Document:

Exhibit 10.4

 

FIRPTA AFFIDAVIT

 

Section 1445 of
the Internal Revenue Code of 1986, as amended (the “Code”) provides that a transferee of a U.S. real property interest
must withhold tax if the transferor is a foreign person. To inform Reliability Incorporated, a Texas corporation (the “Transferee”)
that withholding of tax is not required upon the disposition of interests in The Maslow Media Group, Inc., a Virginia corporation
(the “Company”) by the undersigned transferor (the “Transferor”), the undersigned hereby certifies the
following on behalf of Transferor:

		1.	Transferor is not a “foreign person” (as defined in the Code and Treasury Regulations).

2.       Transferor’s
U.S. taxpayer identification number is ________________________.

		3.	Transferor’s address is :________________________

  

 

4.Transferor understands that this certification may be disclosed to the Internal Revenue Service by Transferee and that
any false statement contained herein could be punished by fine, imprisonment, or both.

 

Under penalties
of perjury, I declare that I have examined this certification and to the best of my knowledge and belief it is true, correct and
complete, and I further declare that I have authority to sign this document on behalf of Transferor.

 

Dated: _______,
2019

 

TRANSFEROR NAME: _____________________________________

 

 

By:______________________________

 

Name:______________________________

 

Title:______________________________

(if applicable)Exhibit 4.1

 

COMMON A
MARYLAND REAL ESTATE INVESTMENT TRUST CUSIP 81761L 10 2 THIS
CERTIFIES THAT is the registered holder of FULLY PAID AND NONASSESSABLE COMMON SHARES OF BENEFICIAL INTEREST IN SERVICE
PROPERTIES TRUST a Maryland real estate investment trust (the “Trust”), transferable on the books of the Trust
by the holder hereof in person or by its duly authorized attorney upon surrender of this Certificate properly endorsed. This Certificate
and the shares evidenced hereby are issued and shall be held subject to all of the provisions of the Declaration of Trust and
Bylaws of the Trust and any amendments thereto. The holder of this Certificate and every transferee or assignee hereof by accepting
or holding the same agrees to be bound by all of the provisions of the Declaration of Trust and Bylaws of the Trust, as amended
from time to time. This Certificate is not valid unless countersigned and registered by the Transfer Agent and Registrar. IN WITNESS
WHEREOF, the Trust has caused this Certificate to be executed on its behalf by its duly authorized officers. Dated: PRESIDENT
AND CHIEF EXECUTIVE OFFICER CHIEF FINANCIAL OFFICER AND TREASURER COUNTERSIGNED AND REGISTERED: EQUINITI TRUST COMPANY TRANSFER
AGENT AND REGISTRAR BY AUTHORIZED SIGNATURE SVC AMERICAN FINANCIAL PRINTING INCORPORATED – MINNEAPOLIS THE
DECLARATION OF TRUST PROVIDES THAT THE NAME “SERVICE PROPERTIES TRUST” REFERS TO THE TRUSTEES UNDER THE DECLARATION
OF TRUST, COLLECTIVELY AS TRUSTEES, BUT NOT INDIVIDUALLY OR PERSONALLY, AND NO TRUSTEE, SHAREHOLDER, EMPLOYEE OR AGENT OF THE
TRUST SHALL BE HELD TO ANY PERSONAL LIABILITY, JOINTLY OR SEVERALLY, IN CONNECTION WITH THIS INSTRUMENT. ALL PERSONS DEALING WITH
THE TRUST IN ANY WAY SHALL LOOK ONLY TO THE ASSETS OF THE TRUST FOR PAYMENT OF ANY SUM OR PERFORMANCE OF ANY OBLIGATION. COMMON
SHARES $.01 PAR VALUE PER SHARE SEE REVERSE FOR IMPORTANT NOTICE ON TRANSFER RESTRICTIONS AND OTHER INFORMATION COMMON SHARES
$.01 PAR VALUE PER SHARE

 

    	 		 

     

    

 

 

 

