Assignment and Transfer of Stock Certificate

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© Copyright Envision Corporation. 2002. All rights reserved.

Protected by the copyright laws of the United States & Canada and by international treaties. IT IS
ILLEGAL AND STRICTLY PROHIBITED TO DISTRIBUTE, PUBLISH, OFFER FOR SALE, LICENSE OR SUBLICENSE, GIVE OR DISCLOSE TO ANY OTHER
PARTY, THIS PRODUCT IN HARD COPY OR DIGITAL FORM. ALL OFFENDERS WILL BE SUED IN A COURT OF LAW.

ASSIGNMENT AND TRANSFER OF STOCK CERTIFICATE


©

C
o This Assignment and Transfer of Stock Certificate (the “Assignment”) is made and effective [DATE],
p
y BETWEEN: [CORPORATION NAME] (the "Corporation"), a corporation organized and
r existing under the laws of the [STATE/PROVINCE], with its head office located
i at:
g
h
t AND: [TRANSFEROR NAME] (the "Transferor"), an individual having his main
residence located at:
E
n
v
i FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers to [TRANSFEREE],
s [AMOUNT] shares of the stock of [COMPANY NAME] (the Corporation) standing in the name of the
i undersigned on the books of the Corporation and represented by Certificate [NUMBER].
o
The undersigned hereby and irrevocably constitutes and appoints [NAME OF ATTORNEY-IN-FACT],
n attorney-in-fact, to transfer the said stock on the books of the within named Corporation with full power of
substitution in the premises.
C
o
r
Dated: [DATE]
p
o CORPORATION TRANSFEROR
r
a
t
i Authorized Signature Authorized Signature
o
n
. Print Name and Title Print Name and Title

2
0
0 In the presence of:
2
.

A Authorized Signature
l
l
Print Name and Title
r
i
Assignment and Transfer of Stock Certificate

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