Form of Common Stock Certificate

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EX-4.1 3 d117132dex41.htm EX-4.1 EX-4.1

Exhibit 4.1

 

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)

  TTEE   

–  trustee under Agreement dated                     

  

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 NUMBERS OF ASSIGNEE

   
 
      
 
PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS INCLUDING POSTAL ZIP CODE OF ASSIGNEE.
 
 
                                                                                                                                                                                                                                               Shares
of the common stock represented by this certificate and do hereby irrevocably constitutes 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                                         

 

 

     

  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 whatsoever.

SIGNATURE 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 S.E.C. RULE 17Ad-15.