SERVICE PROPERTIES TRUST IMPORTANT NOTICE
 PURSUANT AND SUBJECT TO THE TERMS OF THE AMENDED AND RESTATED DECLARATION
OF TRUST OF THE TRUST, AS AMENDED FROM TIME TO TIME (THE “DECLARATION”), THE TRUST HAS THE AUTHORITY TO CREATE ONE
OR MORE ADDITIONAL CLASSES OR SERIES OF SHARES AND ISSUE ADDITIONAL SHARES OF ANY EXISTING CLASS OR SERIES OF SHARES. THE TRUST
WILL FURNISH A FULL STATEMENT OF (i) THE AUTHORITY OF THE TRUST TO CREATE ADDITIONAL CLASSES OR SERIES OF SHARES AND ISSUE ADDITIONAL
SHARES OF ANY EXISTING CLASS OR SERIES OF SHARES, (ii) THE TERMS OF ANY EXISTING CLASS OR SERIES OF SHARES, AND (iii) SUCH OTHER
INFORMATION AS IS REQUIRED BY APPLICABLE LAW, WITHOUT CHARGE TO ANY SHAREHOLDER UPON REQUEST TO THE SECRETARY OF THE TRUST. THE
SHARES EVIDENCED BY THIS CERTIFICATE ARE SUBJECT TO RESTRICTIONS ON OWNERSHIP AND TRANSFER WHICH ARE OR MAY HEREAFTER BE CONTAINED
IN THE DECLARATION OR IN THE AMENDED AND RESTATED BYLAWS ADOPTED BY THE TRUST, AS AMENDED FROM TIME TO TIME (THE “BYLAWS”),
INCLUDING PROVISIONS WHICH PROHIBIT THE OWNERSHIP OF MORE THAN 9.8% OF ANY CLASS OR SERIES OF THE TRUST’S SHARES OF BENEFICIAL
INTEREST BY ANY PERSON OR GROUP. THIS DESCRIPTION OF THE RESTRICTIONS UPON OWNERSHIP OR TRANSFER OF THE TRUST’S SECURITIES
IS NOT COMPLETE. A MORE COMPLETE DESCRIPTION OF THESE RESTRICTIONS AND OF VARIOUS RIGHTS AND OBLIGATIONS OF SHAREHOLDERS APPEARS
IN THE DECLARATION OR BYLAWS, AS APPLICABLE, AND IN CERTAIN OTHER AGREEMENTS WHICH MAY FROM TIME TO TIME BE ENTERED INTO BY THE
TRUST AFFECTING THE RIGHTS AND OBLIGATIONS OF SHAREHOLDERS. COPIES OF THE DECLARATION, BYLAWS AND AGREEMENTS AFFECTING THE RIGHTS
AND OBLIGATIONS OF SHAREHOLDERS AS IN EFFECT FROM TIME TO TIME WILL BE SENT WITHOUT CHARGE TO ANY SHAREHOLDER UPON REQUEST TO
THE SECRETARY OF THE TRUST. THIS CERTIFICATE ALSO EVIDENCES AND ENTITLES THE HOLDER HEREOF TO CERTAIN RIGHTS AS SET FORTH IN THE
RENEWED RIGHTS AGREEMENT DATED AS OF MAY 15, 2007 BETWEEN THE TRUST AND WELLS FARGO BANK, NATIONAL ASSOCIATION, AS SUCCESSOR RIGHTS
AGENT, AND ANY AMENDMENTS OR RENEWALS THEREOF (THE “RIGHTS AGREEMENT”), THE TERMS OF WHICH ARE HEREBY INCORPORATED
HEREIN BY REFERENCE AND A COPY OF WHICH IS ON FILE AT THE PRINCIPAL OFFICES OF THE TRUST. UNDER CERTAIN CIRCUMSTANCES, AS SET
FORTH IN THE RIGHTS AGREEMENT, SUCH RIGHTS WILL BE EVIDENCED BY SEPARATE CERTIFICATES AND WILL NO LONGER BE EVIDENCED BY THIS
CERTIFICATE. THE TRUST WILL MAIL TO THE HOLDER OF THIS CERTIFICATE A COPY OF THE RIGHTS AGREEMENT, AS IN EFFECT ON THE DATE OF
MAILING, WITHOUT CHARGE PROMPTLY AFTER RECEIPT OF A WRITTEN REQUEST THEREFOR. UNDER CERTAIN CIRCUMSTANCES SET FORTH IN THE RIGHTS
AGREEMENT, RIGHTS BENEFICIALLY OWNED (AS SUCH TERM IS DEFINED IN THE RIGHTS AGREEMENT) BY ANY PERSON WHO IS, WAS OR BECOMES AN
ACQUIRING PERSON, OR ANY AFFILIATE OR ASSOCIATE THEREOF (AS SUCH TERMS ARE DEFINED IN THE RIGHTS AGREEMENT), WHETHER CURRENTLY
HELD BY OR ON BEHALF OF SUCH PERSON OR BY ANY SUBSEQUENT HOLDER, MAY BECOME NULL AND VOID. THE RIGHTS SHALL NOT BE EXERCISABLE,
AND SHALL BE VOID SO LONG AS HELD, BY A HOLDER IN ANY JURISDICTION WHERE THE REQUISITE QUALIFICATION TO THE ISSUANCE TO SUCH HOLDER,
OR THE EXERCISE BY SUCH HOLDER, OF THE RIGHTS IN SUCH JURISDICTION SHALL NOT HAVE BEEN OBTAINED OR BE OBTAINABLE. The following
abbreviations, when used in the inscription on the face of this Certificate, shall be construed as though they were written out
in full according to applicable laws or regulations: TEN COM–as tenants in commonUTMA – ____________ Custodian ____________
(Cust)(Minor) TEN ENT–as tenants by entiretiesunder Uniform Transfers to Minors JT TEN–as joint tenants with right
of survivorshipAct ________________________________ and not as tenants in common(State) Additional abbreviations may also be used
though not in above list. For value received ________________________________________________ hereby sell, assign, and transfer
unto (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS INCLUDING ZIP CODE OF ASSIGNEE) Shares of beneficial interest represented by
the within Certificate, and do hereby irrevocably constitute and appoint Attorney to transfer the said shares on the books of
the within-named Trust with full power of substitution in the premises. Dated ________________X X NOTICE: THE SIGNATURE TO THIS
ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR WITHOUT ALTERATION OR
ENLARGEMENT OR ANY CHANGE WHATEVER. SIGNATURE GUARANTEED ALL GUARANTEES MUST BE MADE BY A FINANCIAL INSTITUTION (SUCH AS A BANK
OR BROKER) WHICH IS A PARTICIPANT IN THE SECURITIES TRANSFER AGENTS MEDALLION PROGRAM (“STAMP”), THE NEW YORK STOCK
EXCHANGE, INC. MEDALLION SIGNATURE PROGRAM (“MSP”), OR THE STOCK EXCHANGES MEDALLION PROGRAM (“SEMP”)
AND MUST NOT BE DATED. GUARANTEES BY A NOTARY PUBLIC ARE NOT ACCEPTABLE. PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER
OF ASSIGNEEExhibit

Matthew Moellering
1 Express Drive
Columbus, OH 43230

Dear Matt:

Congratulations! It is my pleasure to offer you a promotion to President and Chief Operating Officer.  This letter outlines the new details of your compensation, and supplements and amends your employment agreement dated March 20, 2017. The effective date for the changes outlined in this letter is September 22, 2019. Your next eligibility for merit review will be Spring 2020.

	
			
	Position Compensation Summary:
	Current
	New

	Your Base Pay Rate:
	Annual: $793,000
	Annual: $825,000

	Your Annual IC Payout Target: 
IC as a % of your annual salary:
IC dollar amount:
	

85%
$674,050
	

90%
$742,500

	Your Annual Cash Compensation Target:
	$1,467,050
	$1,567,500

	Your Annual Long-term Incentive Grant:
	$1,300,000
	$2,000,000

	Your Annual Total Direct Compensation at Target:
	$2,767,050
	$3,567,500

Your new Incentive Compensation participation rate of 90% will begin with the 2019 Fall season. Your annual cash compensation at target will be $1,567,500 (your base salary plus 90% target IC), and your annual cash compensation could be up to $2,310,000 (your annual salary plus 180% maximum IC). Beginning with the next annual grant in 2020 your Long-term Incentive Compensation will be increased to a fair market value of $2,000,000.

If you have any questions, please contact Katie Maurer, Human Resources.  

	
			
	Sincerely,
	 
	I accept the changes as described above:

	 
	 
	 

	Tim Baxter
	 
	Matthew Moellering

	Chief Executive Officer
	 
	 

	Express

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