[NAME OF CORPORATION]
- A Corporation Registered in the State of [STATE] -
Stock Certificate Number: [N] For: [NUMBER OF SHARES] Shares of Preferred STOCK This certifies that [NAME OF PREFERRED STOCK BUYER] (“Preferred Stock Purchaser”) is the holder of record for [Number of Shares Purchased] shares of Preferred Stock of [NAME OF CORPORATION]. These shares are transferable only on the share register of this corporation, in person Preferred Stock Purchaser, or by a duly authorized attorney, upon surrender of this certificate properly endorsed or assigned to the satisfaction of this corporation. This certificate and the associated shares of Preferred Stock represented hereby are issued by the corporation and shall be held by Preferred Stock Purchaser in accordance with the provisions of the Articles of Incorporation and the by-laws of this corporation, as may be amended. Detail on the rights, powers, limitations, restrictions and other characteristics of this and other classes of stock or series (if any) will be provided to any Preferred Stock Purchaser without charge upon written request to the Treasurer of [NAME OF CORPORATION]. Duly Authorized Corporate Officers: Secretary:
For:
[NAME OF SECRETARY] Date:
[NAME OF PRESIDENT] Date:
SEE ALSO RESTRICTIVE LEGENDS ON REVERSE SIDE OF THIS PREFERRED STOCK CERTIFICATE
[NAME OF CORPORATION]
Preferred Stock Certificate Number
In consideration for value received of $[PREFERRED STOCK PURCHASE PRICE] For the purchase of [NUMBER OF SHARES] shares of Preferred Stock of this corporation, [NAME OF CORPORATION] does hereby sell, assign, convey and transfer to [NAME OF PREFERRED STOCK BUYER] the Preferred Stock shares so represented by this certificate. Further, this Corporation hereby irrevocably appoints and
directs [NAME OF AUTHORIZED OFFICER OR ATTORNEY] to transfer and record this transaction on the share register of this Corporation with full power of substitution in the premises. Witnessed By: For Purchaser:
Print name and title here; sign above Date:
Print [NAME OF PREFERRED STOCK BUYER] and title here; sign above * Date:
* NOTICE: THE PURCHASER SIGNATURE BLOCK ABOVE MUST BE THE SAME AS GIVEN UPON THE FRONT OF THIS CERTIFICATE, IN EVERY RESPECT AND WITHOUT ALTERATION OR ANY OTHER CHANGE WHATSOEVER. THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE BEEN ACQUIRED FOR INVESTMENT AND HAVE NOT BEEN REGISTERED UNDER THE U.S. SECURITIES ACT OF 1933 (“THE ACT”). SUCH SHARES MAY NOT BE SOLD, TRANSFERRED OR PLEDGED WITHOUT SUCH REGISTRATION UNLESS THE CORPORATION RECEIVES AN OPINION OF COUNSEL REASONABLY ACCEPTABLE TO IT STATING THAT SUCH SALE OR TRANSFER IS EXEMPT FROM THE REGISTRATION AND PROSPECTUS DELIVERY REQUIREMENTS OF THE ACT. COPIES OF THE AGREEMENT, IF ANY, REGARDING THE PURCHASE OF THESE SHARES AND RESTRICTING THEIR TRANSFER MAY BE OBTAINED AT NO COST BY WRITTEN REQUEST MADE BY THE HOLDER OF RECORD OF THIS CERTIFICATE TO THE SECRETARY OF THIS CORPORATION AT THE PRINCIPAL EXECUTIVE OFFICES THEREOF.