Assignment And Transfer Of Stock Certificate
FOR VALUE RECEIVED,
the undersigned hereby sells, assigns and transfers to
_____________________________the following shares of the stock of
_________________________ (the "Corporation") standing in the name of the undersigned on the books of the Corporation and represented by the following Certificate No (s).:
NUMBER OF SHARES CERTIFICATE NO (S).
hereby and irrevocably constitutes and appoints
________________________________ as his attorney to transfer the said stock on the books of the Corporation with full power of substitution in the premises.
Dated this_____ day of_________________, 201(x).