Document:

Exhibit

41Exhibit 10.3
EMPLOYERS HOLDINGS, INC.
EQUITY AND INCENTIVE PLAN
FORM OF
RESTRICTED STOCK UNIT AGREEMENT

THIS RESTRICTED STOCK UNIT AGREEMENT (this "Agreement"), is made effective as of_______________, 20__ (the "Date of Grant"), between Employers Holdings, Inc. (the "Company") and the individual named as the grantee on the signature page hereto (the "Grantee"), pursuant to the Company Equity and Incentive Plan, as amended from time to time (the "Plan"), which is a part of this Agreement.  Capitalized terms not defined herein will have the meanings ascribed to such terms in the Plan.  To the extent that there is a conflict between the terms of the Plan and this Agreement, the terms of the Plan will govern.

1.Grant of Restricted Stock Units.  The Company hereby grants to the Grantee, __________________ Restricted Stock Units (the "RSUs").  The RSUs shall be subject to the terms and conditions set forth herein and, to the extent applicable, the Plan.

2.Vesting of Restricted Stock Units. 

(a)Subject to subsections 2(b), (c) and (d) below, the RSUs shall become vested as to 25% of the RSUs on March 15, 2018, and as to an additional 25% of the RSUs on each of the first three anniversaries of the first vesting date, provided that the Grantee has been continuously employed by the Company or any Subsidiary thereof through the relevant vesting dates and subject to accelerated vesting as set forth in Section 3 below and Section 7 of the Plan.

(b)Termination of Employment by Reason of Death or Disability.  If the Grantee's employment terminates by reason of death or the Grantee's total and permanent disability (as defined in any agreement between the Grantee and the Company or, if no such agreement is in effect, as determined by the Committee (or its delegate) in its good faith discretion, in accordance with the definition used by the Company’s then current Long Term Disability insurance carrier), then the RSUs shall become fully vested as of such date of termination.

(c)Termination by Reason of Retirement.   If the Grantee’s employment terminates by reason of the Grantee’s Retirement (as defined below), then 50% of the Grantee’s then unvested RSUs shall become vested as of the date of such termination and all of the Grantee’s remaining unvested RSUs shall cease to vest and shall be forfeited and cancelled as of the date of such termination, without consideration.  For purposes of this Agreement, “Retirement” shall mean the Grantee’s termination of employment after attaining age 60 and completing 10 years of continuous service with the Company (or any Subsidiary thereof), and provided (i) that the Grantee has given written notice of the Grantee’s intent to retire to the Company (or its designate), no fewer than six months prior to the date that the Grantee terminates employment, in a form satisfactory to the Company (or its designate); and (ii) that such termination of employment constitutes a “separation of employment” within the meaning of Section 409A of the Code (a “Separation of Service”). 

(d)Termination of Employment other than by Reason of Death, Retirement or Disability.  Subject to Section 3 below, if the Grantee's employment terminates for any reason other than by reason of death, Retirement or the Grantee's total and permanent disability, then all of the Grantee's unvested RSUs shall immediately be forfeited and canceled as of such date without consideration.

3.Change in Control Provisions.  In the event of a Change of Control:

(a)If RSUs Are Assumed.  If the RSUs are assumed or substituted for in connection with a Change in Control, then, upon the termination of the Grantee’s employment without Cause during the 24-month period following such Change in Control, (i) such RSUs shall become fully vested, (ii) any restrictions, payment conditions, and forfeiture conditions applicable to such RSUs shall lapse, and (iii) any performance conditions imposed with respect to such RSUs shall be deemed to be fully achieved.

(b)If RSUs Are Not Assumed.  With respect to outstanding RSUs that are not assumed or substituted in connection with a Change in Control, upon the occurrence of the Change in Control (i) such RSUs shall become fully vested, (ii) any restrictions, payment conditions, and forfeiture conditions applicable to any such RSUs shall lapse, and (iii) any performance conditions imposed with respect to such RSUs shall be deemed to be fully achieved. Notwithstanding the foregoing, no settlement or distribution under this Agreement that constitutes an item of “deferred compensation” under Section 409A of the Code, and that becomes payable by reason of such Change in Control shall be made to the Grantee until a termination 

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of the Grantee’s employment that constitutes a Separation from Service or, if earlier, the death of the Grantee, and no such settlement or distribution of deferred compensation shall be made to the Grantee prior to the earlier of (a) the expiration of the six month period measured from the date of the Grantee’s Separation from Service, and (b) the date of the Grantee’s death, if (i) the Grantee is deemed at the time of such Separation from Service to be a “specified employee” within the meaning of that term under Section 409A of the Code and (ii) such delayed commencement is otherwise required to avoid an “additional tax” under Section 409A of the Code.  

