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S-8 Filing
Distribution Solutions (DSGR) S-8Registration of securities for employees
Filed: 23 Dec 09, 12:00am
COMMON STOCK | COMMON STOCK |
Certificate Number | Shares |
DATED ‹‹Month, Day, Year›› | ||||||
COUNTERSIGNED AND REGISTERED: COMPUTERSHARE TRUST COMPANY, N.A. TRANSFER AGENT AND REGISTRAR | ||||||
Chairman of the Board of Directors | ||||||
Secretary | By | |||||
AUTHORIZED SIGNATURE |
TEN COM | - as tenants in common | UNIF GIFT MIN ACT | __________ Custodian __________ | |||||||
(Cust) | (Minor) | |||||||||
TEN ENT | - as tenants by the entireties | under Uniform Gifts to Minors Act _______ | ||||||||
(State) | ||||||||||
JT TEN | - as joint tenants with right of survivorship and not as tenants in common | UNIF TRF MIN ACT | __________ Custodian __________ | |||||||
(Cust) | (Minor) | |||||||||
under Uniform Transfers to Minors Act _______ | ||||||||||
(State) |
Signature(s) Guaranteed: Medallion Guarantee Stamp | ||||
Dated: ____________ 20 ______ Signature: __________________ Signature: __________________ | THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUION (Banks, Stockbrokers, Savings and Loan Associations and Credit Unions) WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM PURSUANT TO S.E.C. RULE 17Ad-15. | |||
Notice: | The signature to this assignment must correspond with the name as written upon the face of the certificate, in every particular, without alteration or enlargement, or any change whatever. |