EX-10.4


 Exhibit 10.4 
 NON-QUALIFIED STOCK OPTION AGREEMENT 
 FOR NON-EMPLOYEE DIRECTORS

 UNDER THE CITIZENS HOLDING COMPANY 
 2013 INCENTIVE COMPENSATION PLAN 
  

					
	 Name of Optionee:
	  	  
	  	
			
	 No. of Option Shares:
	  	  
	  	
			
	 Option Exercise Price Per Share:
	  	 $
	  	
		  	 [FMV on Grant Date]

			
	Grant Date:	  	  
	  	
			
	Expiration Date:	  	  
	  	

 Pursuant to the Citizens Holding Company 2013 Incentive Compensation Plan as amended through the date
hereof (the “Plan”), Citizens Holding Company (the “Company”) hereby grants under this agreement (this “Agreement”) to the Optionee named above, who is a director of the Company but is not an
employee of the Company or any Subsidiary, an option (the “Stock Option”) to purchase on or prior to the Expiration Date specified above all or part of the number of Shares specified above at the Option Exercise Price Per Share
specified above subject to the terms and conditions set forth herein and in the Plan. The Stock Option is not intended to be an “incentive stock option” under Section 422 of the Code. Capitalized terms in this Agreement shall have the
meanings specified in the Plan, unless a different meaning is specified herein. 
 1. Exercisability Schedule. No portion
of the Stock Option may be exercised until such portion shall have become exercisable. Except as set forth below, and subject to the discretion of the Committee to accelerate the exercisability schedule hereunder, the Stock Option shall be
exercisable with respect to the following number of Option Shares on the dates indicated: 
  

					
	 Incremental Number of

Option Shares Exercisable
                                         
                                         
                              Exercisability Date

			
		 	(        %)	 	
			
		 	(        %)	 	
			
		 	(        %)	 	







 Once exercisable, the Stock Option shall continue to be exercisable at any time or times
prior to the close of business on the Expiration Date, subject to the provisions hereof and of the Plan. Notwithstanding anything herein to the contrary or in the Plan, in the event of a Change of Control, the Stock Option shall become fully
exercisable as of the effective time of the Change of Control. 
 2. Manner of Exercise. 

(a) The Optionee may exercise the Stock Option only in the following manner: from time to time on or prior to the Expiration Date of the
Stock Option, the Optionee may give written notice to the Committee of his or her election to purchase some or all of the Option Shares purchasable at the time of such notice. This notice shall specify the number of Option Shares to be purchased.

 Payment of the purchase price for the Option Shares may be made by one or more of the following methods: (i) in cash or
its equivalent (e.g., by personal check) at the time the Stock Option is exercised, (ii) in Shares having a Fair Market Value equal to the aggregate Option Exercise Price Per Share for the Option Shares being purchased and satisfying such other
requirements as may be imposed by the Committee; provided, that such Shares has been held by the Optionee for no less than six months (or such other period as established from time to time by the Committee in order to avoid adverse accounting
treatment applying generally accepted accounting principles), (iii) partly in cash and partly in Shares (as described in the preceding clause (ii)), (iv) if there is a public market for the Shares at such time, through the delivery of
irrevocable instructions to a broker to sell Stock obtained upon the exercise of the Stock Option and to deliver promptly to the Company an amount out of the proceeds of such sale equal to the aggregate Option Exercise Price Per Share for the Option
Shares being purchased; provided that in the event the Optionee chooses to pay the Option Exercise Price Per Share as so provided, the Optionee and the broker shall comply with such procedures and enter into such agreements of indemnity and other
agreements as the Committee shall prescribe as a condition of such payment procedure, or (v) through “net settlement” in Shares. In the case of a “net settlement” of a Stock Option, the Company will not require a cash
payment of the Option Exercise Price Per Share for the Option Shares being purchased, but will reduce the number of Shares issued upon the exercise by the largest number of whole Shares that have a Fair Market Value that does not exceed the
aggregate Option Exercise Price Per Share for the Option Shares set forth in this Agreement. With respect to any remaining balance of the aggregate Option Exercise Price Per Share for the Option Shares, the Company shall accept a cash payment.
Payment instruments will be received subject to collection. 
 The transfer to the Optionee on the records of the Company or of
the transfer agent of the Option Shares will be contingent upon (i) the Company’s receipt from the Optionee of the full purchase price for such Option Shares, as set forth above, (ii) the fulfillment of any other requirements
contained herein or in the Plan or in any other agreement or applicable laws and regulations, and (iii) the receipt by the Company of any agreement, statement or other evidence that the Company may require to satisfy itself that the issuance of
the Shares pursuant to the exercise of Stock Options under the Plan and any subsequent resale of such Shares will be in compliance with applicable laws and regulations. 






