Self-Directed Brokerage Account

Participant Disclosure and Acknowledgement Form

After considering a variety of factors, including the makeup of our workforce and the desire of certain employees for greater investment flexibility, ABC Company (the Plan Sponsor) has elected to offer a Self-Directed Brokerage Account (SDBA) within our retirement plan. For those participants desiring additional selection beyond our menu of “core funds”, the SDBA option will allow participants to invest in a wide array of individual stocks, bonds, exchange traded funds (ETFs) and outside mutual funds. As you are aware, First National Bank acts as the Trustee of our 401(k) plan. The SDBA product is an additional option available in our retirement program offered through First National Bank and BPAS, delivered by Schwab.

For several reasons, a self-directed brokerage account is not appropriate for all plan participants. There are unique risks inherent in investing in individual securities or non-diversified investments which go beyond the risks typically associated with investing in mutual funds. Company-specific factors can cause individual security prices to fluctuate dramatically, which can impact your account value drastically in a short timeframe. There is also a significantly greater burden on the investor to conduct research before making investment decisions. Because of the additional risks associated with offering a self-directed brokerage account window, ABC Company has decided that it will only offer the SDBA feature to participants who agree to the terms outlined in this letter.

To enroll in this SDBA, please initial each of the following statements and sign this disclosure:

¾ I understand that the SDBA is an additional option beyond our plan’s core menu of funds. I have asked to enroll in the self-directed brokerage account program, freely and of my own will.

¾ I understand that there are risks associated with investing in direct securities which go beyond those associated with traditional mutual funds. I accept full responsibility for any and all investments made within my SDBA account, and will indemnify and hold harmless the Plan Sponsor, First National Bank and BPAS for any investment losses incurred as a result of my investment decisions within the SDBA.

¾ I understand that investments offered within the SDBA window are outside of our plan’s ongoing due diligence or fiduciary monitoring process. I understand that neither the Plan Sponsor, First National Bank or BPAS make any representations as to the suitability or appropriateness of any investment available through the SDBA, whether they be individual stocks or bonds, mutual funds, exchange traded funds or any other investment vehicle.

¾ I understand that the SDBA offers access to a menu of publicly traded stocks, bonds and mutual funds, but that certain assets may not be purchased or held within the SDBA either as a result of regulations applicable to qualified plans and / or administrative restrictions of the SDBA provider. For example, a participant cannot purchase or hold illiquid securities, real estate, limited partnerships, options, closely held securities, foreign securities, private placements and other non-standard assets as determined by the provider of the SDBA program or applicable law.

¾ I have familiarized myself with and agree to the fee schedule which applies to the SDBA program, and understand that these fees will automatically be deducted from my account.

¾ I understand that mutual funds purchased within the SDBA may impose certain sales charges or redemption fees (as stated in the fund prospectus). I understand that it will be my responsibility to research any investments I purchase through the SDBA, and to obtain and read copies of fund prospectuses, offering circulars, or other pertinent documents before making transactions in any mutual fund or security.

¾ I understand that a ___% limitation will apply on the percentage of my account I can transfer to the SDBA. (Once this threshold is reached, additional amounts cannot be transferred to the SDBA). I agree to abide by this restriction. Also, I understand that the core funds side of my account will be utilized for the assessment of plan-level fees, if applicable.

¾ I agree to abide by all applicable state and federal securities laws within my SDBA account, and understand that neither the Plan Sponsor, First National Bank nor BPAS will be in a position to monitor my SDBA activity to ensure compliance with applicable state or federal securities laws.

¾ I understand that it is my responsibility to maintain the security of my PIN and SDBA access information. I agree to notify the Plan Sponsor and First National Bank immediately in the event of loss or theft of my account number or PIN for the SDBA account, or if I suspect that an unauthorized person has accessed my account.

¾ I agree to read all statements and trade confirmations associated with my SDBA account. I agree to notify the Plan Sponsor and First National Bank immediately in the event of a dispute or error.

¾ I understand that neither the Plan Sponsor, First National Bank nor BPAS guarantee that the SDBA will continue to be offered, whether in its current form or otherwise. I agree not to hold the Plan Sponsor, First National Bank or BPAS liable for any damages arising from a decision to discontinue offering or modify the SDBA feature.

¾ I understand that additional rules or limitations may be presented over time within the SDBA account as a result of changing federal or state securities laws, new provider policies or business practices, or changes made by the Plan Sponsor, First National Bank or BPAS.

I consent to all the above and wish to enroll in the SDBA account program.

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Name SSN Date