Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge receipt of a copy of the Plan. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. Notice of Exercise of Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth Bancorp, Inc. (the "Company") pursuant to an option ("Option") granted under the 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 Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the Company, but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.
Appears in 1 contract
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge the Recipient acknowledges receipt of a copy of the Plan. The Recipient acknowledges that he or she may not and will not rely on any statement of account or other communication or document issued in connection with the Plan other than the Plan, this Agreement, and any document signed by an authorized representative of the Company that is designated as an amendment of the Plan or this Agreement. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH PROVIDENT BANCORP, INC. 2004 STOCK INCENTIVE PLAN Notice of Exercise of Stock Option ------------------------------------------------------------------------------ Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Provident Bancorp, Inc. 2004 Stock Incentive Plan ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth Provident Bancorp, Inc. (the "CompanyProvident") pursuant to an option ("Option") granted under the 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 Agreement entered into between the Company Provident and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth Provident Bancorp, Inc., 00 Xxxxx Xxxxxxxc/o Provident Bank, Falmouth400 Rella Boulevaxx, Massachusetts 02340 Xxxxxxxxxx, New York, Attention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the Company, but in no event more than three days after such date Provident ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.
Appears in 1 contract
Samples: Incentive Plan Stock Option Agreement (Provident New York Bancorp)
Plan Provisions Control. This Agreement Award Notice and the rights and obligations created hereunder shall be subject to all of the terms and conditions of the Plan that would apply if this Award Notice were being made under the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this AgreementAward Notice, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this AgreementAward Notice, you acknowledge receipt of a copy of the Plan. APPENDIX You acknowledge that you may not and will not rely on any statement of account or other communication or document issued in connection with the Award other than the Plan, this Award Notice, or any document signed by an authorized representative of the Company that is designated as an amendment of the Plan or this Award Notice. Appendix A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. to 2019 CFO Supplemental Performance Award Notice of Exercise of Stock Option and Award Agreement Beneficiary Designation Form GENERALINFORMATION Use this Notice form to inform designate the Committee administering Beneficiary(ies) who may receive Shares that become vested at your death. Name of PersonMaking Designation Social Security Number ______-_____-______ BENEFICIARYDESIGNATION Complete sections A and B. If no percentage shares are specified, each Beneficiary in the 1997 Stock Option Plan for Outside Directorssame class (primary or contingent) shall have an equal share. If any designated Beneficiary predeceases you, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") that you are exercising your right to purchase the shares of common stock each remaining Beneficiary in the same class ("Shares"primary or contingent) of Falmouth Bancorp, Inc. (shall be increased proportionately. A PRIMARY BENEFICIARY(IES). I hereby designate the "Company") pursuant to an option ("Option") granted following person as my primary Beneficiary under the Plan. If you are not , reserving the person to whom the Option was granted ("Option Recipient"), you must attach to this Notice proof of your right to exercise 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 Option granted following person(s) as my contingent Beneficiary(ies) under the Stock Option Agreement entered into between Plan to receive benefits only if all of my primary Beneficiaries should predecease me, reserving the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered right to change or mailed by certified mail, return receipt requested torevoke this designation at any time prior to my death as to all outstanding Awards: Falmouth Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretary. The effective date of the exercise of the Option Name Address Relationship Birthdate Share % % %Total=100% SIGN HERE I understand that this Beneficiary Designation shall be the earliest date practicable following the date this Notice is effective only if properly completed and received by the CompanyCorporate Secretary of Sterling Bancorp prior to my death, but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice and that it is subject to all of the terms and conditions of the Plan Plan. I also understand that an effective Beneficiary designation revokes my prior designation(s) with respect to all outstanding Awards. Your Signature Date ---------------------------------------------------- Internal Use Only ------------------------------------------------------------ This Beneficiary Designation was received by the Corporate Secretary of Xxxxxxxx Xxxxxxx on the date indicated. By Authorized Signature Date Comments EXHIBIT B STERLING BANCORP 2015 OMNIBUS EQUITY AND INCENTIVE PLAN 2019 CFO Supplemental Performance Stock Award Notice Performance Goals [Applicable Measures and targets to be determined by the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.Compensation Committee]
Appears in 1 contract
Samples: Sterling Bancorp
Plan Provisions Control. This Agreement Award Notice and the rights and obligations created hereunder shall be subject to all of the terms and conditions of the Plan that would apply if this Award Notice were being made under the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this AgreementAward Notice, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this AgreementAward Notice, you acknowledge receipt of a copy of the Plan. APPENDIX You acknowledge that you may not and will not rely on any statement of account or other communication or document issued in connection with the Award other than the Plan, this Award Notice, or any document signed by an authorized representative of the Company that is designated as an amendment of the Plan or this Award Notice. Appendix A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. to 2019 GC Supplemental Performance Award Notice of Exercise of Stock Option and Award Agreement Beneficiary Designation Form GENERALINFORMATION Use this Notice form to inform designate the Committee administering Beneficiary(ies) who may receive Shares that become vested at your death. Name of PersonMaking Designation Social Security Number ______-_____-______ BENEFICIARYDESIGNATION Complete sections A and B. If no percentage shares are specified, each Beneficiary in the 1997 Stock Option Plan for Outside Directorssame class (primary or contingent) shall have an equal share. If any designated Beneficiary predeceases you, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") that you are exercising your right to purchase the shares of common stock each remaining Beneficiary in the same class ("Shares"primary or contingent) of Falmouth Bancorp, Inc. (shall be increased proportionately. A PRIMARY BENEFICIARY(IES). I hereby designate the "Company") pursuant to an option ("Option") granted following person as my primary Beneficiary under the Plan. If you are not , reserving the person to whom the Option was granted ("Option Recipient"), you must attach to this Notice proof of your right to exercise 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 Option granted following person(s) as my contingent Beneficiary(ies) under the Stock Option Agreement entered into between Plan to receive benefits only if all of my primary Beneficiaries should predecease me, reserving the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered right to change or mailed by certified mail, return receipt requested torevoke this designation at any time prior to my death as to all outstanding Awards: Falmouth Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretary. The effective date of the exercise of the Option Name Address Relationship Birthdate Share % % %Total=100% SIGN HERE I understand that this Beneficiary Designation shall be the earliest date practicable following the date this Notice is effective only if properly completed and received by the CompanyCorporate Secretary of Sterling Bancorp prior to my death, but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice and that it is subject to all of the terms and conditions of the Plan Plan. I also understand that an effective Beneficiary designation revokes my prior designation(s) with respect to all outstanding Awards. Your Signature Date ---------------------------------------------------- Internal Use Only ------------------------------------------------------------ This Beneficiary Designation was received by the Corporate Secretary of Xxxxxxxx Xxxxxxx on the date indicated. By Authorized Signature Date Comments EXHIBIT B STERLING BANCORP 2015 OMNIBUS EQUITY AND INCENTIVE PLAN 2019 GC Supplemental Performance Stock Award Notice Performance Goals [Applicable Measures and targets to be determined by the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.Compensation Committee]
Appears in 1 contract
Samples: Sterling Bancorp
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge receipt of a copy of the Plan. APPENDIX A TO STOCK OPTION AGREEMENT HOME BANCORP OF ELGIN, INC. 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES NOTICE OF FALMOUTH BANCORPEXERCISE OF STOCK OPTION -------------------------------------------------------------------------------- USE THIS NOTICE TO INFORM THE COMMITTEE ADMINISTERING THE HOME BANCORP OF ELGIN, INC. Notice 1997 STOCK OPTION PLAN("PLAN") THAT YOU ARE EXERCISING YOUR RIGHT TO PURCHASE SHARES OF COMMON STOCK ("SHARES") OF HOME BANCORP OF ELGIN, INC. (THE "COMPANY") PURSUANT TO AN OPTION ("OPTION") GRANTED UNDER THE 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 AGREEMENT ENTERED INTO BETWEEN THE COMPANY AND THE OPTION RECIPIENT ("AGREEMENT"). THIS NOTICE SHOULD BE PERSONALLY DELIVERED OR MAILED BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED TO: HOME BANCORP OF ELGIN, INC., C/O HOME FEDERAL SAVINGS AND LOAN ASSOCIATION OF ELGIN, 16 NORTH SPRING STREET, ELGIN, ILLINOIS 60120 ATTENTION: CORPORATE SECXXXXXX. XXX XXXXXXXXX XXXX XX XXX XXXXXXXX XX THE OPTION SHALL BE THE EARLIEST DATE PRACTICABLE FOLLOWING THE DATE THIS NOTICE IS RECEIVED BY THE COMPANY, BUT IN NO EVENT MORE THAN THREE DAYS AFTER SUCH DATE ("EFFECTIVE DATE"). EXCEPT AS SPECIFICALLY PROVIDED TO THE CONTRARY HEREIN, CAPITALIZED TERMS SHALL HAVE THE MEANINGS ASSIGNED TO THEM UNDER THE PLAN. THIS NOTICE IS SUBJECT TO ALL OF THE TERMS AND CONDITIONS OF THE PLAN AND THE AGREEMENT. OPTION INFORMATION IDENTIFY BELOW THE OPTION THAT YOU ARE EXERCISING BY PROVIDING THE FOLLOWING INFORMATION FROM THE STOCK OPTION AGREEMENT. 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 Stock Home Bancorp of Elgin, Inc. in the amount of $______________ / / I enclose Shares duly endorsed for transfer to the Company with all stamps attached and having a fair market value of $______________ Total Exercise Price $______________ 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 AND OUTSIDE DIRECTORS 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 issued to me pursuant to this Notice, but that I may request the Company to retain or sell a sufficient number of such Shares to cover the amo 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 the Committee on the day after the Effective Date of my Option Use 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. 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 I understand that I must rely on, and consult with, my own tax and legal counsel (and not the Company) 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 to inform and that I must consult with my own tax advisor regarding how and when such income will be reportable. _______________________________________ __________________ S H Signature Date I E G R ________________________________________________________________ N E Address -------------------------------------------------------------------------------- INTERNAL USE ONLY -------------------------------------------------------------------------------- CORPORATE SECRETARY Received [CHECK ONE]: / / By Hand / / By Mail Post Marked ______________________ DATE OF POST MARK By____________________________________________ ______________________ AUTHORIZED SIGNATURE DATE OF RECEIPT -------------------------------------------------------------------------------- APPENDIX B TO STOCK OPTION AGREEMENT HOME BANCORP OF ELGIN, INC. 1997 STOCK OPTION PLAN BENEFICIARY DESIGNATION FORM -------------------------------------------------------------------------------- GENERAL INFORMATION USE THIS FORM TO DESIGNATE THE BENEFICIARY(IES) WHO MAY EXERCISE OPTIONS OUTSTANDING TO YOU AT THE TIME OF YOUR DEATH. NAME OF PERSON MAKING DESIGNATION_____________________ 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 Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth Bancorp, Inc. (the "Company") pursuant to an option ("Option") granted following person as my primary Beneficiary under the Plan. If you are not , reserving the person to whom the Option was granted ("Option Recipient"), you must attach to this Notice proof of your right to exercise 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 Option granted following person(s) as my contingent Beneficiary(ies) under the Stock Option Agreement entered into between Plan to receive benefits only if all of my primary Beneficiaries should predecease me, reserving the Company and the Option Recipient ("Agreement")right to change or revoke this designation at any time prior to my death as to all outstanding Options. This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretary. The effective date of the exercise of the Option NAME ADDRESS RELATIONSHIP BIRTHDATE SHARE ____________________ ___________________ __________ __________ _______% ___________________ ____________________ ___________________ __________ __________ _______% ___________________ ____________________ ___________________ __________ __________ _______% ___________________ Total = 100% I understand that this Beneficiary Designation shall be the earliest date practicable following the date this Notice is effective only if properly completed and received by the CompanyCorporate Secretary of Home Bancorp of Elgin, but in no event more than three days after such date ("Effective Date"). Except as specifically provided Inc. prior to the contrary hereinmy death, capitalized terms shall have the meanings assigned to them under the Plan. This Notice and that it is subject to all of the terms and conditions of the Plan and Plan. I also understand that an effective Beneficiary designation revokes my prior designation(s) with respect to all outstanding Options. _______________________________________ __________________ S H Your Signature Date I E G R N E -------------------------------------------------------------------------------- INTERNAL USE ONLY -------------------------------------------------------------------------------- This Beneficiary Designation was Comments received by the Agreement. OPTION INFORMATION Identify below Corporate Secretary of Home Bancorp of Elgin, Inc. on the Option that you are exercising by providing the following information from the Stock Option Agreementdate indicated.
Appears in 1 contract
Plan Provisions Control. This Agreement 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 AgreementCertificate, 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 AgreementCertificate, you acknowledge receipt of a copy of the PlanPlan and a copy of the related Prospectus dated October 25, 2006. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH CERTIFICATE PFF BANCORP, INC. Notice of Exercise of Stock Option 2006 EQUITY INCENTIVE PLAN NOTICE OF EXERCISE OF STOCK OPTION Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth PFF Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth PFF Bancorp, Inc. (the "Company") pursuant to an option ("Option") granted under the PFF Bancorp, Inc. 2006 Equity Incentive 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 Agreement Certificate entered into between the Company PFF Bancorp, Inc. and the Option Recipient ("AgreementCertificate"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth PFF Bancorp, Inc., 00 Xxxxx Xxxxxxx0000 Xxxxxxxx Xxxxxx, FalmouthRancho Cucamonga, Massachusetts 02340 CA 91730, Attention: Corporate SecretaryEmployee Compensation and Benefits Committee. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyPFF Bancorp, but in no event more than three days after such date Inc. ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option AgreementCertificate.
