RoomStore, Inc. Common Stock Certificate and Assignment Form

Contract Categories: Business Finance › Stock Agreements
Summary

This document is a stock certificate issued by RoomStore, Inc. representing ownership of shares in the company. It outlines the rights of the shareholder under the company's Amended and Restated Articles of Incorporation and provides instructions for transferring ownership of the shares to another party. The certificate requires proper identification and signature guarantees for any transfer, and notes that a bond of indemnity is needed if the certificate is lost or destroyed.

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EX-4.1 5 dex41.htm EXHIBIT 4.1 Exhibit 4.1

Exhibit 4.1

 

ROOMSTORE, INC.

The shares represented by this certificate are subject to the provisions of the Amended and Restated Articles of Incorporation of RoomStore, Inc.

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.

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 POSTAL ZIP CODE OF ASSIGNEE.

 

           
           
      Shares

of the common stock represented by this certificate, and do hereby appoint

 

 

     
 
 

as Attorney to transfer the said shares on the books of the Company, with full power of substitution in the premises.

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 WHATEVER.

 

Signature(s) Guaranteed
By    
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, MUTILATED OR DESTROYED, THE CORPORATION WILL REQUIRE A BOND OF INDEMNITY AS A CONDITION TO THE ISSUANCE OF A REPLACEMENT CERTIFICATE.