Stock Transfer Agent Forms – Mountain Share Transfer

Mountain Share Transfer utilizes and accepts the following stock transfer agent forms.  The following forms are available for download and use:

 Shareholder Forms:

  • Affidavit of Domicile:  An affidavit of domicile is used to state where a person resides (or where a deceased person resided). This form is typically required when transferring shares of deceased owners. The signature on the form must be notarized. Must also be accompanied by the Transfer Instruction Letter.
  • Limited Liability Certification:  This form is used by a limited liability corporation to authorize one or more of its managers to assign, transfer, and deliver shares of stock, bonds, debentures, or notes owned by the LLC.
  • Shareholder’s Representation Letter – 6 Month Hold:
  • Shareholders Representation Letter – 12 Month Hold:
  • Sole Proprietorship Certification:  This form is used to certify that an entity is a sole proprietorship.
  • Stock Power:  This form is used to authorize the change of ownership of a security. Please include the certificate number, number of shares, security name, signature and medallion.
  • Third Party Release:  This form is used to transfer securities into the name of a third party.
  • Trust Certification:  This form is used for the certification of a trust.
  • Waiver of Probate:  This form is used to certify that an estate has not been and will not be probated.

Issuer Forms:

Corporate Resolution – Signatory Authorization:  A corporate resolution is used to authorize a corporate officer to transfer securities on behalf of the corporation. Must also be accompanied by the Transfer Instruction Letter.