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).

__________________________  __________________________