INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE

EXHIBIT 4.12

 

 

NUMBER		SHARES
INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE   AUTHORIZED:  100,000,000 COMMON SHARES, $0.01 PAR VALUE PER SHARE

				CUSIP 83084T 30 9 SEE REVERSE FOR CERTAIN DEFINITIONS

 

THIS CERTIFIES that

 

SPECIMEN

 

is the owner of

 

Fully Paid and Non-Assessable Common Stock, $0.01 Par Value of

SKYLINE MEDICAL INC.

 

transferable on the books of the Corporation in person or by attorney upon surrender of this Certificate duly endorsed or assigned.  This Certificate and the shares represented hereby are subject to the laws of the State of Delaware, and to the Articles of Incorporation and the Bylaws of the Corporation, as now or hereafter amended.  This Certificate is not valid until countersigned by the Transfer Agent.

 

IN WITNESS WHEREOF, the Corporation has caused this Certificate to be signed by the facsimile signatures of its duly authorized officers and to be sealed with the facsimile seal of the Corporation.

 

Dated:

 

President	[SEAL]	Secretary

 

Countersigned:

CORPORATE STOCK TRANSFER, INC.

3200 Cherry Creek South Drive, Suite 430

Denver, CO  80209

 

BY
	Transfer Agent and Registrar Authorized Officer

 

 

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 entireties			(Cust)	(Minor)
JT TEN	-as joint tenants with right of survivorship and not as tenants in common			Under Uniform Gifts to Minors 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.