Llc Certificate Template Page 2

(REVERSE SIDE OF CERTIFICATE

FOR INTERESTS OF ________________, LLC)

FOR

VALUE

RECEIVED,

the

undersigned

hereby

sells,

assigns

and

transfers

unto

___________________________________________________ (print or typewrite name of Transferee),

__________________ (insert Social Security or other taxpayer identification number of Transferee), the

following specified percentage of Interests: ______________ (identify the percentage of Interests being

transferred), and irrevocably constitutes and appoints __________________________, as attorney-in-

fact, to transfer the same on the books and records of the Company, with full power of substitution in

the premises.

Dated: __________________________

Signature: __________________________

(Transferor)

Address:

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Parent category: Business