Document:

Exhibit 10.11

    
      

    

     

    

      Exhibit
        10.11

      

      OFFICER
        SALARY CONTINUATION AGREEMENT

      

      

      THIS
        AGREEMENT,
        made
        and entered into this 30th day of March, 2007, by and between Bank of Upson,
        a
        bank organized and existing under the laws of the State of Georgia (hereinafter
        referred to as the “Bank”), and Douglas J. Hertha, an Officer of the Bank
        (hereinafter referred to as the “Officer”), a member of a select group of
        management employees of the Bank.

      

      WHEREAS,
        the
        Officer has been and continues to be a valued Officer of the Bank;

      

      WHEREAS,
        the
        purpose of this Agreement is to further the growth and development of the
        Bank
        by providing the Officer with supplemental retirement income, and thereby
        encourage the Officer’s productive efforts on behalf of the Bank and the Bank’s
        shareholders, and to align the interests of the Officer and those
        shareholders.

      

      WHEREAS,
        it is
        the desire of the Bank and the Officer to enter into this Agreement under
        which
        the Bank will agree to make certain payments to the Officer at retirement
        or the
        Officer’s Beneficiary in the event of the Officer’s death pursuant to this
        Agreement;

      

      ACCORDINGLY,
        it is
        intended that the Agreement be “unfunded” for purposes of the Employee
        Retirement Income Security Act of 1974, as amended (“ERISA”) and not be
        construed to provide income to the participant or beneficiary under the Internal
        Revenue Code of 1986, as amended (the “Code”), particularly Section 409A of the
        Code and guidance or regulations issued thereunder, prior to actual receipt
        of
        benefits; and

      

      THEREFORE,
        it is
        agreed as follows:

      

      
        	
                I.

              	
                EFFECTIVE
                  DATE

              

      

      

      The
        Effective Date of this Agreement shall be March 29, 2006.

      

      
        	II.	
                FRINGE
                  BENEFITS

              

      

      

      The
        salary continuation benefits provided by this Agreement are granted by the
        Bank
        as a fringe benefit to the Officer and are not part of any salary reduction
        plan
        or an arrangement deferring a bonus or a salary increase. The Officer has
        no
        option to take any current payment or bonus in lieu of these salary continuation
        benefits except as set forth hereinafter.

      

      
        
           

        

        
          
          

          
            

          

        

        
           

        

      

      

      
        	III.	
                DEFINITIONS

              

      

      

      
        	 	
                A.

              	
                Retirement
                  Date:

              

      

      

      If
        the
        Officer remains in the continuous employ of the Bank, the Officer shall retire
        from active employment with the Bank on the later of the Officer’s sixty-fifth
        (65th)
        birthday or Separation from Service.

      

      
        	 	
                B.

              	
                Normal
                  Retirement Age:

              

      

      

      “Normal
        Retirement Age” shall mean the date on which the Officer attains age sixty-five
        (65).

      

      
        	
              	C.	
                Plan
                  Year:

              

      

      

      Any
        reference to “Plan Year” shall mean a calendar year from January 1st
        to
        December 31st.
        In the
        year of implementation, the term “Plan Year” shall mean the period from the
        effective date to December 31st
        of the
        year of the effective date.

      

      
        	
              	D.	
                Termination
                  of Employment:

              

      

      

      “Termination
        of Employment” shall mean voluntary resignation of employment by the Officer or
        the Bank’s discharge of the Officer without cause, prior to the Normal
        Retirement Age.

      

      
        	
              	E.	
                Separation
                  from Service:

              

      

      

      “Separation
        from Service” shall mean that the Officer has experienced a Termination of
        Employment from the Bank. Where the Officer continues to perform services
        for
        the Bank following a Termination of Employment, however, and the facts and
        circumstances indicate that such services are intended by the Bank and the
        Officer to be more than “insignificant” services, a Separation from Service will
        not be deemed to have occurred and any amounts deferred under this Agreement
        may
        not be paid or made available to the Officer. The determination of whether
        such
        services are considered “insignificant” will be based upon all facts and
        circumstances relating to the termination and upon any applicable rules and
        regulations issued under Section 409A of the Code. Military leave, sick leave,
        or other bona fide leaves of absence are not generally considered terminations
        of employment.

      
        
           

        

        
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            2
            -

          
            

          

        

        
           

        

      

      

      
        	 	
                F.

              	
                Discharge
                  for Cause:

              

      

      

      The
        term
“for cause” shall mean any of the following that result in an adverse effect on
        the Bank: (i) the commission of a felony or gross misdemeanor involving fraud
        or
        dishonesty; (ii) the willful violation of any banking law, rule, or banking
        regulation (other than a traffic violation or similar offense); (iii) an
        intentional failure to perform stated duties; or (iv) a breach of fiduciary
        duty
        involving personal profit. If a dispute arises as to discharge “for cause,” such
        dispute shall be resolved by arbitration as set forth in this Agreement.
        In the
        alternative, if the Officer is permitted to resign due to inappropriate conduct
        as defined above, the Board of Directors may vote to deny all benefits. A
        majority decision by the Board of Directors is required for forfeiture of
        the
        Officer’s benefits. 

      

      
        	 	
                G.

              	
                Change
                  of Control:

              

      

      

      “Change
        of Control” shall mean a change in ownership or control of the Bank as defined
        in Treasury Regulation Section 1.409A-3(g)(5) or any subsequently applicable
        Treasury Regulation.

      

      
        	 	
                H.

              	
                Restriction
                  on Timing of Distribution:

              

      

      

      Notwithstanding
        any provision of this Agreement to the contrary, distributions to the Officer
        may not commence earlier than six (6) months after the date of a Separation
        from
        Service, as that term is used under Section 409A if, pursuant to Internal
        Revenue Code Section 409A, the Officer is considered a “specified employee”
under Internal Revenue Code Section 416(i), of the Bank if any stock of the
        Bank
        is publicly traded on an established securities market or otherwise. In the
        event a distribution is delayed pursuant to this paragraph, the originally
        scheduled payment shall be delayed for six (6) months, and shall commence
        instead on the first day of the seventh month following Separation from Service.
        If payments are scheduled to be made in installments, the first six (6) months
        of installment payments shall be delayed, aggregated, and paid instead on
        the
        first day of the seventh month, after which all installment payments shall
        be
        made on their regular schedule. If payment is scheduled to be made in a lump
        sum, the lump payment shall be delayed for six (6) months and instead be
        made on
        the first day of the seventh month.

      

      
        	 	
                I.

              	
                Beneficiary:

              

      

      

      The
        Officer shall have the right to name a Beneficiary of the death benefit as
        described in Paragraph IV herein. The Officer shall have the right to name
        such
        Beneficiary at any time prior to the Officer’s death and submit it to the Plan
        Administrator (or Plan Administrator’s representative) on the form provided.
        Once received and acknowledged by the Plan Administrator, the form shall
        be
        effective. The Officer may change a Beneficiary designation at any time by
        submitting a new form to the Plan Administrator. Any such change shall follow
        the same rules as for the original Beneficiary designation and shall
        automatically supersede the existing Beneficiary form on file with the Plan
        Administrator. 

      
        
           

        

        
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            3
            -

          
            

          

        

        
           

        

      

      

      If
        the
        Officer dies without a valid Beneficiary designation on file with the Plan
        Administrator, death benefits shall be paid to the Officer’s
        estate.

      

      If
        the
        Plan Administrator determines in its discretion that a benefit is to be paid
        to
        a minor, to a person declared incompetent, or to a person incapable of handling
        the disposition of that person’s property, the Plan Administrator may direct
        distribution of such benefit to the guardian, legal representative or person
        having the care or custody of such minor, incompetent person or incapable
        person. The Plan Administrator may require proof of incompetence, minority
        or
        guardianship as it may deem appropriate prior to distribution of the benefit.
        Any distribution of a benefit shall be a distribution for the account of
        the
        Officer and the Beneficiary, as the case may be, and shall be a complete
        discharge of any liability under the Agreement for such distribution
        amount.

      

      
        	IV.	
                RETIREMENT
                  BENEFIT

              

      

      

      Upon
        attainment of the Retirement Date, the Bank shall pay the Officer an annual
        benefit equal to Fifty Thousand and 00.100th
        Dollars
        ($50,000.00). Said benefit shall be paid in equal monthly installments
        (1/12th
        of the
        annual benefit) until the death of the Officer. Said payment shall be made
        the
        first day of the month following the date of such Separation from Service.
        

      

      
        	V.	
                DEATH
                  BENEFIT 

              

      

      

      
        	
              	A.	
                Pre-Retirement
                  Death Benefit:

              

      

      

      In
        the
        event the Officer should die while actively employed by the Bank at any time
        after the date of this Agreement but prior to the Officer attaining the
        Retirement Date, the Bank will pay the accrued balance on the date of death,
        of
        the Officer’s accrued liability retirement account in one (1) lump sum, the
        first day of the second month following the Officer’s death, to the
        Beneficiary.

      

      
        	
              	B.	
                Post-Retirement
                  Death Benefit:

              

      

      

      Upon
        the
        death of the Officer, if there is a balance in the accrued liability retirement
        account, such balance shall be paid in one (1) lump sum to the Beneficiary.
        Said
        payment due hereunder shall be made the first day of the second month following
        the Officer’s death.

      

      
        	VI.	
                ACCRUED
                  LIABILITY RETIREMENT
                  ACCOUNT

              

      

      

      The
        Bank
        shall account for this benefit using the regulatory accounting principles
        of the
        Bank’s primary federal regulator. The Bank shall establish an accrued liability
        retirement account for the Officer into which appropriate reserves shall
        be
        accrued.

      
        
           

        

        
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            4
            -

          
            

          

        

        
           

        

      

      

      
        	VII.	
                VESTING

              

      

      

      The
        Officer shall be vested in the accrued liability retirement account in
        accordance with the following schedule to a maximum of one hundred percent
        (100%).

      

      
        	
                Age
                  of Officer

              	
                Vested
                  (to a maximum of 100%)

              
	
                Age
                  59 and under

              	
                0%

              
	
                60

              	
                50%

              
	
                61

              	
                60%

              
	
                62

              	
                70%

              
	
                63

              	
                80%

              
	
                64

              	
                90%

              
	
                65

              	
                100%

              

      

      

      
        	VIII.	
                TERMINATION
                  OF EMPLOYMENT

              

      

      

      In
        the
        event that the employment of the Officer shall terminate prior to Normal
        Retirement Age, by the Officer’s voluntary action, or by the Officer’s discharge
        by the Bank without cause, then this Agreement shall terminate upon the date
        of
        such termination of employment and the Bank shall pay to the Officer an amount
        of money equal to balance of the Officer’s accrued liability retirement account
        on the date of said termination, multiplied by the Officer’s cumulative vested
        percentage. This compensation shall be paid in one (1) lump sum the first
        day of
        the second month following Separation from Service. 

      

      In
        the
        event the Officer’s death should occur after such termination but prior to the
        payment provided for in this paragraph, the balance shall be paid, in one
        (1)
        lump sum to the Beneficiary. Said payment due hereunder shall be made the
        first
        day of the second month following the decease of the Officer.

      

      In
        the
        event the Officer shall be discharged for cause at any time, this Agreement
        shall terminate and all benefits provided herein shall be forfeited.

      

      
        	IX.	
                CHANGE
                  OF CONTROL

              

      

      

      If
        the
        Officer subsequently suffers a Termination of Employment (voluntarily or
        involuntarily), except for cause, anytime subsequent to a Change of Control,
        then the Officer shall receive the benefits stated in Paragraph IV herein
        upon
        attaining Normal Retirement Age, as if the Officer had been continuously
        employed by the Bank until the Officer’s Normal Retirement Age.

      
        
           

        

        
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            5
            -

          
            

          

        

        
           

        

      

      

      
        	X.	
                RESTRICTIONS
                  ON FUNDING

              

      

      

      The
        Bank
        shall have no obligation to set aside, earmark or entrust any fund or money
        with
        which to pay its obligations under this Agreement. The Officer, their
        beneficiary(ies), or any successor in interest shall be and remain simply
        a
        general creditor of the Bank in the same manner as any other creditor having
        a
        general claim for matured and unpaid compensation.

      

      The
        Bank
        reserves the absolute right, at its sole discretion, to either fund the
        obligations undertaken by this Agreement or to refrain from funding the same
        and
        to determine the extent, nature and method of such funding. Should the Bank
        elect to fund this Agreement, in whole or in part, through the purchase of
        life
        insurance, mutual funds, disability policies or annuities, the Bank reserves
        the
        absolute right, in its sole discretion, to terminate such funding at any
        time,
        in whole or in part. At no time shall any Officer be deemed to have any lien,
        right, title or interest in any specific funding investment or assets of
        the
        Bank.

      

      If
        the
        Bank elects to invest in a life insurance, disability or annuity policy on
        the
        life of the Officer, then the Officer shall assist the Bank by freely submitting
        to a physical exam and supplying such additional information necessary to
        obtain
        such insurance or annuities.

      

      
        	XI.	
                MISCELLANEOUS

              

      

      

      
        	 	
                A.

