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Stock / Bond Power Form
The undersigned hereby assigns and transfers to Northwestern College and Northwestern Media:
Shares of Stock
______ shares of common stock of _____________________________________________________ represented by Certificate No.(s) _______________________________________________________ inclusive, standing in the name of the undersigned on the books of said Corporation.
OR
Bond
______ bond of _____________________________________________________________________ in the principal amount of $________________________, Certificate No. ________________________ standing in the name of the undersigned on the books of said Corporation.
The undersigned does (do) hereby irrevocably constitute and appoint Edward Jones to transfer the said stock(s), bond(s), or debenture(s), as the case may be, on the books of said Corporation with full power of substitution in the premises.
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| Signed |
_______________________________________________ Date ____________________ |
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Donor |
| Signed |
_______________________________________________ Date ____________________ |
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Donor (joint-owner) |
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