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

EX-4.3 6 d693356dex43.htm EX-4.3 EX-4.3

Exhibit 4.3

COMMON STOCK
SIRVA®
COMMON STOCK
NUMBER
northAmerican.
MOVING SERVICES
ALLIED®
SHARES
CUSIP
INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
SEE REVERSE FOR CERTAIN DEFINITIONS
THIS CERTIFIES THAT
SPECIMEN
IS THE RECORD HOLDER OF
FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $0.00 PAR VALUE PER SHARE, OF
SIRVA
transferable on the books of the Corporation in person or by duly authorized attorney on surrender of this certificate properly endorsed. This certificate shall not be valid until countersigned by the Transfer Agent and registered by the Registrar. Witness the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers.
Dated:
CORPORATE SECRETARY
CHIEF EXECUTIVE OFFICER
COUNTERSIGNED AND REGISTERED:
AMERICAN STOCK TRANSFER & TRUST COMPANY, LLC
(Brooklyn, NY)
TRANSFER AGENT AND REGISTRAR
BY
AUTHORIZED SIGNATURE
AMERICAN BANK NOTE COMPANY.

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 sells, assigns and transfers unto

 

PLEASE INSERT SOCIAL SECURITY OR OTHER

IDENTIFYING NUMBER OF ASSIGNEE

 

 

 

 

 

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

 

 

 

 

                                                                                                                                                                                                                  shares represented by the within Certificate, and does hereby irrevocably constitute and appoint

                                                                                                                                                                                                        , attorney to transfer the said 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 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.