              	
                Alienability
                  and Assignment Prohibition:

              

      

      

      Neither
        the Officer, nor the Officer’s surviving spouse, nor any other Beneficiary under
        this Agreement shall have any power or right to transfer, assign, anticipate,
        hypothecate, mortgage, commute, modify or otherwise encumber in advance any
        of
        the benefits payable hereunder nor shall any of said benefits be subject
        to
        seizure for the payment of any debts, judgments, alimony or separate maintenance
        owed by the Officer or the Officer’s Beneficiary, nor be transferable by
        operation of law in the event of bankruptcy, insolvency or otherwise. In
        the
        event the Officer or any Beneficiary attempts assignment, commutation,
        hypothecation, transfer or disposal of the benefits hereunder, the Bank’s
        liabilities shall forthwith cease and terminate.

      

      
        	 	
                B.

              	
                Binding
                  Obligation of the Bank and any Successor in
                  Interest:

              

      

      

      The
        Bank
        shall not merge or consolidate into or with another bank or sell substantially
        all of its assets to another bank, firm or person until such bank, firm or
        person expressly agree, in writing, to assume and discharge the duties and
        obligations of the Bank under this Agreement. This Agreement shall be binding
        upon the parties hereto, their successors, beneficiaries, heirs and personal
        representatives.

      
        
           

        

        
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            6
            -

          
            

          

        

        
           

        

      

      

      
        	 	
                C.

              	
                Amendment
                  or Revocation:

              

      

      

      Subject
        to Paragraph XIII, it is agreed by and between the parties hereto that, during
        the lifetime of the Officer, this Agreement may be amended or revoked at
        any
        time or times, in whole or in part, by the mutual written consent of the
        Officer
        and the Bank. Any such amendment shall not be effective to decrease or restrict
        any Officer’s accrued benefit under this Agreement, determined as of the date of
        amendment, unless agreed to in writing by the Officer, and provided further,
        no
        amendment shall be made, or if made, shall be effective, if such amendment
        would
        cause the Agreement to violate Internal Revenue Code Section 409A. In the
        event
        this Agreement is terminated, such termination shall not cause a distribution
        of
        benefits, except under limited circumstances as permitted under Section 409A
        (i.e., 30 days before or 12 months after a Change of Control event, upon
        termination of all arrangements of the same type, or upon corporate dissolution
        or bankruptcy).

      

      
        	 	
                D.

              	
                Gender:

              

      

      

      Whenever
        in this Agreement words are used in the masculine or neutral gender, they
        shall
        be read and construed as in the masculine, feminine or neutral gender, whenever
        they should so apply.

      

      
        	 	
                E.

              	
                Headings:

              

      

      

      Headings
        and subheadings in this Agreement are inserted for reference and convenience
        only and shall not be deemed a part of this Agreement.

      

      
        	 	
                F.

              	
                Applicable
                  Law:

              

      

      

      The
        laws
        of the State of Georgia shall govern the validity and interpretation of this
        Agreement.

      

      
        	 	
                G.

              	
                Partial
                  Invalidity:

              

      

      

      If
        any
        term, provision, covenant, or condition of this Agreement is determined by
        an
        arbitrator or a court, as the case may be, to be invalid, void, or
        unenforceable, such determination shall not render any other term, provision,
        covenant, or condition invalid, void, or unenforceable, and the Agreement
        shall
        remain in full force and effect notwithstanding such partial
        invalidity.

      

      
        	 	
                H.

              	
                Not
                  a Contract of Employment:

              

      

      

      This
        Agreement shall not be deemed to constitute a contract of employment between
        the
        parties hereto, nor shall any provision hereof restrict the right of the
        Bank to
        discharge the Officer, or restrict the right of the Officer to terminate
        employment.

      
        
           

        

        
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            7
            -

          
            

          

        

        
           

        

      

      

      

      
        	 	
                I.

              	
                Tax
                  Withholding:

              

      

      

      The
        Bank
        shall withhold any taxes that are required to be withheld, under Section
        409A of
        the Code and regulations thereunder, from the benefits provided under this
        Agreement. The Officer acknowledges that the Bank’s sole liability regarding
        taxes is to forward any amounts withheld to the appropriate taxing
        authority(ies).

      

      
        	 	
                J.

              	
                Opportunity
                  to Consult with Independent Advisors:

              

      

      

      The
        Officer acknowledges that he has been afforded the opportunity to consult
        with
        independent advisors of his choosing including, without limitation, accountants
        or tax advisors and counsel regarding both the benefits granted to him under
        the
        terms of this Agreement and the: (i) terms and conditions which may affect
        the
        Officer’s right to these benefits; and (ii) personal tax effects of such
        benefits including, without limitation, the effects of any federal or state
        taxes, Section 280G of the Code, Section 409A of the Code and guidance or
        regulations thereunder, and any other taxes, costs, expenses or liabilities
        whatsoever related to such benefits, which in any of the foregoing instances
        the
        Officer acknowledges and agrees shall be the sole responsibility of the Officer
        notwithstanding any other term or provision of this Agreement. The Officer
        further acknowledges and agrees that the Bank shall have no liability whatsoever
        related to any such personal tax effects or other personal costs, expenses,
        or
        liabilities applicable to the Officer and further specifically waives any
        right
        for himself or herself, and his or her heirs, beneficiaries, legal
        representative, agents, successor and assign to claim or assert liability
        on the
        part of the Bank related to the matters described above in this paragraph.
        The
        Officer further acknowledges that he has read, understands and consents to
        all
        of the terms and conditions of this Agreement, and that he enters into this
        Agreement with a full understanding of its terms and conditions.

      

      
        	 	
                K.

              	
                Permissible
                  Acceleration Provision:

              

      

      

      Under
        Section 409A(a)(3), a payment of deferred compensation may not be accelerated
        except as provided in regulations by the Internal Revenue Code. Certain
        permissible payment accelerations include payments necessary to comply with
        a
        domestic relations order, payments necessary to comply with certain conflict
        of
        interest rules, payments intended to pay employment taxes, and certain de
        minimis payments related to the participant’s termination of the Officer’s
        interest in the plan. 

      
        
           

        

        
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            8
            -

          
            

          

        

        
           

        

      

      

      
        	XII.	
                ADMINISTRATIVE
                  AND CLAIMS PROVISION

              

      

      

      
        	 	
                A.

              	
                Plan
                  Administrator:

              

      

      

      The
“Plan
        Administrator” of this Agreement shall be Bank of Upson. As Plan Administrator,
        the Bank shall be responsible for the management, control and administration
        of
        the Agreement. The Plan Administrator may delegate to others certain aspects
        of
        the management and operation responsibilities of the Agreement including
        the
        employment of advisors and the delegation of ministerial duties to qualified
        individuals.

      

      
        	
              	B.	
                Claims
                  Procedure:

              

      

      

      a.    Filing
        a Claim for Benefits:

      

      Any
        insured, Beneficiary, or other individual, (“Claimant”) entitled to benefits
        under this Agreement will file a claim request with the Plan Administrator.
        The
        Plan Administrator will, upon written request of a Claimant, make available
        copies of all forms and instructions necessary to file a claim for benefits
        or
        advise the Claimant where such forms and instructions may be obtained. If
        the
        claim relates to disability benefits, then the Plan Administrator shall
        designate a sub-committee to conduct the initial review of the claim (and
        applicable references below to the Plan Administrator shall mean such
        sub-committee).

      

      b.    Denial
        of Claim:

      

      
        	 	 	
                A
                  claim for benefits under this Agreement will be denied if the Bank
                  determines that the Claimant is not entitled to receive benefits
                  under the
                  Agreement. Notice of a denial shall be furnished the Claimant within
                  a
                  reasonable period of time after receipt of the claim for benefits
                  by the
                  Plan Administrator. This time period shall not exceed more than
                  ninety
                  (90) days after the receipt of the properly submitted claim. In
                  the event
                  that the claim for benefits pertains to disability, the Plan Administrator
                  shall provide written notice within forty-five (45) days. However,
                  if the
                  Plan Administrator determines, in its discretion, that an
                  extension of time for processing the claim is required, such extension
                  shall not exceed an additional ninety (90) days. In the case of
                  a claim
                  for disability benefits, the forty-five (45) day review period
                  may be
                  extended for up to thirty (30) days if necessary due to circumstances
                  beyond the Plan Administrator’s control, and for an additional thirty (30)
                  days, if necessary. Any
                  extension notice shall indicate the special circumstances requiring
                  an
                  extension of time and the date by which the Plan Administrator
                  expects to
                  render the determination on
                  review.

              

      

      
        
           

        

        
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            9
            -

          
            

          

        

        
           

        

      

      

      

      c.    Content
        of Notice:

      

      
        	 	 	
                The
                  Plan Administrator shall provide written notice to every Claimant
                  who is
                  denied a claim for benefits which notice shall set forth the
                  following:

              

      

       

      
        	
              	(i.)	
                The
                  specific reason or reasons for the
                  denial;

              

      

      

      
        	 	
                (ii.)

              	
                Specific
                  reference to pertinent Agreement provisions on which the denial
                  is
                  based;

              

      

      

      
        	 	
                (iii.)

              	
                A
                  description of any additional material or information necessary
                  for the
                  Claimant to perfect the claim, and any explanation of why such
                  material or
                  information is necessary; and

              

      

      

      
        	 	
                (iv.)

              	
                Any
                  other information required by applicable regulations, including
                  with
                  respect to disability benefits. 

              

      

      

      d.    Review
        Procedure:

      

      
        	 	 	
                The
                  purpose of the Review Procedure is to provide a method by which
                  a Claimant
                  may have a reasonable opportunity to appeal a denial of a claim
                  to the
                  Plan Administrator for a full and fair review. The Claimant, or
                  his duly
                  authorized representative, may:

              

      

       

      
        	 	
                (i.)

              	
                Request
                  a review upon written application to the Plan Administrator. Application
                  for review must be made within sixty (60) days of receipt of written
                  notice of denial of claim. If the denial of claim pertains to disability,
                  application for review must be made within one hundred eighty (180)
                  days
                  of receipt of written notice of the denial of
                  claim;

              

      

      

      
        	 	
                (ii.)

              	
                Review
                  and copy (free of charge) pertinent Agreement documents, records
                  and other
                  information relevant to the Claimant’s claim for
                  benefits;

              

      

      

      
        	 	
                (iii.)

              	
                Submit
                  issues and concerns in writing, as well as documents, records,
                  and other
                  information relating to the
                  claim.

              

      

      
        
           

        

        
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            10
            -

          
            

          

        

        
           

        

      

      

      e.    Decision
        on Review:

      

      A
        decision on review of a denied claim shall be made in the  following
        manner:

      

      
        	 	
                (i.)

              	
                The
                  Plan Administrator may, in its sole discretion, hold a hearing
                  on the
                  denied claim. If the Claimant’s initial claim is for disability benefits,
                  any review of a denied claim shall be made by members of the Plan
                  Administrator other than the original decision maker(s) and such
                  person(s)
                  shall not be a subordinate of the original decision maker(s). The
                  decision
                  on review shall be made promptly, but generally not later than
                  sixty (60)
                  days after receipt of the application for review. In the event
                  that the
                  denied claim pertains to disability, such decision shall not be
                  made later
                  than forty-five (45) days after receipt of the application for
                  review. If
                  the Plan Administrator determines that an extension of time for
                  processing
                  is required, written notice of the extension shall be furnished
                  to the
                  Claimant prior to the termination of the initial sixty (60) day
                  period. In
                  no event shall the extension exceed a period of sixty (60) days
                  from the
                  end of the initial period. In the event the denied claim pertains
                  to
                  disability, written notice of such extension shall be furnished
                  to the
                  Claimant prior to the termination of the initial forty-five (45)
                  day
                  period. In no event shall the extension exceed a period of thirty
                  (30)
                  days from the end of the initial period. The extension notice shall
                  indicate the special circumstances requiring an extension of time
                  and the
                  date by which the Plan Administrator expects to render the determination
                  on review.

              

      

      

      
        	 	
                (ii.)

              	
                The
                  decision on review shall be in writing and shall include specific
                  reasons
                  for the decision written in an understandable manner with specific
                  references to the pertinent Agreement provisions upon which the
                  decision
                  is based. 

              

      

      

      
        	 	
                (iii.)

              	
                The
                  review will take into account all comments, documents, records
                  and other
                  information submitted by the Claimant relating to the claim without
                  regard
                  to whether such information was submitted or considered in the
                  initial
                  benefit determination. Additional considerations shall be required
                  in the
                  case of a claim for disability benefits. For example, the
                  claim will be reviewed without deference to the initial adverse
                  benefits
                  determination and, if the initial

              

      

      
        
           

        

        
          -
            11
            -

          
            

          

        

        
           

        

      

      adverse
        benefit determination was based in whole or in part on a medical judgment,
        the
        Plan Administrator will consult with a health care professional with appropriate
        training and experience in the field of medicine involving the medical judgment.
        The health care professional who is consulted on appeal will not be the same
        individual who was consulted during the initial determination or the subordinate
        of such individual. If the Plan Administrator obtained the advice of medical
        or
        vocational experts in making the initial adverse benefits determination
        (regardless of whether the advice was relied upon), the Plan Administrator
        will
        identify such experts.

       

      
        	 	
                (iv.)

              	
                The
                  decision on review will include a statement that the Claimant is
                  entitled
                  to receive, upon request and free of charge, reasonable access
                  to, and
                  copies of, all documents, records or other information relevant
                  to the
                  Claimant’s claim for benefits.

              

      

      

      
        	 	 	
                f.

