STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. For Value Received, hereby sells, assigns and transfers unto Decru, Inc., a Delaware corporation (the “Company”), pursuant to the Repurchase Option under that certain Early Exercise Stock Purchase Agreement, dated by and between the undersigned and the Company (the “Agreement”), ( ) shares of Common Stock of the Company standing in the undersigned’s name on the books of the Company represented by Certificate No(s). and does hereby irrevocably constitute and appoint the Company’s Secretary attorney to transfer said Common Stock on the books of the 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 Agreement, in connection with the repurchase of shares of Common Stock issued to the undersigned pursuant to the Agreement, and only to the extent that such shares remain subject to the Company’s Repurchase Option under the Agreement. Dated: (Signature) (Print Name) (Instruction: Please do not fill in any blanks other than the “Signature” line and the “Print Name” line.) Mxxx X. Xxxxxxx Cxxxxx Godward LLP Five Palo Alto Square 3000 Xx Xxxxxx Xxxx Xxxx Xxxx, XX 00000 Dear Sir or Madam: As Escrow Agent for both Decru, Inc., a Delaware corporation (“Company”), and the undersigned purchaser of Common Stock of the Company (“Purchaser”), you are hereby authorized and directed to hold the documents delivered to you pursuant to the terms of that certain Early Exercise Stock Purchase Agreement (“Agreement”), dated to which a copy of these Joint Escrow Instructions is attached as Exhibit C, in accordance with the following instructions:
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. For Value Received, the undersigned hereby sells, assigns and transfers unto Hot Topic, Inc., a California corporation (the “Company”), pursuant to the Reacquisition Right under that certain Restricted Stock Bonus Agreement, dated as of October 8, 2010 by and between the undersigned and the Company (the “Agreement”), _____________________ shares of Common Stock of the Company standing in the undersigned’s name on the books of the Company represented by Certificate No(s). _______________ (or uncertificated and recorded at the office of the Company’s transfer agent, if applicable) and does hereby irrevocably constitute and appoint the Company’s Secretary as attorney to transfer said Common Stock on the books of the 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 Agreement, in connection with the reacquisition of shares of Common Stock issued to the undersigned pursuant to the Agreement, and only to the extent that such shares remain subject to the Company’s Reacquisition Right under the Agreement. Dated: _______________ (Signature) (Print Name) (Instruction: Please do not fill in any blanks other than the “Signature” line and the “Print Name” line.) 504505 v3/SD 504505 v3/SD Secretary Hot Topic, Inc. 00000 X. Xxx Xxxx Xxxxxx City of Industry, CA 91748 Ladies and Gentlemen: As Escrow Agent for both Hot Topic, Inc., a California corporation (“Company”) and the undersigned Director (“Director”), you are hereby authorized and directed to hold the documents delivered to you pursuant to the terms of that certain Restricted Stock Bonus Agreement dated as of October 8, 2010 (“Agreement”), to which a copy of these Joint Escrow Instructions is attached as Exhibit B, in accordance with the following instructions:
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. For Value Received, C-Motech Co., Ltd. hereby sells, assigns and transfers unto Franklin Wireless Corp (the “Company”), pursuant to the Common Stock Repurchase Agreement, dated July 27, 2010 by and between the undersigned and the Company (the “Agreement”), one million five hundred sixty six thousand six hundred seventy two (1,566,672) shares of Common Stock of the Company standing in the undersigned’s name on the books of the Company represented by Certificate Numbers _____________and does hereby irrevocably constitute and appoint the Company’s Secretary attorney to transfer said stock on the books of the 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 Agreement, in connection with the repurchase of shares of Common Stock issued to the undersigned.
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED, I hereby sell, assign and transfer unto ____________________________________ (_________) shares of Common Stock, $0.0001 par value per share, of Xilio Therapeutics, Inc. (the “Corporation”) standing in my name on the books of the Corporation represented by Certificate(s) Number __________ herewith, and do hereby irrevocably constitute and appoint Xxxxxx Xxxxxx Xxxxxxxxx Xxxx and Xxxx LLP attorney to transfer the said stock on the books of the Corporation with full power of substitution in the premises. Dated: PARTICIPANT: [Name] Name of Spouse (if any): Instructions to Participant: Please do not fill in any blanks other than the signature line(s). The purpose of the Stock Assignment Separate from Certificate is to enable the Company to acquire the Shares upon exercise of its Right of First Refusal and/or Purchase Option without requiring additional signatures on the part of the Participant or Participant’s spouse, if any. The signature(s) to this assignment must correspond with the name as written upon the face of the certificate, in every particular, without alteration, enlargement, or any change whatever. The 83(b) election should be filed by mailing a signed election form by certified mail, return receipt requested to the IRS Service Center where you file your tax returns. See xxx.xxx.xxx.
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED, _______________ hereby sells, assigns and transfers unto KAL Energy, Inc., a Delaware corporation (the “Company”), ________________ (_________) shares of the Common Stock of the Company, standing in his, her or its name on the books of said Company represented by Certificate No. ____ herewith and does hereby irrevocably constitute and appoint __________ his, her or its attorney to transfer the said stock on the books of the within named Company with full power of substitution in the premises.
