EX-99.D.1 4 v235130_ex99-d1.htm EXHIBIT D.1
 
Exhibit d.1
 
 
No. __________
 
CUSIP NO.  [_______________]
 
GSV CAPITAL CORP.
Incorporated under the Laws of the State of Maryland
 
___________________ Shares
Common Stock
 
Par Value $.01 Per Share
  
SEE REVERSE FOR CERTAIN DEFINITIONS AND OTHER INFORMATION
 
THIS CERTIFIES THAT ______________________________________________________________________ IS THE OWNER OF ______________________________________________________________________ FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, WITH A PAR VALUE OF $.01 PER SHARE, OF GSV CAPITAL CORP. (the “Corporation”), transferable on the books of the Corporation in person or by duly authorized attorney upon surrender of this certificate if properly endorsed. This certificate is not valid unless countersigned by the Transfer Agent and registered by the Registrar.
    
WITNESS the seal of the Corporation and the facsimile signatures of its duly authorized officers.
 
Dated: _____________, 2011
 
 
GSV CAPITAL CORP.
 
Secretary
CORPORATE SEAL
Chief Executive Officer
 
2010
 
 
MARYLAND
 
     
     
Transfer Agent
 
   
 
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
tenants by the entireties
                                         (Cust)                          (Minor)
     
JT TEN
as joint tenants with right of
                                Under Uniform Gifts to Minors
 
    survivorship and not as tenants
    in common
 
                                Act:                                                       
                                                                 (State)
 
Additional Abbreviations may also be used though not in the above list.
 
IMPORTANT NOTICE
 
The Corporation will furnish to any stockholder, on request and without charge, a full statement of the information required by Section 2-211(b) of the Corporations and Associations Article of the Annotated Code of Maryland with respect to the designations and any preferences, conversion and other rights, voting powers, restrictions, limitations as to dividends and other distributions, qualifications, and terms and conditions of redemption of the stock of each class which the Corporation has authority to issue and, if the Corporation is authorized to issue any preferred or special class in series, (i) the differences in the relative rights and preferences between the shares of each series to the extent set, and (ii) the authority of the Board of Directors to set such rights and preferences of subsequent series.  This Certificate and the shares of Common Stock represented hereby are issued and shall be held subject to all the provisions of the charter and bylaws of the Corporation and all amendments thereto (copies of which may be obtained from the secretary of the Corporation), to all of which the holder of this certificate by acceptance hereof assents.
 
 KEEP THIS CERTIFICATE IN A SAFE PLACE.  IF IT IS LOST, STOLEN OR DESTROYED, THE CORPORATION WILL REQUIRE A BOND OF INDEMNITY AS A CONDITION TO THE ISSUANCE OF A REPLACEMENT CERTIFICATE.
 
 
For Value Received,                              the undersigned hereby sells, assigns and transfers unto
 
PLEASE INSERT SOCIAL SECURITY OR OTHER
        IDENTIFYING NUMBER OF ASSIGNEE
 
 
(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE)
 
 
 

 
 
shares of the Common Stock represented by this Certificate, and does 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
  
 
  
 
  
By:
  
 
 
  
 
  
 
  
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(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.