(c)Definition of Assumed or Substituted For.  For purposes of this Section 3, RSUs shall be considered assumed or substituted for if, following the Change in Control, such RSUs remain subject to the same terms and conditions that were applicable to such units immediately prior to the Change in Control, except that such units confer the right to receive, for each such unit the consideration (whether stock, cash or other securities or property) received in the Change in Control by holders of shares of Stock for each share of Stock held on the effective date of the Change in Control (and if holders were offered a choice of consideration, the type of consideration chosen by the greatest number of holders of the outstanding shares).  Such assumption or substitution shall comply with the applicable provisions of Section 409A of the Code.

(d)Discretionary Cashout.  Notwithstanding any other provision of the Plan or this Agreement, in the event of a Change in Control that constitutes a change in the ownership or effective control of the Company or in the ownership of a substantial portion of the assets of the Company within the meaning of Section 409A of the Code, the Committee may, in its discretion, provide that upon the occurrence of such Change in Control, the RSUs shall be cancelled in exchange for a payment in an amount equal to (i) the consideration paid per share of Stock in such Change in Control multiplied by (ii) the number of RSUs granted hereunder that had not been settled as of such date.  Such payment shall be made within 30 days following such Change in Control; provided, however, that if such payment constitutes an item of “deferred compensation” under Section 409A of the Code, no settlement or distribution under this Agreement that constitutes an item of “deferred compensation” under Section 409A of the Code, and that becomes payable by reason of such Change in Control shall be made to the Grantee until a termination of the Grantee’s employment that constitutes a Separation from Service or, if earlier, the death of the Grantee, and no such settlement or distribution of deferred compensation shall be made to the Grantee prior to the earlier of (a) the expiration of the six month period measured from the date of the Grantee’s Separation from Service, and (b) the date of the Grantee’s death, if (i) the Grantee is deemed at the time of such Separation from Service to be a “specified employee” within the meaning of that term under Section 409A of the Code and (ii) such delayed commencement is otherwise required to avoid an “additional tax” under Section 409A of the Code.  

4.Settlement of RSUs and Section 409A Provisions.  Unless otherwise provided in Section 3 above or in the Plan, including, without limitation, by reason of a Change in Control, the RSUs shall be settled in whole shares of Stock (i.e., the Grantee shall receive one share of Stock for each RSU) within 30 days following the date such RSUs become vested, subject to any provision of this Agreement or the Plan that may delay such settlement by reason of Section 409A of the Code.  Consistent with the foregoing, no settlement or distribution under this Agreement that constitutes an item of “deferred compensation” under Section 409A of the Code, and that becomes payable by reason of the termination of the Grantee’s employment hereunder shall be made to the Grantee unless and until the termination of the Grantee’s employment constitutes a Separation from Service, and no such settlement or distribution of deferred compensation shall be made to the Grantee prior to the earlier of (a) the expiration of the six month period measured from the date of the Grantee’s Separation from Service, and (b) the date of the Grantee’s death, if (i) the Grantee is deemed at the time of such Separation from Service to be a “specified employee” within the meaning of that term under Section 409A of the Code and (ii) such delayed commencement is otherwise required to avoid an “additional tax” under Section 409A of the Code.  All settlements and payments that are delayed pursuant to the immediately preceding sentence shall be paid to the Grantee upon expiration of such six month period (or if earlier, upon the Grantee’s death).  Each individual settlement or payment under this Agreement shall be a “separate payment” for purposes of Section 409A of the Code, and notwithstanding the foregoing provisions of this Agreement, to the extent permitted under Section 409A of the Code, any separate settlement or payment under this Agreement shall not be “deferred compensation” subject to Section 409A and the six month delay described above, to the extent provided or permitted in any applicable exception or provision under Section 409A of the Code.

5.No Right to Continued Employment.  Neither the Plan nor this Agreement shall be construed as giving the Grantee the right to continue in the employ or service of the Company or any Subsidiary thereof or to be entitled to any remuneration or benefits not set forth in the Plan, this Agreement or other agreement or to interfere with or limit in any way the right of the Company or any such Subsidiary to terminate such Grantee's employment.  Nor does this Agreement constitute an employment contract.

6.Legend on Certificates.  The certificates representing the whole shares of Stock issued in settlement of the RSUs that are delivered to the Grantee pursuant to Section 4 of this Agreement shall be subject to such stop transfer orders and other restrictions as the Committee may determine is required by the rules, regulations, and other requirements of the Securities 

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and Exchange Commission, any stock exchange upon which such shares of Stock are listed, any applicable federal or state laws or the Company's Certificate of Incorporation and Bylaws, and the Committee may cause a legend or legends to be put on any such certificates to make appropriate reference to such restrictions.

7.Transferability.  An RSU may not be assigned, alienated, pledged, attached, sold or otherwise transferred or encumbered by the Grantee otherwise than by will or by the laws of descent and distribution, and any such purported assignment, alienation, pledge, attachment, sale, transfer or encumbrance shall be void and unenforceable against the Company or any Subsidiary thereof; provided that the designation of a beneficiary shall not constitute an assignment, alienation, pledge, attachment, sale, transfer or encumbrance. 

