Can the form be signed electronically?

Yes. Under the ESIGN Act (15 U.S.C. ch. 96) and UETA, electronic signatures are valid for most consent forms provided intent, consent, attribution, and record retention are satisfied.

Is notarization required?

Generally no for internal equity consents, but some states or specific plan documents may require notarization; verify state rules and plan terms before finalizing.

What happens if an employee misses the deadline?

If the employee fails to return the form by the stated deadline, the employer may treat it as non-acceptance; check plan rules for grace periods or discretionary extensions.

How should signed forms be stored?

Store as tamper-evident PDFs with audit trails and backup copies; follow IRS, HIPAA, and internal retention policies applicable to your organization.

Do signed consents affect tax reporting?

Potentially. Repricing can change tax timing and withholding; coordinate with finance to determine reporting impact on W-2 or 1099 forms.

How to correct a submitted form?

If an error is found, complete a corrective consent or amendment and have all affected parties sign; keep both original and correction for the audit trail.

Electronic Signature
Templates
HR
HR Option Repricing Consent Form

HR Option Repricing Consent Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

HR OPTION REPRICING CONSENT FORM

Employee Name: Employee ID:

Position: Department:

Reporting Manager: Hire Date:

Original Option Grant

Grant Date: Grant Agreement Reference/ID:

Total Number of Options Granted: Original Exercise Price (per share): $

Original Vesting Schedule

Proposed Repricing Terms

Effective Date of Repricing:

New Exercise Price (per share): $ Number of Options Affected:

Revised Vesting or Other Material Terms Consideration to Employee (if any)

Employee Acknowledgments and Certifications

By checking the boxes below and signing this Consent, the Employee acknowledges and agrees to the following statements:

I acknowledge that this Consent amends the terms of the original Option Agreement to the extent set forth herein and that the amended terms shall govern the affected options upon effectiveness of this Consent.

I have been advised that the repricing may have tax consequences to me, including potential ordinary income and withholding obligations, and I accept responsibility for any taxes or reporting required as a result of this repricing.

I acknowledge that the Company is not providing tax or legal advice and that I have had the opportunity to obtain independent tax and legal advice before executing this Consent.

I voluntarily consent to the repricing and agree to execute any additional documents reasonably necessary to effectuate the amendment to the Option Agreement.

Employee Comments (optional)

Legal Notices

This Consent, when executed by the Employee, constitutes a binding amendment to the Option Agreement solely with respect to the options and terms described above. Except as expressly amended by this Consent, all other terms and conditions of the underlying Option Agreement and any applicable equity plan remain in full force and effect. The Company makes no representation regarding the tax treatment of the repricing.

The Employee acknowledges that acceptance of this Consent is voluntary and that the Employee may decline to accept the repricing, subject to any company policies or deadlines communicated separately. Any deadlines for acceptance are set forth by the Company in a separate notice.

Employment Information (Required)

Full Legal Name Home Address Phone Email

Employment History

Employer 1 — Company Name

Title: Dates Employed: From To

Responsibilities Reason for Leaving Employer 2 — Company Name

Title: Dates Employed: From To

Responsibilities Reason for Leaving

Education

Highest Degree Institution Graduation Date

References

Reference 1 Reference 2 Reference 3

Legal Disclosures

At-Will Employment Statement: Employment with the Company is at-will unless otherwise expressly provided in a written agreement signed by an authorized representative of the Company. Nothing in this Consent or the equity plan shall alter or modify the at-will employment relationship.

Equal Opportunity Statement: The Company provides equal employment opportunities to all employees and applicants without regard to protected characteristics. This Consent is administered consistent with applicable employment laws and Company policy.

Authorization and Background Checks

I authorize the Company and its agents to contact my previous employers, references, and any other parties identified in this form for purposes related to my employment and this Consent.

I authorize the Company to conduct background checks and verifications as permitted by law. I certify that the information provided in this form is true and complete to the best of my knowledge.

Applicant Certification

I certify that all information provided in this Consent and accompanying materials is true, accurate, and complete. I understand that false or misleading information may result in disciplinary action, up to and including termination. By signing below, I agree to be bound by the amended terms described herein and acknowledge that I have read and understood this document.

Printed Name:

Signature:

Date:

What the HR Option Repricing Consent Form Is

The HR Option Repricing Consent Form documents an employee's agreement to revised terms when an employer elects to reprice outstanding stock options or grants. It records key modifications — for example, a reduced exercise price, new vesting schedule, or modified expiration — and creates an auditable record that both parties sign. Employers typically use the form to confirm consent required under the equity plan, to update payroll and tax withholding instructions, and to preserve corporate governance and securities-compliance evidence in case of audits or future disputes.

Why a Clear Consent Form Matters

A well-drafted HR Option Repricing Consent Form protects both the employer and employee by documenting consent, clarifying financial effects, and creating a reproducible record for tax and compliance purposes.

Who typically completes and approves this form

Several internal and external stakeholders interact with repricing consent forms during the review and execution process.

Human resources and equity administrators — prepare notices, track elections, update plan records and payroll systems.
Employees and option holders — review revised terms, decide whether to accept, and provide a dated signature of consent.
Legal and finance teams — confirm plan compliance, tax treatment, and corporate approvals before final execution.

Clear role separation reduces processing delays and helps ensure the final signed form meets governance, tax, and securities requirements.

Step-by-step: Completing a Repricing Consent Form

Follow these steps to complete and record the employee election accurately.

