|[ID]||Incorporated under the laws of the state of Delaware||[Shares]|
Par value [Par Value] [Security Name] Stock
This is to certify that
is the owner of
fully paid and non-assessable shares of par value [Par Value] [Security Name] of [Company Name]
Transferrable only on the books of the Corporation by the holder thereof in person or by a duly authorized Attorney upon surrender of this Certificate properly endorsed. TRANSFER OF THE SHARES REPRESENTED BY THIS CERTIFICATE MAY BE RESTRICTED. SEE LEGENDS ON REVERSE SIDE.
Witness, the signatures of the duly authorized officers of the Corporation
Dated: [Grant Date]
|[Third Party Signature][CEO]||[Third Party Signature][Secretary]|
For Value Received, [Shareholder Name] hereby sells, assigns and transfers unto _____________________________ _________________________ shares represented by the within certificate and does hereby irrevocably constitute and appoint ____________________________ Attorney to transfer the said shares on the share register of the within named Corporation with full power of substitution in the premises.
Notice: The signature on this assignment must correspond with the name as written upon the face of this certificate, in every particular, without alteration or enlargement, or any change whatever.
THE SECURITIES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AND HAVE BEEN ACQUIRED FOR INVESTMENT AND NOT WITH A VIEW TO, OR IN CONNECTION WITH, THE SALE OR DISTRIBUTION THEREOF. NO SUCH SALE OR DISTRIBUTION MAY BE EFFECTED WITHOUT AN EFFECTIVE REGISTRATION STATEMENT RELATED THERETO OR AN OPINION OF COUNSEL IN A FORM SATISFACTORY TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED UNDER THE SECURITIES ACT OF 1933. THE SHARES REPRESENTED BY THIS CERTIFICATE MAY BE TRANSFERRED ONLY IN ACCORDANCE WITH THE TERMS OF AN AGREEMENT BETWEEN THE COMPANY AND THE STOCKHOLDER, A COPY OF WHICH IS ON FILE WITH AND MAY BE OBTAINED FROM THE SECRETARY OF THE COMPANY AT NO CHARGE.