EXTEND HEALTH INC - FORM S-1/A - EX-4.1 - SPECIMEN COMMON STOCK CERTIFICATE OF THE REGISTRANT - April 30, 2012

Attached files

file filename
S-1/A - AMENDMENT NO. 3 TO FORM S-1 - EXTEND HEALTH INCd211158ds1a.htm
EX-1.1 - FORM OF UNDERWRITING AGREEMENT - EXTEND HEALTH INCd211158dex11.htm
EX-10.2 - 2004 EQUITY INCENTIVE PLAN AND FORM OF STOCK OPTION AGREEMENT - EXTEND HEALTH INCd211158dex102.htm
EX-10.1 - FORM OF INDEMNIFICATION AGREEMENT - EXTEND HEALTH INCd211158dex101.htm
EX-10.3 - 2007 EQUITY INCENTIVE PLAN AND FORM OF STOCK OPTION AGREEMENT - EXTEND HEALTH INCd211158dex103.htm
EX-21.1 - LIST OF SUBSIDIARIES OF THE REGISTRANT - EXTEND HEALTH INCd211158dex211.htm
EX-23.1 - CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM - EXTEND HEALTH INCd211158dex231.htm
EX-10.16 - EXECUTIVE INCENTIVE COMPENSATION PLAN - EXTEND HEALTH INCd211158dex1016.htm
EX-10.4 - 2012 EQUITY INCENTIVE PLAN AND FORM OF AWARD AGREEMENT - EXTEND HEALTH INCd211158dex104.htm

Exhibit 4.1

 

LOGO

THE BOARD OF THIS CORPORATION HAS THE AUTHORITY TO CREATE AND DETERMINE THE RELATIVE RIGHTS AND PREFERENCES OF CLASSES OR SERIES OF SHARES OF CAPITAL STOCK OTHER THAN COMMON STOCK. THIS CORPORATION WILL FURNISH TO ANY SHAREHOLDER UPON WRITTEN REQUEST SENT TO ITS PRINCIPAL EXECUTIVE OFFICES, AND WITHOUT CHARGE, A FULL STATEMENT OF THE BOARD’S AUTHORITY TO CREATE AND DETERMINE THE RELATIVE RIGHTS AND PREFERENCES OF CLASSES OR SERIES OF SHARES OF CAPITAL STOCK AS WELL AS THE DESIGNATIONS, PREFERENCES, LIMITATIONS AND RELATIVE RIGHTS OF THE SHARES OF EACH CLASS OR SERIES THEN OUTSTANDING OR AUTHORIZED TO BE ISSUED.

 

 

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       UTMA –   

 

    Custodian   

 

             (Cust)       (Minor)

TEN ENT

  

–

   as tenants by entireties          under Uniform Transfers to Minors

JT TEN

  

–

  

as joint tenants with right of survivorship

and not as tenants in common

          Act   

 

                (State)

Additional abbreviations may also be used though not in 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 ZIP CODE OF 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  

 

     

X

      

X

      

 

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, INC. MEDALLION SIGNATURE PROGRAM (“MSP”), OR THE STOCK EXCHANGES MEDALLION PROGRAM (“SEMP”) AND MUST NOT BE DATED. GUARANTEES BY A NOTARY PUBLIC ARE NOT ACCEPTABLE.