Emphasys Medical, Inc. Form of Common Stock Certificate

Summary

This document is a template for a common stock certificate issued by Emphasys Medical, Inc., a Delaware corporation. It certifies ownership of fully paid and non-assessable shares of the company's common stock, which are transferable on the company's books upon proper endorsement and surrender of the certificate. The certificate must be countersigned by the transfer agent and registrar to be valid. It also outlines procedures for transferring shares and provides information on shareholder rights upon request.

EX-4.1 2 dex41.htm FORM OF COMMON STOCK CERTIFICATE Form of Common Stock Certificate


		Exhibit 4.1

COMMON STOCK		COMMON STOCK
NUMBER		SHARES
	[EMPHASYS MEDICAL, INC. LOGO]
		CUSIP 29158P 400
	INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE	SEE REVERSE FOR
		CERTAIN DEFINITIONS

This Certifies that

is the owner of

FULLY PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK, $0.001 PAR VALUE, OF

	EMPHASYS MEDICAL, INC.

transferable only 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


[EMPHASYS MEDICAL, INC. Corporate Seal]

/s/ EDWARD Y. KIM		/s/ JOHN G. McCUTCHEON
ASSISTANT SECRETARY		PRESIDENT AND CHIEF EXECUTIVE OFFICER

		COUNTERSIGNED AND REGISTERED:
		AMERICAN STOCK TRANSFER AND TRUST COMPANY

		TRANSFER AGENT AND REGISTRAR

		BY
		AUTHORIZED SIGNATURE

EMPHASYS MEDICAL, INC.

The Corporation will furnish without charge to each stockholder who so requests a copy of the powers, designations, preferences and relative, participating, optional or other special rights to each class of stock or series thereof, and the qualifications, limitations, or restrictions of such preferences and/or rights.

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

TEN ENT —

as tenants by the entireties

(Cust) (Minor)

JT TEN —

as joint tenants with right

of survivorship and not as tenants

in common

under Uniform Trans 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 ZIP CODE, OF ASSIGNEE)
______________________________________________________________________________________________________________________

________________________________________________________________________________________________________________ Shares
represented by the within Certificate, and do hereby irrevocably constitute and appoint

______________________________________________________________________________________________________________ Attorney
to transfer the said shares on the books to the within named Corporation with full power of substitution in the premises.

Dated:

		X

		X
NOTICE:		THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME(S) AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER.

THE SIGNATURES(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.

SIGNATURE(S) GUARANTEED BY:

_____________________________________________________________________________