Fill and Sign the Assignment Stock Form

Bill of Sale and Assignment of Stock by Separate Instrument For value received, I, ____________________________________________________ , of ___________________________________________________________________________ _____________________________________ (street address, city, county, state, zip code) , sell, assign and transfer to _________________________________________________________ of __________________________________________________________________________ ______________________________________ (street address, city, county, state, zip code) , his representatives and assigns, with full power to transfer the same on the books of the corporation, ___________ ( number ) shares of ______________________________ (e.g., common) stock of __________________________________________________________ (name of corporation) , represented by the following certificates: ____________________________________________ ____________________________________________ (numbers of certificates and amount of shares represented by each). The above-named corporation has its principal place of business at ______________________________________________________________________________ __________________________________ (street address, city, county, state, zip code) . I covenant that such shares of stock now stand in my name on the books of the above-named corporation. WITNESS my signature on this the ____ day of ________________, 20___. ____________________________________