              	
                Exhaustion
                  of Remedies:

              

      

      

      
        	 	 	 	
                A
                  Claimant must follow the claims review procedures under this Agreement
                  and
                  exhaust his or her administrative remedies before taking any further
                  action with respect to a claim for
                  benefits.

              

      

      

      
        	 	
                C.

              	
                Arbitration:

              

      

      

      If
        claimants continue to dispute the benefit denial based upon completed
        performance of this Agreement or the meaning and effect of the terms and
        conditions thereof, then claimants may submit the dispute to an Arbitrator
        for
        final arbitration. The Arbitrator shall be selected by mutual agreement of
        the
        Bank and the claimants. The Arbitrator shall operate under any generally
        recognized set of arbitration rules. The parties hereto agree that they and
        their heirs, personal representatives, successors and assigns shall be bound
        by
        the decision of such Arbitrator with respect to any controversy properly
        submitted to it for determination.

      

      Where
        a
        dispute arises as to the Bank’s discharge of the Officer “for cause,” such
        dispute shall likewise be submitted to arbitration as above described and
        the
        parties hereto agree to be bound by the decision thereunder.

      

      
        	
                XIII.

              	
                TERMINATION
                  OR MODIFICATION OF AGREEMENT BY REASON OF CHANGES IN THE LAW, RULES
                  OR
                  REGULATIONS

              

      

      

      The
        Bank
        is entering into this Agreement upon the assumption that certain existing
        tax
        laws, rules and regulations will continue in effect in their current

      
        
           

        

        
          -
            12
            -

          
            

          

        

        
           

        

      

      form.
        If
        any said assumptions should change and said change has a detrimental effect
        on
        this Agreement, then the Bank reserves the right to terminate or modify this
        Agreement accordingly. Any such termination or modification shall not be
        effective to decrease or restrict any Officer’s Accrued Liability Retirement
        Account under this Agreement, determined as of the date of amendment, unless
        agreed to in writing by the Officer, and provided further, no amendment shall
        be
        made, or if made, shall be effective, if such termination or modification
        would
        cause the Agreement to violate Internal Revenue Code Section 409A. In the
        event
        this Agreement is terminated, such termination shall not cause a distribution
        of
        benefits, except under limited circumstances as permitted under Section 409A
        (i.e., 30 days before or 12 months after a Change in Control event, upon
        termination of all arrangements of the same type, or upon corporate dissolution
        or bankruptcy). Upon a Change of Control, this paragraph shall become null
        and
        void effective immediately upon said Change of Control.

      

      

      IN
        WITNESS WHEREOF,
        the
        parties hereto acknowledge that each has carefully read this Agreement and
        executed the original thereof on the first day set forth hereinabove, and
        that,
        upon execution, each has received a conforming copy.

      

      
        	 	
                BANK
                  OF UPSON

              
	 	
                Thomaston,
                  Georgia

              
	 	 
	 	 
	 	 
	__________________________	
                By:_______________________________

              
	
                Witness
                  

              	
                (Bank
                  Officer other than Insured)                  
                   Title

              
	 	 
	 	 
	 	 
	__________________________	__________________________________
	
                Witness

              	
                Douglas
                  J. Hertha

              

      

      

      
        
           

        

        
          -
            13
            -

          
            

          

        

        
           

        

      

      BENEFICIARY
        DESIGNATION FORM FOR THE OFFICER SALARY CONTINUATION AGREEMENT

      

      
        	
                I.

              	
                PRIMARY
                  DESIGNATIONS 

              
	 	 	 	 	 
	 	
                A.

              	
                Person(s)
                  as a Primary Designation:

                (Please
                  indicate the percentage for each beneficiary.)

              
	 	
                 

                1.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                2.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                3.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                4.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 
	
                II.

              	
                ESTATE
                  AND/OR TRUST AS PRIMARY DESIGNATIONS

              
	 	 	 	 	 
	 	
                A.

              	
                Estate
                  as a Primary Designation:

                An
                  Estate can still be listed even if there is no
                  will.

              
	 	 	
                 

                My
                  Primary Beneficiary is The Estate of 

              	 	
                 

                as
                  set forth in the Last Will and 

              
	 	 	 	
                (Insert
                  full name)

              	 
	 	 	
                Testament
                  dated the

              	 	
                day
                  of

              	 	 	
                ,
                  200

              	
                and
                  any codicils thereto.

              
	 	 	 
	 	
                B.

              	
                Trust
                  as a Primary Designation:

              
	 	 	
                 

                Name
                  of the Trust: 

              
	 	 	
                 

                Execution
                  Date of the Trust:

              	
                 

                Name
                  of the Trustee:

              
	 	 	
                 

                Beneficiary
                  of the Trust:

                (please
                  indicate the percentage for each beneficiary):

              
	 	 	
                 

                Name(s):

              
	 	 	
                 

                Name(s):

              
	 	 	
                 

                Is
                  this an Irrevocable Life Insurance Trust?□
Yes □
No

              
	 	 	
                (If
                  yes and this designation is for a Joint Beneficiary Designation
                  Agreement,
                  an Assignment of Rights form must
                  be completed.)

              

      

      

       

      
        
           

        

        
          -
            14 -

          
            

          

        

        
           

        

      

      
 

      

      
        	
                III.

              	
                SECONDARY
                  (CONTINGENT) DESIGNATIONS 

              
	 	 	 	 	 
	 	
                A.

              	
                Person(s)
                  as a Secondary (Contingent) Designation:

                (Please
                  indicate the percentage for each beneficiary in the event of the
                  Primary’s
                  Death.)

              
	 	
                 

                1.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                2.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                3.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                4.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	
                IV.

              	
                ESTATE
                  AND/OR TRUST AS SECONDARY (CONTINGENT)
                  DESIGNATIONS

              
	 	 	 	 	 
	 	
                A.

              	
                Estate
                  as a Secondary (Contingent) Designation:

              
	 	 	
                 

                My
                  Primary Beneficiary is The Estate of 

              	 	
                 

                as
                  set forth in the last will and

              
	 	 	
                Testament
                  dated the

              	 	
                day
                  of

              	 	 	
                ,
                  200

              	
                and
                  any codicils thereto.

              
	 	 	 
	 	
                B.

              	
                Trust
                  as a Secondary (Contingent) Designation:

              
	 	 	
                 

                Name
                  of the Trust: 

              
	 	 	
                 

                Execution
                  Date of the Trust:

              	
                 

                Name
                  of the Trustee:

              
	 	 	
                 

                Beneficiary
                  of the Trust:

                (please
                  indicate the percentage for each beneficiary):

              
	 	 	
                 

                Name(s):

              
	 	 	
                 

                Name(s):

              
	 	 	
                 

                Is
                  this an Irrevocable Life Insurance Trust?□
Yes □
No

              
	 	 	
                (If
                  yes and this designation is for a Joint Beneficiary Designation
                  Agreement,
                  an Assignment of Rights form must
                  be completed.)

