Document:

exhibit42

Exhibit 4.2     

 

3.   TYPE OF OWNERSHIP   Please select one ownership type and attach any applicable documentation.   CUSTODIAL OWNERSHIP         Third Party IRA Plan Custodian (Select IRA type)    Traditional IRA    SEP/IRA  Roth IRA              Other Custodial Relationship (Please specify)       NON-CUSTODIAL OWNERSHIP         A. Individual     B. Joint Tenant with Rights of Survivorship         C. Corporation: (Specify type – please check one)    S-Corporation  C-Corporation         D. Partnership    E. Trust    F. Pension Fund         G. Uniform Gift/Transfer to Minors (UGMA/UTMA)           UGMA/UTMA, State of  Minor’s Name         H. Transfer on Death    I. Other (Please specify)   When you open an account, you must provide your name, address, social security number, date of birth and other information that   will allow us to identify you. Jones Lang LaSalle Income Property Trust, Inc. (the “Company”) encourages all prospective investors   to consult with their investment advisor and read the Company’s prospectus, including all supplements and amendments thereto   (the “Prospectus”), prior to submitting this form. The Prospectus contains important information regarding the terms, conditions   and potential risks associated with an investment in the Company.   Reference #   Wire Date   Account #   Important information about opening an account:   1.  INVESTMENT   A. Initial Investment Amount   We do not accept cash, cashier’s checks/official bank checks, starter checks, foreign checks, money orders, third-party   checks or traveler’s checks.   $     (Minimum initial investment is $10,000)            Check this box if you are purchasing shares from a registered investment advisor or bank acting as a custodian in a   fee-only account. (Investment advisor listed in Section 10 must agree to this election and/or custodian information must be   included in section 4E.)       B. Payment will be made via: (Check one)           Wired Funds:         Enclosed Check         (Payable to Jones Lang LaSalle Income Property Trust, Inc.)   2.   ACCOUNT TYPE   The Jones Lang LaSalle Income Property Trust, Inc. offers for sale Class A and Class M shares. The Prospectus contains additional   information regarding the Class A and Class M share classes, including the different fees which are payable with respect to each   class. Please check the box below to indicate your purchase of Class A or M shares.           Class A Shares      Class M Shares    Check here if you are a registered representative or an immediate family member of a registered representative.    Check here if you are applying Rights of Accumulation.    

 

B. Joint Owner/Co-Investor (If applicable)   First Name    MI     Last Name    Gender:       Male        Female        Social Security Number / Tax ID Number    Date of Birth          (MM/DD/YYYY)      U.S. Address (No P.O. Boxes Accepted)          City      State     Zip Code    Email Address      U.S. citizen                Resident alien                Nonresident alien   A. Investor   First Name    MI     Last Name    Gender:       Male        Female        Social Security Number / Tax ID Number    Date of Birth    (MM/DD/YYYY)      U.S. Address (No P.O. Boxes Accepted)          City      State     Zip Code    Email Address      U.S. citizen                Resident alien                Nonresident alien   4.   INVESTOR INFORMATION   C. Transfer on Death Beneficiary Information (For accounts with rights of survivorship only)        (Whole % only. Additional Beneficiaries may be added on a separate sheet of paper.)   First Name    MI     Last Name   SSN    Date of Birth    (MM/DD/YYYY)            %   PRIMARY   First Name    MI     Last Name              %   SSN    Date of Birth    (MM/DD/YYYY)   First Name    MI     Last Name   SSN    Date of Birth    (MM/DD/YYYY)            %   SECONDARY   First Name    MI     Last Name              %   SSN    Date of Birth    (MM/DD/YYYY)   +   = 100%   +   = 100%    

 

