EX-4.1 Common Stock Certificate

Contract Categories: Business Finance - Stock Agreements
EX-4.1 2 l09572gexv4w1.txt EX-4.1 COMMON STOCK CERTIFICATE Exhibit 4.1 COMMON STOCK COMMON STOCK NATIONAL INTERSTATE INCORPORATED UNDER THE LAWS OF CUSIP 63654U 10 0 THE STATE OF OHIO SEE REVERSE FOR CERTAIN DEFINITIONS NATIONAL INTERSTATE CORPORATION THIS CERTIFIES THAT is the record holder of FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $.01 PAR VALUE PER SHARE, OF NATIONAL INTERSTATE CORPORATION transferable on the books of the Corporation in person or by duly authorized attorney upon surrender of the Certificate properly endorsed. 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: /s/ Michael A Schroeder [SEAL] /s/ Alan R. Spachman SECRETARY PRESIDENT AND CHAIRMAN OF THE BOARD COUNTERSIGNED AND REGISTERED NATIONAL CITY BANK CLEVELAND, OHIO TRANSFER AGENT AND REGISTRAR BY AUTHORIZED SIGNATURE NATIONAL INTERSTATE CORPORATION The following abbreviations, when used in the inscription on the face of this certificate, shall be considered 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 under Uniform Gifts, to Minors tenants in common ACT ____________________________________________________ (State) UNIF TRF MIN ACT - _________________________ Custodian (until age _____) (Cust) _______________________________ under Uniform Transfers (Minor) 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 ASSIGNEES - --------------------------------------- - --------------------------------------- ________________________________________________________________________________________________________________________________ (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE ________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ Shares of the Common Stock represented by the within Certificate, and do(es) 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 _____________________________________________ X __________________________________________ X __________________________________________ NOTICE: THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME(S) AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER. SIGNATURE GUARANTEED: By _________________________________________________________________________________________________________________ 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.