Document:

Exhibit 4.2

 

CITIZENS
INDEPENDENT BANCORP, INC.

 

WARRANT CERTIFICATE

	Warrant No. ____	_______ __, 2013

 

Void
After Expiration under
the Terms Herein

 

This
Certifies That, for value received, ___________________________ or his, her or its assigns (“Holder”)
is entitled to subscribe for and purchase from Citizens
Independent Bancorp, Inc., an Ohio corporation (the “Company”),
during the Exercise Period (as defined below), ______ common shares, without par value, of the Company (the “Shares”)
at an exercise price equal to 90% of the book value of a Company common share as reflected on the books of the Company on the last
day of the month prior to the warrant exercise date (the “Exercise Price”), subject to adjustment as
provided herein. This warrant (this “Warrant”) is being issued in connection with the Company’s
offering of up to a maximum of _______ common shares at a purchase price of $____ per share (the “Stock Offering”)
pursuant to the terms of the Company’s Prospectus dated _________________, 2013 (the “Prospectus”).
As described in the Prospectus, all purchasers of the common shares in the Stock Offering receive, at no additional charge, one
Warrant to purchase one Share for each two common shares purchased in the Stock Offering. The Holder represents and warrants that
the Holder has received and read the Prospectus.

 

1.          Exercise
of Warrant. The rights represented by this Warrant may be exercised in whole or in part at any time until _________,
2015 (the “Exercise Period”) by Holder’s delivery of the following to the Company at its address
set forth below (or at such other address as it may designate by notice in writing to Holder):

 

(a)          an
executed Notice of Exercise in the form attached hereto;

 

(b)          payment
of the Exercise Price for each Share for which this Warrant is being exercised, in cash or by check; and

 

(c)          this
Warrant.

 

Upon the exercise of
the rights represented by this Warrant, a certificate or certificates for the Shares so purchased, registered in the name of Holder
or persons affiliated with Holder, if Holder so designates, shall be issued and delivered to Holder within a reasonable time after
the rights represented by this Warrant shall have been so exercised. In the event of the exercise to purchase fewer than all of
the Shares that may be purchased under this Warrant, the Company shall cancel this Warrant and execute and deliver to the Holder
a new warrant of like tenor for the balance of the Shares purchasable under this Warrant.

 

The person in whose
name any certificate or certificates for Shares are to be issued upon exercise of this Warrant shall be deemed to have become the
holder of record of such Shares on the date on which this Warrant was surrendered to the Company and payment of the Exercise Price
was made, irrespective of the date of delivery of such certificate or certificates.

 

    	1

    	 

    

 

2.          Covenants
of the Company. The Company covenants and agrees that all Shares that may be issued upon the exercise of the rights
represented by this Warrant will, upon issuance, be validly issued and outstanding, fully paid and nonassessable, and free from
all taxes, liens and charges with respect to the issuance thereof. The Company further covenants and agrees that the Company will,
at all times during the Exercise Period, have authorized and reserved a sufficient number of Company common shares to provide for
the exercise of the rights represented by this Warrant.

 

3.          Representations,
Warranties and Covenants of Holder. Holder understands that this Warrant is not transferable and that Holder cannot
effect a transfer of all or any part of this Warrant.

 

4.          Adjustment
of Exercise Price and Number and Kind of Securities or Property Purchasable upon Exercise. The number of Shares purchasable
upon exercise of this Warrant (or other securities or property at the time purchasable upon exercise of this Warrant) and the Exercise
Price therefor, are subject to adjustment upon the occurrence of the following events between the date this Warrant is issued and
the date it is exercised; provided, however, that no such adjustment shall be made as a result of any such event
if the terms of the Shares treat Holder as if Holder was a holder of the Shares as of the date of such event:

 

4.1           Adjustment
for Stock Splits, Share Dividends, Recapitalizations, etc. The Exercise Price, if not already reflected, and the number
of Shares purchasable upon exercise of this Warrant (or other securities or property at the time purchasable upon exercise of this
Warrant) shall each be proportionally adjusted to reflect any share dividend, stock split, reverse stock split, combination of
shares, reclassification, recapitalization or other similar event affecting the number of outstanding common shares (or such other
securities).

