Form of Stock Certificate for Common Stock

Contract Categories: Business Finance - Stock Agreements
EX-4.1 5 tm2110925d10_ex4-1.htm EXHIBIT 4.1

Exhibit 4.1

 

AMERICAN STOCK TRANSFER & TRUST COMPANY, LLC

[Reverse Side of Stock Certificate] The Corporation will furnish to any stockholder, upon request and without charge, a full statement of the designations, relative rights, preferences and limitations of the shares of each class and series authorized to be issued, so far as the same have been determined, and of the authority, if any, of the Board to divide the shares into classes or series and to determine and change the relative rights, preferences and limitations of any class or series. Such request may be made to the Secretary of the Corporation or to the Transfer Agent named on this certificate. 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 ______ (Cust) (Minor) TEN ENT - as tenant by the entireties 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 TYPE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE) _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ ________________________________________________________________________ Shares of the Common Stock represented by the within Certificate, and do hereby irrevocably constitute and appoint _____________________________________________________________________________________ Attorney, to transfer the said stock registered on the books of the within-named Corporation with full power of substitution in the premises. Dated ____________________ ___________________________________________ SIGNATURE(S) GUARANTEED: ___________________________________________ 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. _______________________________________________ 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 RULE 17Ad-15 UNDER THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED.