AstroNova, Inc. - FORM 10-K - EX-4 - April 8, 2016

Attached files

file filename
10-K - FORM 10-K - AstroNova, Inc.d266722d10k.htm
EX-21 - EX-21 - AstroNova, Inc.d266722dex21.htm
EX-2.3 - EX-2.3 - AstroNova, Inc.d266722dex23.htm
EX-31.1 - EX-31.1 - AstroNova, Inc.d266722dex311.htm
EX-23.1 - EX-23.1 - AstroNova, Inc.d266722dex231.htm
EX-32.2 - EX-32.2 - AstroNova, Inc.d266722dex322.htm
EX-32.1 - EX-32.1 - AstroNova, Inc.d266722dex321.htm
EX-31.2 - EX-31.2 - AstroNova, Inc.d266722dex312.htm

Exhibit 4

 

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ZQ|CERT#|COY|CLS|RGSTRY|ACCT#|TRANSTYPE|RUN#|TRANS#
COMMON STOCK
PAR VALUE $0.05
Certificate Number
ZQ00000000
COMMON STOCK
THIS CERTIFICATE IS TRANSFERABLE IN CANTON, MA, JERSEY CITY, NJ AND
COLLEGE STATION, TX
Shares
** 000000******************
*** 000000*****************
**** 000000****************
***** 000000***************
****** 000000**************
ASTRO-MED, INC
ORGANIZED UNDER THE LAWS OF THE STATE OF RHODE ISLAND
THIS CERTIFIES THAT MR. SAMPLE & MRS SAMPLE & CUSIP 04638F 10 8
MR. SAMPLE & MRS. SAMPLE
SEE REVERSE FOR CERTAIN DEFINITIONS is the owner of
*** ZERO HUNDRED THOUSAND
ZERO HUNDRED AND ZERO***
FULLY PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK OF $.05 PAR VALUE OF
ASTRO-MED INC. (herein called the “Corporation”) transferable on the books of the Corporation by the holder hereof in person or by duly authorized attorney upon surrender of this certificate properly endorsed. This certificate and the shares represented hereby are issued and shall be subject to all of the provisions of the Articles of Incorporation and the By-Laws of the Corporation as amended from time to time. 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.
President and Chief Executive Officer
Senior Vice President, Treasurer and Chief Financial Officer
ASTRO-MED, INC
INCORPORATED
SEAL
1969
RHODE ISLAND
DATED DD-MMM-YYYY
COUNTERSIGNED AND REGISTERED:
COMPUTERSHARE TRUST COMPANY, N.A.
TRANSFER AGENT AND REGISTRAR,
By AUTHORIZED SIGNATURE
1234567
ASTRO-MED INC
PO BOX 43004, Providence, RI 02940-3004
MR A SAMPLE
DESIGNATION (IF ANY) ADD 1 ADD 2 ADD 3 ADD 4
CUSIP XXXXXX XX X
Holder ID XXXXXXXXXX
Insurance Value 1,000,000.00
Number of Shares 123456
DTC 12345678 123456789012345
Certificate Numbers Num/No. Denom. Total
1234567890/1234567890 1 1 1
1234567890/1234567890 2 2 2
1234567890/1234567890 3 3 3
1234567890/1234567890 4 4 4
1234567890/1234567890 5 5 5
1234567890/1234567890 6 6 6
Total Transaction 7

 

 

ASTRO-MED, INC.

THE 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 OF CAPITAL STOCK AUTHORIZED TO BE ISSUED BY THE CORPORATION, THE VARIATIONS IN THE RELATIVE RIGHTS AND PREFERENCES BETWEEN THE SHARES OF EACH SERIES OF ANY PREFERRED OR SPECIAL CLASS OF CAPITAL STOCK, SO FAR AS THE SAME MAY HAVE BEEN FIXED AND DETERMINED, AND THE AUTHORITY OF THE BOARD OF DIRECTORS TO FIX AND DETERMINE THE RELATIVE RIGHTS AND PREFERENCES OF SUBSEQUENT SERIES.

 

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                                                
                 (Cust)                                         (Minor)  
TEN ENT   - as tenants by the entireties      under Uniform Gifts to Minors Act                                    
                                                                            (State)  
JT TEN  

- as joint tenants with right of survivorship and not as tenants in common

    UNIF TRF MIN ACT   -                            Custodian (until age                             )  
                 (Cust)  
                   under Uniform Transfers to Minors Act               
       (Minor)                                                                 (State)  
Additional abbreviations may also be used though not in the above list.

 

   PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE

For value received,                                  hereby sell, assign and transfer unto

     

 

 

(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL 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:                                                                  20                     

Signature(s) Guaranteed: Medallion Guarantee Stamp

 

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.

 

 

 

Signature:  

 

       
Signature:  

 

       
  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.       
          

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