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					                  PROGRESSIVE CASUALTY INSURANCE COMPANY
                                   (A stock Insurance Company, herein called the Underwriter)

                       EXCESS DEPOSIT INSURANCE BOND APPLICATION
                                                            FDIC No.

Applicant
                                (List all entities applying for coverage including all Subsidiaries)
Street Address           City            State       Zip Code
P.O. Box          City           State           Zip Code
Telephone          Fax            Website
Representative authorized to receive notices from the Insurer on behalf of entities proposed for this insurance:
Name           Title         E-Mail

                                            PART I – GENERAL INFORMATION
Requested Effective Date
Requested Limit of Liability $
Please complete attached Account Holders Report (to be attached to application)

1. CURRENT COVERAGES:
                                                 Limits               Expiration Date               Company
    Financial Institution Bond
    Director & Officer Liability
    Excess Deposit Bond

2. REGULATORY INFORMATION (from the most recent exam):
    a. Most recent regulatory examination:           Date                        Regulatory Authority
    b. During the past 3 years has the Applicant or any Subsidiary been placed under or, to the best of
       your knowledge, does management anticipate any:
       i. type of formal enforcement action, order or agreement; or                                                Yes   No
       ii. memorandum of understanding requiring public disclosure as set forth by securities law?                 Yes   No
If yes, provide details below or by attachment.


3. CLASSIFIED ASSETS:
    Most recent dollar amount of internally classified assets:
    Substandard          $
    Doubtful             $
    Loss                 $


4. MANAGEMENT/LOSSES:
    a. During the past two years, have any Directors or Officers been alerted to any of the following conditions:
        i.   Concentration of credit which warrants reduction or correction?                                   Yes       No
        ii. Extensions of credit which warrants reduction or correction?                                       Yes       No

                                                             Page 12
                                                       Form No. ED1010 (01/07)
         iii. Significant violations of law or regulations?                                                              Yes      No
         iv. Conflict of interest transactions?                                                                          Yes      No
    b.   Have there been any changes in the senior management team within the last two years?                            Yes      No
    c. Is the Applicant or any Subsidiary a defendant in any lawsuit or loss which, if the allegations
       are proven, could materially affect the financial condition of the Applicant or any Subsidiary?                    Yes      No
    If any of the answers to Question 4(a) thru (c) are yes, provide details below or by attachment.



5. Attach copy of the most recent External Audit Report or Directors Exam.

                                    PART II – REPRESENTATION STATEMENT
The undersigned declare that, to the best of their knowledge and belief, the statements in this Application, and any
additional material submitted, are true and complete, and that reasonable efforts have been made to obtain sufficient
information from each and every individual or entity proposed for this insurance to facilitate the proper and accurate
completion of this Application.
It is further agreed by the Applicant that the particulars and statements contained in this Application (a copy of which
will be attached to the Bond), any prior Applications upon which a Bond was issued, and any material submitted in
connection with any such current or prior Application (which shall be on file with the Insurer and be deemed attached
to the Bond as if physically attached) are the basis of the Bond and are to be considered as incorporated in and
constituting a part of the Bond. It is further agreed by the Applicant that the statements in this Application or any
material submitted therewith are their representations, and they are material and that the Bond is issued in reliance upon
the truth of such representations.
The signing of this Application does not bind the undersigned to purchase the insurance and accepting this Application
does not bind the Underwriter to complete the insurance or to issue any particular Bond. If a Bond is issued, it is
understood and agreed that the Underwriter relied upon this Application, any previous Applications, and any additional
material submitted in issuing each such Bond and any Endorsements thereto. The undersigned further agrees that if the
statements in this Application or any other materials submitted change before the effective date of any proposed Bond,
which would render this Application inaccurate or incomplete, notice of such change will be reported in writing to the
Underwriter immediately.

                                              PART III - FRAUD WARNINGS
ARKANSAS, LOUISIANA, NEW JERSEY, NEW MEXICO and VIRGINIA: Any person who knowingly presents a false or
fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a
crime. In Arkansas and Louisiana, that person may be subject to fines, imprisonment or both. In New Mexico, that person may be
subject to civil fines and criminal penalties. In Virginia, penalties may include imprisonment, fines and denial of insurance benefits.

