EX1A-6 MAT CTRCT 29 f1a2016ex6xvii_myomoinc.htm FORM OF MANAGEMENT INCENTIVE PLAN LETTER BETWEEN THE COMPANY AND THE EXECUTIVE OFFICER

Exhibit 6.17

January 2016

Employee Name

Dear X:

The Board of Director s of Myomo, Inc. (the "Company") has adopted the Myomo, Inc. Management Incenti ve Plan (the "Plan") to induce certain employees and other se rvice providers to continue their service to the Company and to encourage suc h individual s to exert their very be st effort toward th e completion of a potential sa le of th e Company. The Company i s pleased to invite you to participate in the Plan and to offer you an award in accordance with the term s of this letter and the Plan as of the date first set forth above.

The terms of the Plan are detailed in the copy of the Plan that has been provided to you, and those terms are incorporated in and made a part this letter. As described in more detail in the Plan, the Plan entitles you to a portion of a Bonus Pool to be created upon the occurrence of a Change in Control. Your share of the Bonus Pool will be 25% percent of such Bonus Pool. As detailed in the Plan, in order to be eligible to receive a Bonus under the Plan, you must:

(i) sign and return this letter;

(ii) be employe d by or otherwise providing services to the Company on the date of the Change in Control or have been terminated by the Company without Cause within two months prior to such Change in Control;

(iii) deliver an effective general release of claims in favor of the Company and related person s and entities in a form and manner sa tisfactory to the Company (the "Release") and any re vocat ion period applicable to such Releas e must hav e expired on or within 60 days after the Change in Control; and

(iv) d e liv e r such other docum e nts as may be required by the Company under the terms of the Plan.

Myomo, Inc.● One Broadway, 14th Floor ● Cambridge ● MA 02142

Tel. 617.996.9058 ● Fax. 617.886.0333

This l ette r and th e Plan constitute th e en tire agreement between yo u and th e Company w ith respect to the subject matter hereof a nd supersede in all r espects any and all prior agreements (oral or written) between you a nd the Company concerning s uch s ubject matter. In th e eve nt of a conflict between the terms of thi s letter and the terms of the Plan, the terms of th e Plan sha ll govern yo ur Bonus.

By signing below, you ac knowled ge (i) yo ur participation in the Plan, (ii) that you hav e received and read a copy of the Plan (and agree to keep confidential the terms and conditions of the Plan) and (iii) that yo u agree that any Bonus is subject to all of the terms and conditions of the Plan and this letter.

Congratu l ations on bein g se lected to participat e in the Plan.

| Myomo, Inc.
| By: |
| Name: |
| Title: |

AGREED TO AND ACCEPTED |
Employee Name |

Myomo, Inc. ● One Broadway, 14th Floor ● Cambridge ● MA 02142

Tel. 617.996.9058 ● Fax. 617.886.0333