[With Non-Recourse]

　　FOR VALUE RECEIVED， the undersigned hereby sells and transfers all right， title and interest in and to the account[s] receivable as annexed¹； to _.  The undersigned warrants that the said account[s] are just and due and the undersigned has not received payment for same or any part thereof； provided， however， that said account[s] are sold without recourse to the undersigned in the event of non-payment.

　　Signed under seal this_ day of _， 19_.

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