Crescent State Bank Endorsement Split Dollar Agreement
EXHIBIT
10(xxi)
Crescent
State Bank
This
Endorsement Split Dollar Agreement
(this
“Agreement”) is entered into as of this 24th day of October, 2007 by and between
Crescent State Bank, a North Carolina-chartered commercial bank (the “Bank”),
and Xxx Xxxxxx, an executive of the Bank (the “Executive”). This Agreement shall
append the Split Dollar Policy Endorsement entered into on even date herewith
or
as subsequently amended, by and between the aforementioned parties.
Whereas,
to
encourage the Executive to remain an employee of the Bank, the Bank is willing
to divide the death proceeds of a life insurance policy on the Executive’s life,
and
Whereas,
the
Bank will pay life insurance premiums from its general assets.
Now
Therefore,
in
consideration of the foregoing premises and other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged,
the
parties hereto agree as follows.
Article
1
General
Definitions
Capitalized
terms not otherwise defined in this Agreement are used herein as defined in
the
Salary Continuation Agreement dated as of the date of this Agreement between
the
Bank and the Executive. The following terms shall have the meanings
specified.
1.1 “Administrator”
means
the administrator described in Article 7
1.2 “Executive’s
Interest”
means
the benefit set forth in section 2.2
1.3 “Insured”
means
the Executive.
1.4 “Insurer”
means
each life insurance carrier for which there is a Split Dollar Policy Endorsement
attached to this Agreement.
1.5 “Net
Death Proceeds”
means
the total death proceeds of the Policy minus the cash surrender
value.
1.6 “Policy”
means
the specific life insurance policy or policies issued by the
Insurer.
1.7 “Split
Dollar Policy Endorsement”
means
the form required by the Administrator or the Insurer to indicate the
Executive’s interest, if any, in a Policy on the Executive’s life.
Article
2
Policy
Ownership/Interests
2.1 Bank
Ownership.
The
Bank is the sole owner of the Policy and shall have the right to exercise all
incidents of ownership. The Bank shall be the beneficiary of the remaining
death
proceeds of the Policy after the Executive’s interest is paid according to
section 2.2 below.
2.2 Death
Benefit.
Provided the Executive’s death occurs before the Executive’s Separation from
Service, at the Executive’s death the Executive’s beneficiary designated in
accordance with the Split Dollar Policy Endorsement shall be entitled to an
amount equal to the lesser of (x)
100% of
the Net Death Proceeds or (y)
$500,000 (the “Executive’s Interest”). The Executive’s Interest shall be
extinguished when the Executive’s Separation from Service occurs and the
Executive’s beneficiary shall be entitled to no benefits under this Agreement
for the Executive’s death occurring thereafter. The Executive shall have the
right to designate the beneficiary of the Executive’s Interest.
2.3 Option
to Purchase.
The
Bank shall not sell, surrender, or transfer ownership of the Policy before
the
Executive’s Separation from Service without first giving the Executive or the
Executive’s transferee the option to purchase the Policy for a period of 60
days. The purchase price shall be an amount equal to the Policy cash surrender
value. The option to purchase the Policy shall lapse if not exercised within
60
days after the date the Bank gives written notice of the Bank’s intention to
sell, surrender, or transfer ownership of the Policy. This provision shall
not
impair the Bank’s right to terminate this Agreement.
2.4 Comparable
Coverage.
The
Bank shall maintain the Policy in full force and effect. The Bank may not amend,
terminate, or otherwise abrogate the Executive’s interest in the Policy before
the Executive’s Separation from Service unless the Bank replaces the Policy with
a comparable insurance policy to cover the benefit provided under this Agreement
and executes a new split dollar agreement and endorsement for the comparable
insurance policy. The Policy or any comparable policy shall be subject to claims
of the Bank’s creditors.
2.5 Internal
Revenue Code Section 1035 Exchanges.
