Tyson Foods 2014 Annual Report Download - page 131

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ASSIGNMENT FORM
FOR VALUE RECEIVED, the undersigned hereby sell(s), assign(s) and transfer(s) unto
PLEASE INSERT
SOCIAL SECURITY OR OTHER
IDENTIFYING NUMBER OF ASSIGNEE
__________________________________________________________________________________
__________________________________________________________________________________
PLEASE PRINT OR TYPEWRITE
NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE
____________________________________________________________________________
the within Security and all rights thereunder, hereby irrevocably constituting and appointing
__________________________________________________________________________________
attorney to transfer said Security on the books of the Company, with full power of substitution in the premises.
CH1 2535151v2
DATED: __________________________
____________________________________
NOTICE: The signature to this assignment must correspond with the
name as written upon the face of the within instrument in every
particular, without alteration or enlargement or any change whatsoever.