PAR PETROLEUM CORPORATION CORPORATE STOCK TRANSFER, INC. TRANSFER FEE: AS REQUIRED

EX-4.1 5 d408010dex41.htm FORM OF THE COMPANY'S COMMON STOCK CERTIFICATE Form of the Company's Common Stock Certificate

Exhibit 4.1

 

PAR PETROLEUM CORPORATION

CORPORATE STOCK TRANSFER, INC.

TRANSFER FEE: AS REQUIRED

THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE RIGHTS, PRIVILEGES, RESTRICTIONS AND CONDITIONS ATTACHED THERETO PURSUANT TO THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OF THE CORPORATION, DATED AUGUST 31, 2012, AND THE STOCKHOLDERS’ AGREEMENT, DATED AUGUST 31, 2012. THE CORPORATION WILL FURNISH TO A SHAREHOLDER, ON DEMAND AND WITHOUT CHARGE, A FULL COPY OF THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION AND/OR A FULL COPY OF THE STOCKHOLDERS’ AGREEMENT.

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   UNIF GIFT MIN ACT -  

Custodian

JT TEN

   -   as joint tenants with right       (Cust)                                 (Minor)
    of survivorship and not as       under Uniform Gifts to Minors
    tenants in common      
        Act  

 

          (State)

Additional abbreviations may also be used though not in the above list.

 

 

 

PLEASE INSERT SOCIAL SECURITY OR OTHER

IDENTIFYING NUMBER OF ASSIGNEE

 

  
   
   
   

 

FOR VALUE RECEIVED,

  

 

   hereby sell, assign and transfer unto

 

 

 

PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS INCLUDING POSTAL ZIP CODE OF ASSIGNEE

 

 

 

 

 

 

 

 

 

 

 

   Shares

of the Common 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:                    20     ,

 

  Signature: X  

 

Signature(s) Guaranteed:    
  Signature: X  

 

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. THE SIGNATURE(S) SHOULD 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.