Assignment Of Stock Certificate
For value received,
I, ___________________________________, of
__________________________________________________, assign to
_________________________________, of _____________________________,
assignee _______ shares of stock of _____________________, which shares stand in my name on the books of such corporation and are represented by certificate No. _______________________.
I warrant that the assigned certificate is genuine and, to my knowledge, valid, and that I have the legal right to transfer it.
I appoint assignee my attorney in fact to effect a transfer of the assigned shares on the books of _____________ with full power of substitution in the premises.
Dated ____________________, 201(x).