GreyStone Power Corporation

Assignment of Certificate of Deposit

Member Number:

Service Address:

Name of Business:

Contact Person:

Contact Email Address:

Contact Phone Number:

Member Information

*Business Address:
City:
State:
Zip Code:
*Member Signatory Name:
*Title:
*Phone Number:
*Email Address:

Financial Institution Information

*Financial Institution:
*Financial Institution Address:
*City:
*State:
*Zip Code:
*Authorized Signatory Name:
*Signatory Title:
*Phone Number:
*Email Address:

CD 1
CD Number:
Date of Issue:
Amount:
Maturity Date:
CD 2
CD Number:
Date of Issue:
Amount:
Maturity Date:
CD 3
CD Number:
Date of Issue:
Amount:
Maturity Date:
CD 4
CD Number:
Date of Issue:
Amount:
Maturity Date:

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