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Assignment of stock








ASSIGNMENT OF STOCK


For good and valuable consideration, receipt of which is

hereby acknowledged, I, ____________________________ the

undersigned, residing at ___________________________ hereby sell,

assign and transfer to _____________________________, residing at

_______________________________, (_____) shares of the

stock of _________________________ [the "Corporation"] standing

in my name on the books of the Corporation, represented by

Certificate No. ______________, and hereby irrevocably constitute

and appoint __________________, attorney-in-fact to transfer the

stock on the books of the within named Corporation, with full

power of substitution in the premises.


Dated: _______________________________


In the presence of:


________________________
Form 211

 
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