PHSB FINANCIAL CORPORATION
STOCK ORDER FORM
DEADLINE
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This order form, properly executed and with the full payment must and will be
deemed received upon the date and the time of delivery of the form to one of our
offices. Please submit your order using the enclosed postage-paid envelope or
hand-delivering the order form to any office of Peoples Home Savings Bank.
NUMBER OF SHARES
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Fill in the number of shares you wish to purchase and the total amount due. No
fractional shares will be issued. The minimum order is 25 shares. With the
exception of the ESOP, no person (or persons who have subscription rights
through a single account) may purchase in the Offerings more than 10,000 shares
of Common Stock and no person (or persons who have subscription rights through a
single account), together with associates of persons acting in concert with such
person, may purchase in the aggregate more than 20,000 shares of Common Stock.
See the Prospectus for a description of purchase limitations, including how to
determine whether your purchases will be aggregated with any associates or
persons acting in concert.
METHOD OF PAYMENT
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Check the appropriate box(es). You may pay by cash, check, or money order. If
paying by check or money order, please make it payable to PHSB Financial
Corporation. If paying by cash, please hand-deliver your order form. Your funds
will earn interest at the interest rate paid on passbook savings accounts from
the date of receipt until the offering is completed. You may also wish to pay by
authorizing withdrawal from your Peoples Home Savings Bank savings or
certificate account(s). If paying by withdrawal, please list the appropriate
account number(s); these designated funds will continue to earn interest at the
contractual rate, but cannot be withdrawn by you.
STOCK REGISTRATION
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Print the name(s) in which you want the stock registered. If you are a voting
member, to protect your priority over other purchasers as described in the
Prospectus, you must take ownership in at least one of the account holders'
names. -------------------------------------------------------------------
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Enter the Social Security Number (or Tax I.D. Number) of a registered owner.
Only one number is required.
Indicate the manner in which you wish to take ownership by checking the
appropriate box. If necessary, check "Other" and note ownership such as
corporation, estate or trust. If stock is purchased for a trust, the date of the
trust agreement and trust title must be included. See the reverse side of this
form for registration guidelines.
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Total
Number of Purchase Total
Shares Price Amount
X $10.00 = $
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[ ] Enclosed is a check or money order payable to
PHSB Financial Corporation, Inc. for $ .
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[ ] I authorize withdrawal from the following Peoples Home Savings
Bank account(s):
Account Number(s) Amount
$
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$
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$
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Total Withdrawal $
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No penalty for early withdrawal.
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Name(s) in which stock is to be registered.
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Name(s) in which stock is to be registered.
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Address
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City County
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State Zip Code
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Social Security # or Tax ID #
[ ] Individual [ ] Joint Tenants [ ] Tenants in Common
[ ] Uniform Transfer to Minors
[ ] Other
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PHSB FINANCIAL CORPORATION
GUIDELINES FOR REGISTERING STOCK
For reasons of clarity and standardization, the stock transfer industry has
developed uniform stockholder registrations which we will utilize in the
issuance of your PHSB Financial Corporation stock certificate(s). If you have
any questions, please consult your legal advisor.
Stock ownership must be registered in one of the following manners:
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INDIVIDUAL Avoid the use of two initials. Include the first given name,
middle initial and last name of the stockholder. Omit words of
limitation that do not affect ownership rights such as "special
account," "single man," "personal property," etc.
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JOINT Joint ownership of stock by two or more persons shall be
inscribed on the certificate with one of the following types of
joint ownership. Names should be joined by "and," do not connect
with "or". Omit titles such as "Mrs.," "Dr.," etc. JOINT TENANTS
Joint Tenancy with Right of Survivorship and not as Tenants in
Common may be specified to identify two or more owners where
ownership is intended to pass automatically to the surviving
tenant(s). TENANTS IN COMMON Tenants in common may be specified
to identify two or more owners. When stock is held in a tenancy
in common, upon the death of one co-tenant, ownership of the
stock will be held by the surviving co-tenant(s) and by the heirs
of the deceased co-tenant. All parties must agree to the transfer
or sale of shares held in this form of ownership.
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UNIFORM Stock may be held in the name of a custodian for a minor under
TRANSFORM the Uniform Gifts to Minors laws of the individual states. There
TO MINORS may be only one custodian and one minor designated on a stock
certificate. The standard abbreviation of custodian is "CUST,"
while the description "Uniform Gifts to Minors Act" is
abbreviated "UNIF GIFT MIN ACT." Standard U.S. Postal Service
state abbreviations should be used to describe the appropriate
state. For example, stock held by John P. Jones under the
Delaware Uniform Gifts to Minors Act will be abbreviated.
JOHN P. JONES CUST SUSAN A. JONES
UNIF GIFT MIN ACT
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FIDUCIARIES Stock held in a fiduciary capacity must contain the following:
1. The name(s) of the fiduciary --
* If an individual, list the first given name, middle
initial, and last name.
* If a corporation, list the corporate title.
* If an individual and a corporation, list the
corporation's title before the initial.
