Document:

Exhibit 4.3

 Exhibit 4.3 
 LAKE SHORE BANCORP, INC. 
 2006
RECOGNITION AND RETENTION PLAN 
 RESTRICTED
STOCK AWARD NOTICE 
  

					
		
	  
	  	  

	 Name of Award Recipient
	  	Social Security Number
	
	  

		 	 Street Address
	  	
			
	  
	 	  
	  	  

	 City
	 	State	  	ZIP Code

 This Restricted Stock Award Notice is intended to set forth the terms and conditions on which an Award has been
granted under the Lake Shore Bancorp, Inc. 2006 Recognition and Retention Plan. Set forth below are the specific terms and conditions applicable to this Award. Attached as Exhibit A are its general terms and conditions. 
  

											
	 Restricted Stock Award
	  	(A)	  	(B)	  	(C)	  	(D)	  	(E)
	 Effective Date
	  		  		  		  		  	
						
	 Class of Shares*
	  	Common	  	Common	  	Common	  	Common	  	Common
						
	 No. of Awarded Shares*
	  		  		  		  		  	
						
	 Type of Award (Escrow or Legended Certificate)
	  		  		  		  		  	
						
	 Vesting Date*
	  		  		  		  		  	

	*	Subject to adjustment as provided in the Plan and the General Terms and Conditions. 

  
 By signing where indicated below, Lake Shore Bancorp, Inc. (the “Company”) grants this
Award upon the specified terms and conditions, and the Award Recipient acknowledges receipt of this Restricted Stock Award Notice, including Exhibit A, and agrees to observe and be bound by the terms and conditions set forth herein. 
  

							
	LAKE SHORE BANCORP, INC.	 		 	AWARD RECIPIENT
				
	By	 	  
	 		 	  

		 	Name:	 		 	
		 	Title:	 		 	

  

 Instructions: This page should be completed by or on behalf of the Compensation Committee. Any blank space intentionally left blank should be crossed out. An Award consists of shares granted with uniform terms and conditions. Where
shares granted under an Award are awarded on the same date with varying terms and conditions (for example, varying vesting dates), the awards should be recorded as a series of grants each with its own uniform terms and conditions. 

 EXHIBIT A 
 LAKE SHORE BANCORP, INC. 
 2006
RECOGNITION AND RETENTION PLAN  
 RESTRICTED
STOCK AWARD 
 General Terms And Conditions 
 Section 1. Size and Type of Award. The shares of Common Stock, par value $0.01 per share, of Lake Shore Bancorp, Inc.
(“Shares”) covered by this Award (“Awarded Shares”) are listed on this Restricted Stock Award Notice. Your Restricted Stock Award Notice designates the Awarded Shares as either “Escrow” or “Legended
Certificate”. 
 (a) Legended Certificate. If your Awarded Shares are designated
“Legended Certificate,” a stock certificate evidencing the Awarded Shares will be issued in your name and held in a brokerage account at the Plan Trustee. The stock certificate will bear a legend indicating that it is subject to all of the
terms and conditions of this Award Notice and the Plan. You will be required to elect to be taxed on the Fair Market Value of the Awarded Shares as of the date they are placed in the brokerage account in your name, pursuant to section 83(b) of the
Internal Revenue Code of 1986, as amended. You must make this election in writing, in the manner required by applicable Internal Revenue Service Regulations, and file it with the Internal Revenue Service and the Company within 30 days after the date
on which the Awarded Shares are placed in your brokerage account. 
 (b) Escrow. If your Awarded
Shares are designated “Escrow,” the Awarded Shares will either be held in the name of the Plan Trustee or Compensation Committee on a pooled basis with other Awarded Shares that have been designated “Escrow,” or they will be
evidenced by a legended stock certificate in your name that will be placed in a brokerage account for you at the Plan Trustee. You will not be permitted to elect to be taxed currently on the Fair Market Value of the Awarded Shares and instead will
be subject to income tax on the Awarded Shares as and when they become vested. 
 Section 2. Vesting. 

(a) Vesting Dates. The Vesting Dates for your Awarded Shares are specified on this Award Notice. On each
Vesting Date, you will obtain unrestricted ownership of the Awarded Shares that vest on that Vesting Date. A stock certificate (or a book entry listing) evidencing your unrestricted ownership of the vested Awarded Shares will be deposited in your
brokerage account at the Plan Trustee. If a legended stock certificate evidencing these Awarded Shares was previously placed in your brokerage account, it will be exchanged for an unrestricted certificate or book entry listing. 
 (b) Forfeitures. If you terminate service with the Company prior to
a Vesting Date, you will forfeit any Awarded Shares that are scheduled to vest on that date. When you forfeit Awarded Shares, all of your interest in the Awarded Shares will be canceled and any stock certificate or other evidence of ownership that
was placed in a brokerage account for you will be returned to the Plan Trustee to be used for future awards to others. You agree to take any action and execute and deliver any document that the Company requests to effect the return of your unvested
Awarded Shares. In the event you do not cooperate with the Company in this regard, you hereby appoint and designate the Company as your attorney-in-fact for the purpose of taking any action and signing any document, in your name, which the Company
determines is necessary to enforce the forfeiture. 
 (c) Accelerated Vesting. All of your Awarded
Shares that have not previously vested will become fully vested immediately, and without any further action on your part, in the event of your death, Disability (as defined in the Plan), Retirement (as defined in the Plan) or in the event a Change
of Control (as defined in the Plan). You may designate a Beneficiary to receive any Awarded Shares that vest upon your death using the Beneficiary Designation attached as Appendix A. 
 (d) Definition of Service. For purposes of determining the vesting of your Awarded Shares, you will be deemed
to be in the service of the Company for so long as you serve in any capacity as an employee, officer, non-employee director or emeritus director of the Company or its affiliates. 
 Section 3. Dividends. If your Awarded Shares are in the form of Legended Certificates, any dividends declared by the Company
with a record date that is after the Effective Date specified in this Award Notice will be credited to your brokerage account at the Plan Trustee for your benefit on an unrestricted basis. If your Awarded Shares are designated “Escrow”,
you will receive the dividends on an unrestricted basis, but they will be paid to you by, and will be taxable in the same manner as other compensation paid to you by, the Company; by signing this Award Notice and accepting its terms, you direct the
Plan Trustee to remit to the Company for payment to you any dividends that either of them may receive as the record holder of your unvested Awarded Shares. 
 Section 4. Voting Rights. You shall have the right to control all voting rights relating to all unvested Awarded Shares. If your Awarded Shares are placed in your brokerage account at the
Plan Trustee, you will receive proxy materials for voting in the same manner as other shareholders with Shares in brokerage accounts. If your unvested Awarded Shares are held by the Plan Trustee, the Plan Trustee will ask you for voting directions
and will follow your directions in voting your unvested Awarded Shares. 
 Section 5. Amendment. This Award Notice
may be amended, in whole or in part and in any manner not inconsistent with the provisions of the Plan, at any time and from time to time, by written agreement between you and the Company. 
 Section 6. Plan Provisions Control. This Award Notice, and the rights and obligations created hereunder, shall be subject to
all of the terms and conditions of the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this Award Notice, the terms of the Plan, which are incorporated herein by reference, shall control. 

 APPENDIX A TO RESTRICTED STOCK
AWARD NOTICE 
 LAKE SHORE BANCORP, INC.

 2006 RECOGNITION AND RETENTION PLAN 
 Beneficiary Designation Form 
  

																					
	 GENERAL
 INFORMATION
	 	Use this form to designate the Beneficiary(ies) who will receive Shares available for distribution at the time of your death.
											
	 Name of
 Award Recipient
	 	  	  		  		  		 	 Social Security Number
             –             –         
   
	  		  		 		  		  	
		
	 BENEFICIARY
 DESIGNATION
	 	Complete sections A and B. If no percentage shares are specified, each Beneficiary in the same class (primary or contingent) shall have an equal share. If any designated
Beneficiary predeceases you, the shares of each remaining Beneficiary in the same class (primary or contingent) shall be increased proportionately.
	