D. Trust / Corporation / Partnership / Pension Fund / Other (If applicable)   (Sections 4A and 4B must also be completed with Trustee information if the investment is made on behalf of a Trust)      Name of Business Entity     Tax ID Number    Date of Trust    (MM/DD/YYYY)       E. Custodian Information (If applicable)   (Sections 4A and 4B must also be completed)      Name of Business Entity   Name of Custodian or Trustee        Address          City           State         Zip Code   Custodian Tax ID#    Custodian/Brokerage Account #   Email Address      Daytime Phone Number    5.   DISTRIBUTION DESIGNATION   Please complete this section to enroll in the Distribution Reinvestment Plan (the “DRIP”) or to designate the form of distributions that   you would like to receive (Please select one). If no method is selected, the Company will default to reinvest distributions   pursuant to the DRIP.          A. Reinvest distributions pursuant to the DRIP   The investor elects to invest distributions in additional shares of the Company pursuant to the terms of the Prospectus and   the DRIP described therein. See Section 10 for important additional information.               B. Check mailed to address set forth in Section 4A of this form          C. Check mailed to Third-Party/Alternate Address/Custodian   Name/Entity Name/Financial Institution   Mailing Address          City    State        Zip Code  Account Number                   D. Direct Deposit (Please complete Section 6)   The investor authorizes the Company or its agent to deposit distributions to the designated bank/brokerage account. This   authority will remain in force until the Company is notified in writing to cancel it. In the event that the Company or its agent   deposits funds erroneously into the account, they are authorized to debit the account for an amount not to exceed the   amount of the erroneous deposit.      Medallion Signature Guarantee   Affix Signature Guarantee Stamp Here    

 

6.   BANKING INSTRUCTIONS FOR DIRECT DEPOSITS AND LARGE ACCOUNTS    Financial Institution                Street Address       City    State        Zip Code              Checking (Please include a voided check)   Account Number        Savings (Please include a deposit check)     Routing Number        Brokerage or Other      Electronic funds transfers require the signatures of the bank account owners exactly as they appear on the bank records.   Registration of the bank account must be the same as names and signatures on this form.      7.   COST BASIS ELECTION   Select one:      FIFO: First in first out method depletes tax lots in the chronological order in which they were acquired.   LIFO: Last in first out method will repurchase newest available shares purchased.   HIFO: Highest cost available shares will be repurchased first.   LOFO: Lowest cost available shares will be repurchased first.   HILT: Long term highest cost available shares will be repurchased first.   HIST: Short term highest cost available shares will be repurchased first.   LILT: Long term lowest cost available shares will be repurchased first.   LIST: Short term lowest cost available shares will be repurchased first.   Specific Identification: Stockholders choose which tax lots they are selling and must specify particular lots to be sold prior   to or at the time of each repurchase.      All investors utilizing Direct Deposit for distributions must provide banking instructions to the investor’s brokerage account or   pre-designated U.S. bank account. All repurchases processed will be electronically delivered to the account on file with the   transfer agent or, upon instruction, to another financial institution provided that the investor has made the necessary funds transfer   arrangements. Funds electronically delivered by the Company or its agents must be to a U.S. financial institution (ACH network   member).   Internal Revenue Service regulations require security issuers to determine the adjusted cost basis for securities sold or repurchased,   the nature of the gain or loss, and to report the information on Form 1099-B. Several tax lot relief methods are available to determine   the adjusted cost basis; select one of the following options as the tax lot relief method to be used. This election may be changed   at any time prior to or at the time of each repurchase.   If no method is selected, the Company will utilize the FIFO method as the default option.     

 

