Form of Common Stock Certificate of the Registrant
Exhibit 4.1
Exhibit 4.1 CHIEF EXECUTIVE OFFICER CHIEF FINANCIAL OFFICER AUTHORIZED SIGNATURE TRANSFER AGENT AND REGISTRAR (Brooklyn, NY) AMERICAN STOCK TRANSFER & TRUST COMPANY, LLC BY COUNTERSIGNED AND REGISTERED: transferable on the books of the Corporation in person or by duly authorized attorney upon surrender of this Certificate properly endorsed. This certificate is not valid unless countersigned by the Transfer Agent and registered by the Registrar. WITNESS the facsimile signatures of the Corporation’s duly authorized officers. Dated: EQUILLIUM, INC. FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $0.0001 PAR VALUE PER SHARE, OF SEE REVERSE FOR CERTAIN DEFINITIONS is the record holder of THIS CERTIFIES THAT INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE EQ EQUILLIUM, INC. SHARES COMMON STOCK CUSIP 29446K 10 6
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. By: SIGNATURE(S) GUARANTEED: THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY NOTICE: PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER. By: Dated to transfer the said stock on the books of the within named Corporation with full power of substitution in the premises. Attorney of the Common Stock represented by this Certificate, and does hereby irrevocably constitute and appoint shares (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE) PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE For Value Received, undersigned hereby sells, assigns and transfers unto Additional abbreviations may also be used though not in the above list. UNIF GIFT MIN ACT–....................Custodian.................... (Cust) (Minor) under Uniform Gifts to Minors Act......................... (State) TEN COM TEN ENT JT TEN as tenants in common as tenants by the entireties as joint tenants with right of survivorship and not as tenants in common ––– 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:
