Document:

EX-4.1

 Exhibit 4.1 

CITIBANK CREDIT CARD ISSUANCE TRUST 

Citiseries 
 Class
2017-A5 Notes 
 Issuer Certificate 

Pursuant to Sections 202 and 301(h) of the Indenture 

Reference is made to the Second Amended and Restated Indenture dated as of September 26, 2000, as amended and restated as of
August 9, 2011, and as further amended and restated as of November 10, 2016, between Citibank Credit Card Issuance Trust (the “Issuer”) and Deutsche Bank Trust Company Americas, as trustee (as so further amended and restated, the
“Indenture”). Capitalized terms used herein that are not otherwise defined have the meanings set forth in the Indenture. All references herein to designated Sections are to the designated Sections of the Indenture. 

Section 301(h) provides that the Issuer may from time to time create a tranche of Notes either by or pursuant to an Issuer Certificate
setting forth the principal terms thereof. Pursuant to this Issuer Certificate, there is hereby created a tranche of Notes having the following terms: 

Series Designation: Citiseries. This series is included in Group 1. 

Tranche Designation: $1,100,000,000 Floating Rate Class 2017-A5 Notes of April 2024 (Legal Maturity Date April 2026) (hereinafter, the “Class
2017-A5 Notes”) 
 Currency: The Class 2017-A5 Notes will be payable, and denominated, in Dollars. 

Denominations: The Class 2017-A5 Notes will be issuable in minimum denominations of $100,000 and multiples of $1,000 in excess of that amount. 

Issuance Date: May 2, 2017 
 Initial Principal
Amount: $1,100,000,000 
 Issue Price: 100% 

Interest Rate: The Class 2017-A5 Notes will accrue interest with respect to any interest period at a per annum rate equal to the Class 2017-A5 Note
Rate for such interest period, calculated on the basis of the actual number of days in such interest period divided by 360. The “Class 2017-A5 Note Rate” means, with respect to the first interest period, 1.64224% per annum and, with
respect to each interest period thereafter, a per annum rate equal to LIBOR for such interest period plus 0.62%. 
 The Issuer will determine LIBOR for each
applicable interest period on the second business day before the beginning of that interest period. For purposes of calculating LIBOR, a business day is any day on which dealings in deposits in U.S. Dollars are transacted in the London interbank
market. 

 “LIBOR” means, as of any date of determination, the rate for deposits in U.S. Dollars for the
Designated Maturity (commencing on the first day of the relevant interest period) which appears on the Reuters Screen LIBOR01 Page as of 11:00 a.m., London time, on such date. If such rate does not appear on the Reuters Screen LIBOR01 Page, the rate
for that day will be determined on the basis of the rates at which deposits in U.S. Dollars are offered by the Reference Banks at approximately 11:00 a.m., London time, on that day to prime banks in the London interbank market for the Designated
Maturity (commencing on the first day of the relevant interest period). The Issuer will request the principal London office of each of the Reference Banks to provide a quotation of its rate. If at least two such quotations are provided, the rate for
that day will be the arithmetic mean of the quotations. If fewer than two quotations are provided as requested, the rate for that day will be the arithmetic mean of the rates quoted by major banks in New York City, selected by the Issuer, at
approximately 11:00 a.m., New York City time, on that day for loans in U.S. Dollars to leading European banks for a period of the Designated Maturity (commencing on the first day of the relevant interest period). 

“Reuters Screen LIBOR01 Page” means the display page currently so designated on the Reuters Monitor Money Rates service (or such other page
as may replace that page on that service or any successor service for the purpose of displaying comparable rates or prices). 
 “Designated
Maturity” means one month. 
 “Reference Banks” means four major banks in the London interbank market selected by the Issuer. 

Scheduled Interest Payment Dates: The 22nd day of each month, beginning June 2017. 

Each payment of interest on the Class 2017-A5 Notes will include all interest accrued from and including the preceding Interest Payment Date — or, for
the first interest period, from and including the Issuance Date — to and including the day preceding the current Interest Payment Date, plus any interest accrued but not previously paid. 

The first deposit targeted to be made to the Interest Funding sub-Account for the Class 2017-A5 Notes will be on the June 21, 2017 Interest Deposit Date
and in an amount equal to $2,559,157.33. 
 Expected Principal Payment Date: April 22, 2024 

Legal Maturity Date: April 22, 2026 
 Monthly
Principal Date: For the month in which the Expected Principal Payment Date occurs, April 22, 2024, and for each other month, the 22nd day of such month, or if such day is not a Business Day, the next following Business Day. 

Required Subordinated Amount of Class B Notes: $65,812,010.00 

Required Subordinated Amount of Class C Notes: $87,749,310.00 

  
 2 

 Controlled Accumulation Amount: $91,666,666.67 

Form of Notes: The Class 2017-A5 Notes will be issued as Global Notes. The Global Notes will initially be registered in the name of Cede &
Co., as nominee of The Depository Trust Company, and will be exchangeable for individual Notes only in accordance with the provisions of Section 204(c). 

Additional Issuances of Class 2017-A5 Notes: The Issuer may at any time and from time to time issue additional Class 2017-A5 Notes, subject to the
satisfaction of (i) the conditions precedent set forth in Section 311(a) and (ii) the following conditions: 
  

	 	(a)	The Issuer has obtained written confirmation from each Rating Agency that there will be no Ratings Effect with respect to the then outstanding Class 2017-A5 Notes as a result of the issuance of such additional Class
2017-A5 Notes; 

  

	 	(b)	As of the date of issuance of the additional Class 2017-A5 Notes, all amounts due and owing to the Holders of the then outstanding Class 2017-A5 Notes have been paid and there is no Nominal Liquidation Amount Deficit
with respect to the then outstanding Class 2017-A5 Notes; 

  

	 	(c)	The additional Class 2017-A5 Notes will be fungible with the original Class 2017-A5 Notes for federal income tax purposes; 

  

	 	(d)	If Holders of the then outstanding Class 2017-A5 Notes have the benefit of a Derivative Agreement, the Issuer will have obtained a Derivative Agreement for the benefit of the Holders of the additional Class 2017-A5
Notes; and 

  

	 	(e)	The ratio of the Controlled Accumulation Amount to the Initial Dollar Principal Amount of the Class 2017-A5 Notes, including the additional Class 2017-A5 Notes, will be equal to the ratio of the Controlled Accumulation
Amount (before giving effect to the additional issuance) to the Initial Dollar Principal Amount of the Class 2017-A5 Notes, excluding the additional Class 2017-A5 Notes. 

As of the date of issuance of additional Class 2017-A5 Notes, the Outstanding Dollar Principal Amount and Nominal Liquidation Amount of the Class 2017-A5
Notes will be increased to reflect the Initial Dollar Principal Amount of the additional Class 2017-A5 Notes. 
 Any outstanding Class 2017-A5 Notes and any
additional Class 2017-A5 Notes will be equally and ratably entitled to the benefits of the Indenture without preference, priority or distinction. 

Optional Redemption Provisions other than Section 1202 “Clean-Up Call”: None 

Additional Early Redemption Events or changes to Early Redemption Events: None 

Additional Events of Default or changes to Events of Default: None 

  
 3 

 Business Day: means any day other than (a) a Saturday or Sunday or (b) any other day on which
national banking associations or state banking institutions in New York, New York or South Dakota, or any other state in which the principal executive offices of any Additional Seller are located, are authorized or obligated by law, executive order
or governmental decree to be closed. 
 Securities Exchange Listing: None 

  
 4 

 The Class 2017-A5 Notes shall have such other terms as are set forth in the form of Note attached
hereto as Exhibit A. Pursuant to Section 202, the form of Note attached hereto has been approved by the Issuer. 
  

