HealthPort, Inc. - FORM S-1/A - EX-4.1 - SPECIMEN COMMON STOCK CERTIFICATE - November 9, 2009

Attached files

file filename
S-1/A - AMENDMENT NO. 4 TO FORM S-1 - HealthPort, Inc.ds1a.htm
EX-3.2 - FORM OF BY-LAWS OF HEALTHPORT, INC. - HealthPort, Inc.dex32.htm
EX-3.1 - FORM OF AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OF HEALTHPORT, INC. - HealthPort, Inc.dex31.htm
EX-1.1 - FORM OF UNDERWRITING AGREEMENT - HealthPort, Inc.dex11.htm
EX-10.1 - FORM OF HEALTHPORT, INC. 2009 OMNIBUS INCENTIVE PLAN - HealthPort, Inc.dex101.htm
EX-23.2 - CONSENT OF DERRICK, STUBBS & STITH, L.L.P. - HealthPort, Inc.dex232.htm
EX-21.1 - LIST OF SUBSIDIARIES OF HEALTHPORT, INC. - HealthPort, Inc.dex211.htm
EX-23.3 - CONSENT OF PRICEWATERHOUSECOOPERS LLP - HealthPort, Inc.dex233.htm
EX-23.1 - CONSENT OF ERNST & YOUNG LLP - HealthPort, Inc.dex231.htm
EX-23.4 - CONSENT OF ERNST & YOUNG LLP - HealthPort, Inc.dex234.htm
EX-10.24 - FORM OF CONTRIBUTION AGREEMENT - HealthPort, Inc.dex1024.htm
EX-10.21 - FORM OF NON-QUALIFIED STOCK OPTION AGREEMENT - HealthPort, Inc.dex1021.htm
EX-10.16 - FORM OF RESTRICTED STOCK AGREEMENT - HealthPort, Inc.dex1016.htm

EXHIBIT 4.1

 

COMMON STOCK

      

COMMON STOCK

$0.001 PAR VALUE

   [Graphic]   

INCORPORATED UNDER THE

LAWS

OF THE STATE OF DELAWARE

      

SEE REVERSE FOR CERTAIN

DEFINITIONS

HEALTHPORT, INC.

THIS CERTIFIES THAT

IS THE OWNER OF

FULLY PAID AND NONASSESSABLE SHARES OF HEALTHPORT, INC.

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 is not valid until countersigned by the Transfer Agent and Registrar. Witness the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers.

Dated:

[CORPORATE SEAL]

 

 

 

      COUNTERSIGNED AND REGISTERED:
SECRETARY       TRANSFER AGENT AND REGISTRAR
   BY   

CHAIRMAN OF THE BOARD

AND CHIEF EXECUTIVE OFFICER

       AUTHORIZED SIGNATURE

 

 

This Corporation will furnish without charge to each stockholder who so requests a statement of the powers, designations, preferences and relative, participating, optional or other special rights of each class of stock or series thereof and the qualifications, limitations or restrictions of such preferences and/or rights.

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                         
TEN ENT    —    as tenants by the entireties          (Cust)      (Minor)
JT TEN    —   

as joint tenants with right of

survivorship and not as tenants

          under Uniform Gifts to Minors Act
      in common                                           
               (State)

Additional abbreviations may also be used though not in the above list.

For Value Received,

    hereby sell(s), assign(s) and transfer(s) 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                                  

                                                                                                                                                                                                                              

NOTICE: THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME(S) AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER.

Signature(s) Guaranteed

                                                                                                                                                                                                                              

THE SIGNATURE(S) MUST 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 SEC RULE 174d-15.

 

2

Also read