              

      

      V. SIGN
        AND DATE

      

      This
        Beneficiary Designation Form is valid until the participant notifies the
        bank in
        writing.

      

      

      
        	__________________________	______________________________
	
                Douglas
                  J. Hertha

              	
                Date

              

      

      
 

       

       

       

       

      -
        15
        -Exhibit 10-12

    
      

    

    

      Exhibit
        10.12

    

    

      JOINT
        BENEFICIARY DESIGNATION

      AGREEMENT

      

      

      
        	
                Insurer:

              	
                ___________________

              
	 	
                ___________________

              
	 	 
	
                Policy
                  Number:

              	
                _____________

              
	 	
                _____________

              
	 	 
	
                Bank:

              	
                Bank
                  of Upson

              
	 	 
	
                Insured:

              	
                Douglas
                  J. Hertha

              
	 	 
	
                Relationship
                  of Insured to Bank:

              	
                Officer

              

      

      

      

      The
        respective rights and duties of the Bank and the Insured in the above-referenced
        policy shall be pursuant to the terms set forth below:

      

      
        	I.	
                DEFINITIONS

              

      

      

      Refer
        to
        the policy contract for the definition of any terms in this Agreement that
        are
        not defined herein. If the definition of a term in the policy is inconsistent
        with the definition of a term in this Agreement, then the definition of the
        term
        as set forth in this Agreement shall supersede and replace the definition
        of the
        terms as set forth in the policy.

      

      
        	
                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
        Joint Beneficiary Designation 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 Agreement.

      

      
        	
                III.

              	
                BENEFICIARY
                  DESIGNATION RIGHTS

              

      

      

      The
        Insured (or assignee) shall have the right and power to designate a beneficiary
        or beneficiaries to receive the Insured’s 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.

      
        
          13

           

        

        
           

          
            

          

        

        
           

        

      

      

      
        	
                IV.

              	
                PREMIUM
                  PAYMENT METHOD

              

      

      

      Subject
        to the Bank’s absolute right to surrender or terminate the policy at any time
        and for any reason, 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 imputed value of
        insurance as required by the Internal Revenue Service. The Bank (or its
        administrator) will report to the Insured the amount of imputed income each
        year
        on Form W-2 or its equivalent.

      

      
        	
                VI.

              	
                DIVISION
                  OF DEATH PROCEEDS

              

      

      

      Subject
        to Paragraphs VII and X herein, the division of the death proceeds of the
        policy
        is as follows:

      

      
        	 	
                A.

              	
                Should
                  the Insured be employed by the Bank or retired from the bank at
                  the time
                  of death, the Insured’s beneficiary(ies), designated in accordance with
                  Paragraph III, shall be entitled to an amount equal to the lesser
                  of Three
                  Hundred Fifty Thousand and 00/100th
                  Dollars ($350,000.00) or eighty percent (80%) of the net-at-risk
                  insurance
                  portion of the proceeds. The net-at-risk insurance portion is the
                  total
                  proceeds less the cash value of the
                  policy.

              

      

      

      
        	 	
                B.

              	
                Should
                  the Insured not be employed by the Bank at the time of death,
                  the Insured’s beneficiary(ies), designated in accordance with Paragraph
                  III, shall be entitled to the percentage as set forth hereinbelow
                  of the
                  proceeds described in Subparagraph VI (A) above that corresponds
                  to the
                  Insured’s age:

              

      

      

      
        	
                Age
                  of the Insured

              	
                Vested
                  (to a maximum of 100%)

              
	
                59
                  and under

              	
                0%

              
	
                Age
                  60

              	
                50%

              
	
                61-65

              	
                An
                  additional 10% vested per year 

              
	
                 

              	
                (to
                  a total maximum of 100%)

              

      

      

      
        	 	
                C.

              	
                The
                  Bank shall be entitled to the remainder of such
                  proceeds.

              

      

      

      
        	 	
                D.

              	
                The
                  Bank and the Insured (or assignees) shall share in any interest
                  due on the
                  death proceeds on a pro rata basis as the proceeds due each respectively
                  bears to the total proceeds, excluding any such
                  interest.

              

      

      
        
          13

           

        

        
           

          
            

          

        

        
           

        

      

      

      
        	
                VII.

              	
                DIVISION
                  OF THE CASH SURRENDER VALUE OF THE
                  POLICY

              

      

      

      The
        Bank
        shall at all times be entitled to an amount equal to the policy’s cash value, as
        that term is defined in the policy contract, less any policy loans and unpaid
        interest or cash withdrawals previously incurred by the Bank and any applicable
        surrender charges. Such cash value shall be determined as of the date of
        surrender or death as the case may be.

      

      
        	
                VIII.

              	
                PREMIUM
                  WAIVER

              

      

      

      
        	 	
                If
                  the policy contains a premium waiver provision, such waived amounts
                  shall
                  be be considered for all purposes of this Agreement as having been
                  paid by
                  the Bank.

              

      

      

      
        	
                IX.

              	
                RIGHTS
                  OF PARTIES WHERE POLICY ENDOWMENT OR ANNUITY ELECTION
                  EXISTS

              

      

      

      In
        the
        event the policy involves an endowment or annuity element, the Bank’s right and
        interest in any endowment proceeds or annuity benefits, on expiration of
        the
        deferment period, shall be determined under the provisions of this Agreement
        by
        regarding such endowment proceeds or the commuted value of such annuity benefits
        as the policy’s cash value. Such endowment proceeds or annuity benefits shall be
        considered to be like death proceeds for the purposes of division under this
        Agreement.

      

      
        	
                X.

              	
                TERMINATION
                  OF AGREEMENT

              

      

      

      
        	 	
                A.

              	
                This
                  Agreement shall terminate at the option of the Bank following thirty
                  (30)
                  days written notice to the Insured upon the happening of any one
                  of the
                  following:

              

      

      

      
        	 	
                1.

              	
                The
                  Insured shall leave the employment of the Bank (voluntarily or
                  involuntarily) prior to the Insured attaining the age of sixty
                  (60); or
                  

              

      

      

      
        	 	
                2.

              	
                The
                  Insured shall be discharged from employment with the Bank for cause.
                  The
                  term “for cause” shall mean: (i) gross negligence or neglect in the
                  performance of his job; (ii) the commission of a felony or gross
                  misdemeanor involving fraud, dishonesty or willful violation of
                  any law
                  that results in any adverse effect on the Bank.

              

      

      

      
        	 	
                B.