 

4.2           Adjustment
for Reorganization, Consolidation, Merger. In case of any reorganization of the Company (or of any other entity, the
securities of which are at the time purchasable on the exercise of this Warrant), or in case the Company (or any such entity) shall
consolidate with or merge into another entity or convey all or substantially all of its assets to another entity, then, and in
each such case, the Company (or such entity) may, in its sole discretion, take such actions as it deems necessary or desirable
with respect to this Warrant, if not previously exercised in full, to provide for the payment of an amount in cash, securities
or other property in exchange for the cancellation of this Warrant. The Board of Directors of the Company (or such entity) shall
determine the form of the payment in its sole discretion and shall determine the amount of such cash, securities or other property
in good faith in order to have the value of the payment in exchange for the cancellation of this Warrant equal the difference between
(a) the value of the cash, securities and property received by holders of outstanding common shares of the Company (or of any other
entity, the securities of which are at the time purchasable on the exercise of this Warrant) in such reorganization, consolidation
or merger for each outstanding Share and (b) the Exercise Price per Share, multiplied by the number of Shares remaining subject
to this Warrant, as if this Warrant were exercised at the close of business on the date immediately preceding the effective date
of such reorganization, consolidation, merger or conveyance.

 

    	2

    	 

    

 

4.3           Liquidation,
Dissolution or Winding Up. Notwithstanding any other provisions hereof, in the event of the liquidation, dissolution, or winding
up of the affairs of the Company (other than in connection with a reorganization, consolidation, merger or conveyance of all or
substantially all of its assets), the right to exercise this Warrant shall terminate and expire at the close of business on the
last full business day before the earliest date fixed for the payment of any distributable amount on the Shares. The Company shall
cause a notice to be mailed to each Holder at least twenty days prior to the applicable record date for such payment stating the
date on which such liquidation, dissolution or winding up is expected to become effective, and the date on which it is expected
the holders of Shares of record shall be entitled to exchange their Shares for securities or other property or assets (including
cash) deliverable upon such liquidation, dissolution or winding up, and that each Holder may exercise the Warrant pursuant to the
terms of Section 1 hereof, during such twenty day period and, thereby, receive consideration on the same basis as other
previously outstanding common shares. The Company’s failure to give notice required by this Subsection 4.3 or any
defect therein shall not affect the validity of such liquidation, dissolution or winding up.

 

4.4           Notice
of Adjustment. When any adjustment is required to be made in the number or kind of securities or property purchasable upon
exercise of this Warrant, or in the Exercise Price, the Company shall promptly notify Holder of such event and of the number and
kind of securities or property thereafter purchasable upon exercise of this Warrant. The notice shall describe the adjustment or
readjustment and show in reasonable detail the facts on which the adjustment or readjustment is based.

 

4.5           No
Change Necessary. The form of this Warrant need not be changed because of any adjustment provided in this Section
4.

 

5.          Fractional
Shares. No fractional Shares (or fractions of any other securities that may be purchased upon the exercise of this Warrant)
shall be issued upon the exercise of this Warrant or as a consequence of any adjustment pursuant hereto. All Shares or other securities
(including fractions) issuable upon exercise of this Warrant shall be aggregated for purposes of determining whether the exercise
would result in the issuance of any fraction of a Share or other security. If, after aggregation, the exercise would result in
the issuance of a fraction of a Share or other security, the Company shall, in lieu of issuance of any fraction, pay Holder otherwise
entitled to such fraction a sum in cash equal to the product resulting from multiplying the Exercise Price (as may have been adjusted
pursuant to the terms of this Warrant) by such fraction.

 

6.          No
Shareholder Rights Prior to Exercise. This Warrant shall not entitle Holder to any voting rights or other rights as
a shareholder of the Company.

 

7.          Amendment
and Waiver. This Warrant may not be amended and the observance of any term may not be waived with respect to Holder
without the written consent of Holder unless such amendment or waiver applies on its face to all Holders in the same manner. Upon
the effectuation of such amendment or waiver in conformance with this Section 7, the Company shall promptly give written
notice thereof to the record holders of the Warrants who have not previously consented thereto in writing.

 

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8.          Lost,
Stolen, Mutilated or Destroyed Warrant. If this Warrant is lost, stolen, mutilated or destroyed, the Company may, on
such terms as to indemnity or otherwise as it may reasonably impose (which shall, in the case of a mutilated Warrant, include the
surrender thereof), issue a new warrant of like denomination and tenor as this Warrant so lost, stolen, mutilated or destroyed.
Any such new warrant shall constitute an original contractual obligation of the Company, whether or not the allegedly lost, stolen,
mutilated or destroyed Warrant shall be at any time enforceable by anyone.