8.   IMPORTANT INVESTOR INFORMATION   All items on this form must be completed in order to process the application. Please note that the Company, its agents and   participating broker-dealers are required by law to obtain, verify and record certain personal information obtained to establish   this account. We may also ask for other identifying documents or financial information relevant to a suitability assessment. If that   information is not provided, we may not be able to open the account.   In order to invest in the Company, we only accept checks drawn from a U.S. bank account or wired funds from a U.S. financial   institution (ACH network member). We do not accept money orders, traveler’s checks, starter checks, foreign checks, counter   checks, third-party checks or cash.   IMPORTANT INFORMATION FOR INVESTORS IN THE DISTRIBUTION REINVESTMENT PLAN:   If you elect to participate in the Distribution Reinvestment Plan, you are requested to promptly notify the Company in writing if   at any time you experience a material change in your financial condition, including the failure to meet the income, net worth and   investment concentration standards imposed by your state of residence and as set forth in the Prospectus and this form relating to   such investment or can no longer make the representations or warranties set forth in Section 9 of this form. This request in no way   shifts the responsibility of the Company’s sponsor, or any other person selling shares on behalf of the Company to you, to make   every reasonable effort to determine that the purchase of shares in this offering is a suitable and appropriate investment based on   information provided by you.   IMPORTANT INFORMATION FOR INVESTORS PURCHASING SHARES UNDER THE TERMS FOR UNIFORM GIFTS OR   TRANSFERS TO MINORS (UGMA / UTMA):   To the extent that shares of the Company are purchased for the benefit of a minor under UGMA /UTMA, the minor will be required   to complete a Subscription Eligibility Form and Account Application at the time that he or she becomes of legal age as defined by   the law of the minor’s state of residency.      9.   CUSTODIAN SIGNATURE (For Custodian identified in Section 4E, as applicable)   The undersigned, being the custodian of the IRA being invested in the Company by the investor, hereby accepts and agrees to   this subscription.   Name of Authorized Signatory      Signature of Authorized Signatory       Date   If the custodian of the IRA being invested in the Company by the investor accepts and agrees to the investor’s election (if applicable)   to invest distributions in additional shares of the Company pursuant to the terms of the Prospectus and the DRIP described therein,   please initial here.           

 

10.   PARTICIPATING BROKER-DEALER / INVESTMENT ADVISOR OR REGISTERED INVESTMENT ADVISOR (“RIA”) INFORMATION   Broker-Dealer   Investment Advisor /RIA Name   Investment Advisor/RIA Mailing Address          City      State          Zip Code   Investment Advisor/RIA Number   Branch Number   CRD Number    Email Address            Daytime Phone Number                Fax Number   The undersigned confirms by its signature, on behalf of the broker-dealer or the investment advisor/RIA, as applicable, that   it (i) has reasonable grounds to believe that the information and representations concerning the investor identified herein are   true, correct and complete in all respects; (ii) has verified that the form of ownership selected is accurate and, if other than   individual ownership, has verified that the individual executing on behalf of the investor is properly authorized and identified; (iii)   has discussed such investor’s prospective purchase of shares with such investor; (iv) has advised such investor of all pertinent   facts with regard to the liquidity and marketability of the shares; (v) has delivered or made available a current Prospectus and   related supplements, if any, to such investor; and (vi) has reasonable grounds to believe that the purchase of shares is a suitable   investment for such investor, that such investor meets the suitability standards applicable to such investor set forth in the   Prospectus and related supplements, if any, and that such investor is in a financial position to enable such investor to realize the   benefits of such an investment and to suffer any loss that may occur with respect thereto. The broker-dealer or the Investment   Advisor/RIA, as applicable, agrees to maintain records of the information used to determine that an investment in shares is   suitable and appropriate for the investor for a period of six years. The undersigned further represents and certifies, on behalf of   the broker-dealer or the Investment Advisor/ RIA, as applicable, that in connection with this subscription for shares, he or she   has complied with and has followed all applicable policies and procedures under his or her firm’s existing Anti-Money Laundering   Program and Customer Identification Program.   The undersigned investment advisor/RIA further represents and certifies that the investor has granted said investment advisor/   RIA a power of attorney with the authority to execute this subscription agreement on the investor’s behalf, including all   required representations.   Investment Advisor/RIA Signature              Date    Broker-Dealer Signature               Date   Branch Manager Signature          (If required by Participating   Broker-Dealer)   Date   If applicable, the investment advisor/RIA must complete all fields in this section and sign below to complete this form. By signing   this form, the investment advisor/RIA warrants that he or she is duly licensed and may sell shares of the Company in the state   designated as the investor’s legal residence, as well as the state in which the sale was made. All sales of securities must be   made through a broker-dealer that has a Participating Broker-Dealer Agreement in effect with LaSalle Investment Management   Distributors, LLC, the Company’s dealer manager.     

