SiT507 - Scotiabank
Account NameFOR VALUE RECEIVED the undersigned hereby sells, assigns and transfers to______________________________________ ________________________________________ __________________NAME OF TRANSFEREEof____________________________ ________________________________________ ________________________ADDRESSthe following securities:(a)__________________________ ________________________________________ ____________________shares ofNUMBER OF SHARES AND CLASS___________________________________ ________________________________________ ___________________NAME OF ISSUEROR(b)$ ______________________ _______ % ________________________________________ ________________DESCRIPTION OF BONDS, DEBENTURE, NOTES, CERTIFICATES OF DEPOSIT OR ________________________________________ ________________________________________ ________________________________________ ______________________________________OT HER SECURITIES AND NAME OF ISSUERstanding in the name of the undersigned and hereby irrevocably appoints________________________________ ________________________________________ ________________________________________ ____________________________THIS SPACE SHOULD BE LEFT BLANKthe attorney of the
Account Name FOR VALUE RECEIVED the undersigned hereby sells, assigns and transfers to
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