
TEN COM | - as tenants in common | UNIF GIFT MIN ACT - | ........................Custodian...................................... | ||
TEN ENT | - as tenants by the entireties | (Cust) | (Minor) | ||
JTTEN | - as joint tenants with right of survivorship and not as tenants in common | under Uniform Gifts to Minors | |||
Act ........................................................................ | |||||
(State) | |||||
COM PROP | - as community property | UNIF TRF MIN ACT - | ........................Custodian (until age.....................) | ||
(Cust) | (Minor) | ||||
.......................................under Uniform Transfers | |||||
(minor) | |||||
to Minors Act......................................................... | |||||
(State) | |||||
FOR VALUE RECEIVED, | hereby sell(s), assign(s) and transfer(s) unto | |
PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE | |
(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE) | ||||
shares | ||||
of the capital stock represented by within Certificate, and do hereby irrevocably constitute and appoint | ||||
attorney-in-fact | ||||
to transfer the said stock on the books of the within named Corporation with full power of the subsitution in the premises. | ||||
Dated | ||
X | ||||
X | ||||
Signature(s) Guaranteed: | NOTICE: | THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALETERATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER. | ||
By | ||
THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION, (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONIS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15. GUARANTEES BY A NOTARY PUBLIC ARE NOT ACCEPTABLE. SIGNATURE GUARANTEES MUST NOT BE DATED. | ||