ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED and pursuant to that certain Common Stock Purchase Agreement between the undersigned (“Grantee”) and Pacific Energy Development Corp (the “Company”) dated _______________ (the “Agreement”), Grantee hereby sells, assigns and transfers unto the Company _________________________________ (________) shares of the Common Stock of the Company standing in Grantee’s name on the Company’s books and represented by Certificate No. _____, and does hereby irrevocably constitute and appoint ______________________ to transfer said stock on the books of the Company with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETO. Dated: ______________________ ______________________________ GRANTEE: ___________________ Instruction: Please do not fill in any blanks other than the signature line. The purpose of this assignment is to enable the Company to exercise its repurchase option set forth in the Agreement without requiring additional signatures on the part of Grantee. I, _____________________, spouse of ____________________________, have read and approved the foregoing Agreement. In consideration of the right of my spouse to purchase shares of Pacific Energy Development Corp as set forth in the Agreement, I hereby appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement insofar as I may have any rights under the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ ________________________________ (Signature of Spouse)
Appears in 1 contract
ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED and pursuant to that certain Common Stock Purchase Agreement between the undersigned (“Grantee”) and Pacific Energy Development Corp (the “Company”) dated _______________ (the “Agreement”), Grantee hereby sells, assigns and transfers unto the Company _________________________________ (________) shares of the Common Stock of the Company standing in Grantee’s name on the Company’s books and represented by Certificate No. _____, and does hereby irrevocably constitute and appoint ______________________ to transfer said stock on the books of the Company with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETO. DatedSignature: ______________________ ______________________________ GRANTEE: ____________________________________ Instruction: Please do not fill in any blanks other than the signature line. The purpose of this assignment is to enable the Company to exercise its repurchase option set forth in the Agreement without requiring additional signatures on the part of Grantee. I, _____________________, spouse of ____________________________, have read and approved the foregoing Agreement. In consideration of the right of my spouse to purchase shares of Pacific Energy Development Corp as set forth in the Agreement, I hereby appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement insofar as I may have any rights under the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ _____________________________________________ (Signature of Spouse)
Appears in 1 contract
ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED RECEIVED, I, Lia ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇-▇▇▇▇▇▇▇, hereby sell, assign and pursuant to that certain Common Stock Purchase Agreement between the undersigned (“Grantee”) and Pacific Energy Development Corp (the “Company”) dated transfer unto ______________________ ___________________ (__________) shares (the “AgreementShares”), Grantee hereby sells, assigns and transfers unto ) of the Common Stock of IdentifySensors Biologics Corp. (the “Company”) standing in my name on the books of the Company represented by Certificate No. _____ herewith and hereby irrevocably constitute and appoint _________________________________ (, attorney, to transfer the Shares on the books of the Company with full power of substitution in the premises. This Stock Assignment may be used only in accordance with the Restricted Stock Award Agreement between the Company and the undersigned effective as of ________) shares of the Common Stock of the Company standing in Grantee’s name on the Company’s books and represented by Certificate No, 2020. Dated: _____, and does hereby irrevocably constitute and appoint ______________________ to transfer said stock on the books of the Company with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETO. Dated: _________________________ ______________________________ GRANTEE: ___________________ Instruction: Please do not fill in any blanks other than (Awardee’s spouse) indicates by the signature line. The purpose execution of this assignment is Assignment his or her consent to enable be bound by the Company terms herein as to exercise its repurchase option set forth his or her interests, whether as community property or otherwise, if any, in the Agreement without requiring additional signatures on the part of GranteeShares. I, _____________________, spouse of ____________________________, have read and approved the foregoing Agreement. In consideration of the right of my spouse to purchase shares of Pacific Energy Development Corp as set forth in the Agreement, I hereby appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement insofar as I may have any rights under the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ ________________________________ (Signature _________________________ Print Name INSTRUCTIONS: Please do not fill in the blanks other than the signature line. The purpose of Spouse)this assignment is to enable the Company to exercise its “Repurchase Option,” as set forth in the Agreement, without requiring additional signatures on the part of Awardee. The undersigned taxpayer hereby makes an election pursuant to Section 83(b) of the Internal Revenue Code with respect to the property described below and supplies the following information in accordance with the regulations promulgated thereunder:
Appears in 1 contract
Sources: Restricted Stock Award Agreement (IdentifySensors Biologics Corp.)
ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED RECEIVED, I, _________________, hereby sell, assign and pursuant to that certain Common Stock Purchase Agreement between the undersigned (“Grantee”) and Pacific Energy Development Corp (the “Company”) dated transfer unto ______________________ ___________________ (__________) shares (the “AgreementShares”), Grantee hereby sells, assigns and transfers unto ) of the Common Stock of IdentifySensors Biologics Corp. (the “Company”) standing in my name on the books of the Company represented by Certificate No. _____ herewith and hereby irrevocably constitute and appoint _________________________________ (________) shares of the Common Stock of the Company standing in Grantee’s name on the Company’s books and represented by Certificate No. _____, and does hereby irrevocably constitute and appoint ______________________ attorney, to transfer said stock the Shares on the books of the Company with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETOThis Stock Assignment may be used only in accordance with the Restricted Stock Award Agreement between the Company and the undersigned effective as of ______________. Dated: ______________________________ ______________________________ GRANTEE: ___________________ Instruction: Please do not fill in any blanks other than the signature line. The purpose of this assignment is to enable the Company to exercise its repurchase option set forth in the Agreement without requiring additional signatures on the part of Grantee. I, _____________________, spouse of ____________________________, have read and approved the foregoing Agreement. In consideration of the right of my spouse to purchase shares of Pacific Energy Development Corp as set forth in the Agreement, I hereby appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement insofar as I may have any rights under the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ ________________________________ (Awardee’s spouse) indicates by the execution of this Assignment his or her consent to be bound by the terms herein as to his or her interests, whether as community property or otherwise, if any, in the Shares. __________________________ Signature __________________________ Print Name INSTRUCTIONS: Please do not fill in the blanks other than the signature line. The purpose of Spouse)this assignment is to enable the Company to exercise its “Repurchase Option,” as set forth in the Agreement, without requiring additional signatures on the part of Awardee. The undersigned taxpayer hereby makes an election pursuant to Section 83(b) of the Internal Revenue Code with respect to the property described below and supplies the following information in accordance with the regulations promulgated thereunder:
Appears in 1 contract
Sources: Restricted Stock Award Agreement (IdentifySensors Biologics Corp.)
ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED and pursuant to that certain Common Restricted Stock Purchase Grant Notice and Restricted Stock Agreement between the undersigned (“Grantee”) and Pacific Energy Development Corp (the “CompanyAward”) dated _________), ______ (the “Agreement”), Grantee hereby sells, assigns and transfers unto the Company ________________ZIOPHARM Oncology, Inc., a Delaware corporation (“Assignee”) _________________ (________) shares of the Common Stock common stock of the Company Assignee, standing in Granteethe undersigned’s name on the Company’s books and of said corporation represented by Certificate No. _____, _ herewith and does do hereby irrevocably constitute and appoint ______________________ as attorney-in-fact to transfer the said stock on the books of the within named Company with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETOThis Assignment may be used only in accordance with and subject to the terms and conditions of the Award, in connection with the reacquisition of shares of Common Stock of the Company issued to the undersigned pursuant to the Award, and only to the extent that such shares remain subject to the Company’s Reacquisition Right under the Award. Dated: ______________________ ______________________________ GRANTEESignature: ___________________ Instruction(Print Name), Recipient [INSTRUCTION: Please do not fill in any blanks other than the signature line. The purpose of this assignment Assignment is to enable the Company to exercise its repurchase option Reacquisition Right set forth in the Agreement Award without requiring additional signatures on your part.] [Date] Secretary ZIOPHARM Oncology, Inc. One First Avenue ▇▇▇▇▇▇ Building ▇▇, ▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Dear Sir/Madam: As Escrow Agent for both ZIOPHARM Oncology, Inc., a Delaware corporation (the part “Company”), and the undersigned recipient of Grantee. I, _____________________, spouse of ____________________________, have read and approved the foregoing Agreement. In consideration stock of the right of my spouse Company (“Recipient”), you are hereby authorized and directed to purchase shares of Pacific Energy Development Corp as set forth in hold the Agreement, I hereby appoint my spouse as my attorney-in-fact in respect documents delivered to you pursuant to the exercise terms of any rights under the Agreement insofar as I may have any rights under the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ _______________________that certain Restricted Stock Grant Notice (including all attachments and exhibits thereto) dated _________ (Signature the “Grant Documents”), to which a copy of Spouse)these Joint Escrow Instructions is attached as Attachment IV, in accordance with the following instructions. Capitalized terms not explicitly defined in these instructions but defined in the Company’s 2020 Equity Incentive Plan (“Plan”) or the Grant Documents shall have the same definitions as provided therein.