			
	CITIBANK CREDIT CARD ISSUANCE TRUST
		
	By	 	 Citibank, N.A.,
 as Managing
Beneficiary

		
		 	/s/ Douglas C. Morrison
		 	Douglas C. Morrison
		 	Vice President

 Dated: May 2, 2017 

  
 5 

 Citiseries 

Class 2017-A5 Notes 

Reference is made to the resolutions adopted by the Board of Directors of Citibank, N.A. on January 25, 2017. The resolutions authorize
Citibank, N.A. from time to time to issue and sell, or to arrange for or participate in the issuance and sale of, one or more series and/or classes of pass-through certificates, participation certificates, commercial paper, notes, bonds or other
securities representing ownership interests in, or backed or secured by, pools of credit card receivables or interests therein (the “Receivables”) in an aggregate principal amount such that up to $45,000,000,000 of such certificates,
commercial paper, notes, bonds or other securities are outstanding at any one time and to sell, transfer, convey, assign or pledge or grant a security interest in all or any portion of its Receivables to Citibank Credit Card Master Trust I, Citibank
Omni Trust or any direct or indirect subsidiaries of Citibank, N.A., affiliates of Citigroup Inc., additional trusts or other entities or trustees in connection therewith on such terms as to be determined by the Citibank, N.A. Securitization Pricing
and Loan Committee (the “Pricing and Loan Committee”). 
 The undersigned, a duly authorized member of the Pricing and Loan
Committee, on behalf of such Pricing and Loan Committee, does hereby certify that the preceding Issuer Certificate, the terms of the tranche of Notes set forth in and to be created by the Issuer Certificate and the increase in the Invested Amount of
the Collateral Certificate resulting from the issuance of such Notes have been approved by such Pricing and Loan Committee. In addition, the following underwriting/selling agent terms with respect to this tranche of Notes have been approved by the
Pricing and Loan Committee: 
 Issue Price: 100% 

Underwriting Commission: 0.325% 

Proceeds to Issuer: 99.675% 

Representative of the Underwriters: Citigroup Global Markets Inc. 

The preceding Issuer Certificate and this certification of Pricing and Loan Committee approval shall be, continuously from the time of their
execution, official records of Citibank, N.A. 
  

	
	/s/ Douglas C. Morrison
	Douglas C. Morrison
	Member of the Securitization Pricing and Loan Committee
	Citibank, N.A.

 Dated: May 2, 2017 

  
 6 

 Exhibit A 

FORM OF 
 CITISERIES 

FLOATING RATE CLASS 2017-A5 NOTES OF APRIL 2024 

(Legal Maturity Date April 2026) 
  

			
	$[    ],000,000	  	REGISTERED
	CUSIP No. 17305E GD1	  	No. R-[1][2][3]

 UNLESS THIS NOTE IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPOSITORY TRUST COMPANY, A NEW YORK
CORPORATION (“DTC”), TO THE ISSUER OR ITS AGENT FOR REGISTRATION OF TRANSFER, EXCHANGE OR PAYMENT, AND ANY NOTE ISSUED IS REGISTERED IN THE NAME OF CEDE & CO. OR IN SUCH OTHER NAME AS IS REQUESTED BY AN AUTHORIZED REPRESENTATIVE
OF DTC (AND ANY PAYMENT IS MADE TO CEDE & CO. OR TO SUCH OTHER ENTITY AS IS REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF DTC), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL INASMUCH AS THE
REGISTERED OWNER HEREOF, CEDE & CO., HAS AN INTEREST HEREIN. 
 THE PRINCIPAL OF THIS NOTE IS PAYABLE AS SET FORTH HEREIN AND IN THE
INDENTURE REFERRED TO BELOW. ACCORDINGLY, THE OUTSTANDING PRINCIPAL AMOUNT OF THIS NOTE AT ANY TIME MAY BE LESS THAN THE AMOUNT SHOWN ON THE FACE HEREOF. 

CITIBANK CREDIT CARD ISSUANCE TRUST 

CITISERIES 
 FLOATING RATE CLASS
2017-A5 NOTES OF APRIL 2024 
 (Legal Maturity Date April 2026) 

CITIBANK CREDIT CARD ISSUANCE TRUST, a trust formed and existing under the laws of the State of Delaware (including any successor, the “Issuer”),
for value received, hereby promises to pay to CEDE & CO., or its registered assigns, the principal amount of [    ] HUNDRED MILLION DOLLARS ($[    ],000,000). The Expected Principal Payment Date for
this Note is April 22, 2024. The Legal Maturity Date for this Note is April 22, 2026. 
 The Issuer hereby promises to pay interest on this Note
on the 22nd day of each month, beginning June 2017, until the principal of this Note is paid or made available for payment, subject to certain limitations set forth in the Indenture. Interest will accrue on the outstanding principal amount of this
Note for each interest period in an amount equal to the product of (i) the actual number of days in such interest period divided by 360, (ii) a rate per annum equal to the 

 
Class 2017-A5 Note Rate for such interest period, and (iii) the outstanding principal amount of this Note as of the preceding Interest Payment Date (after giving effect to any payments of
principal made on the preceding Interest Payment Date) or, with respect to the first Interest Payment Date, the initial principal amount of this Note. The Class 2017-A5 Note Rate will be determined as provided in the Indenture. 

If any Interest Payment Date or Principal Payment Date of this Note falls on a day that is not a Business Day, the required payment of interest or principal
will be made on the following Business Day. 
 This Note is one of the Citiseries, Class 2017-A5 Notes issued pursuant to the Second Amended and Restated
Indenture dated as of September 26, 2000, as amended and restated as of August 9, 2011, and as further amended and restated as of November 10, 2016 (as so further amended and restated and otherwise modified from time to time, the
“Indenture”) between the Issuer and Deutsche Bank Trust Company Americas, as Trustee. For purposes of this Note, the term “Indenture” includes any supplemental indenture or Issuer Certificate relating to the Citiseries, Class
2017-A5 Notes. This Note is subject to all of the terms of the Indenture. All terms used in this Note that are not otherwise defined herein and that are defined in the Indenture will have the meanings assigned to them therein. 

The principal of and interest on this Note are payable in such coin or currency of the United States of America as at the time of payment is legal tender for
payment of public and private debts. 
 Reference is made to the further provisions of this Note set forth on the reverse hereof, which will have the same
effect as though fully set forth on the face of this Note. 
 Unless the certificate of authentication hereon has been executed by the Trustee whose name
appears below by manual signature, this Note will not be entitled to any benefit under the Indenture, or be valid or obligatory for any purpose. 

 IN WITNESS WHEREOF, the Issuer has caused this instrument to be signed, manually or in facsimile, by an Issuer
Authorized Officer. 
  

					
	CITIBANK CREDIT CARD ISSUANCE TRUST
		
	By:    	 	 CITIBANK, N.A.,
 as Managing
Beneficiary of Citibank Credit Card Issuance Trust

			
		 	By:  	 	 
		 		 	Douglas C. Morrison
		 		 	Vice President

 Dated: May 2, 2017 

TRUSTEE’S CERTIFICATE OF AUTHENTICATION 

This is one of the Notes designated above and referred to in the within mentioned Indenture. 

 

			
	DEUTSCHE BANK TRUST COMPANY AMERICAS, as Trustee under the Indenture
		
	By:  	 	 
		 	 Authorized Signatory

 Dated: May 2, 2017 

 REVERSE OF NOTE 

This Note is one of a duly authorized issue of Notes of the Issuer, designated as its Citiseries Floating Rate Class 2017-A5 Notes of April 2024 (Legal
Maturity Date April 2026) (herein called the “Notes”), all issued under an Indenture, to which Indenture reference is hereby made for a statement of the respective rights and obligations thereunder of the Issuer, the Trustee and the
Holders of the Notes. 
 This Note ranks pari passu with all other Class A Notes of the same series, as set forth in the Indenture. This Note is
secured to the extent, and by the collateral, described in the Indenture. 
 The Issuer will pay interest on overdue interest as set forth in the Indenture
to the extent lawful. 
 Each Holder by acceptance of this Note, and each owner of a beneficial interest in this Note by acceptance of a beneficial interest
in this Note, agrees that no recourse may be taken, directly or indirectly, with respect to the obligations of the Issuer or the Trustee on the Notes, against the Issuer, the Issuer Trustee, Citibank, N.A., the Trustee or any affiliate, officer,
employee or director of any of them, and the obligation of the Issuer to pay principal of or interest on this Note or any other amount payable to the Holder of this Note will be subject to Article V of the Indenture. 

Each Holder by acceptance of this Note, and each owner of a beneficial interest in this Note by acceptance of a beneficial interest in this Note, in each case
other than Citibank, N.A. as Holder or owner, agrees that this Note is intended to be debt of Citibank, N.A. for federal, state and local income and franchise tax purposes, and agrees to treat this Note accordingly for all such purposes, unless
otherwise required by a taxing authority. 
 Each Holder by acceptance of this Note, and each owner of a beneficial interest in this Note by acceptance of a
beneficial interest in this Note, agrees that it will not at any time institute against the Issuer, or join in any institution against the Issuer of, any bankruptcy, reorganization, arrangement, insolvency or liquidation proceeding, or other
proceedings under any United States federal or state bankruptcy or similar law in connection with any obligations relating to this Note, the Indenture or any Derivative Agreement. 

