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JACK IN THE BOX INC.
STOCK OPTION AND PERFORMANCE SHARE AWARD AGREEMENT
UNDER THE 2004 STOCK INCENTIVE PLAN
November 26, 2012
 «Name»
RECITALS



AGREEMENT


1CONSIDERATION.

OPTION AWARD
2.1 SHARES OPTIONED; OPTION PRICE.«Total_Shares»
$27.49
2.2OPTION TERM; EXERCISABILITY. 


 
 
 
2.3 EXERCISE DATES. 

 
 



2.4 EXERCISING THE OPTION.



 

2.5 PAYMENT OF EXERCISE PRICE. 


2.6TERMINATION OF EMPLOYMENT.