With the following unilateral and irrevocable act:

[Company Name] company, with legal offices in [Address and Country], represented by [Full Name], as [Qualification],

in the herein act simply named also as «Promissor»,

promises to acquire, in once or in different payments,

from [Full Name], born in [Place], on the [Date of birth] and residing in [Address and Country],

later on simply named also as «Promisee»,

shares issued by [Company Name] company, with legal offices in [Address and Country],

later on simply named also as «Issuer»,

subscribed by the Promisee for a nominal value of [Amount] [Currency],

on the following particular conditions:

1) the put option right can be asserted for the nominal, total or partial amount of the shares held by the Promisee and issued by the Issuer;

2) the Promisee can assert the put option right after 6, 12, 18, 24, 30, 36, 42, 48, 54, 60 months from the date of the shares the Issuer issued;

3) the written application for the enforcement of the put option right will have to be undersigned by the Promisee and will have to be delivered within fifteen days from the expiration of the periods indicated in previous point 2);

4) the application whom is mentioned in previous point 3) will have to carry the nominal value of the shares the right of put option has been exerted for;

5) the purchase price of the shares subject to the exertion of the right of put option (point3) is fixed from now on as equal to the nominal value of the shares subject of the application, added of the 5% if the put option right is exerted after 6 months, of the 11% after 12 months, of the 17% after 18 months, of the 24.5 % after 24 months, of the 33% after 30 months, of the 42.5 % after 36 months, of the 54% after 42 months, of the 67 % after 48 months, of the 82% after 54 months and of the 100% after 60 months from its subscription;

6) the payment of the shares, subject of the application for the exertion of the put option right, is carried out by the Promissor or who else on his behalf, on to the bank account indicated by the Promisee, with currency value fixed on the expiring date of the six-months period mentioned in previous point 2);

7) if the put option right hasn't been yet exerted it can be exerted in the following six-month periods, until the expiration of the 60 months provided by previous point 2);

8) any modification to the herein act can only be made through an agreement undersigned by the Promissor and the Promisee.

Place, date, stamp and signature of the Promissor.