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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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