Improved Standard of Care. We believe that there is a significant unmet need in the severe asthma population. When combined with existing asthma medications, we believe that Bronchial Thermoplasty has the potential to offer many adult asthma patients a substantially improved quality of life by reducing asthma symptoms

EX-4.1 2 f21616a5exv4w1.htm EXHIBIT 4.1 exv4w1
 

Exhibit 4.1
COMMON STOCK       COMMON STOCK                     
         
PAR VALUE $.00001      
     
Certificate
   Number 		  Shares
ASTHMATX, INC.
INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
40,000,000 AUTHORIZED SHARES $.00001 PAR VALUE
     
THIS CERTIFIES THAT   CUSIP 04623N 10 8
     
    SEE REVERSE FOR CERTAIN DEFINITIONS
is the owner of
FULLY-PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK OF
Asthmatx, 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
    COUNTERSIGNED AND REGISTERED:
 
    COMPUTERSHARE TRUST COMPANY, INC.
 
    (DENVER)
 
    TRANSFER AGENT AND REGISTRAR,
 
      
      Secretary
    By                                                                     
 
    AUTHORIZED SIGNATURE
SECURITY INSTRUCTIONS ON REVERSE

 

 

ASTHMATX, 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   UNIF TRF MIN ACT       Custodian (until age )                    
 
                       
 
      and not as tenants in common       (Cust)          (Minor)
                under Uniform Transfers 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 constitute 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 17Ad-15.