Fill and Sign the Assignment Deposit Form

Assignment of Certificate of Deposit Date: ______________ Name of Deposit Owner: _________________________________________________ Address of Deposit Owner: ________________________________________________ Name of Financial Institution: ______________________________________________ Type of account: Certificate of Deposit Original Amount of Deposit: $______________________________ Current rate of interest: ______________ Account Number: _____________________________ Current Amount of Deposit $___________________ Next maturity date (if time deposit): _________________ I. Definitions In this Agreement: A. You, you and your mean anyone signing this Agreement. B. We, we, us and our mean ________________________ (Name of issuer of certificate of deposit) , of _________________________________________ ________________________________ (street address, city, state, zip code) . C. The Borrower means person receiving credit from us other than you, i.e., ______________________ (Name of Borrower) whose address is __________ ________________________________________________________________ (street address, city, state, zip code) . D. The collateral means: 1. Whether or not represented by a certificate of deposit, the deposit account that has the account number set forth in the blanks at the beginning at this Agreement and is maintained at the financial institution identified in those blanks; 2. All other at accounts, whether or not represented by a certificate of deposit , into which is directly or indirectly deposited any money withdrawn or paid from the deposit account referred to in Item D-1 above; 3. All direct or indirect additions to, extensions, renewals and replacements of, increases in, interest, dividends and other income on account of and proceeds at any sale or other disposition of or of any collection on account of any deposit account referred to Items D-1 or D-2 above; and D. All certificates of deposit, passbooks and other instruments and records representing or otherwise relating to any deposit account referred to in Items D-1 or D-2 above or anything referred to in Item D-3 above. II. Security To secure the payment of all indebtedness from you or the Borrower to us existing now or coming into existence in the future, you give us a security interest in the collateral and assign it to us. A person who has a security interest in property has a number of rights depending on what the property is -- for example, if the property is a certificate of deposit , the right under certain circumstances to sell it or collect any money payable on account of it. To assign property means to transfer rights in it. III. Reduction in Rate The rate of interest or effective rate at interest (taking into account the effect of compounding) paid in connection with any deposit account included in the collateral will be reduced to the rate necessary to comply with any law or regulation requiring the rate of interest or effective rate of interest to be at least a specified percentage (such as 1%) below the rate of interest paid in connection with any indebtedness the payment of which is secured by the collateral. If the rate of interest or effective rate of interest paid in connection with any deposit account included in the collateral is reduced as provided in the preceding sentence, it need not be increased except at a time it would be subject to change if It were not included in the collateral. Some assurances about the collateral. You assure us that no one other than you owns any of the collateral or has any claim to any of it. IV. Delivering Instruments and Records You are delivering to us all certificates of deposit, passbooks and other instruments and records included in the collateral and received by you, and you assure us that each of them is genuine and what it appears to be. V. Care of Instruments and Records We will have taken reasonable care at any certificate of deposit , passbook of other instrument or record included in the collateral and delivered to us if we treat it in basically the same way as we treat our own property of the same sort. VI. Promises A. You must promptly: 1. Deliver to us any certificate of deposit , passbook or other instrument or record included in the collateral and received by you, 2. Pay any tax on the ownership of any of the collateral and 3. Sign any document we want signed to protect our interest in any at the collateral. B. Without first obtaining our consent in writing, you must not: 1. Sell, give away or in any other way dispose of any of the collateral, 2. Permit anyone other than you or us have any claim to any of the collateral or 3. Do anything that would adversely affect our interest in any of the collateral. C. Also. without first obtaining our consent in writing, you must not: 1. Ask for or collect any of the collateral, 2. Extend or renew any of the collateral, 3. Agree to any change in any Agreement applicable to any other collateral, 4. Make or settle any claim relating to any of the collateral, 5. Bring, conduct or settle any legal proceeding relating to any of the collateral, 6. Waive any right relating to any of the collateral, 7. Sign, deliver or make any request or order for any withdrawal or payment relating to any at the collateral, 8. Acknowledge receipt of any of the collateral or 9. Sign your name to endorse any check or other order for any payment relating to any of the collateral. VII. Amounts Paid by Us We can, but we do not have to, A. Pay any tax on the ownership of any of the collateral if you do not pay it and B. Make any payment we believe necessary to eliminate any claim to any of the collateral superior to our interest in it. When we ask you to do so, you must immediately pay us any amount we pay under this section and interest at the rate of _______% a year on the portion of that amount not yet paid to us. VIII. Revocation of Authority If you have previously authorized anyone to make withdrawals from any deposit account included in the collateral or to do any other thing concerning any of the collateral, you revoke that authority. IX. Default A. A default under this Agreement occurs if: 1. Any indebtedness from you or the Borrower to us existing now or coming into existence in the future is not paid by the day it becomes due - even though a late charge would not be imposed until later, 2. You violate any provision of this Agreement or of any other Agreement with us existing now or coming into existence in the future, 3. Borrower violates any provision of any Agreement with us existing now or coming into existence in the future, 4. You die or become incompetent or insolvent 5. The Borrower dies or becomes incompetent or insolvent, 6. Any proceeding under any bankruptcy law or other law concerning the relief of debtors is started by or against you or the Borrower, 7. We discover that in this Agreement, any other Agreement with us existing now or coming into existence in the future or any application you have made or make to us for credit you made any false or misleading statement about an important matter, 8. We discover that in any Agreement with us existing now or coming into existence in the future or any application the Borrower has made or makes to us for credit the Borrower made any false or misleading statement about an important matter, 9. We reasonably believe that any indebtedness from you or the Borrower to us existing now or coming into existence in the future will not be paid by the day it becomes due, or 10. We reasonably believe that something seriously affects the value to us of any property in which any interest has been or is given to secure the payment of any indebtedness from you or the Borrower to us existing now or earning into existence in the future. B. If default occurs. If any default under this Agreement occurs, we can: 1. Sell any of the collateral, 2. Take any action described in the third sentence of the section entitled Promises even if doing so would result in a penalty being imposed by the financial institution at which any deposit included in the collateral is maintained, and 3. Exercise any right given us by applicable law. X. Sale At least 10 days before we sell any of the collateral, we will send you a notice of the proposed sale if we are required by applicable law to do so. We will send the notice 10 your current address shown in cur records concerning this Agreement. We can send it by regular mail. To redeem any at the collateral before we sell it, you may pay us all amounts the payment of which is secured by the collateral, including those described in the first sentence of the next section. To redeem any of the collateral means to get it back. Expenses of sate or collection and application of money received from sale or collection. You must pay us any amount we pay for selling any of the collateral, arranging for the sale of any of the collateral or collecting any of the collateral. We will apply any money we receive as a result of the sale or collection as required by applicable law - for example, to (1) amounts described in the first sentence of this section, and (2) other amounts the payment of which is secured by the collateral and that are not yet paid. We can apply the money to those other amounts in any order we choose, whether or not they are then due. XI. Authorization. You irrevocably authorize us, whether or not any default under this Agreement has occurred, to do any of the things described in the Section entitled Promises. XII. Liabilities and Expenses. You must pay us any liability or expense we incur in connection with our interest in any at the collateral. For example, if we hire an attorney to defend or enforce any of our rights in any of the collateral or to perform any other legal service in connection with any of the collateral, you must pay us the attorney's fee and all legal expenses we pay in connection with the defense, enforcement or other legal service. Agreement. You agree to be bound by all provisions of this Agreement. Witness the signature of the Deposit Owner this the ________________ (date) . __________________________ (Printed Name of Deposit Owner) __________________________ (Signature of Deposit Owner) (Acknowledgment form may vary by state) State of _____________________ County of ___________________ Personally appeared before me, the undersigned authority in and for the said County and State, on this __________________ (date) , within my jurisdic tion, the within-named ____________________ (Name of Deposit Owner) , who acknowledged that he executed the above and foregoing instrument. ________________________________ NOTARY PUBLIC My Commission Expires: ____________________