 

9.          Notices.
All notices required or permitted hereunder shall be in writing and shall be deemed effectively given: (a) upon personal
delivery to the party to be notified, (b) when sent by confirmed facsimile if sent during normal business hours of the recipient,
if not, then on the next business day, (c) five business days after having been sent by registered or certified mail, return receipt
requested, postage prepaid, or (d) one business day after deposit with a nationally recognized overnight courier, specifying next
business day delivery, with written verification of receipt. All such notices shall be sent to the Company at the address or facsimile
number listed on the signature page of this Warrant, and to Holder at the address or facsimile number set forth in the record of
the Company, or at such other address as the Company or Holder may designate by ten days’ advance written notice to the other
party hereto.

 

10.         Acceptance.
Receipt of this Warrant by Holder shall constitute acceptance of and agreement to all of the terms and conditions contained
herein.

 

11.         No
Impairment. Except and to the extent as waived or consented to by the Holders in accordance with Section 7 hereof,
the Company will not, by amendment of its Articles of Incorporation or through any reorganization, transfer of assets, consolidation,
merger, dissolution, issue or sale of securities or any other voluntary action, deliberately avoid or seek to avoid the observance
or performance of any of the terms to be observed or performed under the Warrants by the Company, but will at all times in good
faith assist in the carrying out of all the provisions of the Warrants and in the taking of all such action as may be necessary
or appropriate in order to protect the exercise rights of the Holders against impairment.

 

12.         Governing
Law. This Warrant and all rights, obligations and liabilities hereunder shall be governed by and construed under the
laws of the State of Ohio, without giving effect to the conflict of laws provisions thereof.

 

[signature page follows]

 

    	4

    	 

    

 

Executed to be effective
as of _____ __, 2013.

 

	 	Citizens Independent Bancorp, Inc.
	 	 	 
	 	By:	 

 

	 	Address:	188 West Main Street
	 	 	Logan, Ohio  43138
	 	 	Facsimile: (740) _________________________

 

Signature
Page to Warrant to Purchase Common Shares Of Citizens Independent Bancorp, Inc.

 

    	 

    	 

    

 

NOTICE OF EXERCISE

 

TO:
Citizens Independent Bancorp, Inc. 

 

(1)         The
undersigned hereby elects to purchase ________ common shares (the “Shares”) of Citizens Independent
Bancorp, Inc. (the “Company”) pursuant to the terms of the attached Warrant, and tenders herewith
payment of the Exercise Price (as defined in the Warrant) in full in cash or by check, together with all applicable transfer taxes,
if any.

 

(2)         Please
issue a certificate or certificates representing said Shares in the name of the undersigned or in such other name as is specified
below:

 

________________________ 

(Name)

________________________

________________________ 

(Address)

 

	 	 	 
	(Date)	 	(Signature)
	 	 	 
	 	 	 
	 	 	(Print name)Exhibit 4.3

 

THE
TERMS AND CONDITIONS OF THE RIGHTS OFFERING ARE SET FORTH IN THE COMPANY’S PROSPECTUS DATED ________________, 2013 (THE
“PROSPECTUS”) AND ARE INCORPORATED HEREIN BY REFERENCE. COPIES OF THE PROSPECTUS ARE AVAILABLE UPON REQUEST FROM CITIZENS
INDEPENDENT BANCORP, INC. AT (740) 385-8561. The Rights Offering expires at 5:00 p.m., Eastern Time, on ____________, 2013. Citizens
Independent Bancorp, Inc. (the “Company”) may extend the rights offering without notice to you until ____________,
2013 (such date and time, as it may be extended, the “Expiration Date”). RIGHTS CERTIFICATE NO. NUMBER OF RIGHTS REPRESENTED
BY THIS RIGHTS CERTIFICATE SEE REVERSE FOR CERTAIN DEFINITIONS Citizens Independent Bancorp, Inc. INCORPORATED UNDER THE LAWS
OF THE STATE OF OHIO REGISTERED OWNER: SUBSCRIPTION RIGHTS CERTIFICATE Evidencing Non-Transferable Rights to Purchase Common Shares
Subscription Price: $______ Per Share VOID IF NOT EXERCISED ON OR BEFORE THE EXPIRATION DATE The Company has distributed, at no
charge, to each holder of record of the Company’s common shares, no par value per share (“Common Share”), (each
a “Record Date Shareholder”), as of 5:00 Eastern Time on _______________, 2013 (the “Record Date”), one
subscription right (“Subscription Right”) for each Common Share held as of the close of business on the Record Date.
Each Subscription Right entitles a Record Date Shareholder to a Basic Subscription Privilege (the “Basic Subscription Privilege”)
and an Over-Subscription Privilege (the “Over-Subscription Privilege”). The Basic Subscription Privilege gives each
Record Date Shareholder the opportunity to purchase one Common Share at a subscription price of $_____ per share. Fractional Common
Shares resulting from the exercise of the Basic Subscription Privilege will be eliminated by rounding down to the nearest whole
share. In the event that a Record Date Shareholder purchases all of the Common Shares available pursuant to the Record Date Shareholder’s
Basic Subscription Privilege, the Record Date Shareholder may also choose to exercise an Over-Subscription Privilege, subject
to the Company’s acceptance of such subscription, reduction or proration and other limitations as described in the Prospectus,
to subscribe for a portion of any Common Shares that are not purchased by other Record Date Shareholders through the exercise
of their Basic Subscription Privilege. DATED: SECRETARY OF BOARD PRESIDENT AND CEO COUNTERSIGNED AND REGISTERED REGISTRAR AND
TRANSER COMPANY (CRANFORD, NJ) TRANSFER AGENT AND REGISTRAR BY AUTHORIZED SIGNATURE