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto NUVATION BIO INC., a Delaware corporation (the “Company”), pursuant to the Cancellation Right or Repurchase Option under that certain Stock Restriction Agreement, dated ______________, by and between the undersigned and the Company (the “Agreement”) __________________ shares of Common Stock of the Company standing in the undersigned’s name on the books of the Company represented by Certificate No[s] ________________ and does hereby irrevocably constitute and appoint both the Company’s Secretary and the Company’s attorney, or either of them, to transfer said stock on the books of the 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 Agreement, in connection with the cancellation or repurchase of shares of Common Stock issued to the undersigned pursuant to the Agreement, and only to the extent that such shares remain subject to the Company’s Cancellation Right or Repurchase Option under the Agreement. Dated:
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. For Value Received, C-Motech Co., Ltd. hereby sells, assigns and transfers unto Franklin Wireless Corp (the “Company”), pursuant to the Common Stock Repurchase Agreement, dated July 27, 2010 by and between the undersigned and the Company (the “Agreement”), one million eight hundred three thousand six hundred eighty four (1,803,684) shares of Common Stock of the Company standing in the undersigned’s name on the books of the Company represented by Certificate Numbers _____________and does hereby irrevocably constitute and appoint the Company’s Secretary attorney to transfer said stock on the books of the 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 Agreement, in connection with the repurchase of shares of Common Stock issued to the undersigned. Dated: ______________________ ________________________________________ C-Motech Co., Ltd.
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. For Value Received, [•] hereby sells, assigns and transfers unto Novavax, Inc., a Delaware corporation (the “Company”), pursuant to the Restricted Stock Agreement, dated [•], by and between the undersigned and the Company (the “Agreement”) [•] shares of Common Stock of the Company standing in the undersigned’s name on the books of the Company and does hereby irrevocably constitute and appoint both the Company’s Secretary and the Company’s attorney, or either of them, to transfer said stock on the books of the 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 Agreement, in connection with the redemption of shares of Common Stock issued to the undersigned pursuant to the Agreement, and only to the extent that such shares remain unvested under the Agreement. (Signature) (Print Name) [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 redemption rights set forth in the Agreement without requiring additional signatures on the part of Stockholder.]
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. For Value Received, hereby sells, assigns and transfers unto Decru, Inc., a Delaware corporation (the “Company”), pursuant to the Repurchase Option under that certain Early Exercise Stock Purchase Agreement, dated by and between the undersigned and the Company (the “Agreement”), ( ) shares of Common Stock of the Company standing in the undersigned’s name on the books of the Company represented by Certificate No(s). and does hereby irrevocably constitute and appoint the Company’s Secretary attorney to transfer said Common Stock on the books of the 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 Agreement, in connection with the repurchase of shares of Common Stock issued to the undersigned pursuant to the Agreement, and only to the extent that such shares remain subject to the Company’s Repurchase Option under the Agreement. Dated: (Signature) (Print Name) (Instruction: Please do not fill in any blanks other than the “Signature” line and the “Print Name” line.)
STOCK ASSIGNMENT SEPARATE FROM CERTIFICATE. For value received, Pets’ Rx, Inc. hereby assigns and transfers unto Xxxxx Fargo Bank, N.A., a corporation, One Thousand (1,000) shares of the Common Stock of Xxxxxxx X. Xxxxx, Ltd., a Nevada corporation, (the “Corporation”), standing in its name on the books of said Corporation represented by Certificate No. ________ and does hereby irrevocably constitute and appoint any officer of the Corporation to transfer said stock on the books of the Corporation with full power of substitution. Dated: Pets’ Rx, Inc. By: /s/ Xxxxx X. Xxxxxx Xxxxx X. Xxxxxx Its: Chief Financial Officer For value received, NPC Operations, Inc. hereby assigns and transfers unto Xxxxx Fargo Bank, N.A., a corporation, 1,000 shares of the Common Stock of Woodland Animal Medical Center, Inc., an Oklahoma corporation, (the “Corporation”), standing in its name on the books of said Corporation represented by Certificate No. 1 and does hereby irrevocably constitute and appoint any officer of the Corporation to transfer said stock on the books of the Corporation with full power of substitution. Dated: NPC Operations, Inc. By: /s/ Xxxxx X. Xxxxxx Xxxxx X. Xxxxxx Its: Chief Financial Officer Payee Amount Notes Xxxxxx, Xxxxxxx $ 230,000 Xxxxxxxxx, Xxxxx 105,933 Xxxxxxxxxx, Xxxxx & Coast Pet Clinic of Hermosa Beach, Inc. 262,913 Twin Rivers Animal Hospital, P.C. 19,419 Sahara, Xxxxxx 81,476 Lavac Enterprises, Inc. 641,072 Lavac Enterprises, Inc. 180,000 Companion Pet Clinic P.C. 18,179 Xxxxx, Xxxxx & Xxxxxxx, Xxxx 3,819 Gamer, Xxxxxx 308,634 Gamer, Xxxxxx & Xxxxx Xxxx 548,066 Xxxxxxx, Xxxxxx 4,850 Xxxxxx, Xxxxxxx & Xxxxxxxxx 11,772 Xxxxxx, Xxxxxxx & Gabrielle 201,736 Xxxxxxx, Xxxxxx X. 56,981 Accomero, Xxxx 209,891 $ 2,884,741 Capital Leases American Express $ 4,454 DVI Strategic Partners 8,667 US Bank Corp 33,683 American Express 4,863 Highland 13,021 DVI Strategic Partner Group 16,711 DVI Strategic Partner Group 2.252 DVI Strategic Partner Group 7,102 DVI Strategic Partner 1,913 DVI Strategic Partner 2,402 DVI Strategic Partner Group 4,182 DVI Strategic Partner Group 2,169 DVI Strategic Partner Group 12,134 Banker’s Leasing 4,228 DVI 2,779 American Express 6,311 American Express 5,108 DVI Strategic Partner Group 9,946 USB Bank Corp 11,094 Araneta, Inc. 5,196 Minolta Copier 1,866 American Express 30,362 American Express 6,810 DMD Communications 5,578 American Express 23,535 DVI 14,871 Olympic 2,578 DVI Strategic Partner 8,583 Sound Tech 17,837 Toshiba 3,860 Enterprise Fleet Leasing 5,637 Xxxxx Leas...
