TEN COM | - | as tenants in common | UNIF GIFT MIN ACT- | Custodian | |||||||||
TEN ENT | - | as tenants by the entireties | (Cust) | (Minor) | |||||||||
JT TEN | - | as joint tenants with right of survivorship and not as tenants in common | under Uniform Gifts to Minors | ||||||||||
Act | |||||||||||||
(State) | |||||||||||||
UNIF TRF MIN ACT- | Custodian (until age | ) | |||||||||||
(Cust) | |||||||||||||
under Uniform Transfers | |||||||||||||
(Minor) | |||||||||||||
to Minors Act | |||||||||||||
(State) |
For Value received, | hereby sell, assign and transfer unto | |||
PLEASE INSERT SOCIAL SECURITY OR OTHER |
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IDENTIFYING NUMBER OF ASSIGNEE |
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(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE) |
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Shares | ||
of the Common Stock represented by the within Certificate, and do(es) hereby irrevocably constitute and appoint | ||
Attorney | ||
to transfer the said stock on the books of the within named Corporation with full power of substitution in the premises. |
Dated |
X | |||||
X | ||||||
NOTICE: | THE SIGNATURE(S) TO THIS ASSIGNMENT
MUST CORRESPOND WITH THE NAME(S) AS
WRITTEN UPON THE FACE OF THE
CERTIFICATE IN EVERY PARTICULAR
WITHOUT ALTERATION OR ENLARGEMENT OR
ANY CHANGE WHATEVER. |
By |
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THE SIGNATURE(S) MUST BE GUARANTEED BY AN
ELIGIBLE GUARANTOR INSTITUTION (BANKS,
STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND
CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED
SIGNATURE GUARANTEE MEDALLION PROGRAM),
PURSUANT TO S.E.C. RULE 17Ad-15. |