Form of Common Stock Certificate

EX-4.1 3 k90119a3exv4w1.txt FORM OF COMMON STOCK CERTIFICATE Exhibit 4.1 COMMON STOCK COMMON STOCK NUMBER SHARES NEED PREFIX [NORTH POINTE HOLDINGS CORPORATION LOGO] CUSIP 661696 10 4 SEE REVERSE FOR CERTAIN DEFINITIONS INCORPORATED UNDER THE LAWS OF THE STATEMENT OF MICHIGAN THIS CERTIFIES THAT IS THE RECORD HOLDER OF FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, NO PAR VALUE PER SHARE, OF NORTH POINTE HOLDINGS CORPORATION transferable on the books of the Corporation in person or by duly authorized attorney upon surrender of this 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: [NORTH POINTE HOLDINGS /S/ B. Matthew Petcoff CORPORATION CORPORATE /S/ James G. Petcoff SECRETARY SEAL 2001 MICHIGAN] PRESIDENT COUNTERSIGNED AND REGISTERED: SUNTRUST BANK TRANSFER AGENT AND REGISTRAR BY: AUTHORIZED SIGNATURE NORTH POINTE HOLDINGS CORPORATION The Corporation is authorized to issue both common stock and preferred stock. The Corporation will furnish to a shareholder upon request and without charge a full statement of the designation, relative rights, preferences, and limitations of the shares of each class authorized to be issued, and the designation, relative rights, preferences, and limitations of each series so far as the same have been prescribed and the authority of the Board of Directors to designate and prescribe the relative rights, preferences, and limitations of other series. 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) 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 ASSIGNEE - -------------------------------------- - -------------------------------------------------------------------------------- (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. SIGNATURES 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.