SERVICE BANCORP, INC.
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 _____ shares.
METHOD OF PAYMENT
Check the appropriate box(es). You may pay by check, bank draft or money order
and/or authorize withdrawal from your Summit Bank savings or certificate
account(s). If paying by certified or teller's check, please make it payable to
Summit Bank. Your funds will earn interest at the Bank's certificate rate per
annum until the offering is completed. If paying by withdrawal, please list the
appropriate account number(s); these designated funds will continue to earn
interest from a savings or certificate account at the same account rate and
cannot be withdrawn by you until the offering is completed or terminated.
STOCK REGISTRATION
Print the name(s) in which you want the stock registered. See the reverse side
of this form for registration guidelines.
Enter the social security number (or tax I.D. number) of the 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.
NASD AFFILIATION
Please refer to the National Association of Securities Dealers, Inc. (NASD)
affiliation section and check the box if applicable. Under the guidelines of the
NASD, members of the NASD and their associates are subject to certain
restrictions on the transfer of securities purchased in accordance with
subscription rights and to certain reporting requirements upon the purchase of
such securities, as established by the NASD.
_____ Check here and initial below if you are a member of the NASD or a person
associated with an NASD member 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 an NASD member or person associated with an NASD member
has a beneficial interest. I agree (i) not to sell, transfer or hypothecate the
stock for a period of 90 days following issuance, and (ii) to report this
purchase order in writing to the applicable NASD member I am associated with
within one day of the payment for the stock. (Initials)_________
ACKNOWLEDGMENT
Sign and date the 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.
DEADLINE
This form along with the Form of Acknowledgment, properly executed and with the
correct payments must be received by 12:00 noon, Massachusetts Time, on
September___, 1998 and will be deemed received upon the date and the time of
delivery of the form to our office. Please submit your order using the enclosed
postage-paid envelope or hand-delivering to Summit Bank.
TELEPHONE INFORMATION
Please enter both a daytime and evening telephone number where you may be
reached in the event we cannot execute your order as given.
Daytime Phone ( ) ____________________
Evening Phone ( ) ____________________
STOCK ORDER FORM
Number of Shares Offering Price Total Amount Due
______________ X $ 10.00 =_______________
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_____ Enclosed is a certified teller's check, bank draft, or money order
payable to Summit Bank for $________.
_____ I authorize withdrawal from the following Summit Bank account(s):
Account Number(s) Amount
$
$
Total Withdrawal $
_________________________________________________________________
Name(s) in which your stock is to be registered
_________________________________________________________________
Name(s) in which your stock is to be registered
_________________________________________________________________
Address
_________________________________________________________________
City County
_________________________________________________________________
State Zip Code
_________________________________________________________________
Social Security # or Tax ID #
_______ Individual _______ Joint Tenants _______ Tenants in Common
_______ Uniform Gift or Transfer to Minors
_______ Other _____________________________________________
I (we) acknowledge receipt of the Prospectus and the terms and conditions
described therein. I (we) understand that, after receipt by Summit Bank, this
order may not be modified or withdrawn without the consent of Summit Bank.
Further, I (we) certify that my (our) purchase does not conflict with the
purchase limitations in the Plan of Reorganization, 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
Taxpayer Identification number given above is correct; and (2) I am 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.
I ACKNOWLEDGE THAT THIS SECURITY IS NOT A DEPOSIT OR ACCOUNT AND IS NOT
FEDERALLY INSURED AND IS NOT GUARANTEED BY SUMMIT BANK OR ANY FEDERAL OR STATE
GOVERNMENT OR AGENCY.
If anyone asserts that this security is federally insured or guaranteed, or is
as safe as an insured deposit, I should call Thomas J. Curry, Commissioner of
the Commonwealth of Massachusetts Office of the Commissioner of Banks at (617)
727-0607.
I further certify that, before purchasing the Common Stock of Service Bancorp,
Inc., I received a Prospectus. The Prospectus that I received contains
disclosure concerning the nature of the security being offered and describes the
risks involved in the investment. See the "Risk Factors" section of the
Prospectus. In executing this Stock Order Form I affirm that I have read the
Prospectus and am aware of the risks associated with investing in Service
Bancorp, Inc. Common Stock.
____________________________________________________________________________
Signature Date
____________________________________________________________________________
Additional Signature (if required) Date
For assistance, please call the Stock Information
Center, Summit Bank, at (508) ___-_______ from 9:00 a.m. to
5:00 p.m., Massachusetts Time, Monday through Friday.
GUIDELINES FOR REGISTERING STOCK
For reasons of clarity and standardization, the stock transfer industry
has developed uniform stock ownership registration which we will use in issuing
your stock certificate. Common ownership registrations are explained below. If
you have any questions about how your Service Bancorp, Inc. common stock should
be registered, see your legal advisor.
To ensure correct registration, please follow the instructions for the
ownership you select.
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GENERAL INSTRUCTION: o Include the first name, middle initial, and
last name of each person listed. Avoid the
use of an initial in place of the first
name.
o Do not use titles such as Mr., Mrs., Dr.,
etc.
o Omit words that do not affect ownership
rights such as special account, personal
property, etc.
