0001104659-19-000211.txt : 20190102 0001104659-19-000211.hdr.sgml : 20190102 20190102181334 ACCESSION NUMBER: 0001104659-19-000211 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181231 FILED AS OF DATE: 20190102 DATE AS OF CHANGE: 20190102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BLACKMAN DAVID M. CENTRAL INDEX KEY: 0001465427 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35442 FILM NUMBER: 19503025 MAIL ADDRESS: STREET 1: C/O THE RMR GROUP LLC STREET 2: TWO NEWTON PL., 255 WASH. ST., STE. 300 CITY: NEWTON STATE: MA ZIP: 02458 FORMER NAME: FORMER CONFORMED NAME: Blackman David M DATE OF NAME CHANGE: 20090602 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SELECT INCOME REIT CENTRAL INDEX KEY: 0001537667 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 000000000 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: C/O THE RMR GROUP STREET 2: TWO NEWTON PL., 255 WASH. ST., STE. 300 CITY: NEWTON STATE: MA ZIP: 02458 BUSINESS PHONE: (617) 796-8303 MAIL ADDRESS: STREET 1: C/O THE RMR GROUP STREET 2: TWO NEWTON PL., 255 WASH. ST., STE. 300 CITY: NEWTON STATE: MA ZIP: 02458 FORMER COMPANY: FORMER CONFORMED NAME: Select Income REIT DATE OF NAME CHANGE: 20111219 4 1 a4.xml 4 X0306 4 2018-12-31 1 0001537667 SELECT INCOME REIT NASDAQ:SIR 0001465427 BLACKMAN DAVID M. C/O THE RMR GROUP LLC, TWO NEWTON PL., 255 WASH. ST., STE. 300 NEWTON MA 02458 1 1 0 0 President and CEO Common Shares of Beneficial Interest 2018-12-31 4 D 0 40801 0 D 0 D Disposed of pursuant to the Agreement and Plan of Merger, dated as of September 14, 2018, by and among Government Properties Income Trust ("GOV"), GOV MS REIT, a wholly owned subsidiary of GOV, and the issuer in exchange for 42,433 GOV common shares of beneficial interest having a market value of $6.87 per share on the effective date of the merger of the issuer with and into GOV MS REIT, based on the closing price of GOV's common shares of beneficial interest on such effective date, plus cash in lieu of fractional shares. /s/ David M. Blackman 2019-01-02