EX-4.1 5 d692627dex41.htm EX-4.1 EX-4.1

Exhibit 4.1

 

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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 WIN ACT                          Custodian                            

                                             (Cust)                                   (Minor)

                                                     under Uniform Gifts to Minors

                                           Act                                                  

                                                                  (State)

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 OR OTHER IDENTIFYING NUMBER OF ASSIGNEE

 

     
 
       

 

 

  

 

(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS INCLUDING POSTAL 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 Shares on the books of the within named Corporation with full power of substitution in the premises.

 

Dated:                                                                  
x  

 

x  

 

 

                                                 NOTICE:

 

 

THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME(S) AS WRITTEN UPON THE FACE OF THIS CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER.

 

Signature(s) Guaranteed

BY:    
  THE SIGNATURE(S) SHOULD 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.