SECONDARY BENEFICIARY. This Beneficiary Designation hereby revokes any prior Beneficiary Designation which may have been in effect.
SECONDARY BENEFICIARY. In the event I am not survived by any Primary Beneficiary, I hereby appoint the following as Secondary Beneficiary(ies) to receive death benefits under the Agreement. In the event I am survived by more than one Secondary Beneficiary, such Secondary Beneficiaries shall share equally unless I indicate otherwise on an attachment to this form: ----------------------------------------------------------------- Name Relationship ----------------------------------------------------------------- Address ----------------------------------------------------------------- City State Zip I understand that I may revoke or amend the above designations at any time. I further understand that if I am not survived by a Primary or Secondary Beneficiary, my Beneficiary shall be as set forth under the Agreement.
SECONDARY BENEFICIARY. I hereby appoint the following as Secondary Beneficiary(ies) to receive death benefits under the Agreement if none of my Primary Beneficiaries survive me. If I am survived by more than one Secondary Beneficiary, such Secondary Beneficiaries shall share equally unless I indicate otherwise on this form: Name Share Address Relationship5 4 A Trustee may designate any person or a Trust as a Beneficiary. 5 For aid in identification only. I understand that (i) if none of my Primary or Secondary Beneficiaries survive me then payment will be made to my estate; and (ii) if I do not properly designate a Beneficiary, under the Agreement, I will be deemed to have designated my estate as my Primary Beneficiary. I understand that I may revoke or amend the above designations at any time. I further understand that if I am not survived by a Primary or Secondary Beneficiary, my Beneficiary shall be as set forth under the Agreement. Dated:
SECONDARY BENEFICIARY. This Beneficiary Designation hereby revokes any prior Beneficiary Designation which may have been in effect. Such Beneficiary Designation is revocable. DATE: ______________________, 20__ WITNESS DIRECTOR TO: Bank Attention:
SECONDARY BENEFICIARY. In the event I am not survived by any Primary Beneficiary, I hereby appoint the following as my Secondary Beneficiary(ies) to receive death benefits under the Agreement. In the event I am survived by more than one Secondary Beneficiary, such Secondary Beneficiaries shall share equally unless I indicate otherwise on an attachment to this form:
SECONDARY BENEFICIARY. This Beneficiary Designation hereby revokes any prior Beneficiary Designation which may have been in effect. Such Beneficiary Designation is revocable. DATE: , 19 (WITNESS) , Director Exhibit A DIRECTOR DEFERRED COMPENSATION AGREEMENT ELECTION FORM NAME: (Please Print)
SECONDARY BENEFICIARY. Secondary Beneficiary
SECONDARY BENEFICIARY. Annuitant; and
SECONDARY BENEFICIARY. This Beneficiary Designation hereby revokes any prior Beneficiary Designation which may have been in effect. Such Beneficiary Designation is revocable. DATE: , 20 WITNESS EXECUTIVE TO: Bank Attention: I hereby give notice of my election to change the form of payment of my Supplemental Retirement Income Benefit, as specified below. I understand that such notice, in order to be effective, must be submitted in accordance with the time requirements described in my Executive Supplemental Retirement Income Agreement. q I hereby elect to change the form of payment of my benefits from monthly installments throughout my Payout Period to a lump sum benefit payment. q I hereby elect to change the form of payment of my benefits from a lump sum benefit payment to monthly installments throughout my Payout Period. Such election hereby revokes my previous notice of election to receive a lump sum form of benefit payments. Date Acknowledged By: Title: Date This Trust Agreement (“Trust”) made effective the 1st day of April, 2002, by and among E G XxXXXXXXXX (hereinafter referred to as “Grantor”), UNITED COMMUNITY BANK, a federally chartered mutual savings bank having its principal place of business in Lawrenceburg, Indiana, or any successor corporation (hereinafter referred to as the “Bank”), and HOME FEDERAL SAVINGS BANK, a banking corporation with its principal place of business in the State of Indiana (hereinafter referred to as the “Trustee”).
SECONDARY BENEFICIARY. I acknowledge that I have been provided with a copy of the Master Agreement as currently in effect prior to my execution of this Joinder Agreement #2 and that I have been advised that I am entitled to receive any modifications hereinafter made to the Master Agreement by contacting either the Bank or the Administrator. /s/ Xxxxx X. Xxxxxxxx 9-26-96 (Executive) (Date) The Hometown Bank By: /s/ F. Xx Xxxxxxxxx /s/ 09-26-96 (Bank’s duly authorized Officer) (Attest) (Date) The Hometown Bank, formerly Xxxxx Savings Bank, S.S.B., (the “Bank”) and Xxxxx Xxxxxxxx (the “Executive”) hereby agree, for good and valuable consideration, the value of which is hereby acknowledged, that the Executive, who currently is a participant in the Executive Supplemental Retirement Income Master Agreement (“Master Agreement”) established as of July 1, 1993, by the Bank (as such Master Agreement may now exist or hereafter be modified), shall be entitled to a Supplemental Retirement Income Benefit under this Joinder Agreement #3 pursuant to the Master Agreement that is in addition to the benefits provided to the Executive pursuant to the Master Agreement under a Joinder Agreement dated March 17, 1994 (“Joinder Agreement #1”) and Joinder Agreement #2 effective as of August 21, 1996. This Joinder Agreement #3 shall become effective as of March 1, 1998.
