improving patient outcomes through greater control and stability in catheter-based procedures

EX-4.2 5 f22304a2exv4w2.htm EXHIBIT 4.2 exv4w2

Exhibit 4.2

HANSEN MEDICAL, INC.

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
TEN ENT	–	as tenants by the entireties
JT TEN	–	as joint tenants with right
		of survivorship and not as
		tenants in common


UNIF GIFT MIN ACT –		Custodian

	(Cust)		(Minor)
	under Uniform Gifts to Minors

	Act

		(State)


UNIF TRF MIN ACT –		Custodian (until age	)

	(Cust)


				under Uniform Transfers

		(Minor)


		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

of the Common Stock represented by the within Certificate, and do(es) 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	r


	r

	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.

SIGNATURES GUARANTEED:


By

		THE SIGNATURE(S) MUST 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 17 Ad-15.