FOR VALUE RECEIVED, the undersigned does hereby sell, assign and transfer to _____________ (name), its successors or assigns, all rights , titles and interest of the undersigned in and to a certain security interest and debt thereto issued to the undersigned from _____________ (Debtor), under date of ______________, 19____, all as annexed hereto.
Signed this _______________ day of ______________,19____.
______________________________
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