Stock Assignment Separate from Certificate

FOR VALUE RECEIVED, the Assignor hereby sells, assigns, and transfers unto [Full legal name of the Delaware corporation], a Delaware corporation, [Number and class of shares assigned (for example, "100,000 shares of Common Stock")] of the Company standing in the Assignor's name on the books of the Company and represented by Certificate No. [Certificate number representing the assigned shares (or a reference to uncertificated / book-entry shares)] (or, if the shares are uncertificated, represented by the corresponding book-entry), and does hereby irrevocably constitute and appoint [Person appointed as attorney-in-fact to transfer the shares on the Company's books (for example, "the Secretary of the Company")] as the Assignor's attorney-in-fact to transfer the said shares on the books of the Company, with full power of substitution in the premises.

This Stock Power is delivered under the Assignor's Restricted Stock Purchase Agreement in connection with the Company's repurchase of the shares described above and does not modify the terms of that agreement.