Additional abbreviations may also be used though not in the above list.

EX-4.1 3 dex41.htm FORM OF CERTIFICATE Form of Certificate

Exhibit 4.1

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)

UNIF TRF MIN ACT -

......... Custodian (until age ......)

(Cust)

..............under Uniform Transfers

(Minor)

to Minors Act ..........................

(State)

Additional abbreviations may also be used though not in the above list.

For Value received, the undersigned hereby sell(s), assign(s) and transfer(s) unto

PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE

of the Common Shares represented by the within Certificate, and do hereby irrevocably constitute(s) and appoint(s)


		Attorney

to transfer the said Common Shares on the books of the Trust with full power of substitution in the premises.


Dated:
						Assignor


						Assignor


In presence of


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 WHATEVER.

Signature(s) Guaranteed:


By
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.