Alliance Imaging, Inc. Common Stock Certificate

Summary

This document certifies that the named holder owns a specified number of fully paid shares of common stock in Alliance Imaging, Inc., a Delaware corporation. The shares are transferable by the holder or their authorized representative upon proper endorsement and surrender of the certificate. The certificate is only valid when countersigned by the transfer agent and registrar. It includes instructions for transferring ownership and recognizes various forms of joint or custodial ownership under applicable laws.

EX-4.3 5 a2056722zex-4_3.txt EXHIBIT 4.3 Number Shares AI See reverse for certain definitions Incorporated under the laws of the State of Delaware Alliance Imaging, Inc. CUSIP 018606 20 2 This certifies that is the owner of fully paid and non-assessable shares, $.01 par value, of the common stock of ALLIANCE IMAGING, INC. transferable on the books of the Company by the holder hereof, in person or by duly authorized Attorney, upon surrender of this Certificate properly endorsed. This Certificate is not valid until countersigned and registered by the Transfer Agent and Registrar. IN WITNESS WHEREOF, said Company has caused this Certificate to be signed by the facsimile signatures of its duly authorized officers and to be sealed with the facsimile Seal of the Company. Dated: /s/ Russell D. Phillips, Jr. Richard N. Zehner Secretary Chairman and Chief Executive Officer Authorized Signature [Seal of the Company] Countersigned and Registered: AMERICAN STOCK TRANSFER & TRUST COMPANY By Transfer Agent and Registrar 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 JT TEN -- as joint tenants with rights of survivorship Act_____________ and not as tenants in common (State) COM PROP -- as community property UNIF TRF MIN ACT - _________ Custodian (until age______) _________ Under Unifiorm Transfers (Minor) to Minors Act ______________ (State)

Additional abbreviations may also be used though not in the above list. ______________________________________________________ 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 ZIP CODE OF ASSIGNEE) _______________________________________________________________________________ _______________________________________________________________________________ __________________________________________________________________________Shares of the Common Stock represented by the within certificate, and do hereby irrevocably constitute and appoint ________________________________________________________________________Attorney to transfer the said shares on the books of the within named Corporation with full power of substitution in the premises. Dated ________________________________ Signatures(s):_________________________________ _______________________________________________ NOTICE: THE SIGNATURES TO THIS AGREEMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER