EX-4.1 3 ex4_1.txt EXHIBIT 4.1 Number Shares WITS BASIN PRECIOUS MINERALS INC. INCORPORATED UNDER THE LAWS OF THE STATE OF MINNESOTA SEE REVERSE SIDE FOR CERTAIN DEFINITIONS CUSIP 977427 10 3 THIS CERTIFIES THAT is the owner of FULLY PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK, OF THE PAR VALUE OF $.01 PER SHARE, OF ______________________________ WITS BASIN PRECIOUS MINERALS INC. ______________________________________________ transferable on the books of the Corporation by the holder hereof in person or by Attorney by surrender of this certificate properly endorsed. This certificate is not valid unless countersigned by the Transfer Agent and Registrar. IN WITNESS WHEREOF, the said Corporation has caused this certificate to be signed by facsimile signatures of its duly authorized officers. Dated: ------------------------- -------------------------- CHIEF EXECUTIVE OFFICER CHIEF FINANCIAL OFFICER COUNTERSIGNED AND REGISTERED AMERICAN STOCK TRANSFER AND TRUST COMPANY TRANSFER AGENT BY: AUTHORIZED SIGNATURE THE SECRETARY OF THIS CORPORATION WILL FURNISH TO ANY SHAREHOLDER UPON REQUEST AND WITHOUT CHARGE, A FULL STATEMENT OF THE DESIGNATIONS, PREFERENCES, LIMITATIONS AND RELATIVE RIGHTS OF THE SHARES OF EACH CLASS OR SERIES AUTHORIZED TO BE ISSUED, SO FAR AS THEY HAVE BEEN DETERMINED, AND THE AUTHORITY OF THE BOARD TO DETERMINE THE RELATIVE RIGHTS AND PREFERENCES OF SUBSEQUENT CLASSES OR SERIES. -------------------------------------------------------------------------------- The following abbreviations, when used in the inscription of the face of this certificate, shall be construed as though they were written out in full according to applicable law or regulations:
TEN COM - as tenants in common UTMA -- ______________ Custodian _______________ (Cust) (Minor) under Uniform Transfers to Minors Act___________________________ (State) TEN ENT - as tenants by entireties JT TEN - as joint tenants with right of survivorship and not as tenants in common 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 SIP 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 Corporation with full power of substitution in the premises. Dated --------------------------------- --------------------------------- 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 ALL GUARANTEES MUST BE MADE BY A FINANCIAL INSTITUTION (SUCH AS A BANK OR BROKER) WHICH IS A PARTICIPANT IN THE SECURITIES TRANSFER AGENTS MEDALLION PROGRAM ("STAMP"), THE NEW YORK STOCK EXCHANGE MEDALLION SIGNATURE PROGRAM ("MSP"), OR THE STOCK EXCHANGE MEDALLION PROGRAM ("SEMP") AND MUST NOT BE DATED. GUARANTEES MY A NOTARY PUBLIC ARE NOT ACCEPTABLE.