JACKSON HEWITT TAX SERVICE INC. INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE

EX-4.1 3 dex41.htm FORM OF COMMON STOCK CERTIFICATE Form of common stock certificate

Exhibit 4.1

 

 

NUMBER

    SHARES

[JTX]

     

 

 

JACKSON HEWITT TAX SERVICE INC.

INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE

 

 

THIS CERTIFICATE IS TRANSFERABLE IN

    CUSIP [            ]
NEW YORK, NEW YORK    SEE REVERSE FOR CERTAIN DEFINITIONS

 

 

[GRAPHIC]

 

 

This

Certifies

that

 

 

 

is the owner of

 

FULLY PAID AND NONASSESSABLE SHARES OF THE COMMON STOCK, PAR VALUE $0.01, OF

 

JACKSON HEWITT TAX SERVICE INC.

 

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 issued under and shall be subject to all the provisions of the Certificate of Incorporation of the Corporation and any amendments thereto, copies of which are on file with the Corporation and the Transfer Agent, to all of which the holder by acceptance hereof assents. 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:

 

CERTIFICATE OF STOCK

 

[CORPORATE SEAL]

SECRETARY

   CHAIRMAN OF THE BOARD, CHIEF EXECUTIVE OFFICER AND PRESIDENT

 

 

COUNTERSIGNED AND REGISTERED:

THE BANK OF NEW YORK, (New York)

 

 

    TRANSFER AGENT
    AND REGISTRAR

 

BY

 

AUTHORIZED SIGNATURE

 

 

The Corporation will furnish without charge to each stockholder who so requests a copy of the powers, designations, preferences and relative, participating, option or other special rights of each class of stock or series thereof, which the Corporation is authorized to issue, and the qualifications, limitations or restrictions of such preferences and/or rights. Any such request may be made in writing to the office of the secretary of 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 survivorship and not as tenants in common   

under Uniform Gifts 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 OR POSTAL 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 shares on the books of the within named Corporation with full power of substitution in the premises.

 

Dated

  

 

 

 

NOTICE: THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER.

 

 

Signature(s) Guaranteed:

 

 

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.