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STOCK OR BOND POWER

FOR VALUE RECEIVED, the undersigned does (do) hereby sell, assign and transfer to:

______________________________________________________________________

______________________________________________________________________

If Stock, complete this portion

_______________shares of the _______________stock of ___________ represented by Certificate(s) No(s) _______________________inclusive, standing in the name of the undersigned on the books of said Company.

 


 

If Bonds, complete this portion

_________________________bonds of __________________________ in the principal amount of $___________,No(s) _____________inclusive, standing in the name of the undersigned on the books of said Company.

The undersigned does(do) hereby irrevocably constitute and appoint______________ 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.

______________________________
Signature

______________________________
Print Name as signed above

______________________________

SSN

_____________________________________
Signature

_____________________________________
Print Name as signed above

_____________________________________

SSN

IMPORTANT-READ CAREFULLY - - The signature(s) to this Power must correspond with the name(s) as written upon the face of the certificate(s) or bond(s) in every particular without alterations or change whatever.

 

 

 

Date_____________________

Acct. No.________________

Cusip No.________________

S/D______________________


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Investments and Debt Management
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Blacksburg, VA  24061
Phone (540) 231-7094
Fax (540) 231-7751