Attached files
EXHIBIT
10.4
FORM
OF CONVERTIBLE
PREFERRED
STOCK OF
PHYSICIANS
HEALTHCARE MANAGEMENT GROUP, INC.
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[PhyHealth
Logo]
Certificate Number | Shares | |
|
||
PAR
VALUE $0.001
PREFERRED
STOCK
|
CUSIP No. 71943J 10 9 |
THIS CERTIFIES THAT | SPECIMEN |
Is The
Owner on
FULLY PAID AND NON-ACCESSIBLE SHARES OF
THE PREFERRED STOCK PAR VALUE OF $0.001 EACH OF PHYSICIANS HEALTHCARE MANAGEMENT
GROUP, INC. TRANSFERABLE ON THE BOOK OF COPRORATION IN PERSON OR BY DULY
AUTHORIZED ATTORNEY UPON SURRENDER OF THIS CERTIFICATE PROPERY
ENDORSED. THIS CERTIFICATE IS NOT VALID UNTIL COUNTERSIGNED BY THE
TRANSFER AGENT AND REGISTERED BY THE REGISTRAR.
WITNESS
THE FACSIMILE SEAL OF THE CORPORATION AND THE FACSIMILE SIGNATURES OF ITS DULY
AUTHORIZED OFFICERS.
DATED: | ||
RICHARD
E. GOULDING, MD
|
COUNTERSIGNED AND
REGISTERED:
|
|
Secretary | ISLAND STOCK TRANSFER | |
Transfer
Agent
|
ROBERT
L. TRINKA
|
Authorized Signature | ||
President |
100 Second Avenue
South, Suite 300N, St. Petersburg, FL 33701
727.289.0010
|
||
[CORPORATE
SEAL]
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