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ASSIGNMENT AND TRANSFER OF STOCK CERTIFICATE FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers to _____________________________the following shares of the stock of _________________________ (the "Corporation") standing in the name of the undersigned on the books of the Corporation and represented by the following Certificate No (s).: NUMBER OF SHARES CERTIFICATE NO (S). _________ ____________________ _________ ____________________ _________ ____________________ The undersigned hereby and irrevocably constitutes and appoints ________________________________ as his attorney to transfer the said stock on the books of the Corporation with full power of substitution in the premises. Dated this_____ day of_________________, 200(X). ______________________ _______________________
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1/9/2008
English
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