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SWY » Topics » FORM OF EXERCISE NOTICE

These excerpts taken from the SWY 8-K filed Feb 18, 2009.

FORM OF EXERCISE NOTICE

Effective as of today,                              , 20        , the undersigned (“Participant”) hereby elects to exercise Participant’s option to purchase the number of shares of common stock specified below (the “Shares”) of Safeway Inc., a Delaware corporation (the “Company”), under and pursuant to the Safeway Inc. 2007 Equity and Incentive Award Plan (the “Plan”), the Stock Option Grant Notice dated as of                     , 20         and the Stock Option Agreement attached thereto (the “Option Agreement”). Capitalized terms used herein without definition shall have the meanings given in the Plan and, if not defined in the Plan, the Option Agreement.

 

Grant Date:

    __________________________________________

Number of Shares as to which Option is Exercised:

    __________________________________________

Exercise Price per Share:

    $____________

Total Exercise Price:

    $____________

Certificate to be issued in name of:

    __________________________________________

Payment delivered herewith:

   

$______________ (Representing the full exercise price for the Shares, as well as any applicable withholding tax)

Form of Payment:_________________________

                                             (Please specify)

Type of Option:    ¨   Incentive Stock Option    ¨   Non-Qualified Stock Option

Participant acknowledges that Participant has received, read and understood the Plan and the Option Agreement. Participant agrees to abide by and be bound by their terms and conditions. Participant understands that Participant may suffer adverse tax consequences as a result of Participant’s purchase or disposition of the Shares. Participant represents that Participant has consulted with any tax consultants Participant deems advisable in connection with the purchase or disposition of the Shares and that Participant is not relying on the Company for any tax advice. The Plan and Option Agreement are incorporated herein by reference. This Exercise Notice, the Plan and the Option Agreement constitute the entire agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof.

 

ACCEPTED BY:     SUBMITTED BY:
SAFEWAY INC.    
By:         By:    
Print Name:         Print Name:    
Title:         Address:    
         

FORM OF EXERCISE NOTICE

Effective as of today,                     , 20            , the undersigned (“Participant”) hereby elects to exercise Participant’s option to purchase the number of shares of common stock specified below (the “Shares”) of Safeway Inc., a Delaware corporation (the “Company”), under and pursuant to the Safeway Inc. 2007 Equity and Incentive Award Plan (the “Plan”), the Stock Option Grant Notice dated as of             , 20             and the Stock Option Agreement attached thereto (the “Option Agreement”). Capitalized terms used herein without definition shall have the meanings given in the Plan and, if not defined in the Plan, the Option Agreement.

 

Grant Date:

    ________________________________________________

Number of Shares as to which Option is Exercised:

    ________________________________________________

Exercise Price per Share:

    $____________

Total Exercise Price:

    $____________

Certificate to be issued in name of:

    __________________________________________

Payment delivered herewith:

   

$______________ (Representing the full exercise

price for the Shares, as well as any applicable withholding tax)

Form of Payment:_____________________

                                         (Please specify)

 

Type of Option:

       ¨    Incentive Stock Option        ¨    Non-Qualified Stock Option

Participant acknowledges that Participant has received, read and understood the Plan and the Option Agreement. Participant agrees to abide by and be bound by their terms and conditions. Participant understands that Participant may suffer adverse tax consequences as a result of Participant’s purchase or disposition of the Shares. Participant represents that Participant has consulted with any tax consultants Participant deems advisable in connection with the purchase or disposition of the Shares and that Participant is not relying on the Company for any tax advice. The Plan and Option Agreement are incorporated herein by reference. This Exercise Notice, the Plan and the Option Agreement constitute the entire agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof.

 

ACCEPTED BY:

SAFEWAY INC.

     SUBMITTED BY:
By:         By:    
Print Name:         Print Name:    
Title:         Address:    
         

These excerpts taken from the SWY 10-Q filed Jul 23, 2007.

FORM OF EXERCISE NOTICE

Effective as of today,                          , 20    , the undersigned (“Participant”) hereby elects to exercise Participant’s option to purchase the number of shares of common stock specified below (the “Shares”) of Safeway Inc., a Delaware corporation (the “Company”), under and pursuant to the Safeway Inc. 2007 Equity and Incentive Award Plan (the “Plan”), the Stock Option Grant Notice dated as of                     , 20     and the Stock Option Agreement attached thereto (the “Option Agreement”). Capitalized terms used herein without definition shall have the meanings given in the Plan and, if not defined in the Plan, the Option Agreement.

 

Grant Date:   

 

Number of Shares as to which Option is Exercised:   

 

Exercise Price per Share:    $                    
Total Exercise Price:    $                    
Certificate to be issued in name of:   

 

Payment delivered herewith:    $                     (Representing the full exercise price for the Shares, as well as any applicable withholding tax)
  

Form of Payment:                                                                  

                                                   (Please specify)

Type of Option:                ¨  Incentive Stock Option        ¨  Non-Qualified Stock Option

Participant acknowledges that Participant has received, read and understood the Plan and the Option Agreement. Participant agrees to abide by and be bound by their terms and conditions. Participant understands that Participant may suffer adverse tax consequences as a result of Participant’s purchase or disposition of the Shares. Participant represents that Participant has consulted with any tax consultants Participant deems advisable in connection with the purchase or disposition of the Shares and that Participant is not relying on the Company for any tax advice. The Plan and Option Agreement are incorporated herein by reference. This Exercise Notice, the Plan and the Option Agreement constitute the entire agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof.

 

ACCEPTED BY:

SAFEWAY INC.

