreement is entered into, and the Award evidenced hereby is granted, pursuant to the Plan and
shall be governed by and construed in accordance with the Plan and the administrative
interpretations adopted by the Committee thereunder. The word “include” and all variations thereof
are used in an illustrative sense and not in a limiting sense. All decisions of the Committee upon
questions regarding this Agreement will be conclusive. Unless otherwise expressly stated herein,
in the event of any inconsistency between the terms of the Plan and this Agreement, the terms of
the Plan will control. The headings of the sections of this Agreement have been included for
convenience of reference only, are not to be considered a part hereof and will in no way modify or
restrict any of the terms or provisions hereof.
20. Duplicate Originals. The Company and the Grantee may sign any number of copies of this
Agreement. Each signed copy will be an original, but all of them together represent the same
agreement.
21. Rules by Committee. The rights of the Grantee and the obligations of the Company
hereunder will be subject to such reasonable rules and regulations as the Committee may adopt from
time to time.
22. Entire Agreement. This Agreement is in satisfaction of and in lieu of all prior
discussions and agreements, oral or written, between the Company and the Grantee regarding the
subject matter hereof. The Grantee and the Company hereby declare and represent that no promise or
agreement not herein expressed has been made and that this Agreement contains the entire agreement
between the parties hereto with respect to the Award and replaces and makes null and void any prior
agreements between the Grantee and the Company regarding the Award. This Agreement will be binding
upon and inure to the benefit of the parties and their respective heirs, successors and assigns.
23. Grantee Acceptance. The Grantee signified acceptance of the terms and conditions of this
Agreement at the time Grantee surrendered his or her Eligible Awards on the dedicated website for
the Exchange Offer in accordance with the terms and conditions of the Exchange Offer.
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Signature Page to Stock Appreciation Rights Agreement (Series __)
dated as of , 20___ between Liberty Global, Inc., and Grantee
dated as of , 20___ between Liberty Global, Inc., and Grantee
| LIBERTY GLOBAL, INC. | ||||||
| By: Name: |
/s/ Xxxxxxxxx X. Xxxxxxxxx
|
|||||
| Title: | Senior Vice President | |||||
| ACCEPTED: | ||||||
| /s/ Name of Grantee | ||||||
| Grantee Name: | ||||||
| Address: | ||||||
| Employee ID: | ||||||
Grant No.
Number of shares of LBTY___as to which Free-Standing SAR is granted:
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