Common use of OWNERS AUTHORITY Clause in Contracts

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- Title President ----------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick WillettsJames D. Hundley -------------------------------------- Title Chair, III ----------------------------------------------- Title President ----------------------------------------------- Personnel Committee -------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore therefor to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner Owner accepts and agrees to this split dollar endorsementEndorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at WilmingtonProvidence, North CarolinaRhode Island, this 17th as of the 22nd day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- RHODE ISLAND By_________________________________ Title President ----------------------------------------------- _____________________________ 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner Owner accepts and agrees to this split split-dollar policy endorsement. Any transferee's rights shall be subject to this Endorsementendorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington_____________________, North Carolina[State], this 17th _______ day of January______________, 20022001. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- [NAME OF BANK] By_________________________________ Title President ----------------------------------------------- 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:_____________________________

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- Cooperative Bank for Savings -------------------------------------- Title President ----------------------------------------------- -------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- -------------------------------------------------- Title President ----------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- -------------------------------------------------- Title /s/ President ----------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- ------------------------------------------------- Title President ----------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick WillettsJames D. Hundley ----------------------------------- Title Chair, III ----------------------------------------------- Title President ----------------------------------------------- Personnel Committee ----------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- ---------------------------------------------- Title President ----------------------------------------------- ---------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th 22nd day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- --------------------------------------------- Title President ----------------------------------------------- -------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's ’s claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner Owner accepts and agrees to this split split-dollar policy endorsement. Any transferee's ’s rights shall be subject to this Endorsementendorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington_____________________, North CarolinaIowa, this 17th _______ day of January______________, 20022001. COOPERATIVE DUBUQUE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- Title President ----------------------------------------------- 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:TRUST COMPANY By: ________________ Title: ________________

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- -------------------------------------------- Title President ----------------------------------------------- -------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th 22nd day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- Title President ----------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th 22nd day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- --------------------------------------------- Title President ----------------------------------------------- --------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its the Owner's statement of the amount of premiums it the Owner has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, interest and any payments made pursuant to such statement shall discharge the Insurer Bank accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The Owner accepts and agrees to this split dollar endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at WilmingtonCanton, North CarolinaOhio, this 17th ___________ day of January______________________, 20022001. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- Title President ----------------------------------------------- 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:BANK: United National Bank & Trust Company By: _____________________________________ Its: _____________________________________

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- -------------------------------------------- Title President ----------------------------------------------- ---------------------------------------------- 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:

OWNERS AUTHORITY. The Insurer is hereby authorized to recognize the Owner's claim to rights hereunder without investigating the reason for any action taken by the Owner, including its statement of the amount of premiums it has paid on the Policy. The signature of the Owner shall be sufficient for the exercise of any rights under this Endorsement and the receipt of the Owner for any sums received by it shall be a full discharge and release therefore to the Insurer. The Insurer may rely on a sworn statement in form satisfactory to it furnished by the Owner, its successors or assigns, as to their interest, and any payments made pursuant to such statement shall discharge the Insurer accordingly. The owner accepts and agrees to this split dollar endorsement. Any transferee's rights shall be subject to this Endorsement. The undersigned is signing in a representative capacity and warrants that he or she has the authority to bind the entity on whose behalf this document is being executed. Signed at Wilmington, North Carolina, this 17th day of January, 2002. COOPERATIVE BANK FOR SAVINGS By /s/ Frederick Willetts, III ----------------------------------------------- -------------------------------------- Title /s/ President ----------------------------------------------- -------------------------------------- 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: