EX-4.1 3 a2061600zex-4_1.txt EXHIBIT 4.1 Exhibit 4.1 Number [LOGO OF CROSS COUNTRY] Shares CC COMMON STOCK COMMON STOCK CROSS COUNTRY, INC. INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE CUSIP 22748P 10 5 This Certifies that SEE REVERSE FOR CERTAIN DEFINITIONS is the owner of FULLY PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK, $.0001 PAR VALUE, OF CROSS COUNTRY, 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 unless countersigned and registered by the Transfer Agent and Registrar. WITNESS the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers. Dated: CROSS COUNTRY, INC. CORPORATE SEAL 1999 DELAWARE /s/ [ILLEGIBLE] /s/ [ILLEGIBLE] PRESIDENT AND CHIEF FINANCIAL OFFICER CHIEF EXECUTIVE OFFICER COUNTERSIGNED AND REGISTERED: SUNTRUST BANK TRANSFER AGENT AND REGISTRAR By AUTHORIZED SIGNATURE CROSS COUNTRY, INC. The Corporation will furnish without charge to each shareholder who so requests a statement or summary of the powers, designations, preferences and relative, participating, optional or other special rights of each class of stock or series thereof that the Corporation is authorized to issue and of the qualifications, limitation 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 its entirety according to applicable laws or regulations: TEN COM - as tenants in common UNIF GIFT MIN ACT - as Custodian for TEN ENT - as tenants by the entireties ------------------- JT TEN - as joint tenants with right ------------------------------------ of survivorship and not as tenants (Minor) in common under Uniform Gifts to Minors Act of ------------------------------------ (State)
Additional abbreviations may also be used though not in the 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 common stock represented by this Certificate, and do hereby irrevocably constitute and appoint Attorney ------------------------------------------------------------------------ to transfer such stock on the books of the Corporation with full power of substitution in the premises. Dated ---------------------------------------- ------------------------------------ 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(S) GUARANTEED: ------------------------------------ THE SIGNATURES 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.