Form of Unit Certificate

EX-4.04 4 fs12018a8ex4-04_nexeonmed.htm FORM OF UNIT CERTIFICATE

Exhibit 4.04

 

FORM OF SPECIMEN UNIT CERTIFICATE 

 

NUMBER     
U-_____________   UNITS

 

SEE REVERSE FOR CERTAIN 

DEFINITIONS 

 

NEXEON MEDSYSTEMS INC

 

UNITS CONSISTING OF ONE SHARE OF COMMON STOCK AND 

TWO WARRANTS TO EACH PURCHASE ONE SHARE OF COMMON STOCK 

 

THIS CERTIFIES THAT     

 

is the owner of        Units. 

 

Each Unit (“Unit”) consists of one (1) share of common stock, par value $0.001 per share (“Common Stock”), of NEXEON MEDSYSTEMS INC, a Nevada corporation (the “Company”), and two warrants (each, a “Warrant”). Each whole Warrant entitles the holder to purchase one (1) share of Common Stock for $[●] per share (subject to adjustment).

 

Each Warrant will be exercisable at any time or times on or after the date of issuance and will expire unless exercised before 5:00 p.m. New York City time on the date which is five (5) years following the date of issuance. The Common Stock and Warrants comprising the Units represented by this certificate are immediately separable and will be issued separately. 

 

The terms of the Warrants are governed by a Warrant Agreement, dated as of [●], 2018, between the Company and Equity Stock Transfer, LLC, as Warrant Agent, and are subject to the terms and provisions contained therein, all of which terms and provisions the holder of this certificate consents to by acceptance hereof. Copies of the Warrant Agreement are on file at the office of the Warrant Agent at 237 W 37th Street, Suite 602, New York, NY 10018 and are available to any Warrant holder on written request and without cost. 

 

This certificate shall be governed by and construed under New York law. This certificate is not valid unless countersigned by the Transfer Agent and Registrar of the Company. 

  

 

 

 

Witness the facsimile seal of the Company and the facsimile signature of its duly authorized officers. 

 

NEXEON MEDSYSTEMS INC

 

COUNTERSIGNED AND REGISTERED: 
EQUITY STOCK TRANSFER, LLC
TRANSFER AGENT AND REGISTRAR 
BY: 
AUTHORIZED OFFICER 
 
By 
 
(SIGNATURE) 
CHIEF EXECUTIVE OFFICER 
 
(SEAL) 
 
(SIGNATURE) 
SECRETARY 

  

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[REVERSE OF CERTIFICATE]

 

NEXEON MEDSYSTEMS INC 

 

This certificate and the Units represented hereby are issued and shall be held subject to the terms and conditions applicable to the securities underlying and comprising the units, including, as applicable, the Company’s Articles of Incorporation, as amended, and all amendments thereto, the Warrant Agency Agreement and resolutions of the Company’s Board of Directors providing for the issue of securities (copies of which may be obtained from the secretary of the Company), to all of which the holder(s) of this certificate by acceptance hereof assents. 

 

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 

TEN ENT - as tenants by the entireties 

JT TEN - 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(s), assign(s) and transfer(s) unto 

 

PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE(S) 

 

 

(PLEASE PRINT OR TYPEWRITE NAME(S) AND ADDRESS(ES), INCLUDING ZIP CODE, OF ASSIGNEE(S)) 
 
 
 
 
Units represented by the within Certificate, and hereby irrevocably constitute(s) and appoint(s) 
 
 

  

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Attorney to transfer the said Units on the books of the within named Company with full power of substitution in the premises. 

 

Dated: 

 

NOTICE: THE SIGNATURE(S) 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. 

 

Signature(s) 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 SEC RULE 17Ad-15). 

 

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