Series A Preferred Stock Certificate for Family Home Health Services Inc.

Summary

This document certifies ownership of Series A Preferred Stock in Family Home Health Services Inc., a Nevada corporation. It states that the shares are not registered under federal or state securities laws and can only be transferred under certain legal conditions, such as registration or exemption. The certificate is transferable on the corporation’s books by the holder or an authorized agent upon proper endorsement and surrender of the certificate. It is signed by the company’s president and secretary.

EX-4.1 2 k05737exv4w1.txt FORM OF SERIES A PREFERRED STOCK CERTIFICATE Exhibit 4.1 THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT"), OR ANY STATE SECURITIES LAWS AND NEITHER SUCH SHARES NOR ANY INTEREST THEREIN MAY BE OFFERED, SOLD, PLEDGED, ASSIGNED OR OTHERWISE TRANSFERRED UNLESS (1) A REGISTRATION STATEMENT WITH RESPECT THERETO IS EFFECTIVE UNDER THE SECURITIES ACT AND ANY APPLICABLE STATE SECURITIES LAWS, OR (2) IN ACCORDANCE WITH THE PROVISIONS OF REGULATION S, OR (3) PURSUANT TO AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT. INCORPORATED UNDER THE LAWS OF THE STATE OF NEVADA P-1 FAMILY HOME HEALTH SERVICES INC. SERIES A PREFERRED STOCK PAR VALUE $0.001 PER SHARE 100,000,000 Shares Authorized Common 10,000,000 Shares Authorized Preferred This is to Certify that _____________________ is the owner of --_________________ (____________________) -- fully paid and non-assessable Series A Preferred Shares of the above Corporation 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. Witness, the seal of the Corporation and the signature of its duly authorized officers. Dated ____________________ Kevin R. Ruark, President Vicki L. Welty, Secretary FOR VALUE RECEIVED, hereby sell, assign and transfer unto ________________________________________________________________________________ (______________________________) Shares of the Series A Preferred Shares represented by the within certificate, and do hereby irrevocably constitute and appoint to transfer the said stock on the books of the within named Corporation with full power of substitution in the premises. Dated ___________________________________ Signature Signature Guaranteed By: 2