FORM OF SPECIMEN CERTIFICATE EVIDENCING UNITS REPRESENTING LIMITED PARTNERSHIP INTERESTS IN
EXHIBIT 4.1
FORM OF SPECIMEN CERTIFICATE EVIDENCING UNITS
REPRESENTING LIMITED PARTNERSHIP INTERESTS IN
| NUMBER | UNITS | |
| THIS CERTIFICATE IS TRANSFERABLE IN | CUSIP 55907R 10 8 | |
| NEW YORK, N.Y. [AND RIDGEFIELD PARK, N.J.] | SEE REVERSE FOR | |
| CERTAIN DEFINITIONS | ||
MAGELLAN MIDSTREAM HOLDINGS, L.P.
A LIMITED PARTNERSHIP FORMED UNDER THE LAWS OF DELAWARE
In accordance with Section 4.1 of the Fourth Amended and Restated Limited Partnership Agreement, as amended, supplemented or restated from time to time (the “Partnership Agreement”), Magellan Midstream Holdings, L.P., a Delaware limited partnership (the “Partnership”),
hereby certifies that
(the “Holder”) is the registered owner of Units
representing limited partner interests in the Partnership (the “Units”) transferable on the books of the Partnership, in person or by duly authorized attorney, upon surrender of this Certificate properly endorsed. The rights, preferences and limitations of the Units are set forth in, and this Certificate and the Units represented hereby are issued and shall in all respects be subject to the terms and provisions of, the Partnership Agreement. Copies of the Partnership Agreement are on file at, and will be furnished without charge on delivery of written request to the Partnership at, the principal office of the Partnership located at One Williams Center, Tulsa, Oklahoma 74172. Capitalized terms used herein but not defined shall have the meanings given them in the Partnership Agreement.
The Holder, by accepting this Certificate, is deemed to have (i) requested admission as, and agreed to become, a Limited Partner and to have agreed to comply with and be bound by and to have executed the Partnership Agreement, (ii) represented and warranted that the Holder has all right, power and authority and, if an individual, the capacity necessary to enter into the Partnership Agreement, (iii) granted the powers of attorney provided for in the Partnership Agreement and (iv) made the waivers and given the consents and approvals contained in the Partnership Agreement.
This Certificate shall not be valid for any purpose unless it has been countersigned and registered by the Transfer Agent and Registrar.
| Dated: | Magellan Midstream Holdings, L.P. | |||
| By: | Magellan Midstream Holdings GP, LLC, | |||
| its General Partner | ||||
| By: |
| |||
| President | ||||
| By: |
| |||
| President | ||||
| Countersigned and Registered by: | ||
| UMB Bank, n.a., | ||
| as Transfer Agent and Registrar | ||
| By: |
| |
| Authorized Signature | ||
[Reverse of Certificate]
ABBREVIATIONS
The following abbreviations, when used in the inscription on the face of this Certificate, shall be construed as follows 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, though not in the above list, may also be used.
ASSIGNMENT OF UNITS
IN
MAGELLAN MIDSTREAM HOLDINGS, L.P.
FOR VALUE RECEIVED, hereby assigns, conveys, sells and transfers unto
| ______________________________________________________ | ___________________________________________________ | |
| (Please insert Social Security or other identifying number of Assignee) | (Please print or typewrite name and address of Assignee) |
Units representing limited partner interests evidenced by this Certificate, subject to the Partnership Agreement, and does hereby irrevocable constitute and appoint as its attorney-in-fact with full power of substitution to transfer the same on the books of Magellan Midstream Holdings, L.P.
| Date: | NOTE: The signature to any endorsement hereon must correspond with the name as written upon the face of this Certificate in every particular, without alteration, enlargement or change. |
| SIGNATURE(S) MUST BE GUARANTEED BY A MEMBER FIRM OF THE NATIONAL ASSOCIATION OF SECURITY DEALERS, INC. OR BY A COMMERCIAL BANK OR TRUST COMPANY | __________________________________________ (Signature) __________________________________________ (Signature) |
SIGNATURE(S) GUARANTEED
No transfer of the Units evidenced hereby will be registered on the books of the Partnership, unless the Certificate evidencing the Units to be transferred is surrendered for registration or transfer and the Assignee completes and executes the form set forth below.
ASSIGNEE CERTIFICATION
| Type of Entity (check one): | ||||
| [ ] Individual | [ ] Partnership | [ ] Corporation | ||
| [ ] Trust | [ ] Other (specify) | |||
| Nationality (check one): | ||||
| [ ] U.S. Citizen, Resident or Domestic Entity | ||||
| [ ] Foreign Corporation | [ ] Non-resident Alien | |||
If the U.S. Citizen, Resident or Domestic Entity box is checked, the following certification must be completed.
Under Section 1445(e) of the Internal Revenue Code of 1986, as amended (the “Code”), the Partnership must withhold tax with respect to certain transfers of property if a holder of an interest in the Partnership is a foreign person.
To inform the Partnership that no withholding is required with respect to the undersigned interestholder’s interest in it, the undersigned hereby certifies the following (or, if applicable, certifies the following on behalf of the interestholder).
Complete Either A or B:
| A. | Individual Interestholder |
| 1. | I am not a non-resident alien for purposes of U.S. income taxation. |
| 2. | My U.S. taxpayer identification number (Social Security Number) is . |
| 3. | My home address is . |
| 4. | My taxable year ends on December 31st. |
| B. | Partnership, Corporation or Other Interestholder |
| 1. | (name of Interestholder) is not a foreign corporation, foreign partnership, foreign trust or foreign estate (as those terms are defined in the Code and Treasury Regulations). |
| 2. | The interestholder’s U.S. employer identification number is . |
| 3. | The interestholder’s office address and place of incorporation (if applicable) is . |
| 4. | The interestholder’s taxable year ends on December 31st. |
The interestholder agrees to notify the Partnership within sixty (60) days of the date the interestholder becomes a foreign person.
The interestholder understands that this certificate may be disclosed to the Internal Revenue Service by the Partnership and that any false statement contained herein could be punishable by fine, imprisonment or both.
Under penalties of perjury, I declare that I have examined this certification and to the best of my knowledge and belief it is true, correct and complete and, if applicable, I further declare that I have authority to sign this document on behalf of
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| Name of Interestholder | ||||
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| Signature and Date | ||||
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| Title (if applicable) |
Note: If the Assignee is a broker, dealer, bank, trust company, clearing corporation, other nominee holder or an agent of any of the foregoing, and is holding for the account of any other person, this application should be completed by an officer thereof or, in the case of a broker or dealer, by a registered representative who is a member of a registered national securities exchange or a member of the National Association of Securities Dealers, Inc., or, in the case of any other nominee holder, a person performing a similar function. If the Assignee is a broker, dealer, bank, trust company, clearing corporation, other nominee owner or an agent of any of the foregoing, the above certification as to any person for whom the Assignee will hold the Units shall be made to the best of the Assignee’s knowledge.
