Physicians Healthcare Management Group, Inc. Form of Convertible Preferred Stock Certificate
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Summary
This document is a sample certificate representing ownership of fully paid, non-assessable shares of convertible preferred stock in Physicians Healthcare Management Group, Inc. The certificate confirms the holder's rights as a shareholder and outlines that shares are transferable on the company's books upon proper endorsement and surrender of the certificate. The certificate is only valid when countersigned by the transfer agent and registered by the registrar. It includes the signatures of authorized corporate officers and details such as par value and CUSIP number.
EX-10.4 14 ex10_4.htm FORM OF CONVERTIBLE PREFERRED STOCK CERTIFICATE OF PHYSICIANS HEALTHCARE MANAGEMENT GROUP, INC. Unassociated Document
EXHIBIT 10.4
FORM OF CONVERTIBLE
PREFERRED STOCK OF
PHYSICIANS HEALTHCARE MANAGEMENT GROUP, INC.
1
[PhyHealth Logo]
| Certificate Number | Shares | |
| | ||
| PAR VALUE $0.001 PREFERRED STOCK | CUSIP No. 71943J 10 9 |
| THIS CERTIFIES THAT | SPECIMEN |
Is The Owner on
FULLY PAID AND NON-ACCESSIBLE SHARES OF THE PREFERRED STOCK PAR VALUE OF $0.001 EACH OF PHYSICIANS HEALTHCARE MANAGEMENT GROUP, INC. TRANSFERABLE ON THE BOOK OF COPRORATION IN PERSON OR BY DULY AUTHORIZED ATTORNEY UPON SURRENDER OF THIS CERTIFICATE PROPERY 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: | ||
| RICHARD E. GOULDING, MD | COUNTERSIGNED AND REGISTERED: | |
| Secretary | ISLAND STOCK TRANSFER | |
| Transfer Agent |
| ROBERT L. TRINKA | Authorized Signature | ||
| President | 100 Second Avenue South, Suite 300N, St. Petersburg, FL 33701 727 ###-###-#### | ||
[CORPORATE SEAL]
2