     SUBMITTED BY:
By:  

 

     By:  

 

Print Name:  

 

     Print Name:  

 

Title:  

 

      
      Address:  

 

       

 

FORM OF EXERCISE NOTICE

Effective as of today,                          , 20    , the undersigned (“Participant”) hereby elects to exercise Participant’s option to purchase the number of shares of common stock specified below (the “Shares”) of Safeway Inc., a Delaware corporation (the “Company”), under and pursuant to the Safeway Inc. 2007 Equity and Incentive Award Plan (the “Plan”), the Stock Option Grant Notice dated as of                         , 20     and the Stock Option Agreement attached thereto (the “Option Agreement”). Capitalized terms used herein without definition shall have the meanings given in the Plan and, if not defined in the Plan, the Option Agreement.

 

Grant Date:   

 

Number of Shares as to which Option is Exercised:   

 

Exercise Price per Share:    $                    
Total Exercise Price:    $                    
Certificate to be issued in name of:   

 

Payment delivered herewith:    $                     (Representing the full exercise price for the Shares, as well as any applicable withholding tax)
  

Form of Payment:                                                                  

                                                   (Please specify)

Type of Option:                ¨  Incentive Stock Option        ¨  Non-Qualified Stock Option

Participant acknowledges that Participant has received, read and understood the Plan and the Option Agreement. Participant agrees to abide by and be bound by their terms and conditions. Participant understands that Participant may suffer adverse tax consequences as a result of Participant’s purchase or disposition of the Shares. Participant represents that Participant has consulted with any tax consultants Participant deems advisable in connection with the purchase or disposition of the Shares and that Participant is not relying on the Company for any tax advice. The Plan and Option Agreement are incorporated herein by reference. This Exercise Notice, the Plan and the Option Agreement constitute the entire agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof.

 

ACCEPTED BY:

SAFEWAY INC.

     SUBMITTED BY:
By:  

 

     By:  

 

Print Name:  

 

     Print Name:  

 

Title:  

 

      
      Address:  

 

       

 

These excerpts taken from the SWY 8-K filed May 18, 2007.

FORM OF EXERCISE NOTICE

Effective as of today,                     ,    , 20    , the undersigned (“Participant”) hereby elects to exercise Participant’s option to purchase the number of shares of common stock specified below (the “Shares”) of Safeway Inc., a Delaware corporation (the “Company”), under and pursuant to the Safeway Inc. 2007 Equity and Incentive Award Plan (the “Plan”), the Stock Option Grant Notice dated as of                     , 20     and the Stock Option Agreement attached thereto (the “Option Agreement”). Capitalized terms used herein without definition shall have the meanings given in the Plan and, if not defined in the Plan, the Option Agreement.

 

Grant Date:    __________________________________________
Number of Shares as to which Option is Exercised:    __________________________________________
Exercise Price per Share:    $                    
Total Exercise Price:    $                    
Certificate to be issued in name of:    __________________________________________
Payment delivered herewith:   

$                     (Representing the full exercise price for the Shares, as well as any applicable withholding tax)

 

Form of Payment:                                                                      

                                                        (Please specify)

Type of Option: Non-Qualified Stock Option

Participant acknowledges that Participant has received, read and understood the Plan and the Option Agreement. Participant agrees to abide by and be bound by their terms and conditions. Participant understands that Participant may suffer adverse tax consequences as a result of Participant’s purchase or disposition of the Shares. Participant represents that Participant has consulted with any tax consultants Participant deems advisable in connection with the purchase or disposition of the Shares and that Participant is not relying on the Company for any tax advice. The Plan and Option Agreement are incorporated herein by reference. This Exercise Notice, the Plan and the Option Agreement constitute the entire agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof.

 

ACCEPTED BY: SAFEWAY INC.     SUBMITTED BY:
By:  

 

     By:  

 

Print Name:  

 

     Print Name:  

 

Title:  

 

      
      Address:  

 

       

 

FORM OF EXERCISE NOTICE

Effective as of today,                          , 20    , the undersigned (“Participant”) hereby elects to exercise Participant’s option to purchase the number of shares of common stock specified below (the “Shares”) of Safeway Inc., a Delaware corporation (the “Company”), under and pursuant to the Safeway Inc. 2007 Equity and Incentive Award Plan (the “Plan”), the Stock Option Grant Notice dated as of                     , 20     and the Stock Option Agreement attached thereto (the “Option Agreement”). Capitalized terms used herein without definition shall have the meanings given in the Plan and, if not defined in the Plan, the Option Agreement.

 

Grant Date:    __________________________________________
Number of Shares as to which Option is Exercised:    __________________________________________
Exercise Price per Share:    $                    
Total Exercise Price:    $                    
Certificate to be issued in name of:    __________________________________________
Payment delivered herewith:   

$                     (Representing the full exercise price for the Shares, as well as any applicable withholding tax)

Form of Payment:                                                          

                                                    (Please specify)

 

Type of Option:    ¨    Incentive Stock Option            ¨    Non-Qualified Stock Option

Participant acknowledges that Participant has received, read and understood the Plan and the Option Agreement. Participant agrees to abide by and be bound by their terms and conditions. Participant understands that Participant may suffer adverse tax consequences as a result of Participant’s purchase or disposition of the Shares. Participant represents that Participant has consulted with any tax consultants Participant deems advisable in connection with the purchase or disposition of the Shares and that Participant is not relying on the Company for any tax advice. The Plan and Option Agreement are incorporated herein by reference. This Exercise Notice, the Plan and the Option Agreement constitute the entire agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof.

 

ACCEPTED BY:

SAFEWAY INC.

       SUBMITTED BY:
By:  

 

       By:  

 

Print Name:  

 

       Print Name:  

 

Title:  

 

        
        Address:  

 

         

 

EXCERPTS ON THIS PAGE:

8-K (2 sections)
Feb 18, 2009
10-Q (2 sections)
Jul 23, 2007
8-K (2 sections)
May 18, 2007

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