ENDORSEMENT METHOD SPLIT DOLLAR PLAN
The respective rights and duties of the Bank and the Insured in the subject policy shall be as defined in the
Refer to the policy contract for the definition of all terms in this Agreement.
II. POLICY TITLE AND OWNERSHIP
Title and ownership shall reside in the Bank for its use and for the use of the Insured all in accordance with this
Agreement. The Bank alone may, to the extent of its interest, exercise the right to borrow or withdraw on the
policy cash values. Where the Bank and the Insured (or assignee, with the consent of the Insured) mutually agree
to exercise the right to increase the coverage under the subject Split Dollar policy, then, in such event, the rights,
duties and benefits of the parties to such increased coverage shall continue to be subject to the terms of this
III. BENEFICIARY DESIGNATION RIGHTS
The Insured (or assignee) shall have the right and power to designate a beneficiary or beneficiaries to receive his
share of the proceeds payable upon the death of the Insured, and to elect and change a payment option for such
beneficiary, subject to any right or interest the Bank may have in such proceeds, as provided in this Agreement.
IV. PREMIUM PAYMENT METHOD
The Bank shall pay an amount equal to the planned premiums and any other premium payments that might
become necessary to keep the policy in force.
V. TAXABLE BENEFIT
Annually the Insured will receive a taxable benefit equal to the assumed cost of insurance as required by the
Internal Revenue Service. The Bank (or its administrator) will report to the Employee the amount of imputed
income received each year on Form W-2 or its equivalent.
VI. DIVISION OF DEATH PROCEEDS
Subject to Paragraph VII herein, the division of the death proceeds of the policy is as follows:
Insurer: Alexander Hamilton Life Insurance
Jefferson-Pilot Life Insu