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Stock Certificate Assignment
FOR GOOD AND VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, ________________ (hereinafter referred to as Assignor) hereby conveys and assigns to _________________ ("Assignee") all and any ownership rights, privileges, and interests in the shares of stock of the __________________ (hereinafter referred to as Corporation), which are represented by share certificates numbered _____________ and attached hereto.
ASSIGNOR DOES HEREBY further nominate _____________________ as attorney-in-fact and authorizes the transfer of the ownership rights, privileges, and interest of the above-described shares on the stock ledger of said Corporation by said attorney-in-fact.
*** If Required By State Law ***
This Section for Notary:
State of _________
County of ________ [COUNTY]
On [DATE] before me, [NAME OF NOTARY], notary, personally appeared [NAME OF PERSON(S) INVOLVED], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
My commission expires: _____