EXHIBIT 99.1
ORDER AND ACKNOWLEDGEMENT FORM
SECURITY BANCORP, INC.
STOCK ORDER FORM
NUMBER OF SHARES
Fill in the number of shares you wish to purchase and the total amount due. No
fractional shares will be issued. The minimum purchase is 25 shares. No person
or entity, including all persons or entities on a joint account, may purchase
shares with an aggregate purchase price of more than $75,000 (or 7,500 shares
based on the purchase price of $10.00 per share ("Purchase Price")); and no
person or entity, including all persons or entities on a joint account, together
with associates of and persons acting in concert with such person or entity, may
purchase in the aggregate shares with an aggregate purchase price of more than
$150,000 (or 15,000 shares based on the Purchase Price).
METHOD OF PAYMENT
Check the appropriate boxes that show how you wish to pay for the stock. If
paying by check or money order, make it payable to Security Bancorp, Inc. Your
funds will earn interest at Security Federal's passbook rate until the Offering
is completed. If paying by withdrawal from a Security Federal deposit account,
write in the account number(s) and the amount(s) you wish to withdraw. If
payment is made from a CD account, it will continue to earn interest at the same
CD account rate.
STOCK REGISTRATION
Print the name(s) in which you want the stock registered. If you are a
depositor or member, to protect your rights over other purchasers as described
in the Prospectus, you must take ownership in at least one of the account
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holders' names. Subscription rights are nontransferable. Enter the Social
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Security Number (or Tax ID Number) of one registered owner; only one number is
required. See the reverse side of this form for registration guidelines.
NASD AFFILIATION
The NASD's Interpretation with respect to Free Riding and Withholding restricts
the sale of certain initial public offerings to certain NASD members, affiliates
and family members. For an exemption from these restrictions, such persons must
comply with the following conditions: (i) to not sell or transfer the shares for
a period of three months following issuance and (ii) to report this subscription
in writing to the applicable NASD member within one day of payment therefor. By
signing this Stock Order Form, you are certifying that you will comply with
applicable NASD regulations.
TELEPHONE INFORMATION
Please enter the daytime telephone number where you may be contacted in the
event we cannot execute your offer as given.
ACCOUNT VERIFICATION
If you were a depositor on December 31, 1995, March 31, 1997 or ___________ __,
1997, you must list full title and account numbers of all accounts you had at
that date in order to insure proper identification of your purchase right or
preference.
ACKNOWLEDGMENT
Please read the acknowledgement statement carefully and sign on the signature
line. When purchasing as a custodian, corporate officer, etc., add your full
title to your signature. Enter the Social Security number (or Tax ID number) of
the registered owner and date the form; only one number is required.
Subscription priority rights for members as described in the Prospectus will
expire at 12:00 Noon, Central Time, on _________, __, 1997. The Direct
Community Offering may end as early as 12:00 Noon, Central Time, on _______ __,
1997, or any time thereafter when orders for all available shares have been
received, but in no event later than ________ __, 1997. This order form must be
properly completed and received with payment at the above address or at any
Security Federal office prior to the expiration date.
Number Purchase Total
of Shares Price Amount
__________ X $10.00 $___________
[_] Enclosed is check or money order payable to Security Bancorp, Inc.
[_] I authorize withdrawal from the following account(s):
Account Number(s) Amount
_______________________________ $_________________
_______________________________ $_________________
_______________________________ $_________________
Total Withdrawn $_________________
No penalty for early withdrawal
________________________________________________________________________________
Name(s) in which your stock is to be registered
________________________________________________________________________________
Name(s) in which your stock is to be registered
________________________________________________________________________________
Address
________________________________________________________________________________
City State Zip Code
[_] Individual [_] Joint Tenants
[_] Tenants in Common [_] Uniform Gifts to Minors
[_] Other ____________________________________________________________________
Are you an officer, director, general partner, employee or agent of a National
Association of Securities Dealers, Inc. ("NASD") member firm or related to such
person?
[_] Yes [_] No
Daytime Phone ( )
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Were you a member of Security Federal as of
December 31, 1995 March 31, 1997
[_] Yes [_] No [_] Yes [_] No
I acknowledge receipt of the Prospectus and the provisions therein and
understand that after delivery of this order form to Security Bancorp, Inc.,
this order may not be modified or revoked. I certify that this order is for the
above account only and under penalties of perjury, I certify that the Social
Security or Taxpayer ID number given below is correct. I further certify that
this order does not violate purchase limitations set forth more fully in the
Prospectus.
I acknowledge that the common stock offered is not a savings or deposit account
and is not insured or guaranteed by the Savings Association Insurance Fund, the
FDIC or any other government agency.
________________________________________________________________________________
Signature Date
________________________________________________________________________________
Additional Signature (if required) Date
________________________________________________________________________________
Social Security No. or Tax ID No.
THE ADDITION TO AN ORDER OF A NAME WHICH DOES NOT APPEAR ON THE
QUALIFYING ACCOUNT WILL RESULT IN THE LOSS OF SUBSCRIPTION
RIGHTS. FOR ASSISTANCE PLEASE CALL THE SECURITY FEDERAL
SAVINGS BANK OF MCMINNVILLE, TN
STOCK INFORMATION CENTER AT
(615) ___-____
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 Stock Certificates(s). If you have any questions, please
consult your legal advisor.
Stock ownership must be registered in one of the following manners:
________________________________________________________________________________
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.
________________________________________________________________________________
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 as 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.
________________________________________________________________________________
UNIFORM GIFT Stock may be held in the name of a custodian for a minor under
TO MINORS the Uniform TO MINORS:Gifts to Minors laws of the individual
states. There 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
Tennessee Uniform Gift to Minors Act will be abbreviated:
JOHN P. JONES CUST SUSAN A. JONES
UNIF GIFT MIN ACT TN
______________________________________________________________________________
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 individual.
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 the 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 (Date)