Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, make the following beneficiary designation(s) to receive the portion of the proceeds described in paragraph (1) above:
Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, designates the following as beneficiary(s) of the portion of the proceeds described in paragraph (2) of this endorsement: Primary Beneficiary: _________________________________________________________ (Please print) Relationship: ___________________________________________ Contingent Beneficiary (if no Primary Beneficiary exists at the time of death of Insured): _______________________________________________________________ (Please print) Relationship: _________________________________________________ Signed at _____________________, [State], this ________ day of _____________, 2001. THE INSURED: __________________________________ Signature of Participant WITNESSED BY: __________________________ Printed Name of Witness _______________________________ Signature of Witness EXHIBIT C IRREVOCABLE ASSIGNMENT OF SPLIT-DOLLAR LIFE INSURANCE PLAN THIS ASSIGNMENT, dated this _______day of ___________________, _______. WITNESSETH THAT:
Acceptance and Beneficiary Designation. I, Xxxx Xxxxxxxxxx, hereby designate ___________________________ as my primary beneficiary and _______________________ as contingent beneficiary of the [portion of] benefits payable under the terms of the Plan. Signed at Willimantic, Connecticut, this ____ day of 20___. Insured Xxxx Xxxxxxxxxx
Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, designates ______________________________ as direct beneficiary and __________________________ as contingent beneficiary of the portion of the proceeds described in paragraph (1) above. Signed at ________________, Pennsylvania, this ____ day of _____________ , 2000 INSURED ------------------------------- ------------------------------
Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, designates as direct beneficiary and as contingent beneficiary of the portion of the proceeds described in Paragraph 1 above. Executed this day of , 20 INSURED: By (Print name) The following table details the Participant’s vested benefit upon termination of service: VESTING SCHEDULE End of Participant’s Plan Year 1 20% vesting in benefit End of Participant’s Plan Year 2 40% vesting in benefit End of Participant’s Plan Year 3 60% vesting in benefit End of Participant’s Plan Year 4 80% vesting in benefit End of Participant’s Plan Year 5 100% vesting in benefit Upon termination of service due to death or Disability, the Participant’s vested percentage is 100%. If a change of control occurs while employed by the Company, the Participant’s vested percentage is 100%. For eligible active Participants in the Plan prior to December 31, 2014, the Participant’s vested percentage is 100%.
Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, designates (relationship: ) as primary beneficiary(s) and (relationship: ) as secondary/contingent beneficiary of the portion of the proceeds described in paragraph (1) above. Signed at , Ohio, this day of , 20 . INSURED:
Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, designates _________________________________________________________________ (relationship: _____________________________________________) as primary beneficiary and ____________________________________________________________ (relationship: _______ ______________________________) as secondary/contingent beneficiary of the portion of the proceeds described in paragraph (1) above. Signed at ________________, Maryland, this ______ day of ________________, ____.
Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, designates as direct beneficiary and as contingent beneficiary of the portion of the proceeds described in paragraph (1) above. Signed at , Pennsylvania, this day of , 2000. INSURED (print name) The following table details the participants vested benefit upon termination of service: VESTING SCHEDULE End of Plan Year 1 20% vesting in benefit End of Plan Year 2 40% vesting in benefit End of Plan Year 3 60% vesting in benefit End of Plan Year 4 80% vesting in benefit End of Plan Year 5 100% vesting in benefit Upon termination of service due to disability, the participant’s vested percentage is 100%. If a change of control occurs while employed by the bank, the participant’s vested percentage is 100%.
Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, designates the following as beneficiary(s) of the portion of the proceeds described in paragraph (2) above: Primary Beneficiary: ______________________________________________________________ Relationship: ________________________________________________________________ Contingent Beneficiary (if the Primary is deceased): ____________________________________ Relationship: ________________________________________________________________ Signed at _____________________, North Carolina, this _______ day of _____________, 2001. THE INSURED:
Acceptance and Beneficiary Designation. The Insured accepts and agrees to the foregoing and, subject to the rights of the Owner as stated above, designates _______________________________ (relationship: _______________________________) as primary beneficiary(s) and ____________________________ (relationship: _______________________________) as secondary/contingent beneficiary of the portion of the proceeds described in paragraph (1) above. Signed at _______________________________, Ohio, this ______________ day of ___________________, 2001. INSURED: ___________________________________
