Assignment of Security Interest Form

ASSIGNMENT OF SECURITY INTEREST

FOR VALUE RECEIVED, the undersigned does hereby sell,
assign and transfer to _, its successors or assigns, all
right, title 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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