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Stock Certificate Assignment
FOR GOOD AND VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, [Name] of [Address], hereinafter referred to as Assignor, does hereby conveys and assigns to [Name] of [Address], hereinafter referred to as Assignee, all and any ownership rights, privileges, and interests in the shares of stock of the [Corporation] of [Address], hereinafter referred to as Corporation, which are represented by share certificates numbered [Number] and attached hereto.
ASSIGNOR DOES HEREBY further nominate [Name] 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.
This Section for Notary:
STATE OF -------)
) ss: [date]
COUNTY OF ------)
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.
[Name of Notary Public]
My commission expires: [date]