Signature(s)Guaranteed: Medallion Guarantee Stamp
Exhibit 4.1
By
AUTHORIZED SIGNATURE
THIS CERTIFIES THAT
is the owner of
CUSIP
DATED
COUNTERSIGNED AND REGISTERED:
COMPUTERSHARE TRUST COMPANY, N.A.
TRANSFER AGENT AND REGISTRAR,
FULLY-PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK OF
Express, Inc. (hereinafter called the “Company”), transferable on the books of the Company in person or by
duly authorized attorney, upon surrender of this Certificate properly endorsed. This Certificate and the shares
represented hereby, are issued and shall be held subject to all of the provisions of the Articles of Incorporation,
as amended, and the By-Laws, as amended, of the Company (copies of which are on file with the Company and
with the Transfer Agent), to all of which each holder, by acceptance hereof, assents. This Certificate is not valid
unless countersigned and registered by the Transfer Agent and Registrar.
Witness the facsimile seal of the Company and the facsimile signatures of its duly authorized officers.
COMMON STOCK
PAR VALUE $0.01
COMMON STOCK
THIS CERTIFICATE IS TRANSFERABLE IN
CANTON, MA AND NEW YORK, NY
SEE REVERSE FOR CERTAIN DEFINITIONS
Certificate
Number
Shares
EXPRESS, INC.
INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
President and Chief Executive Officer
Executive Vice President, Chief Administrative Officer,
Chief Financial Officer, Secretary and Treasurer
016570| 003590|127C|RESTRICTED||4|057-423
30219E 10 3
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* * 600620* * * * * *
* * * 600620* * * * *
* * * * 600620* * * *
* * * * * 600620* * *
* * * * * * 600620* *
** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
**** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David
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David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr.
Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample ****
Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
**** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David
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Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Sample **** Mr. Sample
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0620**Shares****600620**Shares****600620**Shares****600620**Shares****600620**Shares****600620**Shares****600620**Shares****600620**Shares****600
620**Shares****600620**Shares****600620**Shares****600620**Shares****600620**Shares****600620**Shares***600620**Shares****600620**Shares****60062
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* * * SIX HUNDRED THOUSAND
SIX HUNDRED AND TWENTY* * *
MR. SAMPLE & MRS. SAMPLE &
MR. SAMPLE & MRS. SAMPLE
NNNNN
ZQ 000000
Certificate Numbers
1234567890 ###-###-####
1234567890 ###-###-####
1234567890 ###-###-####
1234567890 ###-###-####
1234567890 ###-###-####
1234567890 ###-###-####
Total Transaction
Num/No.
123456
Denom.
123456
Total
1234567
MR A SAMPLE
DESIGNATION (IF ANY)
ADD 1
ADD 2
ADD 3
ADD 4
PO BOX 43004, Providence, RI ###-###-####
CUSIP XXXXXX XX X
Holder ID XXXXXXXXXX
Insurance Value 1,000,000.00
Number of Shares 123456
DTC 12345678 123456789012345
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
EXPRESS, INC.
THE COMPANY WILL FURNISH WITHOUT CHARGE TO EACH SHAREHOLDER WHO SO REQUESTS, A SUMMARY OF THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OF THE COMPANY AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND RIGHTS, AND THE VARIATIONS IN RIGHTS, PREFERENCES AND LIMITATIONS DETERMINED FOR EACH SERIES, WHICH ARE FIXED BY THE ARTICLES OF INCORPORATION OF THE COMPANY, AS AMENDED, AND THE RESOLUTIONS OF THE BOARD OF DIRECTORS OF THE COMPANY, AND THE AUTHORITY OF THE BOARD OF DIRECTORS TO DETERMINE VARIATIONS FOR FUTURE SERIES. SUCH REQUEST MAY BE MADE TO THE OFFICE OF THE SECRETARY OF THE COMPANY OR TO THE TRANSFER AGENT. THE BOARD OF DIRECTORS MAY REQUIRE THE OWNER OF A LOST OR DESTROYED STOCK CERTIFICATE, OR HIS LEGAL REPRESENTATIVES, TO GIVE THE COMPANY A BOND TO INDEMNIFY IT AND ITS TRANSFER AGENTS AND REGISTRARS AGAINST ANY CLAIM THAT MAY BE MADE AGAINST THEM ON ACCOUNT OF THE ALLEGED LOSS OR DESTRUCTION OF ANY SUCH CERTIFICATE.
|
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 ...............................................…… | |||
| (Cust) (Minor) | ||||||
| TEN ENT | - as tenants by the entireties | under Uniform Gifts to Minors Act ................................................ | ||||
| (State) | ||||||
| JT TEN | - as joint tenants with right of survivorship | UNIF TRF MIN ACT | -……..............……… Custodian (until age.................................... ) | |||
| (Cust) | ||||||
| ........................under Uniform Transfers to Minors Act ................... | ||||||
| (Minor) (State) | ||||||
| Additional abbreviations may also be used though not in the above list.
| ||||||
| PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE | ||
|
For value received, hereby sell, assign and transfer unto
|
(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: 20 | Signature(s) Guaranteed: Medallion Guarantee Stamp 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. | |
|
Signature: | ||
|
Signature: | ||
|
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. | ||
