Incorporated under the Laws of the State of Delaware

EX-4.1 2 ex41tos1a07827004_030912.htm FORM OF STOCK CERTIFICATE ex41tos1a07827004_030912.htm
 
Exhibit 4.1
 
 
No. ______
 
Incorporated under the Laws of the State of Delaware
_________ SHARES

XSTELOS HOLDINGS, INC.
COMMON STOCK
AUTHORIZED CAPITAL, 1,000 SHARES, COMMON STOCK, PAR VALUE $0.001 PER SHARE
SEE REVERSE FOR CERTAIN DEFINITIONS
 
CUSIP No. 



THIS CERTIFIES THAT ___________________________________________________________________ IS THE OWNER OF


_______________________________________________________________________________ fully-paid and non-assessable shares of the above Corporation, transferable on the books of the Corporation by said owner in person or by his duly authorized attorney upon the 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: ____________________
 
 
XSTELOS HOLDINGS, INC.
 
CORPORATE SEAL
 
Delaware 2012
 
Jonathan Couchman, President
Jonathan Couchman, Secretary
 
 
 

 
 
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
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.
 
XSTELOS HOLDINGS, INC.
 
The Corporation will furnish without charge to each stockholder who so requests the powers, designations, preferences and relative, participating, option or other special rights of each class of stock or series thereof of the Corporation and the qualifications, limitations, or restrictions of such preferences and/or rights.  This certificate and the shares represented hereby are issued and shall be held subject to the terms and conditions applicable to the securities underlying and comprising the shares.
 
For Value Received, __________________________________ hereby sell, assign and transfer 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 do 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 __________________
By: ___________________________________________________
   
 
By: ___________________________________________________
 
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.
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.