8.Tax Withholding.   The Company shall have the power and the right to deduct or withhold from the grant of RSUs, or require the Grantee or beneficiary to remit to the Company, an amount sufficient to satisfy federal, state, and local taxes, domestic or foreign, required by law or regulation to be withheld with respect to any taxable event arising as a result of this Agreement.  Without limiting the foregoing, the Company shall be entitled to require, as a condition of delivery of the shares of Stock in settlement of the RSUs, that the Grantee agree to remit an amount in cash sufficient to satisfy all then current and/or estimated future federal, state and local withholding, and other taxes relating thereto.  Payment of any dividend equivalents will be net of such federal, state, and local withholding taxes.

9.Securities Laws.  Upon the acquisition of any shares of Stock pursuant to the settlement of the RSUs, the Grantee will make or enter into such written representations, warranties and agreements as the Committee may reasonably request in order to comply with applicable securities laws or with this Agreement.

10.Notices.  Any notice under this Agreement shall be addressed to the Company in care of the Chief Legal Officer, addressed to the principal executive office of the Company and to the Grantee at the address last appearing in the records of the Company for the Grantee or to either party at such other address as either party hereto may hereafter designate in writing to the other.  Any such notice shall be deemed effective upon receipt thereof by the addressee.

11.Governing Law.  This Agreement shall be governed by and construed in accordance with the laws of the State of Nevada, without regard to the conflicts of laws provisions thereof.

12.Acknowledgement.  By entering into this Agreement the Grantee agrees and acknowledges that the Grantee has received and read a copy of the Plan.   

13.No Stockholder Rights.  Subject to Section 14 below, the Grantee shall have no rights of a stockholder of the Company with respect to the RSUs, including, but not limited to, the rights to vote until the date of issuance of a stock certificate for such shares of Stock. 

14.Dividend Equivalents.  The Grantee shall be credited with a dividend equivalent for each dividend or distribution made prior to each vesting date with respect to the shares of Stock covered by then-outstanding RSUs.  The amount of each dividend equivalent shall be equal to the amount of the applicable dividend or distribution.  The dividend equivalents shall be subject to the same terms and conditions, and shall be payable in cash (without interest) when the underlying RSU becomes payable.  If the underlying RSU does not vest or is forfeited, any dividend equivalents with respect to the underlying RSU will also fail to vest and be forfeited.

15.Repayment Upon Restatement; Clawbacks Generally.  In the event the Company is required to restate any of its financial statements, the Company may (i) require the Grantee to repay to the Company the aggregate Fair Market Value of any RSUs that were settled or any dividend equivalents that were paid or (ii) cancel any outstanding RSUs or any dividend equivalents.  In addition, the RSUs shall be subject to such other repayment, clawback or similar provisions as may be required by the terms of the Plan or applicable law or applicable policy in effect from time to time.

16. Section 409A Compliance. It is intended that this Agreement shall comply with the provisions of section 409A of the Code so as not to subject the Grantee to the payment of additional taxes or interest under section 409A of the Code.  In furtherance of this intent, this Agreement shall be interpreted, operated, and administered in a manner consistent with these intentions, and to the extent that any regulations or other guidance issued under section 409A of the Code would result in the Grantee being subject to payment of additional income taxes or interest under section 409A of the Code, the Grantee and the Company agree to amend this Agreement the extent feasible to avoid the application of such taxes or interest under section 409A of the Code. 
17.Amendment.  This Agreement may not be amended, terminated, suspended or otherwise modified except in a written instrument duly executed by both parties.

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18.Entire Agreement.  This Agreement (and the other writings incorporated by reference herein) constitute the entire agreement between the parties with respect to the subject matter hereof and supersede all prior written or oral negotiations, commitments, representations and agreements with respect thereto

19.Signature in Counterparts.  This Agreement may be signed in counterparts, each of which shall be an original, with the same effect as if the signatures thereto and hereto were upon the same instrument. 
IN WITNESS WHEREOF, this Agreement has been executed and delivered by the parties hereto.
	
	
	EMPLOYERS HOLDINGS, INC.

	
		
	By:
	 

	 
	Douglas D. Dirks

	 
	President and Chief Executive Officer

	 
	 

	 
	 

	 
	GRANTEE

	 
	 

	 
	Insert name of Grantee

4EX-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, [To Be Determined on
April 28]% 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 $[To Be Determined on April 28]. 
 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 

  
 2 

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

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 

  
 3 

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

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

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

		
		 	 
		 	 [Name]

		 	 [Title]

 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. 
  

	
	
	 
	 [Name]

	
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:	 	 

 
					
		 		 	 [Name]

		 		 	 [Title]

 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.

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