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EX-4.1 2 fs1a1ex4i_healthcarecorp.htm FORM OF STOCK CERTIFICATE fs1a1ex4i_healthcarecorp.htm
EXHIBIT 4.1
FORM OF STOCK CERTIFICATE
| Number | Shares | |
| HEALTHCARE CORPORATION OF AMERICA | ||
| INCORPORATED UNDER THE LAWS OF THE STATE OF NEW JERSEY | ||
| AUTHORIZED: 25,000,000 SHARES COMMON STOCK, | ||
| WITHOUT PAR VALUE | ||
| CUSIP | ||
| SEE REVERSE | ||
| FOR | ||
| This | CERTAIN | |
| certifies | DEFINITIONS | |
| that | ||
| is the owner of | ||
| FULLY PAID AND NON-ASSESSABLE | ||
| SHARES OF COMMON STOCK OF | ||
| HEALTHCARE CORPORATION OF AMERICA | ||
| transferable on the books of the corporation in person or by duly | ||
| authorized attorney upon surrender of this certificate properly | ||
| endorsed. This certificate and the shares represented hereby | ||
| are subject to the laws of the State of New Jersey, and to the | ||
| Articles of Incorporation and Bylaws of the Corporation, | ||
| as now or hereafter amended. This certificate is not valid | ||
| unless countersigned by the Transfer Agent. WITNESS | ||
| the facsimile seal of the Corporation and the signature | ||
| of its duly authorized officers | ||
| Gary L. Sekulski Joseph Drucker | ||
| President | [SEAL] | Secretary |
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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 the right of | Act ___________________________________________________ | |
| survivorship and not as tenants | (State) | ||
| in common | |||
Additional abbreviations may also be used though not in the above list.
For value received, ______________________________________ hereby sell, assign and transfer unto
___________________________________________________________________________________________
(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE OF ASSIGNEE)
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
_____________________________________________________________________________
shares of the capital 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 _______________________
X
_______________________________________________________________________________________________________________________
THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THIS CERTIFICATE IN EVERY PARTICULAR WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER. THE SIGNATURE(S) MUST BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (Banks, Stockbrokers, Savings and Loan Associations and Credit Unions)
SIGNATURE GUARANTEED:
A TRANSFER FEE WILL APPLY
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