EX-4.1 2 a2236872zex-4_1.htm EX-4.1

Exhibit 4.1

 

SEE REVERSE FOR IMPORTANT NOTICE REGARDING OWNERSHIP AND TRANSFER RESTRICTIONS AND CERTAIN OTHER INFORMATION INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE COMMON STOCK SEE REVERSE FOR CERTAIN DEFINITIONS FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK OF PAR VALUE $0.0001 EACH OF AGILITI, 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 and the shares represented hereby are issued and shall be held subject to all of the provisions of the Certificate of Incorporation of the Corporation and its Bylaws (as such documents may be amended from time to time), and the holder of this Certificate, by acceptance hereof, assents to all such provisions. This Certificate is not valid until countersigned by the Transfer Agent and registered by the Registrar. WITNESS the facsimile signatures of its duly authorized officers. 2018 0000001

 


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 TENENT IT TEN -as tenants in common -as tenants by the entireties -as joint tenants with right of vorship and not as tenants UNIF GIFr MINACT-Custodian----(CUlt) (Minor) under Uniform Gifts to Minors Act------,------,----­ (S1a o) mcommon -trustee under Agreement dated-----TIEE 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 INCWDING POSTAL ZIP CODE OF ASSIGNEE. Shares of the common stock represented by this 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 NOTICE:Tlle signature to It!is assignment must correspond wiltlltle name aswritten upon ltle face of ltle certificate in IMiry particular wHhout alteration or enlargement or any change whaiiMir. SIGNATURE GUARANTEED; THE SIClNAl\JRE(SlSHOULD BE ClUARArflEED BY AN ELICliBL.E ClUARAIIITOR INSTIT\JTION.IBANKS STOCKBROKERSSAVINGS AND LOANASSOCIATlONSAND CREDrTUNIONSWITHMEMBERSHIP IN AN APPROVED SIGNA 1 URE GUARANTEE MEDALLIONPROGRAM),PURSUANT TO S.E.C.RULE 17M-15.