STOCK CERTIFICATE
Stock Certificate No.: ____________________________ Shares of Stock: ___________________
______________________________ [Company]
INCORPORATED UNDER THE LAWS OF THE STATE OF ___________________
This Certificate hereby certifies that ________________________ [Stockholder] owns _________ shares
of (Check one) No Par Value Common Stock in ______________________________
[Company], a ______________________ [State] corporation, transferable only on the books of the
Corporation by the holder of this certificate in person, or by authorized agent, upon surrender of this
certificate, properly endorsed or assigned.
This Certificate and the shares represented shall be held subject to all the provisions of the Certificate of
Incorporation and the Bylaws of the Corporation and any amendments thereto, copies of which are on file
at the principal office of the Corporation and made a part hereof as fully as though the provisions of said
Certificate of Incorporation and Bylaws were imprinted in full on this certificate, to all of which the holder of
this certificate by acceptance hereof, assents.
A statement of all of the rights, preferences, privileges and restrictions granted to or imposed upon the
respective classes and/or series of shares of stock of the Company and upon the holders thereof may be
obtained by any stockholder upon request and without charge, a copy of such statement.
IN WITNESS THEREOF, the Corporation has caused this certificate to be signed by its duly authorized
officers President, ________________________ [President], and Secretary,
________________________ [Secretary], on ____________________, 20______.
________________________, President ________________________, Secretary
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TRANSFER SECTION
For value received, I, ________________________ [Seller] hereby sell, assign and transfer to
________________________ [Stockholder] _________ shares represented by this certificate, and
instruct the corporate Secretary to record this transfer on the books of the Corporation. Transfer
restrictions, if any, are shown below.
Dated this ______ day of _______________, 20______.
________________________________
(Signature)
NOTICE: The signature on the assignment must correspond with the name as written upon the face of
this certificate, in every particular, without alteration or enlargement, or any change whatsoever.
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The shares represented by this certificate have been acquired for investment and have not been
registered under the Securities Act of 1933, as amended, or any applicable state securities laws. Such
shares represented by this certificate may not be transferred, sold, pledged, or assigned unless so
registered, or unless an exemption from such registration is available.
The stocks referenced herein are subject to the terms and conditions of an agreement by and among the
company and the stockholders of the company. The holder of this certificate may make a written request
to the secretary of the corporation at the principal office of the corporation for copies of the agreement, if
any, at no charge. Any person accepting any interest in such stock shall be deemed to agree to and shall
become bound by all the provisions of said agreement.