	A. PRIMARY BENEFICIARY(IES). I hereby designate the following person as my primary Beneficiary under the Plan, reserving the right to change or revoke this designation at any
time prior to my death:

											
						
	Name	  	Address	  	Relationship	  	Birthdate	  	Share	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  	Total = 100%
	
	B. CONTINGENT BENEFICIARY(IES). I hereby designate the following person(s) as my contingent Beneficiary(ies) under the Plan to receive benefits only if all of my primary
Beneficiaries should predecease me, reserving the right to change or revoke this designation at any time prior to my death with respect to all outstanding Awarded Shares:
						
	Name	  	Address	  	Relationship	  	Birthdate	  	Share	 	
						
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  	Total = 100%

													
				
	 S
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	 	 H
 E
 R
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	  	I understand that this Beneficiary Designation shall be effective only if properly completed and received by the Corporate Secretary of Lake Shore Bancorp, Inc. prior to my death,
and that it is subject to all of the terms and conditions of the Plan. I also understand that an effective Beneficiary designation revokes my prior designation(s) with respect to all outstanding Awarded Shares.	 	

													
		 		  	  	  		  	  	  		 	
		 		  	Your Signature	  		  	Date	  		 	

  

 _________________________________________Internal Use Only_________________________________________ 
  

															
		 		 		 	 	  		  	
		 		 	This Beneficiary Designation was received by the Corporate Secretary of Lake Shore Bancorp, Inc. on the date indicated.	 	 	  	Comments	  	
		 		 		 	 	  		  	
		 		 		 	 	  		  	
		 	 By
	 		 		 		 	 	  		  	
		 		 	 	 		 	 	 	 	  		  	
		 		 	Authorized Signature	 		 	DateExhibit 4.4

 Exhibit 4.4 
 LAKE SHORE BANCORP, INC. 
 2006
STOCK OPTION PLAN 
 STOCK
OPTION CERTIFICATE 
  

					
	  

	 Name of Optionee
	  		  	Social Security Number
	
	  

		  	Street Address	  	
	
	  

	 City
	  	State	  	ZIP Code

 This Stock Option Agreement is intended to set forth the terms and conditions on which a Stock Option has been
granted under the Lake Shore Bancorp, Inc. 2006 Stock Option Plan. Set forth below are the specific terms and conditions applicable to this Stock Option. Attached as Exhibit A are its general terms and conditions. 
  

											
	 Option Grant
	  	(A)	  	(B)	  	(C)	  	(D)	  	(E)
	 Grant Date:
	  		  		  		  		  	
						
	 Class of Optioned Shares*
	  	Common	  	Common	  	Common	  	Common	  	Common
						
	 No. of Optioned Shares*
	  		  		  		  		  	
						
	 Exercise Price Per Share*
	  		  		  		  		  	
						
	 Option Type (ISO or NQSO)
	  		  		  		  		  	
						
	 Vesting
	  		  		  		  		  	
						
	 Earliest Exercise Date*
	  		  		  		  		  	
						
	 Option Expiration Date*
	  		  		  		  		  	

	*	Subject to adjustment as provided in the Plan and the General Terms and Conditions. 

  
 By signing where indicated below, Lake Shore Bancorp, Inc. (the “Company”) grants this
Stock Option upon the specified terms and conditions, and the Optionee acknowledges receipt of this Stock Option Agreement, including Exhibit A, and agrees to observe and be bound by the terms and conditions set forth herein and acknowledges
receipt of a copy of the Lake Shore Bancorp, Inc. 2006 Stock Option Plan. 
  

							
	LAKE SHORE BANCORP, INC.	 		 	OPTIONEE
				
	By	 	  
	 		 	  

		 	Name:	 		 	
		 	Title:	 		 	

  

 Instructions: This page should be completed by or on behalf of the Compensation Committee. Any blank space intentionally left blank should be crossed out. An option grant consists of a number of optioned shares with uniform terms and
conditions. Where options are granted on the same date with varying terms and conditions (for example, varying exercise prices or earliest exercise dates), the options should be recorded as a series of grants each with its own uniform terms and
conditions. 

