Stock Certificate Assignment and Transfer Form for Shareholders

Summary

This document outlines the procedures for shareholders to request information about the company's stock classes and to transfer ownership of shares. Shareholders can obtain details about each class or series of stock upon request. If a stock certificate is lost, stolen, or destroyed, the company requires a bond of indemnity before issuing a replacement. The form also provides instructions for assigning shares to another party, including the need for a signature guarantee from an eligible financial institution.

EX-4.1 7 w35617a4exv4w1.htm EX-4.1 exv4w1

Exhibit 4.1

The Company will furnish without charge to each stockholder who so requests a statement of the number of shares constituting each class or series of stock and the designation thereof, and a copy of the powers, designations, preferences and relative, participating or optional or other special rights of each class of stock or series thereof and the qualifications, limitations or restrictions of such preferences and/or rights. KEEP THIS CERTIFICATE IN A SAFE PLACE. IF IT IS LOST, STOLEN OR DESTROYED THE CORPORATION WILL REQUIRE A BOND OF INDEMNITY AS A CONDITION TO THE ISSUANCE OF A REPLACEMENT CERTIFICATE. 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 (Cust)~ (Minor) . TEN ENT — as tenants by the entireties under Uniform Gifts to Minors JTTEN — as joint tenants with right of survivorship Act and not as tenants in common (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 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 Company with full power of substitution in the premises. Dated NOTICE- THE SIGNATURE TO THIS ASSIGNMENT MUST COARESPONDt NAME AS UPON THE FACE (THE CERTIFICATE IN EVERY PARTICUlAR, WITHOUT AlTERATION OR ENLARGEMENT OB y CHANGE WHATEVE Signature(s) Guaranteed:. THE SIGNATURE(S) SHOULD 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 SEC. RULE 17Ad-15.