FORM OF STOCK CERTIFICATE

EX-4.1 4 y98951a2exv4w1.htm FORM OF STOCK CERTIFICATE exv4w1
 


 

NATIONAL ATLANTIC HOLDINGS CORPORATION

      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 OR SERIES THEREOF AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND/OR RIGHTS.

      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

TEN ENT

JT TEN
  — as tenants in common

— as tenants by the entireties

— as joint tenants with right
   of survivorship and not as
   tenants in common
  UNIF GIFT MIN ACT —   Custodian

(Cust)       (Minor)
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

      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.

PLEASE INSERT SOCIAL SECURITY OR OTHER  
IDENTIFYING NUMBER OF ASSIGNEE  
 

 


Please print or typewrite name and address including postal 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 Corporation with full power of substitution in the premises.

Dated,