EX-4.1 3 l04355bexv4w1.txt EX-4.1 Exhibit 4.1 COMMON SHARES COMMON SHARES [LOGO] PROCENTURY CORPORATION INCORPORATED UNDER THE LAWS OF THE STATE OF OHIO SEE REVERSE FOR CERTAIN DEFINITIONS CUSIP 74268T 10 8 THIS CERTIFIES THAT IS THE OWNER OF FULLY-PAID AND NON-ASSESSABLE COMMON SHARES, WITHOUT PAR VALUE, OF PROCENTURY CORPORATION transferable only 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 and registered by the Transfer Agent and Registrar. Witness the facsimile seal of the corporation and the facsimile signatures of its duly authorized officers. DATED: [corporate seal]
/s/ John A. Marazza /s/ Edward F. Feighan CHIEF OPERATING OFFICER AND SECRETARY CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER COUNTERSIGNED AND REGISTERED NATIONAL CITY BANK (CLEVELAND, OHIO) TRANSFER AGENT AND REGISTRAR BY AUTHORIZED OFFICER
PROCENTURY CORPORATION The corporation will furnish without charge to each shareholder who so requests a copy of the powers, designations, preferences and relative, participating, optional or other special rights of each class of shares or series thereof, which the corporation is authorized to issue, and the qualifications, limitations or restrictions of such preferences and/or rights. 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 under Uniform Gifts to Minors Act of survivorship and not as Act _______________________________ tenants in common (State) UNIF TRANS MIN ACT -- ____________Custodian____________ (Cust) (Minor) under Uniform Transfers to Minors Act_____________________________ (State)
Additional abbreviations may also be used though not in the above list. For Value Received, ___________________________ hereby sell(s), assign(s) and transfer(s) unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE ________________________________________________________________________________ ________________________________________________________________________________ (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS INCLUDING POSTAL ZIP CODE OF ASSIGNEE) ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Common Shares represented by the within certificate and do hereby irrevocably constitute and appoint ________________________________________________________________________________ Attorney, to transfer the said Common Shares 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(S) AS WRITTEN UPON THE FACE OF THIS CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER. Signature(s) Guaranteed: By _____________________________________________________________ THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUITON (BANK, STOCKBROKER, SAVINGS AND LOAN ASSOCIATION OR CREDIT UNION) WITH MEMBERSHIP IN AN APPROVED SIGNATURE MEDALLION PROGRAM, PURSUANT TO S.E.C. RULE 17Ad-15.
