The undersigned, a shareholder of _________________________, herewith dissents and disapproves of the disposition of assets of the corporation of ____________________________, which constitute ________________ percent of the assets of the corporation, to __________________________, on the following terms:
__________________________________________________________________

Number of shares: _________________________
Class of shares: ________________________

The undersigned further demands their rights under the corporation law of _________________.

Dated: _____________________

_____________________________________
Shareholder

Dissent Notice of Shareholder:  Regarding Sale of all Assets of Corporation
Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  This Dissent form can be adapted to a number of different issues relating to stockholder dissent.  It can be most effectively used in small private companies with a few shareholders.  You can add to the number of shareholders in providing your protest.  This formal approach can often lead to a negotiated settlement.

1. Keep a copy of the signed letter.

The undersigned, a shareholder of _________________________, herewith dissents and disapproves of the disposition of assets of the corporation of ____________________________, which constitute ________________ percent of the assets of the corporation, to __________________________, on the following terms:
__________________________________________________________________

Number of shares: _________________________
Class of shares: ________________________

The undersigned further demands their rights under the corporation law of _________________.

Dated: _____________________

_____________________________________
Shareholder

Dissent Notice of Shareholder:  Regarding Sale of all Assets of Corporation
Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  This Dissent form can be adapted to a number of different issues relating to stockholder dissent.  It can be most effectively used in small private companies with a few shareholders.  You can add to the number of shareholders in providing your protest.  This formal approach can often lead to a negotiated settlement.

1. Keep a copy of the signed letter.