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This certified that
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SEE REVERSE FOR CERTAIN DEFINITIONS
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CUSIP
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is the owner of
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Dated:
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COUNTERSIGNED:
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By:
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Transfer Agent and Registrar
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PRESIDENT
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SECRETARY
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TEN COM
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— as tenants in common
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TEN ENT
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— as tenants by the entireties
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JT TEN
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— as joint tenants with right of survivorship and not as tenants in common
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UNIF GIFT MIN ACT — _____________ Custodian _____________
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(Cust) (Minor)
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under Uniform Gifts to Minors
Act ___________________
(State)
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Dated
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Notice: The signature to this assignment must correspond with the name as written upon the face of the
Certificate, in every particular, without alteration or enlargement, or any change whatever.
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