Common use of Delivery Information Clause in Contracts

Delivery Information. Number of shares of Common Stock to be issued: ------------------------- Tax ID Number (If applicable): ---------------------------------------- Please issue the Common Stock and, if applicable, any check drawn on an account of the Company in the following name and to the following address: Issue to: -------------------------------------------- -------------------------------------------- Address: ---------------------------------------------

Delivery Information. Number of shares of Common Stock to be issued: ------------------------- Tax ID Number (If applicable): ---------------------------------------- _________________________________________ Please issue the Common Stock and, if applicable, any check drawn on an account of the Company in the following name and to the following address: Issue to: -------------------------------------------- -------------------------------------------- :_______________________________________ _______________________________________ Address: ---------------------------------------------_______________________________________