Appears in 1 contract
Plan Provisions Control. This Agreement and the rights and obligations created hereunder shall be subject to all of the terms and conditions of the Plan that would apply if this stock option had been granted under the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. Capitalized terms in this agreement have the meaning defined in the Plan, as amended from time to time, unless stated otherwise. By signing this Agreement, you acknowledge receipt of a copy of the PlanPlan and a copy of the Prospectus for this stock option dated November 9, 2001. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH HUDSON CITY BANCORP, INC. Notice DEXXX X. SALAMONE STOCK OPTIXX XXXX NOTICE OF EXERCISE OF STOCK OPTION USE THIS NOTICE TO INFORM HUDSON CITY BANCORP, INC. THXX XXX ARE EXERCISING YOUR RIGHT TO PURCHASE SHARES OF COMMON STOCK ("SHARES") OF HUDSON CITY BANCORP, INC. PUX XXXXT TO AN OPTION ("OPTION") GRANTED UNDER THE STOCK OPTION AGREEMENT BETWEEN HUDSON CITY BANOCORP, INC. AXX XXXIS J. SALAMONE DATED OCTOXXX 00, 0000 (XXX "OPTION AGREEMENT"). 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 AGREEMENT . THIS NOTICE SHOULD BE PERSONALLY DELIVERED OR MAILED BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED TO: HUDSON CITY BANCORP, INC, WEXX 00 CENTURY ROAD, PARAMUS, NEX XXXXXX 00000-0000, XXXXXXXXX: XXXXXXXXX XXXXXTARY. THE EFFECTIVE DATE OF THE EXERCISE OF THE OPTION SHALL BE THE EARLIEST DATE PRACTICABLE FOLLOWING THE DATE THIS NOTICE IS RECEIVED BY HUDSON CITY BANCORP, INC. BUX XX XO EVENT MORE THAN THREE DAYS AFTER SUCH DATE ("EFFECTIVE DATE"). EXCEPT AS SPECIFICALLY PROVIDED TO THE CONTRARY HEREIN, CAPITALIZED TERMS SHALL HAVE THE MEANINGS ASSIGNED TO THEM UNDER THE HUDSON CITY BANCORP, INC. 2000 XXXCK OPTION PLAN (THE "PLAN"). OPTION INFORMATION IDENTIFY BELOW THE OPTION THAT YOU ARE EXERCISING BY PROVIDING THE FOLLOWING INFORMATION FROM THE STOCK OPTION AGREEMENT. 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 Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Hudson City Bancorp, Inc. ("Plan") that you are exercising your right in the amount of $ |_| I enclose Shares duly endorsed for transfer to purchase shares of common stock ("Shares") of Falmouth $_______ Hudson City Bancorp, Inc. (wixx xxx stamps attached and having a fair market value of $ Total Exercise Price $_______ ISSUANCE OF CERTIFICATES I hereby direct that the "Company") stock certificates representing the Shares purchased pursuant to an option ("Option"section 2 above be issued to the following person(s) granted under in the Planamount specified below: NAME AND ADDRESS SOCIAL SECURITY NO. If you are not 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 person amount of federal, state and local taxes required to whom be withheld with respect to the Option was granted ("Option Recipient"), you must attach Shares to be issued to me pursuant to this Notice proof of your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mailNotice, return receipt requested to: Falmouth but that I may request Hudson City Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretarytx xxxxin or sell a sufficient number of such Shares to cover the amount to be withheld. The effective date of the exercise of the Option shall I hereby request that any taxes required to be the earliest date practicable following the date this Notice is received by the Company, but withheld be paid in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.manner [check one]:
Appears in 1 contract
Plan Provisions Control. This Agreement 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 AgreementCertificate, 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 AgreementCertificate, you acknowledge receipt of a copy of the PlanPlan and a copy of the related Prospectus dated May 13, 2004. APPENDIX A TO STOCK OPTION AGREEMENT 1997 CERTIFICATE SLADE'S FERRY BANCORP 2004 EQUITY XXXXXXXVE PLAN NOTICE OF EXERCISE OF STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. Notice of Exercise of Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") Slade's Ferry Bancorp that you are exercising xxxxxxsing your right to purchase shares of common stock ("Shares") of Falmouth Bancorp, Inc. (the "Company") Slade's Ferry Bancorp pursuant to an option xx xxxxon ("Option") granted under the Slade's Ferry Bancorp 2004 Equity Xxxxxxxve 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 Agreement Certificate entered into between the Company Slade's Ferry Bancorp and the Option Recipient Optixx Xxxxpient ("AgreementCertificate"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth Slade's Ferry Bancorp, Inc.100 Slade's Xxxxx Avenue, 00 Xxxxx XxxxxxxSomerset, FalmouthXX 00000, Massachusetts 02340 AttentionXxxxxxxxx: Corporate SecretaryPersonnel Committee. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the Company, Slade's Ferry Bancorp but in no event more evxxx xxxe than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option AgreementCertificate.
Appears in 1 contract
Samples: Slades Ferry Bancorp
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge receipt of a copy of the Plan. APPENDIX A TO STOCK OPTION AGREEMENT BIG FOOT FINANCIAL CORP. 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES NOTICE OF FALMOUTH BANCORP, INCEXERCISE OF STOCK OPTION ------------------------------------------------------------------------------------------------------------------------------------ USE THIS NOTICE TO INFORM THE COMMITTEE ADMINISTERING THE BIG FOOT FINANCIAL CORP. Notice of Exercise of Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Bancorp, Inc. STOCK OPTION PLAN("PLAN") THAT YOU ARE EXERCISING YOUR RIGHT TO PURCHASE SHARES OF COMMON STOCK ("PlanSHARES") that you are exercising your right to purchase shares of common stock OF BIG FOOT FINANCIAL CORP. (THE "COMPANY") PURSUANT TO AN OPTION ("SharesOPTION") of Falmouth Bancorp, Inc. (the "Company") pursuant to an option GRANTED UNDER THE PLAN. IF YOU ARE NOT THE PERSON TO WHOM THE OPTION WAS GRANTED ("Option") granted under the Plan. If you are not the person to whom the Option was granted ("Option RecipientOPTION RECIPIENT"), you must attach to this Notice proof of your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Recipient YOU MUST ATTACH TO THIS NOTICE PROOF OF YOUR RIGHT TO EXERCISE THE OPTION GRANTED UNDER THE STOCK OPTION AGREEMENT ENTERED INTO BETWEEN THE COMPANY AND THE OPTION RECIPIENT ("AgreementAGREEMENT"). This Notice should be personally delivered or mailed by certified mailTHIS NOTICE SHOULD BE PERSONALLY DELIVERED OR MAILED BY CERTIFIED MAIL, return receipt requested toRETURN RECEIPT REQUESTED TO: Falmouth BancorpBIG FOOT FINANCIAL CORP., Inc.C/O FAIRFIELD SAVINGS BANK, 00 Xxxxx Xxxxxxx1190 RFD, FalmouthLONG GROVE, Massachusetts 02340 AttentionILLINOIS 60047 ATTENTION: Corporate SecretaryCORPORATE SXXXXXXXX. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyXXX XXXXXXXXX XXXX XX XXX EXERCISE OF THE OPTION SHALL BE THE EARLIEST DATE PRACTICABLE FOLLOWING THE DATE THIS NOTICE IS RECEIVED BY THE COMPANY, but in no event more than three days after such date BUT IN NO EVENT MORE THAN THREE DAYS AFTER SUCH DATE ("Effective DateEFFECTIVE DATE"). Except as specifically provided to the contrary hereinEXCEPT AS SPECIFICALLY PROVIDED TO THE CONTRARY HEREIN, capitalized terms shall have the meanings assigned to them under the PlanCAPITALIZED TERMS SHALL HAVE THE MEANINGS ASSIGNED TO THEM UNDER THE PLAN. This Notice is subject to all of the terms and conditions of the Plan and the AgreementTHIS NOTICE IS SUBJECT TO ALL OF THE TERMS AND CONDITIONS OF THE PLAN AND THE AGREEMENT. OPTION INFORMATION Identify below IDENTIFY BELOW THE OPTION THAT YOU ARE EXERCISING BY PROVIDING THE FOLLOWING INFORMATION FROM THE STOCK OPTION AGREEMENT. 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 Option order of Big Foot Financial Corp. in the amount of $______________ /_/ I enclose Shares duly endorsed for transfer to the Company with all stamps attached and having a fair market value of $______________ Total Exercise Price $______________ ISSUANCE OF CERTIFICATES I hereby direct that you are exercising by providing 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 AND OUTSIDE DIRECTORS 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 the Company 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 the Committee 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. 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 from or assurances regarding the Stock Option Agreementmanner 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.