 

    	 

    	 

    

 

DELIVERY OPTIONS FOR RIGHTS CERTIFICATE

 

DELIVERY OF THIS SUBSCRIPTION RIGHTS
CERTIFICATE TO AN ADDRESS OTHER THAN AS SET FORTH ABOVE DOES NOT CONSTITUTE A VALID DELIVERY

 

Delivery by facsimile will not constitute
valid delivery.

 

PLEASE PRINT ALL INFORMATION CLEARLY
AND LEGIBLY.

 

Method Of Exercise Of Rights

 

In order to exercise your Basic Subscription
Privilege and Over-Subscription Privilege, you must properly complete and sign this Rights Certificate in Section 2 below where
indicated and return it to the Subscription Agent, Registrar and Transfer Company, together with payment in full for an amount
equal to the subscription price multiplied by the total number of Common Shares subscribed for under your Basic Subscription Privilege
and Over-Subscription Privilege. To be timely, the Subscription Agent must receive the properly completed and executed Rights Certificate
and payment in full for the Common Shares subscribed for at or before 5:00 p.m., Eastern Time, on ____________, 2013, unless such
date is extended by the Company.

 

Full payment for the Common Shares subscribed
for pursuant to your Basic Subscription Privilege and Over-Subscription Privilege must be made payable in United States dollars
by wire transfer, personal check drawn on a U.S. bank, or certified check drawn on The Citizens Bank of Logan, Ohio, in each case
payable to “Registrar and Transfer Company.” You will not be paid any interest on funds paid to the Subscription Agent
regardless of whether the funds are applied to the subscription price or returned to you.

 

SECTION 1: EXERCISE AND SUBSCRIPTION:
The number of Subscription Rights represented by this Rights Certificate and the maximum number of Common Shares for which you
may subscribe under your Basic Subscription Privilege are set forth on the front of this Rights Certificate. Please see “
The Rights Offering—Limit on How Many Common Shares You May Purchase in the Stock Offering ” in the Prospectus
for a description of the purchase limits applicable to the Stock Offering. The undersigned hereby irrevocably exercises one
or more Subscription Rights to subscribe for Common Shares as indicated below, on the terms and subject to the conditions specified
in the Prospectus.

 

Step 1—Basic Subscription
Privilege

I wish to exercise my full Basic Subscription Privilege or a
portion thereof as follows:

 

	Number of	 	 	 	 	 	 
	Common Shares	 	 	 	 	 	Payment Due
	Subscribed for	 	 	 	 	 	Under Basic
	Under Your Basic	 	 	 	 	 	Subscription
	Subscription Privilege	 	 	Subscription Price	 	 	Privilege
	 	 	 	 	 	 	 
	 	×	 	 	 	 	 
	 	 	$	 	=	$	 

 

Step 2—Over-Subscription
Privilege

 

I have exercised my full Basic Subscription Privilege and in
addition to my full Basic Subscription Privilege I wish to subscribe for additional shares under my Over-Subscription Privilege
as follows:

 

	Number of	 	 	 	 	 	 
	Common Shares	 	 	 	 	 	Payment Due
	Subscribed for	 	 	 	 	 	Under Over-
	Under Your Over-	 	 	 	 	 	Subscription
	Subscription Privilege*	 	 	Subscription Price	 	 	Privilege
	 	 	 	 	 	 	 
	 	×	$	 	=	$	 

 

		*	The maximum
number of Common Shares you may subscribe for under your Over-Subscription Privilege is subject to the 9.9% of the total outstanding
limitation.

