Common Stock, par value
Number of Shares
THIS CERTIFIES THAT [Holder Name] is the registered holder of [Holder Shares] shares of Common Stock, par value [$ par value] per share, of [Company Name] (the “Corporation”), transferable only on the books of the Corporation by the holder hereof, in person or by duly authorized attorney, upon surrender of this Certificate properly endorsed or assigned.
IN WITNESS WHEREOF, the said Corporation has caused this Certificate to be signed by its duly authorized officers as of [Date].
[Name of Secretary], Secretary
[Name of President], President
For value received ____________________________________________ hereby sells, assigns and transfers unto _______________________________, _________________________ shares represented by the within Certificate and does hereby irrevocably constitute and appoint ____________________________________________________ attorney to transfer the said shares on the books of the within named corporation with full power of substitution in the premises.
Notice: The signature on this assignment must correspond with the name as written upon the face of this Certificate, in every particular, without alteration or enlargement, or any change whatever.
THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE BEEN ACQUIRED FOR INVESTMENT AND NOT WITH A VIEW TO, OR IN CONNECTION WITH, THE SALE OR DISTRIBUTION THEREOF. NO SUCH SALE OR DISPOSITION MAY BE EFFECTED WITHOUT AN EFFECTIVE REGISTRATION STATEMENT RELATED THERETO OR AN OPINION OF COUNSEL SATISFACTORY TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED UNDER THE SECURITIES ACT OF 1933, AS AMENDED.
THE SALE OR TRANSFER OF THE SECURITIES REPRESENTED BY THIS CERTIFICATE IS SUBJECT TO THE TERMS AND CONDITIONS OF A FOUNDER STOCK PURCHASE AGREEMENT BY AND BETWEEN THE REGISTERED FOUNDER HEREOF AND THE COMPANY THAT PROVIDES FOR A RIGHT OF REPURCHASE. SUCH RESTRICTIONS ARE BINDING UPON TRANSFEREES OF THESE SECURITIES. COPIES OF THE FOUNDER STOCK PURCHASE AGREEMENT MAY BE OBTAINED UPON WRITTEN REQUEST TO THE SECRETARY OF THE COMPANY.
THE SHARES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO A RIGHT OF FIRST REFUSAL OPTION IN FAVOR OF THE CORPORATION, AS PROVIDED IN THE BYLAWS OF THE CORPORATION.
This form has been prepared for general informational purposes only. It does not constitute legal advice, advertising, a solicitation, or tax advice. Transmission of this form and the information contained herein is not intended to create, and receipt thereof does not constitute formation of, an attorney-client relationship. You should not rely upon this document or information for any purpose without seeking legal advice from an appropriately licensed attorney, including without limitation to review and provide advice on the terms of this form, the appropriate approvals required in connection with the transactions contemplated by this form, and any securities law and other legal issues contemplated by this form or the transactions contemplated by this form.
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