Ex-4.1: Specimen Stock Certificate

Contract Categories: Business Finance - Stock Agreements
EX-4.1 3 g00385a1exv4w1.htm EX-4.1: SPECIMEN STOCK CERTIFICATE exv4w1
 

Exhibit 4.1
HOME DIAGNOSTICS, INC. INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
THIS CERTIFICATE IS TRANSFERABLE INSEE REVERSE FOR CERTAIN DEFINITIONS NEW YORK, NY
This Certifies that
is the record holder of
FULLY PAID AND NONASSESSABLE SHARES OF COMMON STOCK, $0.01 PAR VALUE PER SHARE, OF
transferable on the books of the Corporation by the holder hereof in person or by duly authorized Attorney upon surrender of this certificate properly endorsed. This certificate is not valid until countersigned by the Transfer Agent and registered by the Registrar. WITNESS the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers. Dated
CHIEF FINANCIAL OFFICER
PRESIDENT AND CHIEF EXECUTIVE OFFICER

 

 

HOME DIAGNOSTICS, INC.
     The Corporation will furnish without charge to each stockholder who so requests, the powers, designations, preferences and relative, participating, optional or other special rights of each class of stock of the Corporation or series thereof and the qualifications, limitations, or restrictions of such preferences and/or rights. Such requests may be made to the Corporation or the Transfer Agent.
     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 right of               under Uniform Gifts to Minors    
 
      survivorship and not as tenants in common               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 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
    
 
       
 
 
X
    
 
       
 
  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.
Signature(s) 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 17Ad-15.  
KEEP THIS CERTIFICATE IN A SAFE PLACE. IF IT IS LOST, STOLEN, MUTILATED OR DESTROYED, THE CORPORATION WILL REQUIRE A BOND OF INDEMNITY AS A CONDITION TO THE ISSUANCE OF A REPLACEMENT CERTIFICATE.