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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 _____OTHER SECURITIES AND NAME OF ISSUER standing in the name of the undersigned and hereby irrevocably appoints_____THIS SPACE SHOULD BE LEFT BLANKthe attorney of the undersigned to transfer the said securities on the books of the said issuer with full power of DATEW itnessed by_____ _____ SIGNATURE OF WITNESS SIGNATURE OF TRANSFERORS ignature of Transferor is hereby guaranteed byPOWER OF ATTORNEY FORM FOR CERTIFICATE DEPOSITS 8978212 (08/14)Complete(a) OR (b)

Account Name FOR VALUE RECEIVED the undersigned hereby sells, assigns and transfers to

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