Affymax, Inc. Common Stock Certificate Issued to Mr. and Mrs. Sample
This document certifies that Mr. and Mrs. Sample are the registered owners of 600,620 fully paid and non-assessable shares of common stock in Affymax, Inc., a Delaware corporation. The certificate outlines the rights and obligations of shareholders, including transfer procedures, and references the company's Articles of Incorporation and By-Laws. The shares are transferable upon proper endorsement and registration with the transfer agent. The certificate is only valid when countersigned by the transfer agent and registrar.
Exhibit 4.2
COMMON STOCK PAR VALUE $0.001 | COMMON STOCK | |||
[AFFYMAX BLACK AND WHITE LOGO] AFFYMAX™ | ||||
Certificate Number ZQ 000000 | AFFYMAX, INC. INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE 100,000,000 AUTHORIZED SHARES $0.001 PAR VALUE | Shares **600620****** ***600620***** ****600620**** *****600620*** ******600620** | ||
THIS CERTIFIES THAT | MR. SAMPLE & MRS. SAMPLE & MR. SAMPLE & MRS. SAMPLE | CUSIP 00826A 1G 9 SEE REVERSE FOR CERTAIN DEFINITIONS | ||
is the owner of | ***SIX HUNDRED THOUSAND SIX HUNDRED AND TWENTY*** |
FULLY-PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK OF
Affymax, Inc. (hereinafter called the "Company"), transferable on the books of the Company in person or by duly authorized attorney, upon surrender of this Certificate properly endorsed. This Certificate and the shares represented hereby, are issued and shall be held subject to all of the provisions of the Articles of Incorporation, as amended, and the By-Laws, as amended, of the Company (copies of which are on file with the Company and with the Transfer Agent), to all of which each holder, by acceptance hereof, assents. This Certificate is not valid unless countersigned and registered by the Transfer Agent and Registrar.
Witness the facsimile seal of the Company and the facsimile signatures of its duly authorized officers.
| DATED ((Month Day Year)) | |||
President and Chief Executive Officer | COUNTERSIGNED AND REGISTERED COMPUTERSHARE TRUST COMPANY, INC. (DENVER) TRANSFER AGENT AND REGISTRAR | ||
Secretary | By: | AUTHORIZED SIGNATURE | |
[SEAL]
AFFYMAX, INC.
TRANSFER FEE $25.00
The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws or regulations:
TEN COM-as tenants in common | UNIF GIFT MIN ACT- | Custodian (Cust) (Minor) | |
TEN ENT-as tenants by the entireties | under Uniform Gifts to Minors Act | (State) | |
JT TEN-as joint tenants with right of survivorship and not as tenants in common | UNIF TRT MIN ACT | Custodian (until age ) (Cust) (Minor) | |
under Uniform Transfer to Minors Act | (State) |
Additional abbreviations may also be used though not in the above list.
THE COMPANY WILL FURNISH WITHOUT CHARGE TO EACH SHAREHOLDER WHO SO REQUESTS, A SUMMARY OF THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OF THE COMPANY AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND RIGHTS, AND THE VARIATIONS IN RIGHTS, PREFERENCES AND LIMITATIONS DETERMINED FOR EACH SERIES, WHICH ARE FIXED BY THE ARTICLES OF INCORPORATION OF THE COMPANY, AS AMENDED, AND THE RESOLUTIONS OF THE BOARD OF DIRECTORS OF THE COMPANY, AND THE AUTHORITY OF THE BOARD OF DIRECTORS TO DETERMINE VARIATIONS FOR FUTURE SERIES. SUCH REQUEST MAY BE MADE TO THE OFFICE OF THE SECRETARY OF THE COMPANY OR TO THE TRANSFER AGENT. THE BOARD OF DIRECTORS MAY REQUIRE THE OWNER OF A LOST OR DESTROYED STOCK CERTIFICATE, OR HIS LEGAL REPRESENTATIVES, TO GIVE THE COMPANY A BOND TO INDEMNIFY IT AND ITS TRANSFER AGENTS AND REGISTRARS AGAINST ANY CLAIM THAT MAY BE MADE AGAINST THEM ON ACCOUNT OF THE ALLEGED LOSS OR DESTRUCTION OF ANY SUCH CERTIFICATE.
For value received, hereby sell, assign and transfer unto
(PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE)
(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE OF ASSIGNEE)
Shares
of the common stock represented by the within Certificate, and do hereby irrevocably constitue and appoint
Attorney
to transfer the said stock on the books of the within-named Corporation with full power of substitution in the premises.
Dated: 20
Signature:
Signature:
Notice: The signature to this assignment must correspond with the name as written upon the face of the certificate, in every particular, without alteration or enlargement, or any change whatever.
Signature(s) Guaranteed: Medallion Guarantee Stamp
THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (Banks, Stockbrokers, Savings and Loan Associations and Credit Unions) WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM, PURSUANT TO S.E.C. RULE 17 Ad-15.
