Transfer

Stock Transfer Form

Name of Shareholder (Business or Individual)

Number of Shares Owned:

Number of shares can be provided through the ADC Office at 402-694-4088 or Kelsey@GrowAurora.com.

Possession of Stock Certificate(s)(Required)

I can provide the original Stock Certificates to be reissued

I certify that I am unable to locate the certificate described above.

Select one of the following options to transfer shares:(Required)

Return my shares to Stock Treasury

Select an individual/business to transfer the shares to on my behalf.

Transfer my shares to the individual/business listed below.

Name of individual/ business receiving the shares:

Address of individual/ business receiving the shares:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone of individual/ business receiving the shares:

This form has been completed by:

First Last

Phone number of person completing this form.

Relationship to Stockholder of person completing this form (if applicable)

Comments/ Questions(Required)

Please let us know if you have questions or notes about this stock transfer.