Specimen Common Stock Certificate of TheraSense, Inc.
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Summary
This document is a specimen certificate representing shares of common stock in TheraSense, Inc., a Delaware corporation. It certifies that the named holder owns fully paid and non-assessable shares, which are transferable on the company's books upon proper endorsement and surrender of the certificate. The certificate outlines procedures for transfer, replacement if lost, and provides information on shareholder rights. It also includes standard legal language regarding ownership forms and transfer instructions.
EX-4.1 5 dex41.txt SPECIMEN COMMON STOCK CERTIFICATE EXHIBIT 4.1 NUMBER SHARES THER INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE [TheraSense LOGO] -------------------- SEE REVERSE FOR CERTAIN DEFINITIONS CUSIP 883381 10 5 THIS CERTIFIES THAT ----------------------------------------- IS THE RECORD HOLDER OF ----------------------------------------- FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $0.001 PAR VALUE PER SHARE, OF THERASENSE, INC. 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 until countersigned by the Transfer Agent and Registrar. WITNESS the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers. Dated: --------------- [SEAL] /s/ ROBERT D. BROWNELL /s/ W. MARK LORTZ - ------------------------ ----------------------- CORPORATE SECRETARY CHAIRMAN, PRESIDENT AND CHIEF EXECUTIVE OFFICER THERASENSE, INC. THE CORPORATION WILL FURNISH WITHOUT CHARGE TO EACH STOCKHOLDER WHO SO REQUESTS A STATEMENT OF THE DESIGNATIONS, RELATIVE RIGHTS, PREFERENCES AND LIMITATIONS APPLICABLE TO EACH CLASS OF STOCK OR SERIES THEREOF AS ESTABLISHED, FROM TIME TO TIME BY THE CERTIFICATE OF INCORPORATION OF THE CORPORATION, THE NUMBER OF SHARES CONSTITUTING EACH CLASS AND SERIES, AND THE DESIGNATIONS THEREOF AND A STATEMENT OF THE AUTHORITY OF THE CORPORATION'S BOARD OF DIRECTORS TO FIX AND DETERMINE THE RELATIVE RIGHTS AND PREFERENCES OF SUBSEQUENT SERIES. SUCH REQUEST MUST BE MADE TO THE CORPORATION'S SECRETARY AT THE PRINCIPAL EXECUTIVE OFFICE OF THE CORPORATION. Keep this certificate in a safe place. If it is lost, stolen or destroyed, the Corporation will require a bond of indemnity as a condition to the issuance of a replacement 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:
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 NUMBER OR OTHER IDENTIFYING NUMBER OF ASSIGNEE ________________________________________________________________________________ ________________________________________________________________________________ (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE(S) ________________________________________________________________________________
