Document

The Compensation Committee (the “Committee”) of the Board of Directors (the “Board”) of Jack in the Box Inc., a Delaware corporation (the “Company”), which administers the Company’s 2004 Stock Incentive Plan, as amended from time to time (the “Plan”), has granted you as of the Grant Date an award of Performance Shares as defined in Section 2 (the “Award”), on the terms and conditions set forth in this Performance Share Award Agreement (the “Agreement”) entered into effective as of the Grant Date. Capitalized terms that are not defined herein shall have the definition given to them in the Plan.

2.PERFORMANCE SHARE AWARD. Your Award of [# PSUs Granted] Performance Shares (“PSUs”) is based on target achievement of PSU performance goals (“Performance Goals”). Each Performance Share represents an unfunded and unsecured promise of the Company to deliver a share of the Company’s Common Stock (“Stock”) to you upon vesting, subject to the requirements set forth herein. The actual number of shares of Stock issued to you, if any, is a function of the extent to which PSU performance goals established by the Committee are attained within the Performance Period (as the term is defined in Section 4 herein). Except as described in Section 5(b), this Award is contingent on your continued Service with the Company or a Subsidiary Corporation from the Grant Date through the end of the Performance Period.

3.VESTING. Your Award shall become vested upon the achievement, if any, of Performance Goals for the Performance Period (as the term is defined in Section 4 herein), the achievement of which shall be determined by the Committee after the end of the Performance Period (the, “Vesting Date”), and at which time you will receive one share of Stock for each vested PSU, subject to tax withholding as described in Section 7. No portion of the Award shall become vested at any time prior to the date the Committee certifies achievement of the Performance Goals for the Performance Period.

4.PERFORMANCE PERIOD. The full Performance Period for the PSU award shall be the period that begins [Three Fiscal-Year Performance Period Dates], (the “Performance Period”), notwithstanding that annual goals may be established at the beginning of each fiscal year in the Performance Period at the Committee’s discretion.

(a)General. Except as set forth in paragraph (b) below, if your Service terminates for any reason prior to the last date of the Performance Period, the PSU Award will be forfeited to the Company immediately and automatically upon your termination of Service without payment of any consideration for the PSUs, and you will have no further right, title or interest in or to such PSUs or the underlying shares of Stock.

(b)Termination due to Death, Disability, or Retirement. If you cease to provide Service to the Company or a Subsidiary Corporation due to your death, Disability, or Retirement, prior to the last date of the Performance Period, but no earlier than one year after the Grant Date, unvested PSUs shall become vested and payable at the end of the Performance Period based solely on the level of achievement of Performance Goals as determined by the Committee, multiplied by a fraction, the numerator of which is the number of full accounting periods you continuously provided Service to the Company or a Subsidiary Corporate during the Performance Period, and the denominator of which is thirty-nine (39) (the Company divided each of its fiscal years into 13 “accounting periods” of four or five weeks each). For purposes of this Agreement: (i) “Disability” means a physical or mental condition that results in a total and permanent disability to such extent that you are eligible for disability benefits under the federal Social Security Act, and (ii) “Retirement” means your termination of employment for any reason, other than “for cause” (as determined by the Board in its sole discretion), on or after age 55 with 10 or more full years of continuous Service with the Company or a Subsidiary Corporation. Accelerated vesting in accordance with the foregoing will only occur if your termination of Service is also a “separation from service” as defined in Section 409A of the Code.

Subject to the provisions of this Agreement, including Sections 14 and 22(f) the Company shall deliver to you through a Company-designated brokerage firm, within 30 days following the applicable PSU Vesting Date, a number of shares of Stock equal to the number of PSUs that became vested on such Vesting Date (the “Award Shares”), net of any tax withholding.

(a)You will generally recognize taxable income equal to the Fair Market Value of the Award Shares on the date the shares of Stock are issued. This amount is subject to all applicable income taxes, FICA, state disability insurance, and any other similar payroll taxes (“Withholding Obligation”). The Company will withhold any Withholding Obligation from the shares of Stock delivered, and the net balance will be settled in whole shares of Stock. The Withholding Obligation generated by issuing the shares to you will be reported on your W-2.

(b)By accepting this Award, you hereby elect, effective on the date you accept this Award, to sell shares of Stock issued in respect of the Award in an amount determined in accordance with this Section, and to allow the Agent, as defined below, to remit the cash proceeds of such sales to the Company as set forth below (a “Sell to Cover”) to permit you to satisfy the Withholding Obligation to the extent the Withholding Obligation is not otherwise satisfied pursuant to the provisions of Section 7(c) below and further acknowledge and agree to the following provisions:

(1)Sell on the open market at the then prevailing market price(s), on your behalf, as soon as practicable on or after the date on which the shares of Stock are delivered to you pursuant to Section 4 hereof in connection with the vesting of the PSUs, the number (rounded up to the next whole number) of shares of Stock sufficient to generate proceeds to cover (A) your Withholding Obligation arising from the vesting of the PSUs and the related issuance of shares of Stock that is not otherwise satisfied pursuant to Section 7(c) hereof and (B) all applicable fees and commissions due to, or required to be collected by, the Agent with respect thereto;

(ii)You acknowledge that your election to Sell to Cover and the corresponding authorization and instruction to the Agent set forth in this Section is intended to comply with the requirements of Rule 10b5-1(c)(1) under the Exchange Act and to be interpreted to comply with the requirements of Rule 10b5-1(c) under the Exchange Act (your election to Sell to Cover and the provisions of this Section, collectively, the “10b5-1 Plan”). You acknowledge that by accepting this Award, you are adopting the 10b5-1 Plan to permit your satisfaction of your Withholding Obligation. You hereby authorize the Company and the Agent to cooperate and communicate with one another to determine the number of shares of Stock that must be sold pursuant to this Section to satisfy your obligations hereunder.

(iii)You acknowledge that the Agent is under no obligation to arrange for the sale of Stock at any particular price under this 10b5-1 Plan and that the Agent may effect sales as provided in this 10b5-1 Plan in one or more sales and that the average price for executions resulting from bunched orders may be assigned to your account. In addition, you acknowledge that it may not be possible to sell shares of Stock as provided for in this 10b5-1 Plan and in the event of the Agent’s inability to sell shares of Stock, you will continue to be responsible for the timely payment to the Company of all federal, state, local and foreign taxes that are required by applicable laws and regulations to be withheld.

(iii)Withholding shares of Stock from the shares of Stock issued or otherwise issuable to you in connection with the Award with a Fair Market Value (measured as of the date shares of Stock are issued pursuant to Section 4) equal to the amount of the Withholding Obligation; provided, however, that the number of such shares of Stock so withheld shall not exceed the amount necessary to satisfy the Company’s required tax withholding obligations using the minimum statutory withholding rates for federal, state, local and foreign tax purposes, including payroll taxes, that are applicable to supplemental taxable income.

8.STOCK HOLDING REQUIREMENT. As a condition to receipt of this Award, you hereby acknowledge and agree to be bound by applicable stock holding requirements that require you to hold and not transfer under any circumstance until your stock ownership requirement is met (“hold until met”): 50% (rounded to the nearest whole share) of the total shares of Stock issued to you pursuant to vesting of this Award (such percentage applying to Award Shares, net of any portion withheld to satisfy your Withholding Obligation).

10.CLAWBACK/RECOVERY. This Award (and any compensation paid or shares of Common Stock issued under this Award) will be subject to recoupment in accordance with any clawback that the Company is required to adopt pursuant to the listing standards of any national securities exchange or association on which the Company’s securities are listed or as is otherwise required by the Dodd-Frank Wall Street Reform and Consumer Protection Act or other applicable law. No recovery of compensation under such a clawback policy will be an event giving rise to a right to resign for “good reason” or “constructive termination” (or similar term) under any agreement with the Company.

11.LEGALITY. The Company is not required to issue any shares of Stock subject to this Award unless and until all applicable requirements of the Securities and Exchange Commission (the “SEC”), the California Department of Corporations or other regulatory agencies having jurisdiction with respect to such issuance, and any exchanges upon which the Stock may be listed, shall have been fully complied with. If shares of Stock subject to this Award are being distributed subject to restrictions or if the rules and interpretations of the SEC so require, such shares may be issued only if you represent and warrant in writing to the Company that the shares are being acquired for investment and not with a view to the distribution thereof, and any certificates issued upon distribution of the shares shall bear appropriate legends setting forth the restrictions on transfer of such shares. Such legends may not be removed until the Company so requests, based on the opinion of the Company’s Counsel that the restrictions are no longer applicable.

12.ADJUSTMENTS IN STOCK; DISSOLUTION OR LIQUIDATION. Subject to the provisions of the Plan, if the outstanding shares of Stock of the class subject to this Award are increased or decreased, or are changed into or exchanged for a different number or kind of shares or securities as a result of one or more reorganizations, recapitalizations, stock splits, reverse stock splits, stock dividends and the like, appropriate adjustments, to be conclusively determined by the Committee, shall be made in the number and/or type of shares or securities subject to this Award and any fractional shares resulting from adjustments will be rounded down to the nearest whole number. Upon the dissolution or liquidation of the Company, the Award will terminate in full for no consideration.

14.EFFECT OF CHANGE IN CONTROL. Treatment of Award. Notwithstanding the terms set forth in the Plan, in the event of a Change in Control, and subject to your continued Service with the Company or Subsidiary Corporation through such date, your Award shall vest effective as of the date of the Change in Control (except as otherwise provided in this Agreement). For this purpose, the final value of your Award shall be determined by (a) with respect to any completed fiscal year periods during the Performance Period, the extent to which the applicable Performance Goals for such periods have been attained during such periods, if measurable and (b) with respect to fiscal year periods which have not been completed as of the date of the Change in Control (or fiscal year periods described in (a) for which performance is not measurable), the pre-established 100% level with respect to each Performance Target comprising the applicable Performance Goals for such period. Any acceleration of the Award in accordance with the foregoing shall be conditioned upon the consummation of the Change in Control.

15.PLAN CONTROLS. The Award and all terms and conditions set forth in this Agreement are subject in all respects to the terms and conditions of the Plan, which is incorporated herein by reference, as may be amended from time to time, (but no amendment to the Plan shall adversely affect your rights under this Award). In the event of any conflict between the Plan and this Agreement, the Plan will control. The Plan is administered by the Committee and its decisions and interpretations with regard to the Award and this Agreement shall be final, binding and conclusive on all interested parties.

20.ELECTRONIC DELIVERY OF DOCUMENTS. By signing this Agreement, you (i) hereby agree to participate in the Plan through an on-line or electronic system established and maintained by the Company or another third party designated by the Company; (ii) consent to the electronic delivery of this Agreement, all information with respect to the Plan and the Award, and any reports of the Company provided generally to the Company’s stockholders; and (iii) acknowledge that you may receive from the Company a paper copy of any documents delivered electronically at no cost to you by contacting the Company.

21.DATA PRIVACY. You acknowledge and agree that the Company may collect and use your personal information to implement and administer the Award. This personal information may include, without limitation, your employee identification number; first and last names; home and other physical address; email addresses; telephone and fax numbers; organization name, job title, and department name; reporting hierarchy; work history; performance ratings; and payroll information. You further acknowledge and agree that the Company may disclose such information to non-agent third parties assisting the Company in administering the Award.

(c)Except as otherwise expressly provided herein, this Agreement shall be binding upon and inure to the benefit of the Company, its successors and assigns, and you and your heirs, personal representatives, successors and assigns. If the Award is settled after your death, the Award shall be considered transferred to the person or persons (the “Heir”) to whom your rights under the Award passed by will or by the applicable laws of descent and distribution, as to all shares of Stock granted under this Award. It shall be the responsibility of the Heir to notify the Company of any changes in address.

(d)If any provision of this Agreement shall be invalid or unenforceable, such invalidity or unenforceability shall attach only to such provision and shall not in any manner affect or render invalid or unenforceable any other severable provision of this Agreement, and this Agreement shall be carried out as if any such invalid or unenforceable provision were not contained herein.

(f)This Agreement is intended to be exempt from Section 409A of the Code. Should any provision of this Agreement be found to be contrary to this intent, it shall be modified and given effect, in the sole discretion of the Committee and without requiring your consent (notwithstanding anything herein to the contrary), in such manner as the Committee determines to be necessary or appropriate to effectuate an exemption from Section 409A of the Code or comply therewith. The Company has no duty or obligation to minimize the tax consequences to you of this Award and shall not be liable for any adverse tax consequences to you arising in connection with this Award.

IN WITNESS WHEREOF, the Company has granted this Award and the Awardee has executed this Agreement, effective on the Grant Date. You are not required to accept the Award; provided, that if you do not accept the Award prior to the first Vesting Date, this Award and the PSUs granted hereunder will be null and void and you will have no rights thereto. By signing below, you confirm that you understand and agree that this Award is granted in exchange for you agreeing to be bound by this Agreement and the Plan.