The
Executive recognizes and agrees that the Bank may after this Agreement is
adopted wish to exchange the Policy of life insurance on the Executive’s life
for another contract of life insurance insuring the Executive’s life. Provided
that the Policy is replaced or intended to be replaced with a comparable policy
of life insurance, the Executive agrees to provide medical information and
cooperate with medical insurance-related testing required by a prospective
insurer for implementing the Policy or, if necessary, for modifying or updating
to a comparable insurer.
Article
3
Premiums
3.1 Premium
Payment.
The
Bank shall pay any premiums due on the Policy.
3.2 Economic
Benefit.
The
Administrator shall annually determine the economic benefit attributable to
the
Executive based on the life insurance premium factor for the Executive’s age
multiplied by the aggregate death benefit payable to the Executive’s
beneficiary. The “life insurance premium factor” is the minimum factor
applicable under guidance published pursuant to Treasury Reg. section
1.61-22(d)(3)(ii) or any subsequent authority.
3.3 Imputed
Income.
The
Bank shall impute the economic benefit to the Executive on an annual basis,
by
adding the economic benefit to the Executive’s W-2, or if applicable, Form
1099.
Article
4
Assignment
The
Executive may irrevocably assign without consideration all of the Executive’s
interest in the Policy and in this Agreement to any person, entity, or trust
established by the Executive or the Executive’s spouse. If the Executive
transfers all of the Executive’s interest in the Policy, all of the Executive’s
interest in the Policy and in the Agreement shall be vested in the Executive’s
transferee, who shall be substituted as a party hereunder and the Executive
shall have no further interest in this Agreement.
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Article
5
Insurer
The
Insurer shall be bound by the terms of the Policy only. Any payments the Insurer
makes or actions it takes in accordance with the Policy shall fully discharge
it
from all claims, suits, and demands of all entities or persons. The Insurer
shall not be bound by or be deemed to have notice of the provisions of this
Agreement.
Article
6
Claims
and Review Procedures
6.1 Claims
Procedure.
Any
person or entity who has not received benefits under this Agreement that he
or
she believes should be paid (the “claimant”) shall make a claim for benefits as
follows -
6.1.1 Initiation
- written claim.
The
claimant initiates a claim by submitting to the Administrator a written claim
for the benefits. If the claim relates to the contents of a notice received
by
the claimant, the claim must be made within 60 days after the notice was
received by the claimant. All other claims must be made within 180 days after
the date of the event that caused the claim to arise. The claim must state
with
particularity the determination desired by the claimant.
6.1.2 Timing
of Administrator response.
The
Administrator shall respond to the claimant within 90 days after receiving
the
claim. If the Administrator determines that special circumstances require
additional time for processing the claim, the Administrator can extend the
response period by an additional 90 days by notifying the claimant in writing,
before the end of the initial 90-day period, that an additional period is
required. The notice of extension must set forth the special circumstances
and
the date by which the Administrator expects to render its decision.
6.1.3 Notice
of decision.
If the
Administrator denies part or all of the claim, the Administrator shall notify
the claimant in writing of the denial. The Administrator shall write the
notification in a manner calculated to be understood by the claimant. The
notification shall set forth -
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(a)
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The
specific reasons for the denial,
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(b)
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A
reference to the specific provisions of this Agreement on which the
denial
is based,
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(c)
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A
description of any additional information or material necessary for
the
claimant to perfect the claim and an explanation of why it is
needed,
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(d)
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An
explanation of the Agreement’s review procedures and the time limits
applicable to such procedures, and
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(e)
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A
statement of the claimant’s right to bring a civil action under ERISA
section 502(a) after an adverse benefit determination on
review.
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6.2 Review
Procedure.
If the
Administrator denies part or all of the claim, the claimant shall have the
opportunity for a full and fair review by the Administrator of the denial,
as
follows –
6.2.1 Initiation –
written request.
To
initiate the review, the claimant must file with the Administrator a written
request for review within 60 days after receiving the Administrator’s notice of
denial.