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Plan Provisions Control. This Agreement and the rights and obligations created hereunder shall be subject to all of the terms and conditions of the Plan that would apply if this stock option had been granted under the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. Capitalized terms in this agreement have the meaning defined in the Plan, as amended from time to time, unless stated otherwise. By signing this Agreement, you acknowledge receipt of a copy of the PlanPlan and a copy of the Prospectus for this stock option dated April 16, 2004. APPENDIX A TO STOCK OPTION AGREEMENT 1997 FOR RONALD J. BUTKOVICH XXXXCE OF EXERCISE OF STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH -------------------------------------------------------------------------------- USE THIS NOTICE TO INFORM HUDSON CITY BANCORP, INC. Notice THXX XXX ARE EXERCISING YOUR RIGHT TO PURCHASE SHARES OF COMMON STOCK ("SHARES") OF HUDSON CITY BANCORP, INC. PUXXXXXX TO AN OPTION ("OPTION") GRANTED UNDER THE STOCK OPTION AGREEMENT BETWEEN HUDSON CITY BANCORP, INC. ANX XXXXLD J. BUTKOVICH DATED APXXX 00, 0000 (XXX "OPTION AGREEMENT"). 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 AGREEMENT. THIS NOTICE SHOULD BE PERSONALLY DELIVERED OR MAILED BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED TO: HUDSON CITY BANCORP, INC., WXXX 00 CENTURY ROAD, PARAMUS, NEX XXXXXX 00000, XXXXXXXXX: XXXXXXXXX SECRETARY. THE EFFECTIVE DATE OF THE EXERCISE OF THE OPTION SHALL BE THE EARLIEST DATE PRACTICABLE FOLLOWING THE DATE THIS NOTICE IS RECEIVED BY HUDSON CITY BANCORP, INC. BUX XX XO EVENT MORE THAN THREE DAYS AFTER SUCH DATE ("EFFECTIVE DATE"). EXCEPT AS SPECIFICALLY PROVIDED TO THE CONTRARY HEREIN, CAPITALIZED TERMS SHALL HAVE THE MEANINGS ASSIGNED TO THEM UNDER THE HUDSON CITY BANCORP, INC. 2000 XXXCK OPTION PLAN (THE "PLAN"). OPTION INFORMATION IDENTIFY BELOW THE OPTION THAT YOU ARE EXERCISING BY PROVIDING THE FOLLOWING INFORMATION FROM THE STOCK OPTION AGREEMENT. NAME OF OPTION RECIPIENT: Ronald J. Butkovich -------------------------------------------- OPTION GRANT DATE: ________________, __________ (MONTH AND DAY) (YEAR) EXERCISE PRICE PER SHARE: $_________.____ 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 Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth $____________________ Hudson City Bancorp, Inc. ("Plan") that you are exercising your right in xxx xmount of |_| I enclose Shares duly endorsed for transfer to purchase shares of common stock ("Shares") of Falmouth Hudson City Bancorp, Inc. (wixx xxx $____________________ _______________ stamps attached and having a fair market value of Total Exercise Price $____________________ ISSUANCE OF CERTIFICATES I hereby direct that the "Company") stock certificates representing the Shares purchased pursuant to an option ("Option"the above instructions be issued to the following person(s) granted under in the Planamount specified below: NAME AND ADDRESS SOCIAL SECURITY NO. If you are not 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 person amount of federal, state and local taxes required to whom be withheld with respect to the Option was granted ("Option Recipient"), you must attach Shares to be issued to me pursuant to this Notice proof of your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mailNotice, return receipt requested to: Falmouth but that I may request Hudson City Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate SecretaryInc. to xxxxxn or sell a sufficient number of such Shares to cover the amount to be withheld. The effective date of the exercise of the Option shall I hereby request that any taxes required to be the earliest date practicable following the date this Notice is received by the Company, but withheld be paid in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.manner [check one]:
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Plan Provisions Control. This Agreement 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 AgreementCertificate, 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 AgreementCertificate, you acknowledge receipt of a copy of the Plan. APPENDIX Appendix A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORSto Stock Option Certificate VxxxXxxx.xxx, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. Inc. 2005 Stock Incentive Plan Notice of Exercise of Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth BancorpVxxxXxxx.xxx, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("“Shares"”) of Falmouth BancorpVxxxXxxx.xxx, Inc. (the "Company") pursuant to an option ("“Option"”) granted under the VxxxXxxx.xxx, Inc. 2005 Stock Incentive 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 Agreement Certificate entered into between the Company VxxxXxxx.xxx, Inc. and the Option Recipient ("Agreement"“Certificate”). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth BancorpVxxxXxxx.xxx, Inc., 00 3000 X. Xxxxx Xxxxxxx, FalmouthXxxxx, Massachusetts 02340 XX 00000, Attention: Corporate SecretaryCompensation Committee. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyVxxxXxxx.xxx, Inc. but in no event more than three days after such date ("“Effective Date"”). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.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
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Plan Provisions Control. This Agreement 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 AgreementCertificate, 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 AgreementCertificate, you acknowledge receipt of a copy of the PlanPlan and a copy of the related Prospectus dated May 3, 2006. APPENDIX Appendix A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORSto Stock Option Certificate Rome Bancorp, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. Inc. 2006 Stock Option Plan Notice of Exercise of Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Rome Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth Rome Bancorp, Inc. (the "Company") pursuant to an option ("Option") granted under the Rome 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 Agreement Certificate entered into between the Company Rome Bancorp, Inc. and the Option Recipient ("AgreementCertificate"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth Rome Bancorp, Inc., 00 Xxxxx Xxxxxxx000 Xxxx Xxxxxxxx Xxxxxx, FalmouthRome, Massachusetts 02340 NY 13440, Attention: Corporate SecretaryCompensation Committee. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyRome Bancorp, but in no event more than three days after such date Inc. ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option AgreementCertificate. Name of Option Recipient: , Exercise Price per share: $ . Option Grant Date: (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 Rome Bancorp, Inc. in the amount of $ I enclose Shares I have owned for at least six months duly endorsed for transfer to Rome 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.
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Plan Provisions Control. This Agreement Award Notice and the rights and obligations created hereunder shall be subject to all of the terms and conditions of the Plan that would apply if this Award Notice were being made under the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this AgreementAward Notice, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this AgreementAward Notice, you acknowledge receipt of a copy of the Plan. APPENDIX You acknowledge that you may not and will not rely on any statement of account or other communication or document issued in connection with the Award other than the Plan, this Award Notice, or any document signed by an authorized representative of the Company that is designated as an amendment of the Plan or this Award Notice. Appendix A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. to 2019 CRO Supplemental Performance Award Notice of Exercise of Stock Option and Award Agreement Beneficiary Designation Form GENERALINFORMATION Use this Notice form to inform designate the Committee administering Beneficiary(ies) who may receive Shares that become vested at your death. Name of PersonMaking Designation Social Security Number ______-_____-______ BENEFICIARYDESIGNATION Complete sections A and B. If no percentage shares are specified, each Beneficiary in the 1997 Stock Option Plan for Outside Directorssame class (primary or contingent) shall have an equal share. If any designated Beneficiary predeceases you, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") that you are exercising your right to purchase the shares of common stock each remaining Beneficiary in the same class ("Shares"primary or contingent) of Falmouth Bancorp, Inc. (shall be increased proportionately. A PRIMARY BENEFICIARY(IES). I hereby designate the "Company") pursuant to an option ("Option") granted following person as my primary Beneficiary under the Plan. If you are not , reserving the person to whom the Option was granted ("Option Recipient"), you must attach to this Notice proof of your right to exercise 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 Option granted following person(s) as my contingent Beneficiary(ies) under the Stock Option Agreement entered into between Plan to receive benefits only if all of my primary Beneficiaries should predecease me, reserving the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered right to change or mailed by certified mail, return receipt requested torevoke this designation at any time prior to my death as to all outstanding Awards: Falmouth Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretary. The effective date of the exercise of the Option Name Address Relationship Birthdate Share % % %Total=100% SIGN HERE I understand that this Beneficiary Designation shall be the earliest date practicable following the date this Notice is effective only if properly completed and received by the CompanyCorporate Secretary of Sterling Bancorp prior to my death, but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice and that it is subject to all of the terms and conditions of the Plan Plan. I also understand that an effective Beneficiary designation revokes my prior designation(s) with respect to all outstanding Awards. Your Signature Date ---------------------------------------------------- Internal Use Only ------------------------------------------------------------ This Beneficiary Designation was received by the Corporate Secretary of Xxxxxxxx Xxxxxxx on the date indicated. By Authorized Signature Date Comments EXHIBIT B STERLING BANCORP 2015 OMNIBUS EQUITY AND INCENTIVE PLAN 2019 CRO Supplemental Performance Stock Award Notice Performance Goals [Applicable Measures and targets to be determined by the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.Compensation Committee]
Appears in 1 contract
Samples: Sterling Bancorp
Plan Provisions Control. This Agreement 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 AgreementCertificate, 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 AgreementCertificate, you acknowledge receipt of a copy of the Plan. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH CERTIFICATE LAKE SHORE BANCORP, INC. Notice of Exercise of Stock Option 2006 STOCK OPTION PLAN NOTICE OF EXERCISE OF STOCK OPTION Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Lake Shore Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("“Shares"”) of Falmouth Lake Shore Bancorp, Inc. (the "Company") 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 Agreement Certificate entered into between the Company Lake Shore Bancorp, Inc. and the Option Recipient ("Agreement"“Certificate”). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth Lake Shore Bancorp, Inc., 00 Xxxxx 000 Xxxx 0xx Xxxxxx, Xxxxxxx, FalmouthXX 00000, Massachusetts 02340 Attention: Corporate SecretaryCompensation Committee. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyLake Shore Bancorp, but in no event more than three days after such date Inc. ("“Effective Date"”). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.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
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Plan Provisions Control. This Agreement 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 AgreementCertificate, 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 AgreementCertificate, you acknowledge receipt of a copy of the PlanPlan and a copy of the related Prospectus dated October 29, 2004. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH CERTIFICATE PFF BANCORP, INC. Notice 2004 EQUITY INCENTIVE PLAN NOTICE OF EXERCISE OF STOCK OPTION -------------------------------------------------------------------------------- USE THIS NOTICE TO INFORM PFF BANCORP, INC. THAT YOU ARE EXERCISING YOUR RIGHT TO PURCHASE SHARES OF COMMON STOCK ("SHARES") OF PFF BANCORP, INC. PURSUANT TO AN OPTION ("OPTION") GRANTED UNDER THE PFF BANCORP, INC. 2004 EQUITY INCENTIVE 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 PFF BANCORP, INC. AND THE OPTION RECIPIENT ("CERTIFICATE"). THIS NOTICE SHOULD BE PERSONALLY DELIVERED OR MAILED BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED TO: PFF BANCORP, INC., 350 SOUTH GAREY AVENUE, POMONA, CA 00000, XXXXXXXXX: EMPLOYEE COMPENSATION AND BENEFITS COMMITTEE. THE EFFECTIVE DATE OF THE EXERCISE OF THE OPTION SHALL BE THE EARLIEST DATE PRACTICABLE FOLLOWING THE DATE THIS NOTICE IS RECEIVED BY PFF 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 CERTIFICATES. NAME OF OPTION RECIPIENT: ____________________________________________ OPTION GRANT DATE: ________________, __________ (MONTH AND DAY) (YEAR) EXERCISE PRICE PER SHARE: $_________.____ 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 Stock Option Use this Notice PFF Bancorp, Inc, in the amount of $____________________ |_| I enclose Shares I have owned for at least six months duly endorsed for transfer to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth PFF Bancorp, Inc. ("Plan"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 you are exercising your right I am responsible for the amount of federal, state and local taxes required to purchase shares of common stock ("Shares") of Falmouth be withheld with respect to the Shares to be issued to me pursuant to this Notice, but that I may request PFF 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 PFF 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 I understand that I must rely on, and consult with, my own tax and legal counsel (and not PFF Bancorp, Inc.) regarding the application S H of all laws -- particularly tax and securities laws -- to the I E transactions to be effected pursuant to my Option and this Notice. G R I understand that I will be responsible for paying any federal, N E state and local taxes that may become due upon the sale (including a sale pursuant to a "Companycashless exercise") or other disposition of Shares issued pursuant to an option ("Option") granted under the Plan. If you are not the person to whom the Option was granted ("Option Recipient"), you must attach to this Notice proof 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 PFF BANCORP, INC. 2004 EQUITY INCENTIVE 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 your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Award Recipient _________________________ Social Security Number ___-__-____ BENEFICIARY COMPLETE SECTIONS A AND B. IF NO PERCENTAGE SHARES ARE DESIGNATION SPECIFIED, EACH BENEFICIARY IN THE SAME CLASS ("Agreement")PRIMARY OR CONTINGENT) SHALL HAVE AN EQUAL SHARE. This Notice should be personally delivered or mailed by certified mailIF ANY DESIGNATED BENEFICIARY PREDECEASES YOU, return receipt requested to: Falmouth Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the Company, but in no event more than three days after such date THE SHARES OF EACH REMAINING BENEFICIARY IN THE SAME CLASS ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option AgreementPRIMARY OR CONTINGENT) SHALL BE INCREASED PROPORTIONATELY.
Appears in 1 contract
Samples: PFF Bancorp Inc
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge receipt of a copy of the Plan. APPENDIX Appendix A TO STOCK OPTION AGREEMENT to Stock Option Agreement 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORSStock Option Plan for Outside Directors, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORPOfficers and Employees of Falmouth Bancorp, INC. Inc. Notice of Exercise of Stock Option ------------------------------------------------------------------------------- Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth Bancorp, Inc. (the "Company") pursuant to an option ("Option") granted under the 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 Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth Bancorp, Inc., 00 Xxxxx Xxxxxxx20 Davis Straits, Falmouth, Massachusetts 02340 Massacxxxxxxx 00000 Attention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the Company, but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.. Name of Option Recipient: _____________________________________
Appears in 1 contract
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge receipt of a copy of the Plan. APPENDIX A TO STOCK OPTION AGREEMENT HOME BANCORP OF ELGIN, INC. 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. Notice of Exercise of Stock Option -------------------------------------------------------------------------------- Use this Notice notice to inform the Committee administering the Home Bancorp of Elgin, Inc. 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth BancorpHome Bancorp of Elgin, Inc. (the "Company") pursuant to an option ("Option") granted under the Plan. If you are not the person to whom the Option was granted ("Option Recipient"), ) you must attach to this Notice notice proof of your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth BancorpHome Bancorp of Elgin, Inc., 00 Xxxxx Xxxxxxxc/o Home Federal Savings and Loan Association of Elgin, Falmouth16 North Spring Street, Massachusetts 02340 Elgin, Illinois 60120 Attention: Corporate SecretarySxxxxxxxx. The effective date of the exercise of Xxx xxxxxxxxx xxxx xx xxx xxxxxxxx xf the Option shall be the earliest date practicable following the date this Notice is received by the Company, but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.
Appears in 1 contract
Samples: Stock Option Agreement (State Financial Services Corp)
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge the Optionee acknowledges receipt of a copy of the Plan. APPENDIX Appendix A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORSto Stock Option Agreement Dime Community Bancshares, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. Inc. 2004 Stock Incentive Plan Notice of Exercise of Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth BancorpDime Community Bancshares, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth BancorpDime Community Bancshares, Inc. (the "Company") pursuant to an option ("Option") granted under the Dime Community Bancshares, Inc. 2004 Stock Incentive Plan (the “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 Agreement entered into between the Company and the Option Recipient ("“Agreement")”) . This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth BancorpDime Community Bancshares, Inc., 00 Xxxxx Xxxxxxxc/o The Dime Savings Bank of Williamsburgh, Falmouth000 Xxxxxxxxx Xxxxxx, Massachusetts 02340 Xxxxxxxx, Xxx Xxxx 00000, Attention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyDime Community Bancshares, Inc. but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the PlanPlan . This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement. 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 Dime Community Bancshares, Inc. in the amount of $ ¨ I enclose Shares duly endorsed for transfer to Dime Community Bancshares, Inc. with all stamps attached and having a fair market value of $ Total Exercise Price $ 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. Outside Directors and 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 Dime Community Bancshares, 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 the Administrator 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. 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 I G N H E R E I understand that I must rely on, and consult with, my own tax and legal counsel (and not Dime Community Bancshares, 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 _______________________________________________________________________________________________ _______________________________________________________________________________________________ Address 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 Agreement Dime Community Bancshares, Inc. 2004 Stock Incentive Plan
Appears in 1 contract
Samples: Stock Option Agreement (Dime Community Bancshares Inc)
Plan Provisions Control. This Agreement 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 AgreementCertificate, 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 AgreementCertificate, you acknowledge receipt of a copy of the PlanPlan and a copy of the related Prospectus dated July 29, 2003. APPENDIX A TO STOCK OPTION AGREEMENT 1997 CERTIFICATE BRIDGE STREET FINANCIAL, INC. 2003 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES NOTICE OF FALMOUTH BANCORP, INC. Notice of Exercise of Stock Option EXERCISE OF STOCK OPTION -------------------------------------------------------------------------------- Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth BancorpBridge Street Financial, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth BancorpBridge Street Financial, Inc. (the "Company") pursuant to an option ("Option") granted under the Bridge Street Financial, Inc. 2003 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 Agreement Certificate entered into between the Company Bridge Street Financial, Inc. and the Option Recipient ("AgreementCertificate"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth BancorpBridge Street Financial, Inc., 00 Xxxxx Xxxxxxx44 East Bridge Street, FalmouthOswego, Massachusetts 02340 AttentionNew Xxxx, 00000, Xxxxxxxxx: Corporate SecretaryXxxxxxxxx Xxxxxxxxx. The Xhe effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyBridge Street Financial, Inc. but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.Certificate. Name of Option Recipient:_______________________________________________________
Appears in 1 contract
Samples: Bridge Street Financial Inc
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge the Optionee acknowledges receipt of a copy of the Plan. APPENDIX A TO STOCK OPTION AGREEMENT 1997 DIME COMMUNITY BANCORP, INC. 1996 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES NOTICE OF FALMOUTH EXERCISE OF STOCK OPTION USE THIS NOTICE TO INFORM THE COMMITTEE ADMINISTERING THE DIME COMMUNITY BANCORP, INC. Notice 1996 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES ("PLAN") THAT YOU ARE EXERCISING YOUR RIGHT TO PURCHASE SHARES OF COMMON STOCK ("SHARES") OF DIME COMMUNITY BANCORP, INC. ("DIME") PURSUANT TO AN OPTION ("OPTION") GRANTED UNDER THE 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 AGREEMENT ENTERED INTO BETWEEN DIME AND THE OPTION RECIPIENT ("AGREEMENT"). THIS NOTICE SHOULD BE PERSONALLY DELIVERED OR MAILED BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED TO: DIME COMMUNITY BANCORP, INC., C/O THE DIME SAVINGS BANK OF WILLIAMSBURGH, 000 XXXXXXXXX XXXXXX, XXXXXXXX, XXX XXXX 00000, ATTENTION: CORPORATE SECRETARY. THE EFFECTIVE DATE OF THE EXERCISE OF THE OPTION SHALL BE THE EARLIEST DATE PRACTICABLE FOLLOWING THE DATE THIS NOTICE IS RECEIVED BY DIME, BUT IN NO EVENT MORE THAN THREE DAYS AFTER SUCH DATE ("EFFECTIVE DATE"). EXCEPT AS SPECIFICALLY PROVIDED TO THE CONTRARY HEREIN, CAPITALIZED TERMS SHALL HAVE THE MEANINGS ASSIGNED TO THEM UNDER THE PLAN. THIS NOTICE IS SUBJECT TO ALL OF THE TERMS AND CONDITIONS OF THE PLAN AND THE AGREEMENT. OPTION INFORMATION IDENTIFY BELOW THE OPTION THAT YOU ARE EXERCISING BY PROVIDING THE FOLLOWING INFORMATION FROM THE STOCK OPTION AGREEMENT. NAME OF OPTIONEE: _____________________________________________________ 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 Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Dime Community Bancorp, Inc. in the amount of $ _____________ / / I enclose Shares duly endorsed for transfer to Dime with all stamps attached and having a fair market value of $ _____________ Total Exercise Price $ _____________ 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 AND OUTSIDE DIRECTORS 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 Dime 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 the Administrator 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. 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 I understand that I must rely on, and consult with, my own tax and legal counsel (and not Dime Community 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 "Plancashless exercise") or other disposition of Shares issued pursuant to this Notice and that you are exercising your I must consult with my own tax advisor regarding how and when such income will be reportable. _______________________________________ __________________ S H Signature Date I E G R ________________________________________________________________ N E Address -------------------------------------------------------------------------------- INTERNAL USE ONLY CORPORATE SECRETARY Received [CHECK ONE]: / / By Hand / / By Mail Post Marked ______________________ DATE OF POST MARK By____________________________________________ ______________________ AUTHORIZED SIGNATURE DATE OF RECEIPT -------------------------------------------------------------------------------- APPENDIX B TO STOCK OPTION AGREEMENT DIME COMMUNITY BANCORP, INC. 1996 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES BENEFICIARY DESIGNATION FORM GENERAL INFORMATION USE THIS FORM TO DESIGNATE THE BENEFICIARY(IES) WHO MAY EXERCISE OPTIONS OUTSTANDING TO YOU AT THE TIME OF YOUR DEATH Name of Person Making Designation_____________________ 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 purchase shares 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 common stock ("Shares") my primary Beneficiaries should predecease me, reserving the right to change or revoke this designation at any time prior to my death as to all outstanding Options: NAME ADDRESS RELATIONSHIP BIRTHDATE SHARE ____________________ ___________________ __________ __________ _______% ___________________ ____________________ ___________________ __________ __________ _______% ___________________ ____________________ ___________________ __________ __________ _______% ___________________ Total = 100% I understand that this Beneficiary Designation shall be effective only if properly completed and received by the Corporate Secretary of Falmouth Dime Community Bancorp, Inc. (the "Company") pursuant prior to an option ("Option") granted under the Plan. If you are not the person to whom the Option was granted ("Option Recipient")my death, you must attach to this Notice proof of your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the Company, but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice that it is subject to all of the terms and conditions of the Plan and Plan. I also understand that an effective Beneficiary designation revokes my prior designation(s) with respect to all outstanding Options. _______________________________________ __________________ S H Signature Date I E G R ________________________________________________________________ N E Address -------------------------------------------------------------------------------- INTERNAL USE ONLY This Beneficiary Designation was Comments received by the AgreementCorporate Secretary of Dime Community Bancorp, Inc. on the date indicated. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.By______________________ _______________ AUTHORIZED SIGNATURE DATE --------------------------------------------------------------------------------
