| L O A | ||||||||
| LETTER of AUTHORIZATION | ||||||||
| (To transfer securities or money) | ||||||||
| Date: | ||||||||
| Part A: | (Transfer of Ownership) | |||||||
| Certificate(s) to Certifcate(s) | ||||||||
| Please transer the securities listed below: | ||||||||
| From the registered name of | ||||||||
| to the registered name of | The Foundation of The University | |||||||
| of North Carolina at Charlotte, Inc. | ||||||||
| Part B: | (Complete appropriate section(s) below). | |||||||
| No. of Shares | Name of Security | Certificate Number(s) | ||||||
| I hereby finally irrevocably release and discharge you or any claims by me or my | ||||||||
| legal representatives with reference to the foregoing, including the proceeds of | ||||||||
| sale or other disposition thereof. | ||||||||
| Transferor: | Signature: | |||||||
| Signature: | ||||||||
| Acceptance: | Signature: | |||||||
| Signature: | ||||||||