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									[From: Free Document Downloads at TheSmallBusinessOwnersManual.com]


This Cancellation of Indebtedness in Exchange for Shares of
Common Stock document should be used when transferring stock
over to a person or company in exchange for canceling financial
indebtedness.


This document should be reviewed and edited before use in order
to insure that it is used properly.


[Find, then fill-in, or delete text in brackets like this: “[NNN]”


If there are dates in this document, they will automatically change to today’s date.

For additional assistance mailto:LegalHelp@TheSmallBusinessOwnersManual.com or call
888/872-6601)


Otherwise the following text should be reviewed and edited as needed:
                         CANCELLATION OF INDEBTEDNESS
                   IN EXCHANGE FOR SHARES OF COMMON STOCK

The receipt of [N] shares stock of [NAME OF CORPORATION OFFERING SHARES OF
STOCK] (“Offeror”) for the cancellation by [NAME OF ENTITY RECEIVING SHARES OF
STOCK] (“Recipient”) of a current loan outstanding to Recipient, dated [DATE] with a
remaining unpaid principal amount and unpaid accrued interest, if any, totaling $[N] is hereby
acknowledged.



For Offeror:                                             For Recipient:



Print Name and Title                                     Print Name and Title


Date: April 26, 2012                                     Date: April 26, 2012

								
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