Stock Certificate Assignment and Transfer Form
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Summary
This document is a standard form used to transfer ownership of common stock from one party to another. The current stockholder authorizes the sale, assignment, and transfer of shares to a new owner, whose details must be provided. The form requires the signature of the current holder, which must match the name on the certificate and be guaranteed by an eligible financial institution. This process ensures the legal and accurate transfer of stock ownership on the corporation's records.
EX-4.1 4 l37365aexv4w1.htm EX-4.1 EX-4.1
Exhibit 4.1

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 | ||
TEN ENT | - | as tenants by the entireties | ||
JT TEN | - | as joint tenants with right | ||
of survivorship and not as | ||||
tenants in common |
UNIF GIFT MIN ACT- | .................... | Custodian | .................... | |||||||
(Cust) | (Minor) | |||||||||
under Uniform Gifts 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 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,
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: | ||||
THE SIGNATURE(S) MUST 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. |