 

Step 3—Total Shares and Total Amount Enclosed

 

	 	 	 	 	 	 	Total Amount
	Total Shares:	 	 	Subscription Price	 	 	Enclosed:
	 	 	 	 	 	 	 
	 	×	$	 	=	$	 
	 	 	 	 	 	 	 
	Number of Common Shares	 	 	 	 	 	Total Payments Due
	Subscribed for under Basic	 	 	 	 	 	under Basic Subscription
	Subscription Privilege (Step 1) plus	 	 	 	 	 	Privilege (Step 1) plus
	Over-Subscription Privilege (Step 2)	 	 	 	 	 	Over- Subscription Privilege
	 	 	 	 	 	 	(Step 2)

 

I certify that the purchase of Common
Shares pursuant to the Subscription Rights (basic or over-subscription)               
 will  OR                will not
result in my (our) owning either directly or indirectly, of record or beneficially, more than ___________ Common Shares.

 

SECTION 2: SUBSCRIPTION AUTHORIZATION:
I acknowledge that I have received the Prospectus for this offering of Subscription Rights and I hereby irrevocably subscribe
for the number of Common Shares indicated above on the terms and conditions set forth in the Prospectus.

 

Signature of Subscriber(s)

 

	 
	 	 
	 

 

	 	 
	(address if different than that listed	 
	on this Rights Certificate)	 
	 	 
	Telephone number	 
	(including area code)	 

 

SECTION 3: SPECIAL ISSUANCE INSTRUCTIONS
(IF YOU COMPLETE THIS SECTION, YOU MUST ALSO COMPLETE SECTIONS 4 AND 5): The Subscription Rights are not transferable in any
way, except by operation of law. By executing below, you hereby represent and warrant that the person in whose name you are requesting
that we issue the Common Shares is a transferee by operation of law. Evidence satisfactory to the Company that any such permitted
transfer is proper must be delivered by mail, hand, express mail or overnight courier to Registrar and Transfer Company at the
address specified above prior to the Expiration Date.

 

Complete the following ONLY if the Common
Shares subscribed for are to be issued in a name other than that of the registered holder

 

	Issue Shares to:	 	 

 

	Soc. Sec. #/Tax ID#:	 	 
	 	 	 

 

	Address:	 	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 

  

SECTION 4: ACKNOWLEDGMENT (TO BE COMPLETED
ONLY IF YOU COMPLETED SECTION 3. IF YOU COMPLETE THIS SECTION, YOU MUST ALSO COMPLETE SECTION 5): I/We acknowledge receipt
of the Prospectus and understand that, after delivery to Registrar and Transfer Company as Subscription Agent, I/we may not modify
or revoke this Rights Certificate. Under penalties of perjury, I/we certify that the information contained herein, including the
social security number or taxpayer identification number given above, is correct.

 

The signature below must correspond with
the name of the registered holder exactly as it appears on the books of the Company’s transfer agent without any alteration
or change whatsoever

 

	Signature(s) of	 
	Registered Holder:	 
	 	 
	 	 
	 	 
	Date:                                     	 

 

If signature is by trustee(s), executor(s), administrator(s),
guardian(s), attorney(s)-in-fact, agent(s), officer(s) of a corporation or another acting in a fiduciary or representative capacity,
please provide the following information (please print).

 

	Name: 	 	 	Capacity:	 

 

	Soc. Sec. #/Tax ID #:	 	 

 

	Address: 	 	 	Phone:	 
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 

 

SECTION 5: GUARANTEE OF SIGNATURES (TO BE COMPLETED ONLY
IF YOU COMPLETED SECTIONS 3 AND 4): All Subscription Right holders who specify special issuance or delivery instructions must
have their signatures guaranteed by an Eligible Guarantor Institution, as defined in Rule 17Ad-15 of the Securities Exchange Act
of 1934, as amended.

 

	Name of Firm:	 

 

	Authorized Signature: 	 

 

	Address:	 	 	Name:	 

 

	 	 	 	 
	 	 	 	 
	 	 	Title:	 

 

	City, State, Zip Code:	 
	 	 
	 	 

  

	Area Code and Telephone Number:  	 

 

Any questions regarding this Rights Certificate
or submitting payments in the Rights Offering may be directed to Registrar and Transfer Company at (800) 368-5948 or info@rtco.com.

  

You are advised to review the Prospectus and the Instructions
as to Use of Citizens Independent Bancorp, Inc. Rights Certificates included with this Rights Certificate. Additional copies of
these materials may be obtained from the Company by calling ___________________ at (740) 385-8561.

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