provide additional consumer value and convenience

EX-4.1 5 g22358a5exv4w1.htm EX-4.1 exv4w1
Exhibit 4.1
CUSIP 74165N 10 5

 

PRIMO WATER CORPORATION
     The Corporation is authorized to issue more than one class of stock. A statement of the powers, designations, preferences, and the relative participating, optional, or other rights of each class and series of stock and the qualifications, limitations or restrictions thereon will be provided without charge to each stockholder upon request to the 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
TEN ENT
  —   as tenants by the entireties
JT TEN
  —   as joint tenants with right
of survivorship and not as
tenants in common
             
UNIF GIFT MIN ACT—
      Custodian    
 
           
 
  (Cust)       (Minor)
    under Uniform Gifts to Minors Act  
 
           
 
          (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, INCLUDING ZIP CODE, OF ASSIGNEE
 
 
 
Shares of the capital 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,
        
 
       
 
      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.
SIGNATURE(S) GUARANTEED:  
 
THE SIGNATURE(S) MUST 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.