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ASSIGNMENT OF CERTIFICATE OF DEPOSIT AS SECURITY (Pursuant to the Telephone Solicitation Act, Tex. Bus. & Com. Code, Section 302.001 et seq.)

I, (We) _________________________________________________________________,
(Assignor's Name)

______________________________________________________________________________,
(Assignor's Address)

(______)______________________, hereafter assignor, for the benefit of _______________
(Assignor's Phone)

______________________________________________________________________________,
(Name of Company)

______________________________________________________________________________,
(Company Address)

do hereby assign to the Secretary of State of the State of Texas all right, title and interest of the assignor in and to: CD No. ________________________ for $_______________________ issued by ____________________________________________,
(Name of Financial Institution)

_____________________________________________________, an institution insured by
(Address of Financial Institution)

the Federal Deposit Insurance Corporation. THIS assignment will satisfy the requirements of Tex. Bus. & Com. Code, Sec. 302.001 et seq., when the Certificate of Deposit is received. THIS Certificate of Deposit is payable to the favor of the State of Texas and shall be held by the State of Texas for the benefit of any person who is injured by a violation of Tex. Bus. & Com. Code, Sec. 302.001 et seq. THIS assignment shall remain in full force and effect until expressly withdrawn by assignor with the approval of the Secretary of State. ___________________________________ (Assignor's Signature) ___________________________________ (Printed or Typed Name & Title)
Form #3404

STATE OF ___________________ COUNTY OF_________________ Sworn to and subscribed before me on the _________ day of __________________________, __________. ____________________________________ Notary Public Signature Seal ____________________________________ Printed Name of Notary Public My Commission Expires _____________ <<<<<<<<<<<>>>>>>>> The Financial Institution named herein acknowledges this assignment. _________________________________ Signature of Officer _________________________________ Printed Name & Title <<<<<<<<<<<<<<<>>>>>>>>>>>>>>> RECEIPT OF SECURITY AND DIRECTION TO PAY EARNINGS Receipt is acknowledged of the above assignment. The financial institution is hereby authorized and directed to pay any earnings from the C.D. to the assignor. DATE:_____________________________ ________________________________________ Signature (for the Secretary of State) ________________________________________ ___________________ (Printed Name) (Title) _______________________ Date