Fill and Sign the Agreement to Purchase Common Stock of a Shareholder by the Corporation with an Exhibit of a Bill of Sale and Assignment of Form

Agreement to Purchase Common Stock of a Shareholder by the Corporation with an Exhibit of a Bill of Sale and Assignment of Stock by Separate Instrument For and in consideration of $______________________ , cash, the undersigned _____________________________________ (Name of Seller) of ________________________ ______________________________________________________________________________ _________________________________________ (street address, city, county, state, zip code) , (hereinafter called Seller ), agrees to sell, assign, transfer, and set over to ___________________ ______________________ (Name of B uyer) , a corporation organized and existing under the laws of ________________________________________ ( state) and having its principal place of business at (street address, city, county, state, zip code) , (hereinafter called Buyer , with full power to transfer the same on the books of the corporation, _____________shares of the common stock of Buyer . The stock is represented by the following certificates: (numbers of certificates and amount of shares represented by each) ________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. Closing of this sale shall be in the offices of (e.g., closing attorney or address of either Buyer or Seller ) ________________________________________________________________ _____________________________________________________________________________ at ___________ (time of day) on the __________________________________________ (date) , or as otherwise agreed by the parties. Seller warrants that the stock now stands in _______ (his or her) name on the books of the corporation and that all assessments to date are paid on the shares; and that Seller has good and marketable title to all shares of said stock, free and clear of all liens, claims, equities, encumbrances, and restrictions of every kind, and has full, complete and unrestricted legal right, power and authority to assign, transfer, and deliver such stock pursuant to this Agreement. Buyer agrees to purchase the shares for the cash consideration set forth above. Seller agrees to duly endorse the stock certificates described above over to Buyer at Closing . If said stock certificates have been lost or destroyed, S eller agrees to transfer title to said stock over to Buyer in a form substantially the same as Exhibit A attached hereto and made a part hereof by reference. WITNESS our signatures on this the _____ day of ______________________________, 20____. ____________________________________ (Name of Buyer) _________________________________________ By: ________________________________ _________________________________________ ____________________________________ (Printed Name & Signature of Seller) (Printed Name & Signature) ____________________________________ (Office in Corporation) (Attach Exhibit A) EXHIBIT A Bill of Sale and Assignment of Stock by Separate Instrument For value received, the undersigned __________________________________________ (Name of Seller) of _____________________________________________________________ ______________________________________________________________________________ _________________________________________ (street address, city, county, state, zip code) , (hereinafter called Seller ), does hereby sell, assign, transfer, and set over to _________________ ____________________ (Name of B uyer) , a corporation organized and existing under the laws of ___________________________________ ( state) and having its principal place of business at ____________________________________________________________________________ ______________________________________________________________________________ ________________________________________ (street address, city, county, state, zip code) , (hereinafter called Buyer, with full power to transfer the same on the books of the corporation, _____________shares of the common stock of Buyer, represented by the following certificates: (numbers of certificates and amount of shares represented by each) _____________________ _____________________________________________________________________________ _____________________________________________________________________________ _ . Seller hereby agrees to indemnify and save Buyer harmless against any and all costs, damages, actions, or expenses which might result from the failure of Seller to duly endorse the original or any replacement stock certificates as described above. WITNESS my signature on this the ____ day of ________________________________, 20____. ____________________________________ ____________________________________ (Printed Name & Signature of Seller)