Preferred Stock Terms Notice

PREFERRED STOCK TERMS NOTICE
Notice No.:
For your convenience, the application/notice that you are reviewing includes all questions
contained on the type of capital/dividend application/notice that you completed. We have
provided all questions for your review to ensure that you have an opportunity to see those
questions that you answered and the questions that you did not previously see or answer.
Your attention should be focused on those questions with answers, with the other
questions provided for your information.

National Bank Identifying Information
Charter No.:
Name of Bank:
Street address:
City:
County:
State:
Zip:
Supervisory
District:

Preferred Stock Terms Details
Notification of intent to issue preferred stock according to 12 CFR 5.46(g)(2).
Description of the terms of the preferred stock concerning the preferred stock
dividends, voting and conversion rights, retirement of the preferred stock, and
rights to exercise control over management. If the shareholders already have
approved the related amendments to the Articles of Association, include them. If the
shareholders have not yet approved the amendments, provide a copy of the
proposed amended Articles of Association, if prepared:

The bank:
_ has obtain
_ will obtain
shareholder approval of the (retirement of capital stock/acquisition of treasury
stock) on date:
The bank:
_ has prepared
_ will prepare
proxy materials under 12 CFR11and
_ has filed
_ will file
such proxy materials with the Securities and Corporate Practices Division.
Contact Person Requests for additional information or other communications about this proposal
should be directed to:

Name:
Title:
Street Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Additional Attachments

Signature
Signature of Authorized Officer:
Typed Name:
Title:
Date:
Name of Bank:
BankNet Security verified that was a valid signer for as of .