01

Review Notice: Read the repricing summary, effective date, and new option terms before deciding.
02

Confirm Eligibility: Verify grant identifiers, award date, and vesting status match company records.
03

Make Election: Indicate acceptance or rejection, and specify any required payment elections.
04

Sign & Date: Provide a dated signature and return by the stated deadline.

Typical online workflow configuration

Configure fields and routing to match your internal approval steps and audit requirements.

Field	Configuration
Signature Field	Required, signer must date
Checkbox Field	Required for acceptance option
Grant ID Field	Alphanumeric, exact match validation
Routing Logic	Send to HR → Finance → Legal sequentially

Digital signing and file-format requirements

Choose a platform that supports secure fields, audit trails, and the file formats your records team needs.

Supported Formats: PDF, DOCX, HTML
Authentication Options: Email, SMS code, or stronger
Integrations: HRIS and payroll systems

Ensure the chosen solution provides tamper-evident signed PDFs, a complete audit trail, and integrations to update payroll and equity ledgers automatically.

Where to send the completed form

Route final signed copies to each team that must update records or confirm tax treatment.

HRIS / Payroll: Upload a signed PDF so payroll updates reflect new exercise prices.
Equity Administration: Send to the stock plan administrator for ledger and cap table updates.
Finance: Provide copy for tax withholding and accounting adjustments.
Legal: Store executed consents for governance and securities compliance.

Typical timelines and processing expectations

Common deadlines and processing steps that affect elections, payroll, and tax reporting.

Election Period:

Employee must return consent by stated deadline, typically 14–30 days.

Effective Date:

New terms take effect on the stated MM/DD/YYYY; affects vesting and exercise timing.

Payroll Cutoff:

Submit signed form before payroll cutoff to apply withholding changes the same pay period.

Tax Reporting:

Repricing impacts 1099/W-2 reporting for the tax year when options are exercised or taxed.

Record Retention:

Retain executed forms per corporate and regulatory retention policies.

Common preparation and execution pitfalls

Using abbreviated or informal names that do not match payroll or equity records, causing reconciliation delays and potential tax errors.
Leaving effective dates or grant identifiers blank or inconsistent, which can invalidate the employer's ability to apply revised terms.
Failing to route signed copies to finance and the equity administrator, delaying withholding adjustments and ledger updates.
Accepting scanned image signatures without an accompanying audit trail or signer attribution, creating disputes over consent authenticity.

Key risks and consequences of incorrect forms

Tax Withholding Errors: May trigger corrected W-2s or 1099 obligations

Invalid Consent: Could render repricing unenforceable

Securities Noncompliance: Plan rule breaches risk corporate liability

Payroll Delays: Withholding and reporting may be postponed

Audit Exposure: Missing audit trail increases regulator scrutiny

Reputational Harm: Employee disputes can harm retention

Security and compliance controls to require

Encryption in Transit: TLS 1.2/1.3

Encryption at Rest: AES-256

Audit Trail: Timestamped actions recorded

Access Controls: Role-based permissions

HIPAA / BAA: BAA available if PHI present

Certifications: SOC 2 Type II, ISO 27001

Comparing eSignature vendors for HR Option Repricing Consent Forms

Common vendor features and pricing models to consider when selecting an eSignature provider for high-volume internal HR documents.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day trial	Varies	Varies	Varies	Varies
Bulk Send	Yes	Yes	Yes	Yes	Varies
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Real-world examples of consent form use

Two practical examples show how organizations use signed repricing consents to complete operational and compliance tasks.

Optica Ventures (COO)

Optica centralized repricing notices to reduce confusion and speed responses

streamlined electronic routing to HR and payroll
As COO Brian Fitzgibbons noted, a simple, easy-to-use interface made it easier for both staff and counterparties to complete the process reliably and quickly.

Xerox (NetSuite Director)

Xerox integrated signed consents into NetSuite to automate ledger updates

used conditional fields to capture differing plan provisions
Kodi-Marie Evans described improved flexibility and the ability to produce the right signed document in the right format for integrations.

Who is authorized to sign

Company Authorized Signatory — Chief People Officer

Typically an executive or delegated HR administrator signs on behalf of the company to accept plan amendments or to certify that repricing follows corporate approvals and equity-plan terms; their signature binds the company for administrative and accounting purposes.

Employee — Option Holder

The individual option holder must sign or electronically consent to the repricing terms to show assent; their dated signature creates the employee-level consent required under most equity-plan rules.

Frequently asked questions and troubleshooting

Answers to common questions about completing, signing, and storing HR Option Repricing Consent Forms.

Need help? Contact support

Can the form be signed electronically?
Yes. Under the ESIGN Act (15 U.S.C. ch. 96) and UETA, electronic signatures are valid for most consent forms provided intent, consent, attribution, and record retention are satisfied.
Is notarization required?
Generally no for internal equity consents, but some states or specific plan documents may require notarization; verify state rules and plan terms before finalizing.
What happens if an employee misses the deadline?
If the employee fails to return the form by the stated deadline, the employer may treat it as non-acceptance; check plan rules for grace periods or discretionary extensions.
How should signed forms be stored?
Store as tamper-evident PDFs with audit trails and backup copies; follow IRS, HIPAA, and internal retention policies applicable to your organization.
Do signed consents affect tax reporting?
Potentially. Repricing can change tax timing and withholding; coordinate with finance to determine reporting impact on W-2 or 1099 forms.
How to correct a submitted form?
If an error is found, complete a corrective consent or amendment and have all affected parties sign; keep both original and correction for the audit trail.

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