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Office of Investment Management

Stock Power Form

Assignment Separate from Security

For Value Received, the undersigned hereby sell(s), assign(s), and transfer(s) to


If Stock,
Complete
this portion

_____________ shares of the_________ stock of_________________________________ represented by Certificate

No(s)___________________________________ standing in the name of the undersigned on the books of said Corporation.

 


If Bond,
Complete
this
portion


One bond of the _________________________________________

in the principal amount of $_____________________,

No(s)______________________ standing in the name of the undersigned on the books of said Corporation.

The undersigned does (do) hereby irrevocably constitute and appoint

______________________________

_______________________________Attorney to transfer the said
stock(s), bond, or debenture(s), as the case may be on the books of said Corporation with full power of substitution in the premises.

Signed_______________________
Dated_________________ Signed_______________________