Common use of Split Dollar Policy Endorsement Clause in Contracts

Split Dollar Policy Endorsement. Insured: Xxxxx X. Xxxxxx Insurer: Midland National Life Insurance Company Policy No. 690216 According to the terms of The Cortland Savings and Banking Company Fourth Amended Split Dollar Agreement and Endorsement dated as of , 2011, the undersigned Owner requests that the above-referenced policy issued by the Insurer provide for the following beneficiary designation and limited contract ownership rights to the Insured:

Split Dollar Policy Endorsement. Insured: Xxxxx X. Xxxxxxx Xxxxxx Insurer: Midland National Life Insurance Company Policy No. 690216 690213 According to the terms of The Cortland Savings and Banking Company Fourth Third Amended Split Dollar Agreement and Endorsement dated as of December 3, 20112008, the undersigned Owner requests that the above-referenced policy issued by the Insurer provide for the following beneficiary designation and limited contract ownership rights to the Insured:

Split Dollar Policy Endorsement. Insured: Xxxxx X. Xxxxxxx Xxxxxx Insurer: Midland National Life Insurance Company Policy No. 690216 00690213 According to the terms of The Cortland Savings and Banking Company Fourth Amended Split Dollar Agreement and Endorsement dated as of , 2011, the undersigned Owner requests that the above-referenced policy issued by the Insurer provide for the following beneficiary designation and limited contract ownership rights to the Insured:

Split Dollar Policy Endorsement. Insured: Xxxxx X. Xxxxxx Insurer: Midland National Life Insurance Company Policy No. 690216 According to the terms of The Cortland Savings and Banking Company Fourth Third Amended Split Dollar Agreement and Endorsement dated as of December 3, 20112008, the undersigned Owner requests that the above-referenced policy issued by the Insurer provide for the following beneficiary designation and limited contract ownership rights to the Insured:

Split Dollar Policy Endorsement. Insured: Xxxxx Jxxxx X. Xxxxxx Xxxxxxxx Insurer: Midland National Life Insurance Company Policy No. 690216 According 688313 Pursuant to the terms of The the Cortland Savings and Banking Company Fourth Bancorp Amended Split Dollar Agreement and Endorsement dated as of December 18, 20112007, the undersigned Owner requests that the above-referenced policy issued by the Insurer provide provides for the following beneficiary designation and limited contract ownership rights to the Insured:

Split Dollar Policy Endorsement. Insured: Xxxxx Xxxxxxx X. Xxxxxx Xx. Insurer: Midland National Life Insurance Company Policy No. 690216 690221 According to the terms of The Cortland Savings and Banking Company Fourth Third Amended Split Dollar Agreement and Endorsement dated as of December 3, 20112008, the undersigned Owner requests that the above-referenced policy issued by the Insurer provide for the following beneficiary designation and limited contract ownership rights to the Insured: