EX-4.1 9 forms4_ex4-1wfb071404.txt EX. 4.1 - SPECIMEN - PEN GAMING Exhibit 4.1 -------------------------------------------------------------------------------- ------ ------- NUMBER SHARES ------ ---------------------------------------------------- ------- 0 Incorporated under the laws of the State of Delaware ------ ---------------------------------------------------- ------- ---------------------- Peninsula Gaming Corp. ---------------------- -------------------------------------------------------------------------------- Total Authorized Issue See Reverse for 1,000 Shares $0.10 Par Value Certain Common Stock Definitions -------------------------------------------------------------------------------- SPECIMEN This is to Certify that ___________________ is the owner of _____________________ fully paid and non-assessable shares of the above Corporation transferable 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. Witness, the seal of the Corporation and the signatures of its duly authorized officers. Dated -------------------------------- ------------------------------ -------------------------------------------------------------------------------- COPYRIGHT 1999 CORPEX BANKNOTE CO., BAY SHORE N.Y. 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 MIN 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 represented by the within Certificate, and do hereby irrevocable 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 _________________________ In presence of _________________________________ 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. The purported sale, assignment, transfer, pledge, or other disposition of any security or securities issued by a corporation that holds a license is conditional and ineffective until approved by the Louisiana Gaming Control Board. If the board finds that the owner of this security does not meet the qualification requirements of the act, then the board may suspend or revoke the license or the board may condition the license requiring that the disqualified person or persons may not: a. receive dividends or interest on the securities of the corporation; b. exercise directly or through a trustee or nominee, a right conferred by the securities of the corporation; c. receive remuneration from the licensee; d. receive any economic benefit from the licensee; e. continue in an ownership or economic interest in the licensee. THE SECURITIES EVIDENCED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT"), OR ANY STATE SECURITIES LAWS. NO SUCH SECURITY NOR ANY INTEREST OR PARTICIPATION THEREIN MAY BE REOFFERED, SOLD, ASSIGNED, TRANSFERRED, PLEDGED, ENCUMBERED OR OTHERWISE DISPOSED OF IN THE ABSENCE OF SUCH REGISTRATION OR UNLESS SUCH TRANSACTION IS EXEMPT FROM, OR NOT SUBJECT TO, REGISTRATION.