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SEC Filings

S-4/A
AVALON CABLE OF MICHIGAN INC/ filed this Form S-4/A on 05/28/1999
Entire Document
 
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                                Assignment Form


To assign this Senior Discount Note, fill in the form below: (I) or (we) assign
and transfer this Senior Discount Note to


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                 (Insert assignee's soc. sec. or tax I.D. no.)


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(Print or type assignee's name, address and zip code)

and irrevocably appoint_______________________________________________________
to transfer this Senior Discount Note on the books of the Issuers. The agent may
substitute another to act for him.


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Date:  _______________________

                               Your Signature:________________________________
                               (Sign exactly as your name appears on the face of
                                this Senior Discount Note)

                               Tax Identification No.:________________________


                               SIGNATURE GUARANTEE:

                               -----------------------------------------------

                               Signatures must be guaranteed by an "eligible
                               guarantor institution" meeting the requirements
                               of the Registrar, which requirements include
                               membership or participation in the Security
                               Transfer Agent Medallion Program ("STAMP") or
                               such other "signature guarantee program" as may
                               be determined by the Registrar in addition to, or
                               in substitution for, STAMP, all in accordance
                               with the Securities Exchange Act of 1934, as
                               amended.

                                     A-11