NUMBER
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SHARES
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Dated: |
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Chief Executive Officer |
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Chief Financial Officer
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TEN COM
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-
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as tenants in common
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UNIF GIFT MIN ACT
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-
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Custodian
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(Cust) | (Minor) | |||||
under Uniform Gifts to Minors Act (State)
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TEN ENT
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-
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as tenants by the entireties
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JT TEN
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-
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as joint tenants with right of survivorship and not as tenants in common
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(PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER(S) OF ASSIGNEE(S))
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(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE)
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Shares of common stock represented by the within Certificate, and does hereby irrevocably constitute and appoint
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Attorney to transfer the said shares on the books of the within named Corporation with full power of substitution in the premises.
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Dated
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Stockholder
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By:
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