 

11.   INVESTOR SIGNATURES   Please read and separately initial each of the representations below in order to complete the application for purchasing   and owning shares of the Company.   If you have more questions about this offering or if you would like additional copies of the Prospectus, please visit the Company’s   website at www.JLLIPT.com. Investment advisors can also contact their wholesale representatives. In the case of trust accounts,   you may not grant any person a power of attorney to make the representations on your behalf.      To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions   to obtain, verify and record information that identifies each person who opens an account. What this means for you is that when   you open an account, we will ask for your name, address, social security number, date of birth and other information that will   allow us to identify you. This will assist us in ensuring that your information is secure.   PLEASE NOTE: ALL ITEMS MUSTS BE READ AND INITIALED       I, the investor (or in the case of fiduciary accounts, the person authorized to sign on such subscriber’s   behalf), hereby represent and warrant to the Company as follows:                  (a) I have received a copy of the final Prospectus (the Prospectus and all supplements and    amendments thereto that were filed with the Securities and Exchange Commission) for Jones    Lang LaSalle Income Property Trust, Inc. at least five business days before completing this form.          (b) I understand that the Company files a supplement to its Prospectus following the end of each    month disclosing daily pricing information for the preceding month, which I can access    through  the Company’s website at www.JLLIPT.com, the SEC’s website at www.sec.gov or    from my investment advisor. I also understand that following each business day, I can access    the Company’s daily pricing information for that day from any of these sources as well as    through the Company’s toll-free automated telephone line at 855-652-0277. I have received    the Company’s NAV per share from one or more of these sources before completing this form.             (c) I have (i) a minimum net worth of at least $250,000, or (ii) a minimum net worth of at least    $100,000 and a minimum annual gross income of at least $70,000, and, if applicable, I    meet the higher suitability requirements imposed by my state of primary residence as set forth    in the Prospectus under “Suitability Standards.” I acknowledge that these suitability    requirements can be met by myself or the fiduciary acting on my behalf. For these purposes,    “net worth” is calculated excluding the value of my home, home furnishings and automobiles.             (d) With the purchase of shares of the Company, no more than 10% of my liquid net worth will be    invested in shares of the Company and other similar programs, including direct participation    programs, with liquid net worth being defined as that portion of net worth that consists of    cash, cash equivalents and readily marketable securities.               (e) I acknowledge that shares of the Company are not liquid, that there is no public market for    the shares and that the Company may be unable to repurchase my shares at any particular time.             (f) I am purchasing the shares for my own account or on behalf of a trust or other eligible entity.    If I am purchasing shares on behalf of a trust or other eligible entity, I have due authority to    sign this agreement and to legally bind the trust or other eligible entity to the terms and    conditions for purchasing shares of the Company.   Investor/   Owner   Co-Investor/   Joint-Owner    

 

By signing this subscription agreement, I agree to the terms and conditions for owning shares of the Company as outlined in this   form, the Prospectus and any applicable supplements. I certify that I have received a copy of this prospectus and that I meet the   net worth and gross annual income requirements described above. The Company will assert these representations and warranties   in any proceeding in which a stockholder or a regulatory authority attempts to hold the Company liable because stockholders   did not receive copies of this prospectus or because the Company failed to adhere to each state’s suitability requirements. I   certify under penalties of perjury that I am not involved in any money laundering schemes and the source of any investment in the   Company is not derived from any criminal activities.   I further acknowledge that after an account is opened with the Company, I will receive account statements, a confirmation of my   purchase and other correspondence which I must carefully review to ensure that my instructions have been properly acted upon. If   any discrepancies are noted, I agree to notify the Company or the transfer agent in a timely manner. My failure to notify one of the   above entities on a timely basis will relieve such entities of any liability with respect to any discrepancy.   I certify that I am of legal age to sign this form. For joint accounts, all parties must sign.   Except in the case of a fiduciary account, the investor may not grant any person a power of attorney to make the above   representations on his, hers or its benefit.      SUBSTITUTE W-9   The undersigned certifies, under penalties of perjury, (i) that the taxpayer identification number shown in this   Subscription Agreement is true, correct and complete, (ii) that I am (we are) not subject to backup withholding either   because I (we) have not been notified that I am (we are) subject to backup withholding as a result of a failure to report   all interest or distributions, or the Internal Revenue Service has notified me (us) that I am (we are) no longer subject to   backup withholding and (iii) I am (we are) a U.S. citizen or other U.S. person.   NOTE: The Internal Revenue Service does not require your consent to any provision of this document other than the   certification regarding backup withholding. Form W-9 instructions are available upon request.   NOTE: By signing this form, you are not waiving any rights that you may have under federal and state securities laws.           Name of Authorized Signatory     Signature of Authorized Signatory        Date      Name of Co-Investor/Joint Owner     Signature of Co-Investor/Joint Owner       Date      12.   SUBSCRIPTION CHECKLIST    

