STOCK TRANSFER
	
FOR VALUE RECEIVED, the undersigned __________________________________ 
of ______________________________________ hereby sells, assigns and transfers to
of ______________________________________ and its successors and assigns, ( __ ) 
shares of the ______________________________ stock of, _____________________ 
represented by Certificate No(s). ____________________________________, inclusive, 
standing in name of the undersigned in the books of said company.  The undersigned also hereby irrevocably constitutes and appoints, ____________________ attorney-in-fact, to transfer the said stock on the books of said company with full power of substitution in the premises.

Signed this _________________ day of _______________ (month), ____ (year).

Witnessed:

________________________________	            _____________________________
Witness					            Signature Guaranteed