COLORADO: It is unlawful to knowingly provide false, incomplete or misleading facts or information to an insurance company for
the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and
civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading
facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant
with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within
the Department of Regulatory Agencies.

DISTRICT OF COLUMBIA, KENTUCKY and PENNSYLVANIA: Any person who knowingly and with intent to defraud any
insurance company or other person files an application for insurance or statement of claim containing materially false information or
conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is
a crime. In District of Columbia, penalties include imprisonment and/or fines. In addition, the Insurer may deny insurance benefits if
the applicant provides false information materially related to a claim. In Pennsylvania, the person may also be subject to criminal and
civil penalties.

FLORIDA: Any person who knowingly and with intent to injure, defraud or deceive the Insurer, files a statement of claim or an
application containing any false, incomplete or misleading information is guilty of a felony of the third degree.


                                                             Page 22
                                                       Form No. ED1010 (01/07)
MAINE, TENNESSEE and WASHINGTON It is a crime to knowingly provide false, incomplete or misleading information to an
insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines and/or denial of insurance
benefits.

OHIO: Any person who, with intent to defraud or knowing that he is facilitating a fraud against the Insurer, submits an application or
files a claim containing a false or deceptive statement is guilty of insurance fraud.

OKLAHOMA: WARNING: Any person who knowingly and with intent to injure, defraud or deceive the Insurer, makes any claim
for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.

By ______________________________________                Date ______________ Title _________________________________
Signature of the Chief Executive Officer
(or other Senior Officer if the Chief Executive Officer is also the Chairman of the Board)

By ______________________________________                 Date ______________
Signature of the Chairman of the Board

A BOND CANNOT BE ISSUED UNLESS THE APPLICATION IS SIGNED/DATED BY TWO INDIVIDUALS.

Agent Name                                                      License Number

                                                 Submit Application to:
                                Progressive Group of Insurance Companies, PLG Division
                             5920 Landerbrook Drive, PLG-L21 • Mayfield Heights, OH 44124
                      Telephone: (800) 274-5222 • Fax: (800) 456-6590 • Website: banks.progressive.com




                                                             Page 32
                                                       Form No. ED1010 (01/07)
                                               PROGRESSIVE CASUALTY INSURANCE COMPANY
                                                           (A Stock Insurance Company, herein called the Underwriter)

                                                                 Excess Deposit Insurance Bond
                                                                  ACCOUNT HOLDERS REPORT

Excess Deposit Bond Report of Account Holders as of                    /     /
                                                                 Mo/Day/Yr

Name of                                                                                                                                           Uninsured
Account Holder                           Type of Account     Address                                City         State   Zip   Account #     Deposit Amount




(If additional Account Holders, use Page 2)                                                                                    TOTAL                            $

The total of Uninsured Deposit Amount cannot exceed the Total Limit of Liability as shown in Item 3 of the Declarations. It is agreed and understood that
coverage is in effect only as to the listed Account Holders. No coverage exists as to any Account Holder for Uninsured Deposits until the Bank submits a
written Account Holder Report listing the Account Holder and the Underwriter acknowledges receipt of the report and agrees in writing to coverage of the
Account Holders' Uninsured Deposits.

It is understood that all Account Holders must be listed even if previously reported. Failure to list a previously reported Account Holder will void coverage
for that specified Account Holder.


Name of Bank:                                                                         FDIC No.

_________________________________________________________                             Date:      ________________
Signature and Title of Authorized Bank Representative
Excess Deposit Bond Report of Account Holders as of         /     /
                                                      Mo/Day/Yr

Name of                                                                                                                   Uninsured
Account Holder              Type of Account       Address                        City   State   Zip   Account #      Deposit Amount




                                                                                                      TOTAL PAGE 2               $
                                                                                                      TOTAL PAGE 1               $
                                                                                                      GRAND TOTAL                $

Name of Bank:                                                         FDIC No.
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