SEE BELOW FOR RESTRICTIVE LEGEND(S)

NOTICE OF ISSUANCE OF STOCK

*____________________* Shares
____________________ Stock
[[Company Name]]
A Delaware Corporation

____________________ is the record holder of ____________________ shares of ____________________ Stock of

____________________, a Delaware corporation (the “Company”), issued pursuant to an agreement between the Company and the
stockholder dated ____________________, transferable only on the books of the Company by the holder, in person, or by duly
authorized attorney, upon delivery of a properly endorsed stock power.

Such shares are issued and shall be held subject to all the provisions of the Certificate of Incorporation and the Bylaws of the
Company and any amendments thereto, copies of which are on file at the principal office of the Company and made a part hereof as
fully as though the provisions of said Certificate of Incorporation and Bylaws were imprinted in full on this notice, to all of which the
holder of this notice, by acceptance hereof, assents.

A statement of all of the rights, preferences, privileges and restrictions granted to or imposed upon the respective classes
and/or series of shares of stock of the Company and upon the holders thereof may be obtained by any stockholder upon request and
without charge, at the principal office of the Company, and the Company will furnish any stockholder, upon request and without
charge, a copy of such statement.

____________________

____________________
 ____________________

ACKNOWLEDGEMENT OF RECEIPT OF NOTICE

____________________ (the “Stockholder”) and ____________________, a Delaware corporation (the “Company”),

acknowledge Stockholder’s receipt on ____________________ of the notice of issuance made available herewith or attached hereto
with respect to the ____________________ shares of Common Stock of the Company (the “Shares”) issued pursuant to the Restricted
Stock Purchase Agreement dated ____________________ by and between the Company and the Stockholder (the “Agreement”).
Stockholder further acknowledges that the Secretary of the Company, or his or her designee, is acting as escrow holder pursuant to the
Agreement. As escrow holder, the Secretary of the Company, or his or her designee, holds the Shares issued in the Stockholder’s
name.

STOCKHOLDER:

____________________

SPOUSE OF STOCKHOLDER (IF APPLICABLE):

____________________

THE COMPANY:

____________________