Stock Certificate Assignment and Transfer Form
This document is an assignment and transfer form for stock certificates. It allows the current holder of shares to sell, assign, and transfer ownership to another party by providing the assignee's details and authorizing an attorney to record the transfer on the corporation's books. The form also includes legal notices about the securities not being registered under the Securities Act of 1933 and restrictions on transfer unless certain conditions are met. The corporation will provide information about stock rights and preferences to shareholders upon request.
Exhibit 4.1
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.
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 Act | ||
| (State) | ||||
| JT TEN | - as joint tenants with right of survivorship and not as tenants in common | |||
| 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 POSTAL ZIP CODE OF ASSIGNEE) | ||||||
| Shares | ||
represented by the within Certificate, and do hereby irrevocably constitute and appoint
| Attorney | ||
to transfer the said Shares on the books of the within named Corporation with full power of substitution in the premises.
Dated
In presence of
___________________________________
______________________________
THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE ‘ACT’), AND MAY NOT BE SOLD OR TRANSFERRED IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT UNDER THE ACT OR AN EXEMPTION FROM REGISTRATION THEREUNDER.
THE CORPORATION WILL FURNISH TO ANY STOCKHOLDER, UPON REQUEST AND WITHOUT CHARGE, A STATEMENT OF THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OR SERIES THEREOF AUTHORIZED TO BE ISSUED AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND/OR RIGHTS.
