Stock Certificate Assignment

Date: __________________

FOR GOOD AND VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, ___________________________ (hereinafter referred to as Assignor) hereby conveys and assigns to __________________________ ("Assignee") all and any ownership rights, privileges, and interests in the shares of stock of the _______________________ (hereinafter referred to as Corporation), which are represented by share certificates numbered _____________ and attached hereto.

ASSIGNOR DOES HEREBY further nominate _____________________ as attorney-in-fact and authorizes the transfer of the ownership rights, privileges, and interest of the above-described shares on the stock ledger of said Corporation by said attorney-in-fact.



(Notary Public or bank verification)

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