 

A. Please review this application to ensure that all sections are complete, all additional required information is attached and that   initials and signatures are provided wherever requested. For IRA accounts, mail investor-signed documents to the IRA   Custodian for signatures.   B. Payment by check:   Checks should be made payable to:   Jones Lang LaSalle Income Property Trust, Inc.      Payment by wire:   C. This original application, together   with a check for the full purchase price (if payment by check), should be delivered to the   applicable address below (no faxes):   Questions:   (855) 652-0277   Standard Mail   Jones Lang LaSalle Income Property Trust, Inc.   c/o DST Systems, Inc.   P.O. Box 219165   Kansas City, Missouri 64121-9165   Overnight Delivery   Jones Lang LaSalle Income Property Trust, Inc.   c/o DST Systems, Inc.   430 W. 7th Street, Suite 219165   Kansas City, Missouri 64105   Wire to:   ABA Routing Number:   Beneficiary Name:   Beneficiary Account Number:   For Further Credit to:   Fund Name:   United Missouri Bank, Kansas City, MO   101000695   LaSalle Universal   98-7197-617-3   Investor Name   Jones Lang LaSalle Income Property Trust, Inc.2014.06.30 - Exhibit 10.1

Exhibit 10.1
AMENDMENT  TO
EMPLOYMENT AGREEMENT
This AMENDMENT TO EMPLOYMENT AGREEMENT (“Amendment”) effective as of the dates further set forth herein is entered into between Validus America, Inc. (the “Company”) and Romel Salam (the “Executive”).
WITNESSETH:
WHEREAS, the Company and the Executive are parties to an Employment Agreement dated as of 2 April 2013(the “Agreement”); 
WHEREAS the Company and the Executive wish to amend certain provisions of the Agreement; 
 NOW, THEREFORE, in consideration of the mutual covenants herein contained, the Company and the Executive hereby agree to amend the Agreement as follows: 
		
	1.
	The Agreement is hereby amended effective as of 1 June 2014 by deleting subsection (d) of Section 4.03.

    
		
	2.
	The Agreement is hereby amended effective as of 1 April 2014 by amending and restating Section 4.01 as follows:

Section 4.01    Base Salary.  During the Employment Period, the Executive’s base salary will be $550,000.00 per annum (the “Base Salary”). The Base Salary will be payable annually in arrears in twenty four (24) equal installments. Annually during the Employment Period the Company shall review with the Executive his job performance and compensation, and if deemed appropriate by the Board of Directors of the Company or its delegate, in its discretion, the Executive’s Base Salary may be increased.  
Except as specifically amended above the Agreement is and shall continue to be in full force and effect and is hereby in all respects ratified and confirmed.

[REMAINDER OF PAGE LEFT INTENTIONALLY BLANK]

IN WITNESS WHEREOF, the parties hereto have executed this Amendment on May 20, 2014.
VALIDUS AMERICA, INC.

             /s/ Robert F. Kuzloski
By: _______________________________
Printed Name: Robert F. Kuzloski
Title: Director

ROMEL SALAM
            /s/ Romel Salam
By: _______________________________
Printed Name: Romel Salam

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