              	
                Upon
                  such termination of this Agreement but prior to the termination
                  of the
                  policy by the Bank, the Insured (or assignee) shall have a fifteen
                  (15)
                  day option to receive from the Bank an absolute assignment of the
                  policy
                  in consideration of a cash payment to the Bank, whereupon this
                  Agreement
                  shall terminate. Such cash payment referred to hereinabove shall
                  be the
                  greater of:

              

      

      
        
          13

           

        

        
           

          
            

          

        

        
           

        

      

      

      
        	 	
                1.

              	
                The
                  Bank’s share of the cash value of the policy on the date of such
                  assignment, as defined in this Agreement;
                  or

              

      

      

      
        	 	
                2.

              	
                The
                  amount of the premiums that have been paid by the Bank prior to
                  the date
                  of such assignment.

              

      

      

      
        	 	
                C.

              	
                Should
                  the Insured (or assignee) fail to exercise this option within the
                  prescribed fifteen (15) day period, the Insured (or assignee) agrees
                  that
                  all of his rights, interest and claims in the policy shall terminate
                  as of
                  the date of the termination of this
                  Agreeement.

              

      

      

      
        	 	
                D.

              	
                In
                  the event, however, that the Insured is terminated “for cause” under the
                  terms as set forth in Subparagraph X (A) (2) above, the Bank shall
                  have
                  the right, in its sole discretion, to allow the Insured to exercise
                  the
                  option as set forth above. 

              

      

      

      
        	 	
                E.

              	
                Except
                  as provided above, this Agreement shall terminate upon distribution
                  of the
                  death benefit proceeds in accordance with Paragraph VI
                  above.

              

      

      

      
        	
                XI.

              	
                INSURED’S
                  OR ASSIGNEE’S ASSIGNMENT
                  RIGHTS

              

      

      

      The
        Insured may not, without the written consent of the Bank, assign to any
        individual, trust or other organization, any right, title or interest in
        the
        subject policy nor any rights, options, privileges or duties created under
        this
        Agreement.

      

      
        	
                XII.

              	
                AGREEMENT
                  BINDING UPON THE PARTIES

              

      

      

      This
        Agreement shall bind the Insured and the Bank, their heirs, successors, personal
        representatives and assigns.

      

      
        	
                XIII.

              	
                ADMINISTRATIVE
                  AND CLAIMS PROVISIONS 

              

      

      

      
        	 	
                The
                  following provisions are part of this Agreement and are intended
                  to meet
                  the requirements of the Employee Retirement Income Security Act
                  of 1974
                  (“ERISA”):

              

      

      

      A. Plan
        Administrator:

      

      The
“Plan
        Administrator” of this Joint Beneficiary Designation Agreement shall be Bank of
        Upson. As Plan Administrator, the Bank shall be responsible for the management,
        control, and administration of this Agreement as established herein. The
        Plan
        Administrator may delegate to others certain aspects of the management and
        operation responsibilities of the Agreement, including the employment of
        advisors and the delegation of any ministerial duties to qualified
        individuals.

      
        
          13

           

        

        
           

          
            

          

        

        
           

        

      

      

      
        	 	
                B.

              	
                Basis
                  of Payment of Benefits: 

              

      

      

      Direct
        payment by the Insurer is the basis of payment of benefits under this Agreement,
        with those benefits in turn being based on the payment of premiums as provided
        in this Agreement. 

      

      
        	
              	C.	
                Claim
                  Procedures:

              

      

      

      Claim
        forms or claim information as to the subject policy can be obtained by
        contacting Benmark, Inc. (800-544-6079). When the Plan Administrator has
        a claim
        which may be covered under the provisions described in the insurance policy,
        they should contact the office named above, and they will either complete
        a
        claim form and forward it to an authorized representative of the Insurer
        or
        advise the Plan Administrator what further requirements are necessary. The
        Insurer will evaluate and make a decision as to payment. If the claim is
        payable, a benefit check will be issued in accordance with the terms of this
        Agreement.

      

      In
        the
        event that a claim is not eligible under the policy, the Insurer will notify
        the
        Plan Administrator of the denial pursuant to the requirements under the terms
        of
        the policy. If the Plan Administrator is dissatisfied with the denial of
        the
        claim and wishes to contest such claim denial, they should contact the office
        named above and they will assist in making an inquiry to the Insurer. All
        objections to the Insurer’s actions should be in writing and submitted to the
        office named above for transmittal to the Insurer.

      

      
        	XIV.	
                GENDER

              

      

      

      Whenever
        in this Agreement words are used in the masculine or neuter gender, they
        shall
        be read and construed as in the masculine, feminine or neuter gender, whenever
        they should so apply.

      

      
        	
                XV.

              	
                INSURANCE
                  COMPANY NOT A PARTY TO THIS
                  AGREEMENT

              

      

      

      The
        Insurer shall not be deemed a party to this Agreement, but will respect the
        rights of the parties as herein developed upon receiving an executed copy
        of
        this Agreement. Payment or other performance in accordance with the policy
        provisions shall fully discharge the Insurer from any and all
        liability.

      
        
          13

           

        

        
           

          
            

          

        

        
           

        

      

      

      
        	XVI.	
                CHANGE
                  OF CONTROL

              

      

      

      Change
        of
        Control shall be defined as the occurrence of any one of the
        following:

      

      
        	 	
                a.

              	
                the
                  acquisition of more than fifty percent (50%) of the value or voting
                  power
                  of the Bank’s stock by a person or
                  group;

              

      

      

      
        	 	
                b.

              	
                the
                  acquisition in a period of twelve (12) months or less of at least
                  thirty-five percent (35%) of the Bank’s stock by a person or
                  group;

              

      

      

      
        	 	
                c.

              	
                the
                  replacement of a majority of the Bank’s board in a period of twelve (12)
                  months or less by Directors who were not endorsed by a majority
                  of the
                  current board members; or

              

      

      

      
        	 	
                d.

              	
                the
                  acquisition in a period of twelve (12) months or less of forty
                  percent
                  (40%) or more of the Bank’s assets by an unrelated
                  entity.

              

      

      

      For
        the
        purposes of this Agreement, transfers made on account of deaths or gifts,
        transfers between family members or transfers to a qualified retirement plan
        maintained by the Bank shall not be considered in determining whether there
        has
        been a Change in Control. Upon a Change of Control, if the Insured’s employment
        is subsequently terminated, except for cause, then the Insured shall be one
        hundred percent (100%) vested in the benefits promised in this Agreement
        and,
        therefore, upon the death of the Insured, the Insured’s beneficiary(ies)
        (designated in accordance with Paragraph III) shall receive the death benefit
        provided herein as if the Insured had died while employed by the Bank (see
        Subparagraphs VI [A]).

