COLLAGENEX PHARMACEUTICALS, INC. INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE

EX-4.1 2 a06-6394_1ex4d1.htm INSTRUMENTS DEFINING THE RIGHTS OF SECURITY HOLDERS, INCLUDING INDENTURES

Exhibit 4.1

 

 

 

COLLAGENEX PHARMACEUTICALS, INC.

INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE

COMMON STOCK

PAR VALUE $.01 PER SHARE

 

CUSIP 19419B 10 0

SEE REVERSE FOR CERTAIN DEFINITIONS

 

THIS CERTIFIES that

 

is the owner of

 

FULLY PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK, $.01 PAR VALUE, OF COLLAGENEX PHARMACEUTICALS, INC., (the “Corporation”) transferable on the books of the Corporation 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.

 

WITNESS the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers.

 

Dated:

 

 

Treasurer

 

[SEAL]

 

President and Chief Executive Officer

 

 

Countersigned and Registered:

 

AMERICAN STOCK TRANSFER & TRUST COMPANY

 

(New York)

 

 

 

Transfer Agent
and Registrar

 

 

 

By

 

 

 

 

Authorized Signature

 

 


 

COLLAGENEX PHARMACEUTICALS, INC.

 

THE CORPORATION WILL FURNISH WITHOUT CHARGE TO EACH STOCKHOLDER WHO SO REQUESTS THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OR SERIES THEREOF AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND/OR RIGHTS ANY SUCH REQUEST SHOULD BE ADDRESSED TO THE SECRETARY OF THE CORPORATION AT ITS PRINCIPAL PLACE OF BUSINESS.

 

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

 

UNIT GIFT MIN ACT-                           Custodian                         

 

 

 

(Cust)

(Minor)

 

 

 

 

 

 

 

TEN ENT  – as tenants by the entireties

 

 

under Uniform Gifts to Minors Act

 

 

 

 

JT TEN     – as joint tenants with right

 

 

 

 

   of survivorship and not as

 

 

(State)

 

   tenants in common

 

 

 

 

 

 

 

Additional abbreviation 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 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:

 

 

 

 

 

 

 

 

Signature

 

 

 

 

 

 

 

 

 

 

 

NOTICE:  The signature to this assignment must correspond with the same as written upon the face of the Certificate, in every particular, without alteration or enlargement, or any change whatever.

 

 

 

 

 

 

 

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.