 EXHIBIT A 
 LAKE SHORE BANCORP, INC. 2006 STOCK OPTION PLAN 
 STOCK OPTION CERTIFICATE 
 General Terms and Conditions 
 Section 1. Option Size and Type. The
number of shares of Common Stock, par value $0.01 per share (“Shares”), that have been optioned to you under the Lake Shore Bancorp, Inc. 2006 Stock Option Plan (the “Plan”) is specified in this Stock Option Certificate. If the
“Option Type” shown for your stock option is “ISO”, then your stock option has been designed with the intent that it qualify to the maximum permissible extent for the special tax benefits applicable to incentive stock options
under the Internal Revenue Code of 1986. If the “Option Type” shown for your stock options is “NQSO”, then incentive stock option tax treatment is not applicable. 
 Section 2. Exercise Price. The Exercise Price for your stock options is the price per Share at which you may acquire the Shares
that have been optioned to you and is specified in this Stock Option Certificate. As a general rule, the Exercise Price for your stock options will not change unless there is a stock split, stock dividend, merger or other major corporate event that
justifies an adjustment. 
 Section 3. Vesting. 
 (a) Earliest Exercise Date. You may not exercise your stock options until they are vested. The date on which your stock
options become vested is specified in this Stock Option Certificate as the Earliest Exercise Date. As a general rule, you must be in the service of the Company on an Earliest Exercise Date in order to be vested in the stock options that vest on that
date. You may acquire the Shares that have been optioned to you by exercising your stock options at any time during the period beginning on the Earliest Exercise Date and continuing until the applicable Option Expiration Date, by completing and
filing the Notice of Exercise of Stock Option that is attached to this Stock Option Certificate as Appendix A and by following the procedures outlined therein. 
 (b) Forfeitures. If you terminate service with the Company prior to an Earliest Exercise Date, you will forfeit any stock
options that are scheduled to vest on that date. When you forfeit stock options, you relinquish any and all rights that you have to acquire the Shares that were optioned to you. 
 (c) Accelerated Vesting. Your outstanding stock options that have not previously vested will become fully and immediately
vested, without any further action on your part, in the event of your death or Disability or Retirement (if permitted by the terms of the Plan) before your termination of service with the Company. Similarly, all of your outstanding stock options
that have not previously vested will become fully and immediately vested if a Change of Control occurs before your termination of service with the Company; provided, that these unvested stock options shall accelerate vesting only if no substitute
grant is made pursuant to section 7.3(b) of the Plan. If vesting accelerates, the accelerated vesting date will be the applicable Earliest Exercise Date. You may designate a beneficiary to inherit your rights to any vested, unexercised stock options
that are outstanding to you at your death using the Beneficiary Designation attached as Appendix B. 
 Section 4. Option
Expiration Date. To derive any benefit from your stock options, you must exercise them during the period that begins on the applicable Earliest Exercise Date and ends on the Option Expiration Date. The Option Expiration Date for your
stock options is specified in this Stock Option Certificate. Your Option Expiration Date may be accelerated in the event of your termination of service with the Company. Your stock options will expire on the earliest of (i) the Option
Expiration Date, (ii) three months after your termination of service with the Company for any reason other than death, Disability (as defined in the Plan), Retirement (as defined in the Plan) or Termination for Cause (as defined in the Plan);
(iii) one year after your termination of service due to death, Disability or Retirement; and (iv) the date and time of your Termination for Cause. 
 Note: To qualify for the favorable tax treatment accorded to incentive stock options, you (or, in the event of your death, your estate or designated beneficiaries) must exercise any stock options that are
designated as ISOs within three months after you terminate service as a common-law employee of the Company and its affiliates for any reason other than death or disability and within one year after you terminate service as common-law employee due to
your death or disability. If they are exercised later, they will be subject to tax as if they were designated as NQSOs. 
 Section 5. Amendment. This Certificate may be amended, in whole or in part and in any manner not inconsistent with the provisions of the Plan, at any time and from time to time, by written Certificate between the
Company and you. 
 Section 6. Plan Provisions Control. This Certificate and the rights and obligations created
hereunder shall be subject to all of the terms and conditions of the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this Certificate, the terms of the Plan, which are incorporated herein by reference,
shall control. Capitalized terms in this Certificate have the meaning defined in the Plan, as amended from time to time, unless stated otherwise. By signing this Certificate, you acknowledge receipt of a copy of the Plan. 

 APPENDIX A TO STOCK OPTION
CERTIFICATE 
 LAKE SHORE BANCORP, INC. 2006 STOCK
OPTION PLAN 
 NOTICE OF EXERCISE OF
STOCK OPTION 

 Use this Notice to inform Lake Shore Bancorp, Inc. that you are exercising your right to purchase shares of common stock (“Shares”) of Lake Shore Bancorp, Inc. pursuant to an option (“Option”) granted under the
Lake Shore Bancorp, Inc. 2006 Stock Option Plan (“Plan”). If you are not the person to whom the Option was granted (“Option Recipient”), you must attach to this Notice proof of your right to exercise the Option granted under the
Stock Option Certificate entered into between Lake Shore Bancorp, Inc. and the Option Recipient (“Certificate”). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Lake Shore Bancorp, Inc.,
128 East 4th Street, Dunkirk, NY 14048, Attention: Compensation Committee. The effective date of the exercise of the Option
shall be the earliest date practicable following the date this Notice is received by Lake Shore Bancorp, Inc. (“Effective Date”). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to
them under the Plan. 
  

			
	 OPTION INFORMATION
	  	Identify below the Option that you are exercising by providing the following information from the Stock Option Certificate.

  

											
	Name of Option Recipient:	  	  
	  		  	
						
	Option Grant Date:	  	  
	  	,	  	  
	  	Exercise Price per share:	  	$            .            
		  	(Month and Day)	  		  	(Year)	  		  	

  

			
	 EXERCISE PRICE
	  	Compute the Exercise Price below and select a method of payment.

  

													
	 Total Exercise Price
	  	  
	  	x $	  	  
	  	= $	  	  

		  	(No. of Shares)	  		  	(Exercise Price)	  	Total Exercise Price

 Method of Payment 
  

						
	 ̈	 	 I enclose a certified check, money order, or bank draft payable to the order of Lake Shore Bancorp, Inc. in the amount of
	  	$	                        
			
	  ̈
	 	 I enclose Shares I have owned for at least six months duly endorsed for transfer to Lake Shore Bancorp, Inc. with all stamps attached and having a fair
market value of*
	  	$	                        
			
		 	 Total Exercise Price
	  	$	                        

	*	Subject to Committee approval as an acceptable method of payment. 

 ISSUANCE OF CERTIFICATES 
 I hereby direct that the stock certificates representing the Shares purchased pursuant to section
2 above be issued to the following person(s) in the amount specified below: 
  

					
	 Name and Address
	  	Social Security No.	  	No. of Shares
			
	  
	  		  	
			
	  
	  	            —            —          
  	  	  

			
	  
	  		  	
			
	  
	  	            —            —          
  	  	  

  

			
	 WITHHOLDING ELECTIONS
	  	For Employee Option Recipients with Non-Qualified Stock Options only. Beneficiaries should not complete.

 I understand that I am responsible for the amount of federal, state and local taxes required to be
withheld with respect to the Shares to be issued to me pursuant to this Notice, but that I may request Lake Shore Bancorp, Inc. to retain or sell a sufficient number of such Shares to cover the amount to be withheld. I hereby request that any taxes
required to be withheld be paid in the following manner [check one]: 
  

	 	 ̈	With a certified or bank check that I will deliver to Lake Shore Bancorp, Inc. on the day after the Effective Date of my Option exercise. 

  

	 	 ̈	With the proceeds from a sale of Shares that would otherwise be distributed to me. 

  

	 	 ̈	Retain shares that would otherwise be distributed to me and that have a value equal to the minimum amount required to be withheld by law. 