2. The fiduciary capacity --
* Administrator
* Conservator
* Committee
* Executor
* Trustee
* Personal Representative
* Custodian
3. The type of document governing the fiduciary
relationship. Generally, such relationships are
either under a form of living trust agreement or
pursuant to a court order. Without a document
establishing a fiduciary relationship, your
stock may not be registered in a fiduciary
capacity.
4. The date of document governing the relationship.
The date of the document need not be used in the
description of a trust created by a will.
5. Either of the following:
The name of the maker, donor or testator
or
The name of the beneficiary
Example of Fiduciary Ownership:
JOHN D. SMITH, TRUSTEE FOR TOM A. SMITH
UNDER AGREEMENT DATED ___/___/97
NASD AFFILIATIONS
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Please refer to the National Association of Securities Dealers, Inc., ("NASD")
affiliation section and check the box, if applicable. The NASD Interpretation
With Respect to Free-Riding and Withholding (the "Interpretation") restricts the
sale of a "hot issue" (securities that trade at a premium in the aftermarket) to
NASD members, persons associated with NASD members (i.e., an owner, director,
officer, partner, employee, or agent of a NASD member) and certain members of
their families. Such persons are requested to indicate that they will comply
with certain conditions required for an exemption from the restrictions.
[ ] Check here and initial below if you are a member of the NASD or a person
associated with an NASD member or a partner with a securities brokerage firm or
a member of the immediate family of any such person to whose support such person
contributes directly or indirectly or if you have an account in which a NASD
member or a person associated with a NASD member has a beneficial interest. I
agree (i) not to sell, transfer or hypothecate the stock for a period of three
months following issuance, and (ii) to report this stock purchase in writing to
the applicable NASD member I am associated with within one day of the payment
for the stock.
(Initials) ______________
TELEPHONE INFORMATION
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Please enter both a daytime and an evening telephone number where you may be
reached in the event we cannot execute your order as given. Please include your
area code.
Daytime Phone ( )
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Evening Phone ( )
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ACKNOWLEDGMENT
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Sign and date the order form. When purchasing as a custodian, corporate officer,
etc., add your full title to your signature. An additional signature is required
only when payment is by withdrawal from an account that requires more than one
signature to withdraw funds. Your order will be filled according to the
provisions of the Plan of Conversion as described in the Prospectus.
I (WE) ACKNOWLEDGE THAT THIS SECURITY IS NOT A SAVINGS ACCOUNT OR DEPOSIT AND IS
NOT FEDERALLY INSURED AND IS NOT GUARANTEED BY PEOPLES HOME SAVINGS BANK OR THE
FEDERAL GOVERNMENT.
I (we) further certify that I (we) received a Prospectus prior to purchasing the
Common Stock of PHSB Financial Corporation and acknowledge the terms and
conditions described therein. The Prospectus that I (we) received contains
disclosure concerning the nature of the security being offered and describes the
risks involved in the investment. These include, among others: (1) Peoples Home
Savings Bank originates a large amount of indirect automobile loans and
commercial business loans which have a higher degree of credit risk than
traditional one-to-four family lending; (2) You may not be able to profit from
the sale or merger of PHSB Financial Corporation because of provisions in its
charter documents and other laws and regulation; (3) PHSB Financial
Corporation's low return on equity after the conversion may negatively impact
the value of its common stock; (4) You may not be able to sell your shares when
you desire, or for $10.00 or more per share; (5) The implementation of certain
stock-based benefit plans may increase PHSB Financial Corporation's future
compensation expense and may reduce its earnings; (6) Increases in market rates
of interest could adversely affect PHSB Financial Corporation stockholders'
equity; (7) A downturn in the local economy and increased competition may
adversely affect profitability; and (8) Possible dilutive effect of Restricted
Stock Plan Shares and Stock Option Shares.
If anyone asserts that this security is federally insured or guaranteed, or is
as safe as an insured deposit, I (we) should call the Pennsylvania Department of
Banking of the Commonwealth of Pennsylvania, at (___) ________.
I (we) understand that, after receipt by PHSB Financial Corporation this order
may not be modified or withdrawn without the consent of PHSB Financial
Corporation or Peoples Home Savings Bank. Further, I (we) certify that my (our)
purchase does not conflict with the purchase limitations in the Plan of
Conversion and that the shares being purchased are for my (our) account only and
that there is no present agreement or understanding regarding any subsequent
sale or transfer of such shares. Under penalties of perjury, I (we) certify
that: (1) the Social Security Number or Tax Identification Number given above is
correct; and (2) I (we) am (are) not subject to backup withholding.
Instructions: You must cross out #2 above if you have been notified by the
Internal Revenue Service that you are subject to withholding because of
under-reporting interest or dividends on your tax return.
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Signature Date
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Additional Signature (if required) Date
THIS ORDER NOT VALIDATED UNLESS SIGNED
FOR ASSISTANCE, PLEASE CALL OUR STOCK INFORMATION CENTER AT
(724) 846-6020 (PEOPLES HOME SAVINGS BANK)
FROM __:__ __.M. TO __:__ __.M., MONDAY THROUGH FRIDAY