6.2.2 Additional
submissions – information access.
The
claimant shall then have the opportunity to submit written comments, documents,
records, and other information relating to the claim. Upon request and free
of
charge, the Administrator shall also provide the claimant reasonable access
to
and copies of all documents, records, and other information relevant (as defined
in applicable ERISA regulations) to the claimant’s claim for
benefits.
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6.2.3 Considerations
on review.
In
considering the review, the Administrator shall take into account all materials
and information the claimant submits relating to the claim, without regard
to
whether the information was submitted or considered in the initial benefit
determination.
6.2.4 Timing
of Administrator response.
The
Administrator shall respond in writing to the claimant within 60 days after
receiving the request for review. If the Administrator determines that special
circumstances require additional time for processing the claim, the
Administrator can extend the response period by an additional 60 days by
notifying the claimant in writing before the end of the initial 60-day period
that an additional period is required. The notice of extension must set forth
the special circumstances and the date by which the Administrator expects to
render its decision.
6.2.5 Notice
of decision.
The
Administrator shall notify the claimant in writing of its decision on review.
The Administrator shall write the notification in a manner calculated to be
understood by the claimant. The notification shall set forth
–
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(a)
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The
specific reasons for the denial,
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(b)
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A
reference to the specific provisions of the Agreement on which the
denial
is based,
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(c)
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A
statement that the claimant is entitled to receive, upon request
and free
of charge, reasonable access to and copies of all documents, records,
and
other information relevant (as defined in applicable ERISA regulations)
to
the claimant’s claim for benefits, and
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(d)
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A
statement of the claimant’s right to bring a civil action under ERISA
section 502(a).
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Article
7
Administration
of Agreement
7.1 Administrator
Duties.
This
Agreement shall be administered by an Administrator, which shall consist of
the
Bank’s board of directors or such committee as the board shall appoint. The
Executive may be a member of the Administrator. The Administrator shall also
have the discretion and authority to (x)
make,
amend, interpret, and enforce all appropriate rules and regulations for the
administration of this Agreement and (y)
decide
or resolve any and all questions, including interpretations of this Agreement,
as may arise in connection with the Agreement.
7.2 Agents.
In the
administration of this Agreement, the Administrator may employ agents and
delegate to them such administrative duties as it sees fit (including acting
through a duly appointed representative) and may from time to time consult
with
counsel, who may be counsel to the Bank.
7.3 Binding
Effect of Decisions.
The
decision or action of the Administrator about any question arising out of or
in
connection with the administration, interpretation, and application of this
Agreement and the rules and regulations promulgated hereunder shall be final
and
conclusive and binding upon all persons having any interest in the
Agreement.
7.4 Indemnity
of Administrator.
The
Bank shall indemnify and hold harmless the members of the Administrator against
any and all claims, losses, damages, expenses, or liabilities arising from
any
action or failure to act with respect to this Agreement, except in the case
of
willful misconduct by the Administrator or any of its members.
7.5 Information.
To
enable the Administrator to perform its functions, the Bank shall supply full
and timely information to the Administrator on all matters relating to the
date
and circumstances of the retirement, death, or Separation from Service of the
Executive, and such other pertinent information as the Administrator may
reasonably require.
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Article
8
Miscellaneous
8.1 Amendment
and Termination of Agreement.
This
Agreement may be amended or terminated solely by a written agreement signed
by
the Bank and the Executive. However, this Agreement shall terminate upon the
first to occur of (x)
distribution of the death benefit proceeds in accordance with section 2.2 above,
or (y)
termination of the Salary Continuation Agreement under Article 5 of the Salary
Continuation Agreement, or (z)
the
Executive’s Separation from Service.
8.2 Binding
Effect.
This
Agreement shall bind the Executive and the Bank and their beneficiaries,
survivors, executors, administrators, and transferees, and any Policy
beneficiary.
8.3 No
Guarantee of Employment.
This
Agreement is not an employment policy or contract. It does not give the
Executive the right to remain an employee of the Bank nor does it interfere
with
the Bank’s right to discharge the Executive. It also does not require the
Executive to remain an employee or interfere with the Executive’s right to
terminate employment at any time.
8.4 Successors;
Binding Agreement.
By an
assumption agreement in form and substance satisfactory to the Executive, the
Bank shall require any successor (whether direct or indirect, by purchase,
merger, consolidation, or otherwise) to all or substantially all of the business
or assets of the Bank to expressly assume and agree to perform this Agreement
in
the same manner and to the same extent that the Bank would be required to
perform this Agreement if no succession had occurred.
8.5 Applicable
Law.
This
Agreement and all rights hereunder shall be governed by and construed according
to the laws of the State of North Carolina, except to the extent preempted
by
the laws of the United States of America.
8.6 Entire
Agreement.
This
Agreement and the Salary Continuation Agreement constitute the entire agreement
between the Bank and the Executive concerning the subject matter. No rights
are
granted to the Executive under this Agreement other than those specifically
set
forth.
8.7 Severability.
If any
provision of this Agreement is held invalid, such invalidity shall not affect
any other provision of this Agreement not held invalid, and each such other
provision shall continue in full force and effect to the full extent consistent
with law. If any provision of this Agreement is held invalid in part, such
invalidity shall not affect the remainder of the provision not held invalid,
and
the remainder of the provision together with all other provisions of this
Agreement shall continue in full force and effect to the full extent consistent
with law.
8.8 Headings.
Headings and subheadings herein are included solely for convenience of reference
and shall not affect the meaning or interpretation of any provision of this
Agreement.
8.9 Notices.
All
notices, requests, demands and other communications hereunder shall be in
writing and shall be deemed to have been duly given if delivered by hand or
mailed, certified or registered mail, return receipt requested, with postage
prepaid, to the following addresses or to such other address as either party
may
designate by like notice. Unless otherwise changed by notice, notice shall
be
properly addressed to the Executive if addressed to the address of the Executive
on the books and records of the Bank at the time of the delivery of such notice,
and properly addressed to the Bank if addressed to the board of directors,
Crescent State Bank, 1005 High House Road, P. O. Box 5809, Xxxx, Xxxxx Xxxxxxxx
00000.
In
Witness Whereof,
the
Executive and a duly authorized representative of the Bank have executed this
Endorsement Split Dollar Agreement as of the date first written
above.
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Executive:
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Bank:
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Crescent
State Bank
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/s/
Xxx X. Xxxxxx
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Xxx
Xxxxxx
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By:
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Its:
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Agreement
to Cooperate with Insurance Underwriting Incident to Internal Revenue Code
section 1035 Exchange
I
acknowledge that I have read the Endorsement Split Dollar Agreement and agree
to
be bound by its terms, particularly the covenant on my part set forth in section
2.5 of the Endorsement Split Dollar Agreement to provide medical information
and
cooperate with medical insurance-related testing required by an insurer to
issue
a comparable insurance policy to cover the benefit provided under this
Endorsement Split Dollar Agreement.
Witness
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Xxx
Xxxxxx
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6
Split
Dollar Policy Endorsement
Insured: Xxx
Xxxxxx
Insurer:
Great
West Life Insurance Company
Policy
No.: 86001955
According
to the terms of the Crescent State Bank Endorsement Split Dollar Agreement
dated
as of ,
2007,
the undersigned Owner requests that the above-referenced policy issued by the
Insurer provide for the following beneficiary designation and limited contract
ownership rights to the Insured:
1. Upon
the
death of the Insured, proceeds shall be paid in one sum to the Owner, its
successors or assigns, to the extent of the Owner’s interest in the policy. It
is hereby provided that the Insurer may rely solely upon a statement from the
Owner as to the amount of proceeds it is entitled to receive under this
paragraph.
2. Any
proceeds at the death of the Insured in excess of the amount paid under the
provisions of the preceding paragraph shall be paid in one sum to:
Primary
Beneficiary, Relationship/Social Security Number
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Contingent
Beneficiary, Relationship/Social Security
Number
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The
exclusive rights to change the beneficiary for the proceeds payable under this
paragraph and to assign all rights and interests granted under this paragraph
are hereby granted to the Insured. The sole signature of the Insured shall
be
sufficient to exercise the rights. The Owner retains all contract rights not
granted to the Insured under this paragraph.
3. It
is
agreed by the undersigned that this designation and limited assignment of rights
shall be subject in all respects to the contractual terms of the
policy.
4. Any
payment directed by the Owner under this endorsement shall be a full discharge
of the Insurer, and such discharge shall be binding on all parties claiming
any
interest under the policy.
5. This
Split Dollar Policy Endorsement supersedes and replaces all prior endorsements
of the Insured relating to the above-referenced policy issued by the
Insurer.
6. The
exercise by the Owner of the right to surrender the policy shall terminate
the
rights of the Insured.
7. The
Owner
of the policy is Crescent State Bank. The Owner alone may exercise all policy
rights, except that the Owner will not have the rights specified in paragraph
2
of this Split Dollar Policy Endorsement.
The
undersigned for the Owner 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 executed.
Signed
at
___________,
North
Carolina this ______
day of
____________,
2007
Insured:
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Owner:
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Crescent
State Bank
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/s/
Xxx Xxxxxx
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By:
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Xxx
Xxxxxx
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Its:
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7
Split
Dollar Policy Endorsement
Insured: Xxx
Xxxxxx
Insurer:
New
York
Life Insurance Company
Policy
No.: 56311897
According
to the terms of the Crescent State Bank Endorsement Split Dollar Agreement
dated
as of ,
2007,
the undersigned Owner requests that the above-referenced policy issued by the
Insurer provide for the following beneficiary designation and limited contract
ownership rights to the Insured:
1. Upon
the
death of the Insured, proceeds shall be paid in one sum to the Owner, its
successors or assigns, to the extent of the Owner’s interest in the policy. It
is hereby provided that the Insurer may rely solely upon a statement from the
Owner as to the amount of proceeds it is entitled to receive under this
paragraph.
2. Any
proceeds at the death of the Insured in excess of the amount paid under the
provisions of the preceding paragraph shall be paid in one sum to:
Primary
Beneficiary, Relationship/Social Security Number
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Contingent
Beneficiary, Relationship/Social Security
Number
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The
exclusive rights to change the beneficiary for the proceeds payable under this
paragraph and to assign all rights and interests granted under this paragraph
are hereby granted to the Insured. The sole signature of the Insured shall
be
sufficient to exercise the rights. The Owner retains all contract rights not
granted to the Insured under this paragraph.
3. It
is
agreed by the undersigned that this designation and limited assignment of rights
shall be subject in all respects to the contractual terms of the
policy.
4. Any
payment directed by the Owner under this endorsement shall be a full discharge
of the Insurer, and such discharge shall be binding on all parties claiming
any
interest under the policy.
5. This
Split Dollar Policy Endorsement supersedes and replaces all prior endorsements
of the Insured relating to the above-referenced policy issued by the
Insurer.
6. The
exercise by the Owner of the right to surrender the policy shall terminate
the
rights of the Insured.
7. The
Owner
of the policy is Crescent State Bank. The Owner alone may exercise all policy
rights, except that the Owner will not have the rights specified in paragraph
2
of this Split Dollar Policy Endorsement.
The
undersigned for the Owner 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 executed.
Signed
at
________________,
North
Carolina this ______
day of
________________,
2007.
Insured:
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Owner:
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Crescent
State Bank
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/s/ Xxx Xxxxxx
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By:
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Xxx
Xxxxxx
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Its:
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