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INDIVIDUAL: Instructions: Print the first name, middle initial,
and last name of the person in whose name the stock
is to be registered. You may not list beneficiaries
for this ownership.
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JOINT TENANTS: Joint Tenancy with Right of Survivorship identifies
two or more persons as owners of the stock. Upon the
death of one of the owners, ownership automatically
passes to the surviving tenant(s). Instructions:
Print the first name, middle initial, and last name
of each co-tenant. You may not list beneficiaries for
this ownership.
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UNIFORM GIFTS TO For residents of certain states, stock may be held in
MINORS/UNIFORM the name of a custodian for the benefit of a minor
TRANSFERS TO under the Uniform Transfers to Minors Act. For
MINORS: residents of most other states, stock may be held in
a similar type of ownership under the Uniform Gifts
to Minors Act of the individual states. For either
ownership, the minor is the actual owner of the stock
with the adult custodian being responsible for the
investment until the minor reaches legal age.
Instructions: See your legal advisor if you are
unsure about the correct registration of your stock.
On the first NAME line, print the first name, middle
initial, and last name of the custodian, with the
abbreviation CUST after the name
Print the first name, middle initial, and last name
of the minor on the second NAME line. Only one
custodian and one minor may be designated.
Please indicate the minor's social security number in
the signature block.
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OTHER: Generally, fiduciary relationships (such as
Conservatorship, Legal Trust, Guardianship, etc.) are
established under a form of trust agreement or are
pursuant to a court order. Without a legal document
establishing a fiduciary relationship, your stock may
not be registered in a fiduciary capacity.
Instructions: On the first NAME line, print the first
name, middle initial, and last name of the fiduciary
if the fiduciary is an individual. If the fiduciary
is a corporation, list the corporate title on the
first NAME line. Following the name, print the
fiduciary title such as conservator, personal
representative, etc.
On the second NAME line, print either the name of the
maker, donor or testator OR the name of the
beneficiary. Following the name, indicate the date
and type of legal document establishing the fiduciary
relationship (agreement, court order, etc.) (Use the
space marked OTHER if necessary). Please contact us
if you have any questions. EXAMPLE OF A FIDUCIARY
REGISTRATION: John D. Smith Trustee for Tom A. Smith
Under Agreement Dated 06/09/74. PLEASE NOTE THAT
TOTTEN TRUST AND PAYABLE ON DEATH OWNERSHIPS MAY NOT
BE USED IN REGISTERING STOCK. For example, stock
cannot be registered as John Doe Trustee for Jane Doe
or John Doe Payable on Death to Jane Doe.
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NASD AFFILIATION: Please refer to the NASD AFFILIATION
statement on the face of this form. If applicable,
initial where indicated and check the box. the
National Association of Securities Dealers, Inc.
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
required to indicate that they will comply with
certain conditions required for an exemption from the
restrictions.
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CERTIFICATION FORM
(This Signed Form Must Accompany A Signed Stock Order Form)
I ACKNOWLEDGE THAT THE SHARES OF COMMON STOCK, $.01 PAR VALUE PER SHARE
("COMMON STOCK"), OF SERVICE BANCORP. (THE "CORPORATION"), THE PROPOSED HOLDING
COMPANY FOR SUMMIT BANK (THE "BANK"), ARE NOT GUARANTEED BY THE CORPORATION, THE
BANK OR THE FEDERAL GOVERNMENT.
If anyone asserts that this security is federally insured or
guaranteed, or is as safe as an insured deposit, I should call Thomas J. Curry,
Commissioner of the Commonwealth of Massachusetts Office of the Commissioner of
Banks at (617) 727-0607.
I further certify that, before purchasing the shares of Common Stock of
the Corporation, I received a copy of the Prospectus dated August ___, 1998
which discloses the nature of the shares of Common Stock being offered thereby,
and describes the following risks involved in an investment in the Common Stock
under the heading "Risk Factors" beginning on page ___ of the Prospectus:
1. Growth of the Bank's Commercial Business and Commercial Real
Estate Lending
2. Mutual Company Control of Stock Company and Other
Anti-Takeover Provisions
3. Uncertainty as to Future Growth Opportunities
4. Sensitivity to Changes in Interest Rates
5. Geographic Concentration of Loans
6. Potential Increased Compensation Expenses after the
Reorganization and Offering
7. Financial Benefits to Officers and Directors
8. Possible Dilutive Effect of Issuance of Additional Shares
9. Strong Competition Within the Bank's Market Area
10. Regulatory Oversight and Legislation
11. Absence of Market for Common Stock
12. Possible Increase in Estimated Valuation Range and Number of
Shares Issued
13. Role of the Financial Advisor/Best Efforts Offering
14. Conversion of Mutual Company to Stock Form
15. Conditions to Closing of the Offering
16. Dependence on Key Personnel
17. Technology Risks and Year 2000 Problem
For a more detailed description of the risks involved in the offering,
see "Risk Factors" at pages ___ through ___ of the Prospectus.
Signature: ____________________________________________________
Signature: ____________________________________________________
(Note: If stock is to be held jointly, both parties must sign)
Date: ______________________