Check box if S Corporation
CERTIFICATE OF TRANSFER OF
ARKANSAS BANK OR BANK HOLDING COMPANY STOCK
Check box if S Corporation
NAME OF BANK/BANK HOLDING COMPANY CITY
# Shares Issued, Common Stock # Shares Issued, Preferred Stock
On , 20 , the following number of shares, ,
then Represented by Certificate(s) numbered were transferred by
to , the Certificate(s) issued to said transferee being numbered (Report multiple transfers on reverse side)
*After giving effect to such transfer, the transferee above named will own shares. The undersigned has no knowledge of any additional shares outstanding in the name of a nominee of, or trustee for, said transferee except as may be noted on the opposite side of this Certificate.
___________________________________________
NAME OF BANK/BANK HOLDING COMPANY DATE
FULL ADDRESS
SIGNATURE TITLE
The above transfer is , this , 20 .
“reported” “approved” “disapproved”
ARKANSAS STATE BANK DEPARTMENT
The information requested is required pursuant to the Arkansas Banking Code of 1997, Section 23-48-316.
* If over twenty-five percent of outstanding stock, the percentage before transfer _____________% and after transfer ______________%. Bank holding companies calculate outstanding stock as the total number of shares issued minus treasury shares. If the bank holding company has treasury shares, indicate the # of shares held: _________________.
TRANSFEREE'S OWNERSHIP
AFTER TRANSFER
NEW NUMBER PERCENTAGE
CERTIFICATE NUMBER OF CERTIFICATE SHARES OF
NUMBER SHARES TRANSFEROR TRANSFEREE NUMBER OWNED OUTSTANDING
ADDITIONAL SHARES OUTSTANDING IN THE NAME OF A NOMINEE OF, OR TRUSTEE FOR:
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