# Stock Assignment Separate from Certificate

This assignment separate from certificate (this "Stock Power") is executed by {founder_name} (the "Assignor") in favor of {company_legal_name}, a Delaware corporation (the "Company"), to effect the transfer of the shares described below.

## Key Terms

Company
: {company_legal_name}

Founder (Assignor)
: {founder_name}

Shares Assigned
: {shares_assigned}

Certificate Number
: {certificate_number}

## Assignment

### Assignment Separate from Certificate

FOR VALUE RECEIVED, the Assignor hereby sells, assigns, and transfers unto {company_legal_name}, a Delaware corporation, {shares_assigned} of the Company standing in the Assignor's name on the books of the Company and represented by Certificate No. {certificate_number} (or, if the shares are uncertificated, represented by the corresponding book-entry), and does hereby irrevocably constitute and appoint {attorney_in_fact} 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.

## Signatures

The Assignor has executed this Stock Power as of the date set forth below.

Signature: _______________

Print Name: {founder_name}

Date: {assignment_date}

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