ELECTROMED, INC. Creating superior care through innovation® INCORPORATED UNDER THE LAWS OF THE STATE OF MINNESOTA THIS CERTIFICATE IS TRANSFERABLE IN SOUTH SAINT PAUL, MN. SEE REVERSE SIDE FOR CERTAIN DEFINITIONS CUSIP 285409 10 8 THIS CERTIFIES THAT is the owner of FULLY PAID AND NON-ASSESSABLE COMMON SHARES, $0.01 PAR VALUE, OF ELECTROMED, INC.
Exhibit 4.1
ELECTROMED, INC.
Creating superior care through innovation®
INCORPORATED UNDER THE LAWS OF THE STATE OF MINNESOTA
THIS CERTIFICATE IS TRANSFERABLE
IN SOUTH SAINT PAUL, MN.
SEE REVERSE SIDE
FOR CERTAIN DEFINITIONS
CUSIP 285409 10 8
THIS CERTIFIES THAT
is the owner of
FULLY PAID AND NON-ASSESSABLE COMMON SHARES, $0.01 PAR VALUE, OF
ELECTROMED, 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 until countersigned and registered 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 officer.
Dated:
CHIEF EXECUTIVE OFFICER
AMERICAN FINANCIAL PRINTING INCORPORATED - MINNEAPOLIS
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| 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: |
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| TEN COM | – | as tenants in common | UTMA | – |
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| TEN ENT | – | as tenants by entireties |
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| under Uniform Transfers to Minors | |||
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| JT TEN | – | as joint tenants with right of survivorship |
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| and not as tenants in common |
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| Additional abbreviations may also be used though not in above list. | ||||||||
For value received _____ hereby sell, assign, and transfer unto
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| PLEASE INSERT SOCIAL SECURITY OR OTHER |
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| (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS INCLUDING ZIP CODE OF ASSIGNEE) | |
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_____________________________________________________________________________ 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.
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| Dated |
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| 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. |
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| SIGNATURE GUARANTEED |
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| 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. |
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