This Note and the Indenture will be construed in accordance with and governed by the laws of the State of New York. 

Certain amendments may be made to the Indenture without the consent of the Holder of this Note. This Note must be surrendered for final payment of principal
and interest. 

 ASSIGNMENT 

Social Security or taxpayer I.D. or other identifying number of 

assignee:                        
             
 FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto

  

					
		 	 	 	
			
		 	 	 	
		 	(name and address of assignee)	 	

 the within Note and all rights thereunder, and hereby irrevocably constitutes and appoints
                                         
                                         
                                         
             , attorney, to transfer said Note on the books kept for registration thereof, with full power of substitution in the premises. 

 
  

									
					
	Dated:  	 	 	 		 	 	 	*
		 		 		 	Signature Guaranteed:	 	

  

	*	NOTE: The signature to this assignment must correspond with the name of the registered owner as it appears on the face of the within Note in every particular without alteration, enlargement or any change whatsoever.Exhibit

Exhibit 10.1

THE WESTERN UNION COMPANY 
    PERFORMANCE-BASED RESTRICTED STOCK UNIT AWARD NOTICE
Pursuant to The Western Union Company 2015 Long-Term Incentive Plan (the “Plan”), ________________ (“Executive”) has been granted the Performance-Based Restricted Stock Unit Award described below (the “Award”).  Certain terms and conditions of the Award are set forth immediately below in this Award Notice.  Other terms and conditions are set forth in the Performance-Based Restricted Stock Unit Award Agreement which is appended to this Award Notice.  The Award Notice and the Performance-Based Restricted Stock Unit Award Agreement are together the “Agreement” which is made and entered into between The Western Union Company, a Delaware corporation (the “Company”), and Executive as of the Grant Date.  Capitalized terms not otherwise defined in this Award Notice are defined in the Plan or the Performance-Based Restricted Stock Unit Award Agreement.  
	
		
	Grant Date:
	February 21, 2017

	Target Award:
Maximum Award:
	___ shares of Common Stock
___ shares of Common Stock

	Performance Period:
	January 1, 2017 – December 31, 2019

	Performance Measure:
	$1,500,000,000 Combined Consolidated Operating Income

	Vesting Date:
	Third anniversary of Grant Date

	
		
	 
	 

	 
	THE WESTERN UNION COMPANY,

	 
	a Delaware corporation

	 
	 

	 
	By:      _______________________________

	 
	          Name: _________________________

	 
	          Title:   _________________________

	 
	 

	 
	 

	 
	 

                            

1

THE WESTERN UNION COMPANY 2015 LONG-TERM INCENTIVE PLAN

PERFORMANCE-BASED RESTRICTED STOCK UNIT AWARD AGREEMENT --  
TERMS AND CONDITIONS – U.S. SECTION 16 OFFICER

		
	1.
	Pursuant to The Western Union Company 2015 Long-Term Incentive Plan (the “Plan”), The Western Union Company (the “Company”) hereby grants to you (“Executive”) an award of Restricted Stock Units (the “Units”), in the amount specified in Executive’s Award Notice (which forms part of this Agreement) as of the Grant Date specified in Executive’s Award Notice, related to shares of Common Stock (“Shares”), subject to the terms and conditions set forth in this Agreement and the Plan.  The terms of the Plan are hereby incorporated in this Agreement by this reference and made a part hereof.  Capitalized terms not defined herein shall have the same definitions as set forth in the Plan.

		
	2.
	Each Unit shall provide for the issuance and transfer to Executive of one Share upon lapse of the restrictions set forth in paragraph 3 below and subject to the satisfaction of the Performance Measure during the Performance Period set forth in the Award Notice and the Committee’s determination of the amount of the Award payable to Executive in accordance with Exhibit A.  Upon issuance and transfer of Shares to Executive following the Restriction Period (as defined herein), Executive shall have all rights incident to ownership of such Shares, including but not limited to voting rights and the right to receive dividends. 

		
	3.
	Subject to other provisions of this Agreement and the terms of the Plan, on the third anniversary of the Grant Date, subject to the satisfaction of the Performance Measure during the Performance Period set forth in the Award Notice and the Committee’s determination of the amount of the Award payable to Executive in accordance with Exhibit A, all restrictions on the Units shall lapse and the number of Shares subject to the Units determined by the Committee to be transferred to Executive in accordance with Exhibit A shall be issued and transferred to Executive.  Effective on and after such date, subject to applicable laws and Company policies, Executive may hold, assign, pledge, sell, or transfer the Shares transferred to Executive in Executive’s discretion.  The three-year period in which the Units may be forfeited by Executive is defined as the “Restriction Period.”

Notwithstanding the foregoing provisions in this paragraph 3, Executive will forfeit all rights to the Units unless Executive accepts these Terms and Conditions either through on-line electronic acceptance (if permitted by the Company) or by signing and returning to the Company a copy of these Terms and Conditions on or before the 90th day following the Grant Date.  Signed copies of these Terms and Conditions should be sent to the attention of: Western Union Stock Plan Administration, 12510 E. Belford Avenue, M21B3, Englewood, Colorado  80112.  In addition, notwithstanding any other provision of the Plan or this Agreement, in order for the restrictions on the Units to lapse, Executive must execute and return to the Company or accept electronically an updated restrictive covenant agreement (and exhibits) if requested by the Company which may contain certain noncompete, nonsolicitation and/or nondisclosure provisions.  Failure to execute or electronically accept such an agreement on or before the 90th day following the Grant Date will cause the Units to be forfeited and cancelled by the Company without any payment to Executive.  

2

Prior to the issuance and transfer of Shares upon vesting, the Units will represent only an unfunded and unsecured obligation of the Company.  Any Shares determined by the Committee to be transferred to Executive in accordance with Exhibit A shall be issued and transferred to Executive as soon as administratively practicable after the end of the Restriction Period, and in no event later than March 15 of the calendar year immediately following the year in which the award ceases to be subject to a substantial risk of forfeiture.  If at any time the Company determines, in its discretion, that the listing, registration or qualification of the Shares upon any securities exchange or under any foreign, state or federal law, or the consent or approval of any governmental authority is necessary or desirable as a condition to the issuance and transfer of Shares to the Executive (or Executive’s estate), such issuance and transfer will not occur unless and until such listing, registration, qualification, consent or approval will have been effected or obtained.
		
	4.
	Subject to the last sentence of this paragraph 4, Executive may elect to satisfy Executive’s obligation to advance the amount of any required income or other withholding taxes  (the “Required Tax Payments”) incurred in connection with the Award by any of the following means: (1) a cash payment to the Company, (2) delivery (either actual delivery or by attestation procedures established by the Company) to the Company of Common Stock having an aggregate Fair Market Value, determined as of the Tax Date, equal to the amount necessary to satisfy any such obligation, (3) authorizing the Company to withhold whole Shares which would otherwise be delivered to Executive having an aggregate Fair Market Value, determined as of the Tax Date, or withhold an amount of cash which would otherwise be payable to Executive, equal to the amount necessary to satisfy any such obligation, (4) a cash payment to the Company by a broker-dealer acceptable to the Company to whom Executive has submitted an irrevocable notice of sale, or (5) any combination of (1) and (2).  The Company shall have sole discretion to disapprove of an election pursuant to any of clauses (1)-(5) for any employee who is not an “officer” as defined in Rule 16a-1(f) under the Securities Exchange Act of 1934. 

Executive acknowledges that the ultimate liability for all Required Tax Payments legally due by Executive is and remains Executive’s responsibility and may exceed the amount actually withheld by the Company and/or Executive’s employer.  Executive further acknowledges that the Company and/or Executive’s employer (i) make no representations or undertakings regarding the treatment of any Required Tax Payments in connection with any aspect of the Units, including the grant of the Units, the vesting of the Units, the conversion of the Units into Shares, and the subsequent sale of any Shares acquired at vesting; and (ii) do not commit to structure the terms of the grant or any aspect of the Units to reduce or eliminate Executive’s tax liability.
To avoid negative accounting treatment, the Company may withhold or account for Required Tax Payments by considering applicable minimum statutory withholding rates.  If the obligation for Required Tax Payments is satisfied by withholding in Shares, for tax purposes, Executive is deemed to have been issued the full number of Shares due to Executive at vesting, notwithstanding that a number of Shares are held back solely for the purpose of paying the Required Tax Payments due as a result of any aspect of Executive’s participation in the Plan.  Finally, Executive shall pay to the Company or Executive’s employer any amount of Required Tax Payments that the Company or Executive’s employer may be required to withhold as a result of Executive’s receipt of the Units, the vesting of the Units, or the conversion of the vested Units to Shares that cannot be satisfied by the means previously described.  The Company may refuse to issue Shares to Executive if Executive fails to comply with his obligations in connection with the Required Tax Payments as described herein.

