IRREVOCABLE STOCK POWER (ASSIGNMENT SEPARATE FROM CERTIFICATE)
FOR VALUE RECEIVED, the undersigned does (do) hereby sell, assign and transfer to
(new registration): _______________________________________________ (address): ______________________________________________________
______________________________________________________ ______________________________________________________ ______________________________________________________
(social security number or Tax I.D. number): __________________________
STOCK TRANSFER FORM
Number of Shares: ______ Certificated
______ Book-Entry
_______ Dividend Reinvestment Plan Class of Stock: ___________ Name of Company: ________________________ standing in the name of the undersigned on the books of said Company.
The undersigned does (do) hereby irrevocably constitute and appoint National City attorney to transfer the said stock or bond(s), as the case may be, on the books of said Company, with full power of substitution in the premises. Date:
***IMPORTANT - READ CAREFULLY*** The signature(s) to this Power must correspond with the name(s) as written upon the face of the certificate(s) in every particular without alteration or enlargement or any change whatever. If you are signing as Fiduciary (i.e. Executor, Administrator, Power of Attorney, Partner, Trustee, Officer, Guardian, etc.) you must sign in your authorized capacity. RELEASE STAMP FOR THE INHERITANCE TAX WAIVER (Decedent Transfers Only)
X
Signature of Authorized Signer Capacity __________________________________
X
Signature of Authorized Signer Capacity___________________________________
MEDALLION GUARANTEE STAMP: (Required)
***The Release Stamp for the Inheritance Tax Waiver only applies for transfers involving a decedent.
SIGNATURE(S) MUST BE GUARANTEED BY A BANK, SECURITIES DEALER OR OTHER INSTITUTION WHICH IS A MEMBER OF A MEDALLION SIGNATURE GUARANTEE PROGRAM. NOTARY PUBLIC STAMPS ARE NOT ACCEPTABLE.
INSTRUCTIONS FOR COMPLETING THE STOCK POWER FORM
1. Complete the Name of the new Shareowner(s). Guidelines for common types of stock registrations can be found on the reverse side of the Mailing Instructions sheet which is also enclosed. 2. Complete the address of the new Shareowner(s). 3. Enter the Social Security Number or Taxpayer Identification Number of the new Shareowner(s) 4. Enter the number of shares to be reregistered. Please specify if the shares are Certificated, held in Book Entry including Direct Registration, or held in a Dividend Reinvestment Plan including Employee Stock Purchase Plan shares and Direct Purchase Plan shares. If all of the shares are to be reregistered, enter the word “ALL” on the line in front of the type of shares. 5. Enter the name of the Company the shares are held in. 6. Enter the date on the line provided when the Stock Power has the Medallion Guarantee Stamp signature applied. Important Note: Please do not place the date anywhere near the Medallion Guarantee Stamp, as this will prevent the transfer from being processed. 7. Signature of Authorized Signer. A Medallion Guarantee Stamp must also be placed in the designated box in the lower right corner of the Stock Power Form. 8. If someone other than the current Registered Shareholder is signing the Irrevocable Stock Power, the signer must enter their authorized capacity (i.e. Executor, Administrator, Power of Attorney, Partner, Trustee, Officer, Guardian, etc). 9. Medallion Guarantee Stamp: The Medallion Guarantee Stamp obtained from a Bank or Stock Broker or other financial institution which is a member of a Medallion Signature Guarantee Program should be applied in box provided. 10. Release Stamp for the Inheritance Tax Waiver: The Release Stamp for the Inheritance Tax Waiver can be obtained from a Bank or Stock Broker or other financial institution should be applied here. This stamp is only needed to transfer shares from a deceased Shareholder(s).