Stock Certificate Assignment and Transfer Form for Common Stock

Contract Categories: Business Finance › Assignment Agreements
Summary

This document is a standard assignment and transfer form used to transfer ownership of common stock represented by a physical certificate. The current holder authorizes the sale, assignment, and transfer of shares to a new owner, whose details must be provided. The form requires the signature of the current holder, which must match the name on the certificate and be guaranteed by an eligible financial institution. The document also explains common abbreviations used in stock certificates and complies with SEC regulations.

Read More Arrow
EX-4.12 2 d672944dex412.htm EX-4.12 EX-4.12

Exhibit 4.12

 

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

TEN ENT

  

–

  

as tenants by the entireties

JT TEN

  

–

  

as joint tenants with right

   

of survivorship and not as

   

tenants in common

UNIF GIFT MIN ACT–

                       Custodian                     
  (Cust)                             (Minor)
  under Uniform Gifts to Minors
 

      Act                                      

  (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 POSTAL ZIP CODE, OF ASSIGNEE)
 
     
 
     
 
   

Shares

of the common 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

  

 

   
 

X

  

 

NOTICE:

 

SIGNATURE(S) GUARANTEED:

   THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THE CERTIFICATE, IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT, OR ANY CHANGE WHATEVER.
   

 

    
THE SIGNATURE(S) MUST BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15.