 I understand that the withholding elections I have made on this form are not binding on the Committee, and that the Committee will decide the amount to be
withheld and the method of withholding and advise me of its decision prior to the Effective Date. I further understand that the Committee may request additional information or assurances regarding the manner and time at which I will report the
income attributable to the distribution to be made to me. I further understand that if I have elected to have Shares sold to satisfy tax withholding, I may be asked to pay a minimal amount of such taxes in cash in order to avoid the sale of more
Shares than are necessary. 
 COMPLIANCE WITH TAX AND SECURITIES LAWS 
  

							
	 S
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	 	 H
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	  	 I understand that I must rely on, and consult with, my own tax and legal counsel (and not Lake Shore Bancorp, Inc.) regarding the
application of all laws — particularly tax and securities laws — to the transactions to be effected pursuant to my Option and this Notice. I understand that I will be responsible for paying any federal, state and local taxes that may
become due upon the sale (including a sale pursuant to a “cashless exercise”) or other disposition of Shares issued pursuant to this Notice and that I must consult with my own tax advisor regarding how and when such income will be
reportable.
  

	 	  	  
	  	  

		 		  	Signature	  	Date
		 		  		  	

					
	  
	 	Internal Use Only	 	  

	 	 

													
	 Received [check one]:
	 	 ̈	  	 By Hand
	  	 ̈	  	 By Mail Post Marked
	  	  

		 		 		  		  		  		  	Date of Post Mark
		 		 		  		  		  		  	
		 		 		  		  		  		  	
	By	 	  
	  		  	  

		 	Authorized Signature	  		  		  	Date of Receipt

 APPENDIX B TO STOCK OPTION
CERTIFICATE 
 LAKE SHORE BANCORP, INC. 
 2006 STOCK OPTION PLAN 
 Beneficiary Designation Form 

					
	 GENERAL
 INFORMATION
	 	Use this form to designate the Beneficiary(ies) who will receive vested stock options outstanding to you at the time of your death.
			
	 Name of
 Award Recipient
	 	  	 	Social Security Number             –             –   
         
		
	 BENEFICIARY
 DESIGNATION
	 	Complete sections A and B. If no percentage shares are specified, each Beneficiary in the same class (primary or contingent) shall have an equal share. If any designated
Beneficiary predeceases you, the shares of each remaining Beneficiary in the same class (primary or contingent) shall be increased proportionately.
	
	A. PRIMARY BENEFICIARY(IES). I hereby designate the following person as my primary Beneficiary under the Plan, reserving the right to change or revoke this designation at any
time prior to my death:

											
						
	Name	  	Address	  	Relationship	  	Birthdate	  	Share	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  	Total = 100%
	
	B. CONTINGENT BENEFICIARY(IES). I hereby designate the following person(s) as my contingent Beneficiary(ies) under the Plan to receive benefits only if all of my primary
Beneficiaries should predecease me, reserving the right to change or revoke this designation at any time prior to my death:
						
	Name	  	Address	  	Relationship	  	Birthdate	  	Share	 	
						
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  		  		  		 	
		  	 	  		  		  		 	
		  		  		  		  		 	%
	 	  	 	  	 	  	 	  	 	 	
		  		  	Total = 100%

													
				
	 S
 I
 G
 N
	 	 H
 E
 R
 E
	  	I understand that this Beneficiary Designation shall be effective only if properly completed and received by the Compensation Committee of Lake Shore Bancorp, Inc. prior to my death,
and that it is subject to all of the terms and conditions of the Plan. I also understand that an effective Beneficiary designation revokes my prior designation(s) with respect to all outstanding Stock Options.	 	

													
		 		  	  	  		  	  	  		 	
		 		  	Your Signature	  		  	Date	  		 	

  

 _________________________________________Internal Use Only_________________________________________ 
  

															
		 		 		 	 	  		  	
		 		 	This Beneficiary Designation was received by the Compensation Committee of Lake Shore Bancorp, Inc. on the date indicated.	 	 	  	Comments	  	
		 		 		 	 	  		  	
		 		 		 	 	  		  	
		 	 By
	 		 		 		 	 	  		  	
		 		 	 	 		 	 	 	 	  		  	
		 		 	 Authorized Signature
	 		 	Date

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