EX-4.1 SPECIMEN STOCK CERTIFICATE
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EX-4.1 4 b49029a5exv4w1.txt EX-4.1 SPECIMEN STOCK CERTIFICATE Exhibit 4.1 NUMBER SHARES PF COMMON STOCK COMMON STOCK PHASE FORWARD INCORPORATED INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE SEE REVERSE FOR CERTAIN DEFINITIONS CUSIP 71721R 40 6 THIS CERTIFIES THAT SPECIMEN is the Owner of FULLY PAID AND NONASSESSABLE SHARES OF THE COMMON STOCK, $.01 PAR VALUE, OF PHASE FORWARD INCORPORATED transferable on the books of the Corporation by the holder hereof in person or by duly authorized attorney upon surrender of this Certificate properly endorsed. This Certificate is not valid unless 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: Phase Forward Incorporated CORPORATE SEAL 1997 DELAWARE TREASURER PRESIDENT 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_______ TEN ENT - as tenants by the (Cust) (Minor) entireties under Uniform Gifts to Minors JT TEN - as joint tenants with right of survivorship Act________________________________ and not as tenants in (State) common Additional abbreviations may also be used though not in the above list. For Value Received, ___________________ hereby sells, assigns and transfers unto PLEASE PRINT OR TYPEWRITE IDENTIFYING NUMBER AND NAME OF ASSIGNEE AS IT SHOULD APPEAR ON CERTIFICATE AND SHOW ADDRESS ____________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ _________________________________________________________________________ Shares of the Common Stock 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: __________________________________________ X___________________________________________________________ X___________________________________________________________ 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. Signatures of registered owners on this certificate or on powers of attorney, and signatures of attorneys on this certificate or on powers of substitution, must be guaranteed. Signature Guaranteed:_________________________________ SIGNATURE MUST BE GUARANTEED BY A COMMERCIAL BANK OR FIRM WHICH IS A MEMBER OF A REGISTERED NATIONAL STOCK EXCHANGE.