      

      
        	XVII.	
                AMENDMENT
                  OR REVOCATION, AND EXCHANGE OF
                  POLICY

              

      

      

      Subject
        to the Bank’s sole and absolute right to surrender or terminate any and all life
        insurance policies that are the subject matter of this Agreement, it is agreed
        by and between the parties hereto that, during the lifetime of the Insured,
        this
        Agreement may be amended or revoked at any time or times, in whole or in
        part,
        by the mutual written consent of the Insured and the Bank. The Bank may,
        however, unilaterally and without the consent of the Insured, exchange any
        life
        insurance policy(ies) that are the subject matter of this Agreement, with
        or
        without replacing said policy(ies) and, in the event of a same or similar
        exchange, the Insured expressly agrees to the same.

      

      XVIII. EFFECTIVE
        DATE

      

      The
        Effective Date of this Agreement shall be March 28, 2006.

      
        
          13

           

        

        
           

          
            

          

        

        
           

        

      

      

      
        	XIX.	
                SEVERABILITY
                  AND INTERPRETATION

              

      

      

      If
        a
        provision of this Agreement is held to be invalid or unenforceable, the
        remaining provisions shall nonetheless be enforceable according to their
        terms.
        Further, in the event that any provision is held to be overbroad as written
        such
        provision shall be deemed amended to narrow its application to the extent
        necessary to make the provision enforceable according to law and enforced
        as
        amended.

      

      
        	
                XX.

              	
                TERMINATION
                  OR MODIFICATION OF AGREEMENT BY REASON OF CHANGES IN THE LAW, RULES
                  OR
                  REGULATIONS

              

      

      

      The
        Bank
        is entering into this Agreement upon the assumption that certain existing
        tax
        and accounting laws, rules and regulations will continue in effect in their
        current form. If any said assumptions should change and said change has a
        detrimental effect on this Joint Beneficiary Designation Agreement, then
        the
        Bank reserves the right to terminate or modify this Agreement accordingly.
        Upon
        a Change of Control, this paragraph shall become null and void effective
        immediately upon said Change of Control.

      

      
        	XXI.	
                APPLICABLE
                  LAW

              

      

      

      The
        laws
        of the State of Georgia shall govern the validity and interpretation of this
        Agreement.

      

      

      Executed
        at Upson, Georgia this ______ day of ___________, 2007.

      

      
        	 	
                BANK
                  OF UPSON

              
	 	
                Thomaston,
                  Georgia

              
	 	 
	 	 
	 	 
	_____________________________	
                By:_____________________________

              
	
                Witness
                  

              	
                (Bank
                  Officer other than Insured)          Title

              
	 	 
	 	 
	 	 
	_____________________________	________________________________
	
                Witness

              	
                Douglas
                  John Hertha

              

      

      
        
          13

           

        

        
           

          
            

          

        

        
           

        

      

      BENEFICIARY
        DESIGNATION FORM

      FOR
        THE JOINT BENEFICIARY DESIGNATION AGREEMENT

      

      
        	
                I.

              	
                PRIMARY
                  DESIGNATIONS 

              
	 	 	 	 	 
	 	
                A.

              	
                Person(s)
                  as a Primary Designation:

                (Please
                  indicate the percentage for each beneficiary.)

              
	 	
                 

                1.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                2.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                3.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                4.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 
	
                II.

              	
                ESTATE
                  AND/OR TRUST AS PRIMARY DESIGNATIONS

              
	 	 	 	 	 
	 	
                A.

              	
                Estate
                  as a Primary Designation:

                An
                  Estate can still be listed even if there is no
                  will.

              
	 	 	
                 

                My
                  Primary Beneficiary is The Estate of 

              	 	
                 

                as
                  set forth in the Last Will and 

              
	 	 	 	
                (Insert
                  full name)

              	 
	 	 	
                Testament
                  dated the

              	 	
                day
                  of

              	 	 	
                ,
                  200

              	
                and
                  any codicils thereto.

              
	 	 	 
	 	
                B.

              	
                Trust
                  as a Primary Designation:

              
	 	 	
                 

                Name
                  of the Trust: 

              
	 	 	
                 

                Execution
                  Date of the Trust:

              	
                 

                Name
                  of the Trustee:

              
	 	 	
                 

                Beneficiary
                  of the Trust:

                (please
                  indicate the percentage for each beneficiary):

              
	 	 	
                 

                Name(s):

              
	 	 	
                 

                Name(s):

              
	 	 	
                 

                Is
                  this an Irrevocable Life Insurance Trust?□
Yes □
No

              
	 	 	
                (If
                  yes and this designation is for a Joint Beneficiary Designation
                  Agreement,
                  an Assignment of Rights form must
                  be completed.)

                 

              

      

      
        
          13

           

        

        
           

          
            

          

        

        
           

        

      

      

      
        	
                III.

              	
                SECONDARY
                  (CONTINGENT) DESIGNATIONS 

              
	 	 	 	 	 
	 	
                A.

              	
                Person(s)
                  as a Secondary (Contingent) Designation:

                (Please
                  indicate the percentage for each beneficiary in the event of the
                  Primary’s
                  Death.)

              
	 	
                 

                1.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                2.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                3.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	 	
                 

                4.

              	
                 

                Name:

              	
                 

                Relationship:

              	
                 

                SS#:

              	
                 

                %

              
	 	 	
                 

                Address:

              
	 	 	 	
                (Street)

              	
                (City)

              	
                (State)

              	
                (Zip)

              
	 	 	 
	
                IV.

              	
                ESTATE
                  AND/OR TRUST AS SECONDARY (CONTINGENT)
                  DESIGNATIONS

              
	 	 	 	 	 
	 	
                A.

              	
                Estate
                  as a Secondary (Contingent) Designation:

              
	 	 	
                 

                My
                  Primary Beneficiary is The Estate of 

              	 	
                 

                as
                  set forth in the last will and

              
	 	 	
                Testament
                  dated the

              	 	
                day
                  of

              	 	 	
                ,
                  200

              	
                and
                  any codicils thereto.

              
	 	 	 
	 	
                B.

              	
                Trust
                  as a Secondary (Contingent) Designation:

              
	 	 	
                 

                Name
                  of the Trust: 

              
	 	 	
                 

                Execution
                  Date of the Trust:

              	
                 

                Name
                  of the Trustee:

              
	 	 	
                 

                Beneficiary
                  of the Trust:

                (please
                  indicate the percentage for each beneficiary):

              
	 	 	
                 

                Name(s):

              
	 	 	
                 

                Name(s):

              
	 	 	
                 

                Is
                  this an Irrevocable Life Insurance Trust?□
Yes □
No

              
	 	 	
                (If
                  yes and this designation is for a Joint Beneficiary Designation
                  Agreement,
                  an Assignment of Rights form must
                  be completed.)

              

      

      V. SIGN
        AND DATE

      

      This
        Beneficiary Designation Form is valid until the participant notifies the
        bank in
        writing.

      

      

      
        	___________________________	______________________________
	
                Douglas
                  John Hertha

              	
                Date

              

      

      
 

       

       

      14

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