COVER
EXHIBIT C
PROFESSIONAL BRANCH MANAGER PHANTOM STOCK AGREEMENT
Payment Option Election
Part I. I hereby elect to receive the benefits attributable to the Share
Units and corresponding Matched Share Units of my Account under the Agreement
in the following manner: (check one)
a. ____ in a lump sum one year after the respective
Matched Share Units have fully vested;
b. ____ in three annual installments with the first of such install-
ments occurring one year after the respective Matched
Share Units have fully vested;
c. ____ in a lump sum upon my termination of employment from
Xxxx (but in no event earlier than one year after the
respective Matched Share Units have fully vested); or
d. ____ in three annual installments with the first of such
installments occurring upon my termination of employment
from Xxxx (but in no event earlier than one year after the
respective Matched Share Units have fully vested).
I understand that if I elect to receive distributions in installments,
each installment will be determined by dividing the then value of the amount
to be distributed by the number of installments remaining to be paid
(including the installment then due). If the total distribution is less than
$20,000.00, I understand installment option b and installment option d will
not be available and I will receive a single lump sum payment.
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Professional Branch Manager Phantom Stock Agreement
Payment Option Election
Page Two
I further understand that in the event that my employment with Xxxx
has terminated for any reason and the benefits under this Agreement are to be
paid in installments rather than in a single lump sum, then (regardless of
whether there has or has not been a merger or Change in Control of LMI or
Xxxx), I will be deemed to have automatically made an elective transfer to
Phantom Treasury Bills.
Part II. I hereby direct that, in the event of my death, any balance in my
Account shall be paid to the beneficiary(ies) designated by me in the
following manner: (check one)
a. ____ in a single lump sum distribution
b. ____ continuation of the manner of distribution elected by me
pursuant to Part I above.
Employee:
____________________________
Signature Date
____________________________
Print Full Name
Receipt Acknowledged:
XXXX XXXXX XXXX XXXXXX, INCORPORATED
By:_________________________________________
Signature