EX-4.1 FORM OF COMMON STOCK CERTIFICATE
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EX-4.1 3 g96252a2exv4w1.txt EX-4.1 FORM OF COMMON STOCK CERTIFICATE EXHIBIT 4.1 NUMBER CARIBOU COFFEE COMPANY, INC. SHARES INCORPORATED UNDER THE LAWS OF THE STATE OF MINNESOTA SEE REVERSE SIDE FOR CERTAIN DEFINITIONS CUSIP 142042 20 9 THIS CERTIFIES THAT is the owner of FULLY PAID AND NON-ASSESSABLE COMMON SHARES, $.01 PAR VALUE, OF CARIBOU COFFEE COMPANY, INC. transferable on the books of the Corporation by the holder hereof in person or by Attorney upon surrender of this certificate properly endorsed. This certificate is not valid unless countersigned by the Transfer Agent and Registrar. IN WITNESS WHEREOF, the said Corporation has caused this certificate to be signed by facsimile signatures of its duly authorized officers. Dated: /s/ Daniel E. Lee /s/ Michael J. Coles SECRETARY PRESIDENT AMERICAN FINANCIAL PRINTING INCORPORATED - MINNEAPOLIS COUNTERSIGNED AND REGISTERED WELLS FARGO BANK, N.A. TRANSFER AGENT AND REGISTRAR AUTHORIZED SIGNATURE 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 UTMA - CUSTODIAN ------ -------- (CUST) (MINOR) TEN ENT - AS TENANTS BY ENTIRETIES UNDER UNIFORM TRANSFER TO MINORS JT TEN - AS JOINT TENANTS WITH RIGHT OF SURVIVORSHIP AND ACT NOT AS TENANTS IN COMMON ------------------------- (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 POSTAL ZIP CODE OF ASSIGNEE - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- SHARES - -------------------------------------------------------------------------- OF THE CAPITAL 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 -------------------------------------------- -------------------------------------------- NOTE: 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 GUARANTEED ALL GUARANTEES MUST BE MADE BY A FINANCIAL INSTITUTION (SUCH AS A BANK OR BROKER) WHICH IS A PARTICIPANT IN THE SECURITIES TRANSFER AGENTS MEDALLION PROGRAM ("STAMP"), THE NEW YORK STOCK EXCHANGE, INC. MEDALLION SIGNATURE PROGRAM ("MSP"), OR THE STOCK EXCHANGES MEDALLION PROGRAM ("SEMP") AND MUST NOT BE DATED GUARANTEES BY A NOTARY PUBLIC ARE NOT ACCEPTABLE.
