STOCK POWER AND ASSIGNMENT SEPARATE FROM CERTIFICATE FOR VALUE RECEIVED, [Purchaser Name] (the Holder), hereby
sells, assigns and transfers unto __________________________________________________ (Transferee) ___________________ shares of the Series [Series Letter] Preferred Stock of [Company Name], a Delaware corporation (the Company), standing in Holders name on the Companys books and represented by Certificate No. P[Series Letter]-____, and does hereby irrevocably constitute and appoint _______________________________________ to transfer said stock on the books of the Company with full power of substitution in the premises. Date: [PURCHASER NAME]
(Signature) Address: ____________________ __________ ______ United States Email: ________________