EX-4.1 3 g64342a1ex4-1.txt SPECIMEN OF CERTIFICATE 1 Exhibit 4.1 NUMBER SHARES PZNB 12% SERIES B 12% SERIES B CUMULATIVE CONVERTIBLE CUMULATIVE CONVERTIBLE PREFERRED SHARES PREFERRED SHARES THIS CERTIFICATE IS TRANSFERABLE CUSIP 74264N 30 3 IN NEW YORK, NEW YORK SEE REVERSE FOR OR CANTON, MASSACHUSETTS CERTAIN DEFINITIONS PRISON REALTY TRUST, INC. FORMED UNDER THE LAWS OF THE STATE OF MARYLAND THIS CERTIFIES THAT IS THE REGISTERED HOLDER OF FULLY-PAID AND NON-ASSESSABLE 12% SERIES B CUMULATIVE CONVERTIBLE PREFERRED SHARES, PAR VALUE $.01 PER SHARE, OF Prison Realty Trust, Inc., transferable on the books of the Company 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. In Witness Whereof, the Company has caused the facsimile signatures of its duly authorized officers and the facsimile of its seal to be printed hereon. [SEAL] Dated: COUNTERSIGNED AND REGISTERED: FLEET NATIONAL BANK TRANSFER AGENT AND REGISTRAR, BY /s/ John D. Ferguson CHIEF EXECUTIVE OFFICER AND AUTHORIZED SIGNATURE /s/ Darrell K. Massengale PRESIDENT SECRETARY 2 PRISON REALTY TRUST, INC. THE COMPANY HAS THE AUTHORITY TO ISSUE SHARES OF MORE THAN ONE CLASS. THE COMPANY WILL, ON REQUEST AND WITHOUT CHARGE, FURNISH A FULL STATEMENT OF THE DESIGNATIONS AND ANY PREFERENCES, CONVERSION AND OTHER RIGHTS, VOTING POWERS, RESTRICTIONS, LIMITATIONS AS TO DIVIDENDS, QUALIFICATIONS, AND TERM AND CONDITIONS OF REDEMPTION OF THE SHARES OF EACH CLASS WHICH THE COMPANY IS AUTHORIZED TO ISSUE. SUCH REQUEST MAY BE MADE TO THE SECRETARY OF THE COMPANY AT ITS PRINCIPAL OFFICE. 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 -- as tenants by the entireties ------------- -------- JT TEN -- as joint tenants with right of (Cust) (Minor) survivorship and not as tenants Under Uniform Gifts to Minors in common 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 ZIP CODE, OR ASSIGNEE) ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------ shares of the Capital 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 Company with full power of substitution in the premises. Dated: Signature: ---------------------------------------------------------------------------------------------------- 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 guaranteed: ----------------------------------------------------------------------------------------------------- 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.