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EXHIBIT 10.5.4
PACIFIC STATE BANK
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
THIS
SUPPLEMENTAL LIFE INSURANCE AGREEMENT (the “Agreement”)
is adopted this _______ day of___________________, 2007, by and
between PACIFIC STATE BANK, a bank organized under the laws of the
State of California, located in Stockton, California (the
“Bank”), and _________________ (the
“Executive”).
The
purpose of this Agreement is to retain and reward the Executive, by
dividing the death proceeds of certain life insurance policies
which are owned by the Bank on the life of the Executive with the
designated beneficiary of the Executive. The Bank will pay the life
insurance premiums from its general assets.
Death
proceeds payable under this Agreement shall be paid solely by the
Insurer from the proceeds of any Policy(ies) on the life of the
Insured. In no event shall the Bank be obligated to pay a death
benefit under this Agreement from its general funds. Should an
Insurer refuse or be unable to pay death proceeds endorsed to
Insured under the express terms of this Agreement, or should the
Bank cancel the Policy(ies) for any reason, Executive’s
Beneficiary(ies) shall not be entitled to a death
benefit.
Article 1
Definitions
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Whenever used in this Agreement,
the following terms shall have the meanings specified:
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1.1
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“ Accrued Liability
Balance ” shall mean the amount accrued by the Bank to
fund the future benefit expense associated with the Executive
Supplemental Compensation Agreement
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1.2
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“ Bank’s
Interest ” means the benefit set forth in Section
2.1.
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1.3
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“ Beneficiary
” means each designated person, or the estate of the deceased
Executive, entitled to benefits, if any, upon the death of the
Executive.
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1.4
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“ Beneficiary
Designation Form ” means the form established from time
to time by the Plan Administrator that the Executive completes,
signs and returns to the Plan Administrator to designate one or
more Beneficiaries.
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1.5
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“ Board ”
means the Board of Directors of the Bank as from time to time
constituted.
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1.6
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“ Executive’s
Interest ” means the benefit set forth in Section
2.2.
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1.7
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“ Insurer ”
means the insurance company issuing the Policy on the life of the
Executive.
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1.8
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“ Net Death Proceeds
” means the total death proceeds of the Policy minus the
greater of (i) the cash surrender value or (ii) the aggregate
premiums paid by the Bank.
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1.9
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“ Normal Retirement
Age ” means the Executive attaining age 65.
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1.10
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“ Policy ” or
“ Policies ” means the individual insurance
policy or policies adopted by the Bank for purposes of insuring the
Executive’s life under this Agreement.
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1
Article 2
Policy Ownership/Interests/Insurer/Assignment
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2.1
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Bank’s Interest .
The Bank shall own the Policies and shall have the right to
exercise all incidents of ownership, including the right to
terminate the Policy(ies) without the consent of the Executive. The
Bank shall be the beneficiary of the remaining death proceeds of
the Policies after the Executive’s Interest is determined
according to Section 2.2 below.
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2.2
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Executive’s Interest
. The Executive shall have the right to designate the beneficiary
of the death proceeds. The Executive shall also have the right to
elect and change settlement options that may be permitted. Upon the
termination of this Agreement according to Article 7 herein, the
Executive, the Executive’s transferee or the
Executive’s beneficiary shall have no rights or interests in
the Policy and no death benefit shall be paid under this Section
2.2.
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2.2.1 Death During Active
Service . If the Executive dies while in the active service of
the Bank, the Bank shall pay to the Executive’s beneficiary
One Million, One Hundred Fifty Three Thousand, Two Hundred Twenty
One Dollars ($1,153,221), upon the death of the
Executive.
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2.2.2 Death During Payment of
a Benefit under the Executive Supplemental Compensation
Agreement . If the Executive dies after any benefit
payments have commenced under Article 2 of the Executive
Supplemental Compensation Agreement, dated ______________________,
but before receiving all such payments, the Bank shall cease paying
the remaining benefit, if any, and shall then pay to the
Executive’s beneficiary a split dollar death benefit equal to
the remaining Accrued Liability Balance under the Executive
Supplemental Compensation Agreement.
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2.2.3 Death After Termination
of Employment But Before Commencement of Payment under the
Executive Supplemental Compensation Plan . If the
Executive is entitled to a benefit under Article 2 of the Executive
Supplemental Compensation Agreement, but dies prior to the
commencement of said benefit payments, the Bank shall pay no
benefit under the Executive Supplemental Compensation Agreement but
shall pay to the Executive’s beneficiary the split dollar
death benefit described in Section 2.2.1 of this
Agreement.
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2.3
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Offer to Purchase . If the
Bank discontinues a Policy during the course of this Agreement, the
Bank shall give the Executive at least thirty (30) days to purchase
such Policy. The purchase price shall be the fair market value of
the Policy, as determined under Treasury Reg. §1.61-22(g)(2)
or any subsequent applicable authority. Such notification shall be
in writing. Upon discontinuation of a policy, this Agreement shall
also terminate.
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2.4
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Insurer . The Insurer
shall be bound only by the terms of the Policy. Any payments the
Insurer makes or actions it takes in accordance with the Policy
shall fully discharge it from all claims, suits and demands of all
entities or persons. The Insurer shall not be bound by or be deemed
to have notice of the provisions of this Agreement.
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2
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2.5
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Assignment . The Executive
may assign without consideration all of the Executive’s
interests in the Policy and in this Agreement to any person, entity
or trust. In the event the Executive transfers all of the
Executive’s interest in the Policy, then all of the
Executive’s interest in the Policy and in the Agreement shall
be vested in the Executive’s transferee, who shall be
substituted as a party hereunder and the Executive shall have no
further interest in the Policy or in this Agreement.
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Article 3
Premiums and Imputed Income
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3.1
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Premium Payment . The Bank
shall pay all premiums due on all Policies.
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3.2
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Economic Benefit . The
Bank shall determine the economic benefit attributable to the
Executive based on the life insurance premium factor for the
Executive’s age multiplied by the aggregate death benefit
payable to the Beneficiary. The “life insurance premium
factor” is the minimum factor applicable under guidance
published pursuant to Treasury Reg. § 1.61-22(d)(3)(ii) or any
subsequent authority.
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3.3
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Imputed Income . The Bank
shall impute the economic benefit to the Executive on an annual
basis, by adding the economic benefit to the Executive’s W-2,
or if applicable, Form 1099.
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Article 4
General Limitations
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4.1
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Termination for Cause .
Notwithstanding any provision of this Agreement to the contrary,
the Executive shall forfeit any right to a benefit under this
Agreement if the Bank terminates the Executive’s employment
for cause. Termination of the Executive’s employment for
“Cause” shall mean termination because of personal
dishonesty, willful misconduct, breach of fiduciary duty involving
personal profit, intentional failure to perform stated duties,
willful violation of any law, rule or regulation (other than
traffic violations or similar offenses) or final cease-and-desist
order or material breach of any provision of the Agreement. For
purposes of this paragraph, no act or failure to act on the
Executive’s part shall be considered “willful”
unless done, or omitted to be done, by the Executive not in good
faith and without reasonable belief that the Executive’s
action or omission was in the best interest of the Bank.
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4.2
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Removal . Notwithstanding
any provision of this Agreement to the contrary, the
Executive’s rights in the Agreement shall terminate if the
Executive is subject to a final removal or prohibition order issued
by an appropriate federal banking agency pursuant to Section 8(e)
of the Federal Deposit Insurance Act (“FDIA
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