Appears in 1 contract
Samples: Stock Option Agreement (Dime Community Bancorp Inc)
Plan Provisions Control. This Agreement and the rights and obligations created hereunder shall be subject to all of the terms and conditions of the Plan that would apply if this stock option had been granted under the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. Capitalized terms in this agreement have the meaning defined in the Plan, as amended from time to time, unless stated otherwise. By signing this Agreement, you acknowledge receipt of a copy of the PlanPlan and a copy of the Prospectus for this stock option dated April 16, 2004. APPENDIX A TO STOCK OPTION AGREEMENT 1997 FOR J. CHRISTOPHER NETTLETON XXXXCE OF EXERCISE OF STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH -------------------------------------------------------------------------------- USE THIS NOTICE TO INFORM HUDSON CITY BANCORP, INC. Notice THXX XXX ARE EXERCISING YOUR RIGHT TO PURCHASE SHARES OF COMMON STOCK ("SHARES") OF HUDSON CITY BANCORP, INC. PUXXXXXX TO AN OPTION ("OPTION") GRANTED UNDER THE STOCK OPTION AGREEMENT BETWEEN HUDSON CITY BANCORP, INC. ANX X. XHRISTOPHER NETTLETON DATED XXXXX 00, 0000 (XXX "OPTION AGREEMENT"). 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 AGREEMENT. THIS NOTICE SHOULD BE PERSONALLY DELIVERED OR MAILED BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED TO: HUDSON CITY BANCORP, INC., WXXX 00 CENTURY ROAD, PARAMUS, NEX XXXXXX 00000, XXXXXXXXX: XXXXXXXXX XXXXXTARY. THE EFFECTIVE DATE OF THE EXERCISE OF THE OPTION SHALL BE THE EARLIEST DATE PRACTICABLE FOLLOWING THE DATE THIS NOTICE IS RECEIVED BY HUDSON CITY BANCORP, INC. BUX XX XO EVENT MORE THAN THREE DAYS AFTER SUCH DATE ("EFFECTIVE DATE"). EXCEPT AS SPECIFICALLY PROVIDED TO THE CONTRARY HEREIN, CAPITALIZED TERMS SHALL HAVE THE MEANINGS ASSIGNED TO THEM UNDER THE HUDSON CITY BANCORP, INC. 2000 XXXCK OPTION PLAN (THE "PLAN"). OPTION INFORMATION IDENTIFY BELOW THE OPTION THAT YOU ARE EXERCISING BY PROVIDING THE FOLLOWING INFORMATION FROM THE STOCK OPTION AGREEMENT. NAME OF OPTION RECIPIENT: J. Christopher Nettleton -------------------------------------------- OPTION GRANT DATE: ________________, __________ (MONTH AND DAY) (YEAR) EXERCISE PRICE PER SHARE: $_________.____ 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 Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth $____________________ Hudson City Bancorp, Inc. ("Plan") that you are exercising your right in xxx xmount of |_| I enclose Shares duly endorsed for transfer to purchase shares of common stock ("Shares") of Falmouth Hudson City Bancorp, Inc. (wixx xxx $____________________ _______________ stamps attached and having a fair market value of Total Exercise Price $____________________ ISSUANCE OF CERTIFICATES I hereby direct that the "Company") stock certificates representing the Shares purchased pursuant to an option ("Option"the above instructions be issued to the following person(s) granted under in the Planamount specified below: NAME AND ADDRESS SOCIAL SECURITY NO. If you are not 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 person amount of federal, state and local taxes required to whom be withheld with respect to the Option was granted ("Option Recipient"), you must attach Shares to be issued to me pursuant to this Notice proof of your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mailNotice, return receipt requested to: Falmouth but that I may request Hudson City Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate SecretaryInc. to xxxxxn or sell a sufficient number of such Shares to cover the amount to be withheld. The effective date of the exercise of the Option shall I hereby request that any taxes required to be the earliest date practicable following the date this Notice is received by the Company, but withheld be paid in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.manner [check one]:
Appears in 1 contract
Samples: Hudson City Bancorp Inc
Plan Provisions Control. This Stock Option Agreement 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 provisions of this Stock Option Agreement, the terms of the Plan, which are incorporated incorporated herein by reference, shall control. By signing this Stock Option Agreement, you acknowledge receipt of a copy of the Plan. You acknowledge that you may not and will not rely on any statement of account or other communication or document issued in connection with the Plan other than the Plan, this Stock Option Agreement, and any document signed by an authorized representative of the Company that is designated as an amendment of the Plan or this Stock Option Agreement. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORPNORTH CENTRAL BANCSHARES, INC. 2006 STOCK INCENTIVE PLAN Notice of Exercise of Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth BancorpNorth Central Bancshares, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("“Shares"”) of Falmouth BancorpNorth Central Bancshares, Inc. (the "Company") pursuant pursuant to an option ("“Option"”) granted under the North Central Bancshares, Inc. 2006 Stock Incentive 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 Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth BancorpNorth Central Bancshares, Inc., 00 Xxxxx Xxxxxxxc/o First Federal Savings Bank of Iowa, FalmouthFort Dodge, Massachusetts 02340 Iowa 50501 Attention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyNorth Central Bancshares, Inc. but in no event more than three days after such date ("“Effective Date"”). Except as specifically specifically provided to the contrary contrary herein, capitalized terms shall have the meanings assigned assigned to them under the Plan. This Notice is subject , as amended from time to all of the terms and conditions of the Plan and the Agreementtime. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement. 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 o I enclose a certified check, money order, or bank draft payable to the order of North Central Bancshares, Inc. in the amount of $ o I enclose Shares duly endorsed for transfer to North Central Bancshares, Inc. with all stamps attached and having a fair market value of $ ¨ Return a number of shares from any Option exercised with an aggregate built-in gross [defined as $ fair Market Value on the date of exercise ____the Exercise Price equal to Total Exercise Price $ ISSUANCE OF CERTIFICATES I hereby direct that the stock certificates representing the Shares purchased pursuant to the above instructions 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 North Central Bancshares, 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 North Central Bancshares, 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. ¨ By retaining Shares that would otherwise be distributed to me. I understand that the withholding elections I have made on this form are not binding on the Compensation Committee, and that the Compensation 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 Compensation 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 I G N H E R E I understand that I must rely on, and consult with, my own tax and legal counsel (and not North Central Bancshares, 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]: G By Hand G By Mail Post Marked ____________________ Date of Post Mark _____________________________________________ ______________________________ Authorized Signature Date of Receipt APPENDIX B TO STOCK OPTION AGREEMENT NORTH CENTRAL BANCSHARES, INC. 2006 STOCK INCENTIVE 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 Person Making Designation _______________________________ Social Security Number _______C_____C_______ 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.
Appears in 1 contract
Samples: Stock Option Agreement (North Central Bancshares Inc)
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge receipt of a copy of the Plan. APPENDIX A TO STOCK OPTION AGREEMENT HOME BANCORP OF ELGIN, INC. 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. Notice of Exercise of Stock Option -------------------------------------------------------------------------------- Use this Notice notice to inform the Committee administering the Home Bancorp of Elgin, Inc. 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth BancorpHome Bancorp of Elgin, Inc. (the "Company") pursuant to an option ("Option") granted under the Plan. If you are not the person to whom the Option was granted ("Option Recipient"), ) you must attach to this Notice notice proof of your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth BancorpHome Bancorp of Elgin, Inc., 00 c/o Home Federal Savings and Loan Association of Elgin, 16 Xxxxx XxxxxxxXxxxxx Xxxxxx, FalmouthXxxxx, Massachusetts 02340 AttentionXxxxxxxx 00000 Xttention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the Company, but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.
Appears in 1 contract
Plan Provisions Control. This Agreement 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 AgreementCertificate, 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 AgreementCertificate, you acknowledge receipt of a copy of the Plan. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH CERTIFICATE CMS BANCORP, INC. Notice of Exercise of Stock Option 2007 STOCK OPTION PLAN NOTICE OF EXERCISE OF STOCK OPTION Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth CMS Bancorp, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("“Shares"”) of Falmouth CMS Bancorp, Inc. (the "Company") pursuant to an option ("“Option"”) granted under the CMS Bancorp, Inc. 2007 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 Agreement Certificate entered into between the Company CMS Bancorp, Inc. and the Option Recipient ("Agreement"“Certificate”). This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth CMS Bancorp, Inc., 00 000 Xxxx Xxxxxx, Xxxxx Xxxxxxx000, FalmouthXxxxx Xxxxxx, Massachusetts 02340 Xxx Xxxx 00000, Attention: Corporate SecretaryCompensation Committee. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyCMS Bancorp, but in no event more than three days after such date Inc. ("“Effective Date"”). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.Certificate. Name of Option Recipient: Option Grant Date: , Exercise Price per $hare: $ . (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 CMS Bancorp, Inc. in the amount of $ ¨ I enclose Shares I have owned for at least six months duly endorsed for transfer to CMS Bancorp, Inc. with all stamps attached and having a fair market value of* $ Total Exercise Price $ * Subject to Compensation 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 CMS 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 CMS 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 Compensation Committee, and that the Compensation 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 Compensation 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
Appears in 1 contract
Plan Provisions Control. This Agreement 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 Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. By signing this Agreement, you acknowledge the Optionee acknowledges receipt of a copy of the Plan. APPENDIX Appendix A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORSto Stock Option Agreement Dime Community Bancshares, OFFICERS AND EMPLOYEES OF FALMOUTH BANCORP, INC. Inc. 2004 Stock Incentive Plan Notice of Exercise of Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth BancorpDime Community Bancshares, Inc. ("Plan") that you are exercising your right to purchase shares of common stock ("Shares") of Falmouth BancorpDime Community Bancshares, Inc. (the "Company") pursuant to an option ("Option") granted under the Dime Community Bancshares, Inc. 2004 Stock Incentive Plan (the “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 Agreement entered into between the Company and the Option Recipient ("“Agreement")”) . This Notice should be personally delivered or mailed by certified mail, return receipt requested to: Falmouth BancorpDime Community Bancshares, Inc., 00 Xxxxx Xxxxxxxc/o The Dime Savings Bank of Williamsburgh, Falmouth000 Xxxxxxxxx Xxxxxx, Massachusetts 02340 Xxxxxxxx, Xxx Xxxx 00000, Attention: Corporate Secretary. The effective date of the exercise of the Option shall be the earliest date practicable following the date this Notice is received by the CompanyDime Community Bancshares, Inc. but in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the PlanPlan . This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement. 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 Dime Community Bancshares, Inc. in the amount of $ ¨ I enclose Shares duly endorsed for transfer to Dime Community Bancshares, Inc. with all stamps attached and having a fair market value of $ Total Exercise Price $ 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. Outside Directors and 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 Dime Community Bancshares, 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 the Administrator 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. 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
Appears in 1 contract
Samples: Qualified Stock Option Agreement (Dime Community Bancshares Inc)
Plan Provisions Control. This Agreement and the rights and obligations created hereunder shall be subject to all of the terms and conditions of the Plan that would apply if this stock option had been granted under the Plan. In the event of any conflict between the provisions of the Plan and the provisions of this Agreement, the terms of the Plan, which are incorporated herein by reference, shall control. Capitalized terms in this agreement have the meaning defined in the Plan, as amended from time to time, unless stated otherwise. By signing this Agreement, you acknowledge receipt of a copy of the PlanPlan and a copy of the Prospectus for this stock option dated November 9, 2001. APPENDIX A TO STOCK OPTION AGREEMENT 1997 STOCK OPTION PLAN FOR OUTSIDE DIRECTORS, OFFICERS AND EMPLOYEES OF FALMOUTH HUDSON CITY BANCORP, INC. Notice DENIS J. SALAMONE STOCK OPTION PLAN NOTICE OF XXXXXXXX XX XXXXK OPTION -------------------------------------------------------------------------------- USE THIS NOTICE TO INFORM HUDSON CITY BANCORP, INC. THAT YOU ARE EXERCISING YOUR RIGHT TO PURCXXXX XHARES OF COMMON STOCK ("SHARES") OF HUDSON CITY BANCORP, INC. PURSUANT TO AN OPTION ("OPTION") GRANTED UXXXX XHE STOCK OPTION AGREEMENT BETWEEN HUDSON CITY BANOCORP, INC. AND DENIS J. SALAMONE DATED OCTOBER 29, 2000 (XHE "OPTION AGREEMENT"). IX XXX XXX XXX XXX 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 AGREEMENT . THIS NOTICE SHOULD BE PERSONALLY DELIVERED OR MAILED BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED TO: HUDSON CITY BANCORP, INC, WEST 80 CENTURY ROAD, PARAMUS, NEW JERSEY 00000-1473, ATTENTION: CORPORATX XXXXXXXXX. XXX XXXXXXXXX XXXX XX XXX XXXXXXXX OF THE OPTION SHALL BE THE EARLIEST DATE PRACTICABLE FOLLOWING THE DATE THIS NOTICE IS RECEIVED BY HUDSON CITY BANCORP, INC. BUT IN NO EVENT MORE THAN THREE DAYS AFTER XXXX DATE ("EFFECTIVE DATE"). EXCEPT AS SPECIFICALLY PROVIDED TO THE CONTRARY HEREIN, CAPITALIZED TERMS SHALL HAVE THE MEANINGS ASSIGNED TO THEM UNDER THE HUDSON CITY BANCORP, INC. 2001 STOCK OPTION PLAN (THE "PLAN"). OPTIXX XXXORMATION IDENTIFY BELOW THE OPTION THAT YOU ARE EXERCISING BY PROVIDING THE FOLLOWING INFORMATION FROM THE STOCK OPTION AGREEMENT. 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 PRIC 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 Stock Option Use this Notice to inform the Committee administering the 1997 Stock Option Plan for Outside Directors, Officers and Employees of Falmouth Hudson City Bancorp, Inc. ("Plan") that you are exercising your right in the amount of the order ox $_______ |_| I enclose Shares duly endorsed for transfer to purchase shares of common stock ("Shares") of Falmouth Hudson City Bancorp, Inc. (with all stamps attached and xxxxxg a fair market value of $_______ Total Exercise Price $_______ ISSUANCE OF CERTIFICATES I hereby direct that the "Company") stock certificates representing the Shares purchased pursuant to an option ("Option"section 2 above be issued to the following person(s) granted under in the Planamount specified below: NAME AND ADDRESS SOCIAL SECURITY NO. If you are not 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 person amount of federal, state and local taxes required to whom be withheld with respect to the Option was granted ("Option Recipient"), you must attach Shares to be issued to me pursuant to this Notice proof of your right to exercise the Option granted under the Stock Option Agreement entered into between the Company and the Option Recipient ("Agreement"). This Notice should be personally delivered or mailed by certified mailNotice, return receipt requested to: Falmouth but that I may request Hudson City Bancorp, Inc., 00 Xxxxx Xxxxxxx, Falmouth, Massachusetts 02340 Attention: Corporate Secretaryto retain or sell a sufficient number of xxxx Xhares to cover the amount to be withheld. The effective date of the exercise of the Option shall I hereby request that any taxes required to be the earliest date practicable following the date this Notice is received by the Company, but withheld be paid in no event more than three days after such date ("Effective Date"). Except as specifically provided to the contrary herein, capitalized terms shall have the meanings assigned to them under the Plan. This Notice is subject to all of the terms and conditions of the Plan and the Agreement. OPTION INFORMATION Identify below the Option that you are exercising by providing the following information from the Stock Option Agreement.manner [check one]:
Appears in 1 contract