Appears in 1 contract
ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED and pursuant to that certain Common Stock Purchase Agreement between the undersigned (“Grantee”RECEIVED, hereby sell(s), assign(s) and Pacific Energy Development Corp transfer(s) unto (the “Company”) dated ( ) shares of the common stock of the Company standing in name on the books of the Company represented by Certificate No. herewith and do hereby irrevocably constitute and appoint the Company’s Secretary to transfer the said stock on the books of the Company with full power of substitution in the premises. Dated: Signature Name: INSTRUCTIONS: Please do not fill in any blanks other than the signature line. The purpose of this assignment is to enable the Company to exercise its rights, as set forth in the Class L Common Stock Grant Agreement, without requiring additional signatures on the part of Holder. I, _______________ ______, spouse of _________, have read and approve the foregoing Class L Common Stock Grant Agreement (the “Agreement”). In consideration of the issuance to my spouse of the shares of Common Stock set forth in the Agreement (the “Restricted Shares”), Grantee I hereby sells, assigns appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement and transfers unto agree to be bound by the Company provisions thereof insofar as I may have any rights therein or in or to any Restricted Shares under the community property laws or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the Agreement. Dated: ______________________________________ (Signature of Spouse [Company] [Address] Dear [________]: As escrow agent (the “Escrow Agent”) shares for both Sanken North America, Inc., a Delaware corporation (the “Company”), and the undersigned purchaser or transferee of the Common Stock stock of the Company standing in Grantee’s name on (“Holder”), you are hereby authorized and directed to hold the Company’s books and represented by Certificate No. _____, and does hereby irrevocably constitute and appoint ______________________ documents delivered to transfer said stock on you pursuant to the books terms of that certain Class L Common Stock Grant Agreement (the “Agreement”) between the Company and the undersigned (the “Escrow”), in accordance with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETO. Dated: ______________________ ______________________________ GRANTEE: ___________________ Instruction: Please do not fill in any blanks other than the signature line. The purpose of this assignment is to enable the Company to exercise its repurchase option set forth in the Agreement without requiring additional signatures on the part of Grantee. I, _____________________, spouse of ____________________________, have read and approved the foregoing Agreement. In consideration of the right of my spouse to purchase shares of Pacific Energy Development Corp as set forth in the Agreement, I hereby appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement insofar as I may have any rights under the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ ________________________________ (Signature of Spouse)following instructions:
Appears in 1 contract
Sources: Class L Common Stock Grant Agreement (Allegro Microsystems Inc)
ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED and pursuant to that certain Common Restricted Stock Purchase Award Grant Notice and Restricted Stock Award Agreement between the undersigned (“Grantee”) and Pacific Energy Development Corp (the “CompanyAward”), _________ hereby sells, assigns and transfers unto Vitria Technology, Inc., a Delaware corporation (“Assignee”) dated _____________________ (____________) shares of the “Agreement”)common stock of the Assignee, Grantee standing in the undersigned’s name on the books of said corporation represented by Certificate No. ______ herewith and do hereby sellsirrevocably constitute and appoint ____________ as attorney-in-fact to transfer the said stock on the books of the within named Company with full power of substitution in the premises. This Assignment may be used only in accordance with and subject to the terms and conditions of the Award, assigns in connection with the reacquisition of shares of Common Stock of the Assignee issued to the undersigned pursuant to the Award, and transfers unto only to the Company extent that such shares remain subject to the Assignee’s Reacquisition Right under the Award. Dated: ___________________________________ (________) shares of the Common Stock of the Company standing in Grantee’s name on the Company’s books and represented by Certificate No. _____, and does hereby irrevocably constitute and appoint ______________________ to transfer said stock on the books of the Company with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETO. Dated: ______________________ ______________________________ GRANTEE: ___________________ Instruction[INSTRUCTION: Please do not fill in any blanks other than the signature line. The purpose of this assignment Assignment is to enable the Company to exercise its repurchase option Reacquisition Right set forth in the Agreement Award without requiring additional signatures on your part.] [Date] Corporate Secretary Vitria Technology, Inc. 9▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Sunnyvale, CA 94086 Dear Sir/Madam: As Escrow Agent for both Vitria Technology, Inc., a Delaware corporation (the part “Company”), and the undersigned recipient of Grantee. Istock of the Company (“Recipient”), you are hereby authorized and directed to hold the documents delivered to you pursuant to the terms of that certain Restricted Stock Award Grant Notice (the “Grant Notice”), dated _____________________to which a copy of these Joint Escrow Instructions is attached as Attachment IV, spouse of ____________________________, have read and approved the foregoing Agreement. In consideration of the right of my spouse to purchase shares of Pacific Energy Development Corp as set forth in the Agreement, I hereby appoint my spouse as my attorney-in-fact in respect pursuant to the exercise terms of any rights under that certain Restricted Stock Award Agreement (“Agreement”), which is Attachment I to the Agreement insofar as I may have any rights under Grant Notice, in accordance with the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ ________________________________ (Signature of Spouse)following instructions:
Appears in 1 contract
Sources: Restricted Stock Award Agreement (Vitria Technology Inc)
ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED and pursuant to that certain Common Stock Purchase Agreement between the undersigned (“Grantee”"Purchaser") and Pacific Energy Development Corp RiboGene, Inc. dated _____________, 19___ (the “Company”) dated "Agreement"), Purchaser hereby sells, assigns and transfers unto _______________ (_____) shares of the “Agreement”)Common Stock of RiboGene, Grantee Inc. standing in Purchaser's name on the books of said corporation represented by Certificate No. herewith and does hereby sellsirrevocably constitute and appoint ___________________ to transfer said stock on the books of the within-named corporation with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETO. Dated:____________________, assigns and transfers unto the Company 19__. Signature: __________________________________ (________) shares of the Common Stock of the Company standing in Grantee’s name on the Company’s books and represented by Certificate No. _____, and does hereby irrevocably constitute and appoint ______________________ to transfer said stock on the books of the Company with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETO. Dated: ______________________ ______________________________ GRANTEE: ___________________ Instruction1* INSTRUCTION: Please do not fill in any blanks other than the signature line. The purpose of this assignment is to enable the Company to exercise its repurchase option set forth in the Agreement without requiring additional signatures on the part of GranteePurchaser. CONSENT OF SPOUSE I, ___________________________, spouse of ____________________________, have read and approved hereby approve the foregoing Agreement. In consideration of the right of Company's granting my spouse the right to purchase shares of Pacific Energy Development Corp the Shares as set forth in the Agreement, I hereby agree to be irrevocably bound by the Agreement and further agree that any community property or other such interest shall be similarly bound by the Agreement. I hereby appoint my spouse as my attorney-in-fact in with respect to the any amendment or exercise of any rights under the Agreement insofar as I may have any rights under the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ ________________________________ (Signature Spouse of Spouse)Purchaser
Appears in 1 contract
Sources: Restricted Stock Purchase Agreement (Ribogene Inc / Ca/)
ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED and pursuant to the and that certain Common Restricted Stock Purchase Award Agreement between the undersigned (“Grantee”the "Participant") and Pacific Forbes Energy Development Corp Services Ltd. (the “"Company”") dated _______________ (the “this "Agreement”"), Grantee the Participant hereby sells, assigns and transfers unto the Company _________________________________ (________) shares of the Common Stock of the Company Company, standing in Granteethe Participant’s name on the Company’s books and of the Company represented by Certificate No. ______ herewith, and does hereby irrevocably constitute and appoint ______________________ to transfer said stock such Common Stock on the books of the Company with full power of substitution in the premises. THIS ASSIGNMENT MAY ONLY BE USED AS AUTHORIZED BY THE AGREEMENT AND THE EXHIBITS THERETOThis Assignment may be used only as authorized by this Agreement. Dated: _________________,_____ ______________________________ GRANTEESignature: ___________________ InstructionINSTRUCTIONS: Please do not fill in any blanks other than the signature line. The purpose of this assignment is to enable the Company to exercise its repurchase option the forfeiture provisions as set forth in the Agreement this Agreement, without requiring additional signatures on the part of Granteethe Participant. I[Name] [ADDRESS] Attn.: Corporate Secretary Dear Sir: As Escrow Agent for both Forbes Energy Services Ltd. (the "Company"), _____________________, spouse of ____________________________, have read and approved the foregoing Agreement. In consideration undersigned Participant of the right of my spouse to purchase shares of Pacific Energy Development Corp as set forth in the Agreement, I hereby appoint my spouse as my attorney-in-fact in respect to the exercise of any rights under the Agreement insofar as I may have any rights under the community property laws of the State of California or similar laws relating to marital property in effect in the state of our residence as of the date of the signing of the foregoing Agreement. Dated: ______________ ________________________________ shares of Common Stock (Signature the "Covered Shares") of Spousethe Company (the "Participant"), you are hereby authorized and directed to hold the documents delivered to you pursuant to the terms of that certain Restricted Stock Award Agreement (the "Agreement") between the Company and the undersigned, in accordance with the following instructions:
Appears in 1 contract
Sources: Restricted Stock Award Agreement (Forbes Energy Services Ltd.)