3

		
	5.
	The Units may not be sold, assigned, transferred, pledged, or otherwise disposed of, except by will or the laws of descent and distribution, while subject to restrictions.  If Executive or anyone claiming under or through Executive attempts to make any such sale, transfer, assignment, pledge or other disposition of Units in violation of this paragraph 5, such attempted violation shall be null, void, and without effect.

		
	6.
	Executive shall forfeit Executive’s right to any unvested Units if Executive’s continuous employment with the Company or a Subsidiary or Affiliate terminates for any reason during the Restriction Period (except solely by reason of a period of Related Employment or as set forth in paragraphs 7 and 9).

		
	7.
	Except to the extent paragraph 9 applies, if Executive’s employment with the Company or a Subsidiary or Affiliate terminates involuntarily and without Cause on or after the first anniversary of the Grant Date, subject to Executive’s timely execution of an agreement and release in a form acceptable to the Company which will include restrictive covenants and a comprehensive release of all claims, Executive will be entitled to a prorated Award.  Such prorated Award shall be equal to the amount of the Award which is actually earned, based upon satisfaction of the Performance Measure during the Performance Period (as certified by the Committee in writing) and the Committee’s determination of the amount of the Award payable to Executive in accordance with Exhibit A, multiplied by a fraction, the numerator of which shall equal the number of days Executive was employed with the Company during the Restriction Period and the denominator of which shall equal the number of days in the Restriction Period.  Such prorated Award shall be paid at the same time as if Executive had remained employed with the Company through the end of the Restriction Period.  If Executive’s employment with the Company or a Subsidiary or Affiliate terminates involuntarily and without Cause before the first anniversary of the Grant Date (other than on account of death or Disability), and paragraph 9 does not apply, Executive shall not be entitled to a prorated Award.   

If Executive’s employment with the Company or a Subsidiary or Affiliate terminates by reason of death or Disability, the Award shall be paid, to the extent earned, based upon satisfaction of the Performance Measure  during the Performance Period (as certified by the Committee in writing) and the Committee’s determination of the amount of the Award payable to Executive in accordance with Exhibit A, to Executive or Executive’s executor, administrator, legal representative, beneficiary or similar person (together, the “Beneficiary”), as the case may be, as if Executive had remained employed with the Company through the end of the Restriction Period.  
If Executive’s employment with the Company or a Subsidiary or Affiliate terminates by reason of Retirement, Executive shall be entitled to a prorated Award.  Such  prorated Award shall be equal to the amount of the Award which is actually earned, based upon satisfaction of the Performance Measure during the Performance Period (as certified by the Committee in writing) and the Committee’s determination of the amount of the Award payable to Executive in accordance with Exhibit A, multiplied by a fraction, the numerator of which shall equal the number of days Executive was employed with the Company during the Restriction Period and the denominator of which shall equal the number of days in the Restriction Period.  Such prorated Award shall be paid at the same time as if Executive had remained employed with the Company through the end of the Restriction Period.    

4

		
	8.
	During the Restriction Period, Executive (and any person succeeding to Executive’s rights pursuant to the Plan) will have no ownership interest or rights in Shares underlying the Units, including no rights to receive dividends or other distributions made or paid with respect to such Shares or to exercise voting or other shareholder rights with respect to such Shares.  Executive shall not be entitled to receive dividend equivalents in connection with this Award.  

		
	9.
	If Executive’s employment is terminated by the Company, a Subsidiary or an Affiliate involuntarily and without Cause (or otherwise terminates for an eligible reason according to the terms of the Company severance policy applicable to Executive as of the effective date of a Change in Control (if any)) during the 24-month period commencing on the effective date of the Change in Control, then, subject to the terms of any severance policy applicable to Executive as of the effective date of the Change in Control, the Award shall be paid to Executive, to the extent earned, based upon satisfaction of the Performance Measure during the Performance Period (as certified by the Committee in writing) and in accordance with Exhibit A, as if Executive had remained employed with the Company through the end of the Restriction Period.