 (b) The Shares purchased upon exercise of the Stock Option shall be transferred to the
Optionee on the records of the Company or of the transfer agent upon compliance to the satisfaction of the Committee with all requirements under applicable laws or regulations in connection with such transfer and with the requirements hereof and of
the Plan. The determination of the Committee as to such compliance shall be final and binding on the Optionee. The Optionee shall not be deemed to be the holder of, or to have any of the rights of a holder with respect to, any Shares subject to the
Stock Option unless and until the Stock Option shall have been exercised pursuant to the terms hereof, the Company or the transfer agent shall have transferred the Shares to the Optionee, and the Optionee’s name shall have been entered as the
shareholder of record on the books of the Company. 
 (c) The minimum number of Shares with respect to which the Stock Option
may be exercised at any one time shall be 25 Shares, unless the number of Shares with respect to which the Stock Option is being exercised is the total number of Shares subject to exercise under the Stock Option at the time. 

(d) Notwithstanding any other provision hereof or of the Plan, no portion of the Stock Option shall be exercisable after the Expiration
Date hereof. 
 3. Termination as Director. If the Optionee ceases to be a director of the Company, the period within
which to exercise the Stock Option may be subject to earlier termination as set forth below. 
 (a) Termination by Reason of
Death. If the Optionee ceases to be a director by reason of the Optionee’s death, any portion of the Stock Option outstanding on such date shall become immediately exercisable in full, whether or not exercisable at such time and may be
exercised by his or her legal representative or legatee for a period of 12 months from the date of death or until the Expiration Date, if earlier. 
 (b) Termination Due to Disability. If the Optionee ceases to be a director by reason of the Optionee’s Disability, any portion of the Stock Option outstanding on such date may be exercised, to
the extent exercisable on the date of Disability, by the Optionee, or the Optionee’s legal representative or guardian, as applicable, for a period of 12 months from the date of Disability or until the Expiration Date, if earlier. Any portion of
the Stock Option that is not exercisable on the date of Disability shall terminate immediately and be of no further force or effect. 
 (c) Other Termination. If the Optionee ceases to be a director for any reason other than the Optionee’s death or Disability, any portion of the Stock Option outstanding on such date, to the
extent exercisable, may be exercised for a period of three months from the date of termination or until the Expiration Date, if earlier. 
 4. Incorporation of Plan. Notwithstanding anything herein to the contrary, the Stock Option shall be subject to and governed by all the terms and conditions of the Plan, including the powers of the
Committee set forth in Section 4 of the Plan. 






 5. Transferability. Unless otherwise approved by the Committee, this Agreement is
personal to the Optionee, is non-assignable and is not transferable in any manner, by operation of law or otherwise, other than by will or the laws of descent and distribution. Except as provided in Section 3(b) of this Agreement, the Stock
Option is exercisable, during the Optionee’s lifetime, only by the Optionee, and thereafter, only by the Optionee’s legal representative or legatee. 
 6. No Obligation to Continue as a Director. Neither the Plan nor the Stock Option confers upon the Optionee any rights to continue to serve as a director. 

7. Notices. Notices hereunder shall be mailed or delivered to the Company at its principal place of business and shall be mailed
or delivered to the Optionee at the address on file with the Company or, in either case, at such other address as one party may subsequently furnish to the other party in writing. 

8. Amendment. Pursuant to Section 15 of the Plan, the Committee may at any time amend, alter or discontinue the Plan, but no
such action may be taken that adversely affects the Optionee’s rights under this Agreement without the Optionee’s consent. 
 9. Electronic Consent. The Company may choose to deliver certain statutory materials relating to the Plan in electronic form. By accepting the Stock Option, the Optionee agrees that the Company may
deliver these materials in an electronic format. If at any time the Optionee would prefer to receive paper copies of these documents, as the Optionee is entitled to, the Company will provide paper copies upon written request by the Optionee to the
Secretary of the Company. 
 [SIGNATURE PAGE FOLLOWS] 






 IN WITNESS WHEREOF, the Company has executed this Agreement on and as of the day and
year first above written. 
  

			
	CITIZENS HOLDING COMPANY
		
	 By:
	 	 
	 Name:
	 	 
	 Title:
	 	 


 The foregoing Agreement is hereby accepted and the terms and conditions thereof hereby agreed to by
the undersigned. 
  

			
	 Dated:
                                
	  	  

		  	 Optionee’s Signature

		
		  	  

		  	 Optionee’s Name

		
		  	 Optionee’s Address: