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CCSD BOA REVI ARD OF TR ISED AGEN RUSTEES NDA

2-22-16BoardOpenSessionAgendaPacket

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(FORM <strong>OF</strong> ASSIGNMENT)<br />

FOR VALUE RECEIVED, the undersigned sells, assigns and transfers unto<br />

(Name and Address of Transferee)<br />

the within note and does hereby irrevocably constitute and appoint _______________________________<br />

attorney to transfer the within note on the books kept for registration thereof, with full power of<br />

substitution in the premises.<br />

Dated:<br />

___________________________________<br />

Signature Guaranteed<br />

_____________________________________________<br />

(Authorized Officer)<br />

___________________________________<br />

(Signature must be guaranteed by a<br />

participant in the Securities Transfer Agent<br />

Medallions Program (STAMP))<br />

_____________________________________________<br />

Notice: The signature to the assignment must<br />

correspond with the name of the registered owner as it<br />

appears upon the face of the within note in every<br />

particular, without alteration or enlargement or any<br />

change whatever.<br />

B - 4<br />

2/22/16 Board Agenda Agenda Item 9.5B<br />

(A&F D-IX)<br />

Page 41 of 49

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