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Stock Transfer
STOCK TRANSFER
FOR VALUE RECEIVED, the undersigned [Name of Seller] of [Address of Seller] hereby sells, assigns and transfers to [Name of assignee]
of [Address of assignee] and its successors and assigns, [Number of shares] shares of the [Type of stock] stock of, [Company Name] represented by Certificate No(s). [Certificate numbers], inclusive,
standing in name of the undersigned in the books of said company. The undersigned also hereby irrevocably constitutes and appoints, attorney-in-fact, to transfer the said stock on the books of said company with full power of substitution in the premises.
Signed this [Date signed].
Witnessed:
Witness Signature Guaranteed