PlanVista Corporation Common Stock Certificate

Contract Categories: Business Finance › Stock Agreements
Summary

This document certifies that the named holder owns fully paid and non-assessable shares of common stock in PlanVista Corporation, a Delaware company. The certificate allows the holder to transfer ownership by proper endorsement and surrender of the certificate, subject to registration by the transfer agent, Wachovia Bank. The certificate is only valid with authorized signatures and may require a bond if lost or destroyed. It also includes instructions for assignment and transfer, as well as standard legal abbreviations for ownership types.

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EX-4.11 5 dex411.txt CERTIFICATE OF STOCK
[CERTIFICATE OF STOCK APPEARS HERE WITH THE FOLLOWING INFORMATION:] COMMON STOCK COMMON STOCK NUMBER SHARES INCORPORATED UNDER THE LAWS CUSIP OF THE STATE OF DELAWARE SEE REVERSE FOR CERTAIN DEFINITIONS THIS CERTIFICATE TRANSFERABLE IN CHARLOTTE, NORTH CAROLINA OR NEW YORK, NEW YORK This Certifies that CERTIFICATE OF STOCK FULLY PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK, PAR VALUE $.01 PER SHARE, OF PlanVista Corporation 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. In Witness whereof, the facsimile sealed of the corporation and the facsimile signatures of its duly authorized officers. Dated: /s/ Phillip S. Dingle /s/ Phillip S. Dingle /s/ Jeffrey L. Markle SECRETARY CHAIRMAN [SEAL] PRESIDENT COUNTERSIGNED AND REGISTERED: WACHOVIA BANK, NATIONAL ASSOCIATION (Charlotte, North Carolina) TRANSFER AGENT AND REGISTRAR BY: AUTHORIZED SIGNATURE
PLANVISTA CORPORATION - -------------------------------------------------------------------------------- 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 TRANS MIN ACT- Custodian --------------------- ----------------------- TEN ENT- as tenants by the entireties (Cust) (Minor) JT TEN- as joint tenants with under Uniform Transfers to Minors right of survivorship and Act not as tenants in common -------------------------------------------------- (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 OF ASSIGNEE - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- Shares - ------------------------------------------------------------------------ of the 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. 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 WHATSOEVER. SIGNATURE(S) GUARANTEED: -------------------------------- 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. KEEP THIS CERTIFICATE IN A SAFE PLACE, IF IT IS LOST, STOLEN, OR DESTROYED, THE CORPORATION MAY REQUIRE A BOND OF INDEMNITY AS A CONDITION TO THE ISSUANCE OF A REPLACEMENT CERTIFICATE.