Specimen certificate evidencing shares of common stock
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Business Finance
- Stock Agreements
EX-4.1 3 tm2030737d10_ex4-1.htm EXHIBIT 4.1
Exhibit 4.1
 | NUMBER ***** Vallon Pharmaceuticals, Inc. INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE $0.0001 PAR VALUE COMMON STOCK SHARES ***** CUSIP COMMON STOCK THIS CERTIFIES THAT* SPECIMEN * Is The Owner of ***** FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK OF Vallon Pharmaceuticals, Inc. Transferable on the books of the Corporation 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 registered by the Registrar. Dated:***** COUNTERSIGNED AND REGISTERED: VSTOCK TRANSFER, LLC Transfer Agent and Registrar By: AUTHORIZED SIGNATURE President and Chief Executive Officer |
 | TEN COM -as tenants in common UNIF GIFT MIN ACT.........................Custodia n....................... TEN ENT - as tena nts by the entireties (C ust)(M inor) JT TEN -as joint tenants with the right of Act....................................................... survi vorship and not as tenants (State) in common Additional abbreviations ma y also be used though not in t he above list. For value received, _ hereby sell, assign and transfer unto PLEASEINSERT SOCIAL SECURITY OR OTI-IER IDENTIFYING NUMBER OF ASSIGNEE: (PLEASE PRINT OR TYPEWRJTE NAME AND ADDRESS, INCLUDING ZI P CODE, OF ASSIGNEE) ------------------------------------------------------------shares of the capital stock represented by the within Certificate, and do hereby irrevocably constitute and appoint - ------------------------------------------------------------------· Attorney to transfer the said stock on the books of the within named Corporation with full power of substitution in the premises. Dated-------------------------X TI-lE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND \VITI-I TI·IE NAME AS WRITTEN UPON THE FACE OF TillS CERTIFICATE. THE SIGNATURE(S) MUST BE GUARANTEED BY AN ELIGIBLE GUAR ANTOR INSTITUTION (Banks,Stockbroke«.Savni gs and Loan Associations and Credit Unions). SIGNATURE GUARANTEED: TRANSFER FEE WILL APPLY |
