Common Stock Certificate Form for VelocityHSI, Inc.

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Summary

This document is a form of common stock certificate for VelocityHSI, Inc., a Delaware corporation. It certifies ownership of fully paid and nonassessable shares of the company's common stock, which can be transferred by the holder or their authorized agent upon proper endorsement and surrender of the certificate. The certificate must be countersigned by the transfer agent and registered by the registrar to be valid. It also outlines procedures for transferring shares and provides information on how shareholders can request details about the rights and preferences of each class of stock.

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EX-4.1 2 0002.txt FORM OF COMMON STOCK CERTIFICATE OF VELOCITYHSI EXHIBIT 4.1
VEL [VELOCITYHSI LOGO] VelocityHSI, Inc. INCORPORATED UNDER THE LAWS SEE REVERSE FOR CERTAIN DEFINITIONS OF THE STATE OF DELAWARE CUSIP 92257K 10 2 This Certifies that is the record holder of FULLY PAID AND NONASSESSABLE SHARES OF COMMON STOCK, $.01 PAR VALUE, OF - ----------------======================================== VelocityHSI, Inc.==========================================---------------- transferable 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 registered by the Registrar. WITNESS the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers. Dated: VelocityHSI, Inc. /s/ Charles P. Wingard Corporate /s/ Stephen E. Carlson SEAL SENIOR VICE PRESIDENT, CHIEF FINANCIAL April 19, PRESIDENT AND CHIEF EXECUTIVE OFFICER OFFICER, SECRETARY AND TREASURER 2000 Delaware COUNTERSIGNED AND REGISTERED CHASEMELLON SHAREHOLDER SERVICES, L.L.C. TRANSFER AGENT AND REGISTER AUTHORIZED SIGNATURE
The Corporation shall furnish without charge to each stockholder who so requests a statement of the powers, designations, preferences and relative, participating, optional, or other special rights of each class of stock of the Corporation or series thereof and the qualifications, limitations or restrictions of such preferences and/or rights. Such requests shall be made to the Corporation's Secretary at the principal office of the Corporation. 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 TEN ENT - as tenants by the entireties JT TEN - as joint tenants with right of survivorship and not as tenants in common UNIF GIFT MIN ACT - Custodian -------------------- -------------------- (Cust) (Minor) under Uniform Gifts to Minors Act ----------------- (State) UNIF TRF MIN ACT - Custodian (until age ) -------------------- -------- (Cust) under Uniform Transfer to -------------------- (Minor) Minors Act ------------------- (State) Additional abbreviations may also be used though not in the above list. For Value Received, hereby sell(s), assign(s) and --------------------------- transfer(s) unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE ====================================== ====================================== - -------------------------------------------------------------------------------- (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING 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 on the books of the within named Corporation with full power of substitution in the premises. Dated --------------------- X ------------------------------------- X ------------------------------------- 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 By --------------------------------------------------------------------------- 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.