Stock Certificate Assignment and Transfer Form
This document is a standard stock certificate assignment and transfer form. It allows the current holder of shares in a corporation to sell, assign, and transfer those shares to another party. The form requires the name, address, and identifying number of the new owner, as well as the signature of the current holder, which must be guaranteed by an eligible financial institution. The transfer is subject to applicable laws and may require a transfer fee.
Exhibit 4.1
The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws or regulations.
| 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 the right of Act________________________ |
| survivorship and not as tenants in common (State) | |
| Additional abbreviations may also be used though not in the above list. |
For value received, ______________________________________ hereby sell, assign and transfer unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE:
| (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE) |
shares of the capital stock represented by the within Certificate, and do 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_________________________________________________________________________________________________
THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THIS CERTIFICATE. THE SIGNATURE(S) MUST BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (Banks, Stockbrokers, Savings and Loan Associations and Credit Unions).
SIGNATURE GUARANTEED:
TRANSFER FEE WILL APPLY