		
	10.
	The terms of this Agreement may be amended from time to time by the Committee in its sole discretion in any manner that it deems appropriate; provided, however, that no such amendment shall adversely affect in a material manner any right of Executive under this Agreement without Executive’s written consent.  

		
	11.
	Any action taken or decision made by the Company, the Board, or the Committee or its delegates arising out of or in connection with the construction, administration, interpretation or effect of the Plan or this Agreement shall lie within its sole and absolute discretion, as the case may be, and shall be final, conclusive and binding on Executive and all persons claiming under or through Executive.  By accepting this grant of Units or other benefit under the Plan, Executive and each person claiming under or through Executive shall be conclusively deemed to have indicated acceptance and ratification of, and consent to, any action taken under the Plan by the Company, the Board or the Committee or its delegates.

		
	12.
	This grant of Units is discretionary, non-binding for future years and there is no promise or guarantee that such grants will be offered to Executive in future years.

		
	13.
	The Company is not providing any tax, legal or financial advice, nor is the Company making any recommendations regarding Executive’s participation in the Plan, or Executive’s acquisition or sale of the Shares underlying the Units.  Executive is hereby advised to consult with his or her own personal tax, legal and financial advisors regarding his or her participation in the Plan before taking any action related to the Plan.

		
	14.
	The validity, construction, interpretation, administration and effect of these Terms and Conditions and the Plan and rights relating to the Plan and to this Agreement, shall be governed by the substantive laws, but not the choice of law rules, of the State of Delaware, as provided in the Plan.  For purposes of litigating any dispute that arises directly or indirectly under the grant of the Units or the Agreement, the parties hereby submit to and consent to the jurisdiction of the State of Colorado, and agree that such litigation shall be conducted in the courts of Douglas County, or the federal courts for the United States for the District of Colorado, where this grant is made and/or to be performed.

5

		
	15.
	If one or more provisions of this Agreement shall be held invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby and the invalid, illegal or unenforceable provisions shall be deemed null and void; however, to the extent permissible by law, any provisions which could be deemed null and void shall first be construed, interpreted or revised retroactively to permit this Agreement to be construed as to foster the intent of this Agreement and the Plan.

		
	16.
	Notwithstanding anything in this Agreement to the contrary, this Award, and any related payments, are subject to the provisions of (i) the Company’s Clawback Policy, as in effect on the Grant Date and as may be modified to comply with applicable law, rules, regulations or governmental orders or judgments, and (ii) any clawback, repayment or recapture policy implemented or adopted by the Company after the Grant Date to comply with applicable law, rules, regulations or governmental orders or judgments. 

		
	17.
	To the extent any amounts under this Agreement are payable by reference to Executive’s “termination of employment,” such term shall be deemed to refer to Executive’s “separation from service,” within the meaning of Section 409A of the Code.  Notwithstanding any other provision in this Agreement, if Executive is a “specified employee,” as defined in Section 409A of the Code, as of the date of Executive’s separation from service, then to the extent any amount payable under this Agreement (i) constitutes the payment of nonqualified deferred compensation, within the meaning of Section 409A of the Code, (ii) is payable upon Executive’s separation from service and (iii) under the terms of this Agreement would be payable prior to the six-month anniversary of Executive’s separation from service, such payment shall be delayed until the earlier to occur of (a) the six-month anniversary of the separation from service or (b) the date of Executive’s death. In addition, to the extent any amount payable under this Agreement (i) constitutes the payment of nonqualified deferred compensation, within the meaning of Section 409A of the Code, and (ii) such payment is conditioned upon Executive’s execution of a release and is to be paid or provided during a designated period that begins in one taxable year and ends in a second taxable year, such payment shall be paid or provided in the later of the two taxable years. 

	
		
	I hereby confirm that the foregoing and the documents attached hereto are hereby in all respects accepted and agreed to by the undersigned as of the date of this Agreement:

	 

	

Signature:_________________________

	

Printed Name: ______________________

	Date:       ________________________________
	 

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