Document:

ex10_15.htm

    
      

    

    Exhibit
10.15

    

    OFFICER
SALARY CONTINUATION AGREEMENT

    

    THIS AGREEMENT, made and
entered into this 20th day of June, 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 Trae D. Dorough, 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.

    
      
         

      

      
        - 1
-

        
          

        

      

      
         

      

    

    
      	
              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.

            

    

    

    
      	
               
      

            	
              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,

    
      
         

      

      
        - 2
-

        
          

        

      

      
         

      

    

    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.

    
      
         

      

      
        - 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 Twenty-Five Thousand and 00.100th Dollars
($25,000.00).  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.

    
      
         

      

      
        - 4
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              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.

    

    
      	
              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

    
      
         

      

      
        - 5
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    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.

    

    
      	
               
      

            	
              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

    
      
         

      

      
        - 6
-

        
          

        

      

      
         

      

    

    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.

    

    
      	
               
      

            	
              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

    
      
         

      

      
        - 7
-

        
          

        

      

      
         

      

    

    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.

    

    
      	
              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.

    
      
         

      

      
        - 8
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              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.

    

    
      	
               
      

            	
              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;

            

    

    
      
         

      

      
        - 9
-

        
          

        

      

      
         

      

    

    
      	
               
      

            	
              (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.

            

    

    

    
      	
               
      

            	
              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

            

    

    
      
         

      

      
        - 10
-

        
          

        

      

      
         

      

    

    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 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.

    
      
         

      

      
        - 11
-

        
          

        

      

      
         

      

    

    
      	
               
      

            	
              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
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.

    
      
         

      

      
        - 12
-

        
          

        

      

      
         

      

    

    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

            	 
      	
              Trae
      D. Dorough

            

    

    
      
         

      

      
        - 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#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                2.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                3.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                4.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (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#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                2.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                3.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                4.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (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.

              

      

       

    

    
      	 
      	 
      	 
      	 
      
	 
      	
              Trae
      D. Dorough

            	 
      	
              Date

            

    

    
 

     - 15
-ex10_16.htm

    
      
        

      

    

    Exhibit
10.16

    

    JOINT
BENEFICIARY DESIGNATION

    AGREEMENT

    

    

    
      	
              Insurer:

            	 
      	 
      
	 
      	 
      	 
      
	 
      	 
      	 
      
	
              Policy
      Number:

            	 
      	 
      
	 
      	 
      	 
      
	 
      	 
      	 
      
	
              Bank:

            	
              Bank
      of Upson

            	 
      
	 
      	 
      	 
      
	
              Insured:

            	
              Trae
      D. Dorough

            	 
      
	 
      	 
      	 
      
	
              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.

    
      
         

      

      
        
        

        
          

        

      

      
         

      

    

    
      	
              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 assumed cost 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 Two
      Hundred Fifty Thousand and 00/100th
      Dollars ($250,000.00) 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.

            

    

    
      
         

      

      
        2

        
          

        

      

      
         

      

    

    
      	
              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:

            

    

    
      
         

      

      
        3

        
          

        

      

      
         

      

    

    
      	
               
      

            	
              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

    
      
         

      

      
        4

        
          

        

      

      
         

      

    

    the
Agreement, including the employment of advisors and the delegation of any
ministerial duties to qualified individuals.

    

    
      	
               
      

            	
              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.

    
      
         

      

      
        5

        
          

        

      

      
         

      

    

    
      	
              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.

    
      
         

      

      
        6

        
          

        

      

      
         

      

    

    
      	
              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

            	 
      	
              Trae
      D. Dorough

            

    

    
      
         

      

      
        7

        
          

        

      

      
         

      

    

    
      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#:

              	 
      	
                %

              
	 	 	 	 	 	 	 	 	 
	 
      	 
      	
                 
      

              	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 	 	 	 	 	 	 	 	 
	 
      	
                2.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 	 	 	 	 	 	 	 	 
	 
      	 
      	
                 
      

              	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 	 	 	 	 	 	 	 	 
	 
      	
                3.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 	 	 	 	 	 	 	 	 
	 
      	 
      	
                 
      

              	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 	 	 	 	 	 	 	 	 
	 
      	
                4.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 	 	 	 	 	 	 	 	 
	 
      	 
      	
                 
      

              	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (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.)

            

    

    

      
        
           

        

        
          8

          
            

          

        

        
           

        

      

    

     

    
      
        	
                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#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                2.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                3.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (Street)

              	 
      	
                (City)

              	 
      	
                (State)

              	
                (Zip)

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                4.

              	
                Name:

              	 
      	
                Relationship:

              	 
      	
                SS#:

              	 
      	
                %

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	
                (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.

            
	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      
	 
      	
              Trae
      D. Dorough

            	 
      	
              Date

            

    

     

     

    9

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00139-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00139-of-00352.parquet"}]]