EX-4.1 4 exhibit4-1.htm EXHIBIT 4.1 SusGlobal Energy Corp. - Exhibit 4.1 - Filed by newsfilecorp.com

 


For Value Received, ______________________________________ hereby sell, assign and transfer unto

 
  PLEASE INSERT SOCIAL INSURANCE NUMBER OF ASSIGNEE

 
PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS OF ASSIGNEE
 
 
 

________________________________________________________________________  Shares
Of the capital stock represented by the within certificate, and do hereby irrevocably constitute and appoint

________________________________________________________________________
Attorney, to transfer the said common shares on the Books of the within-named Corporation, with full power of substitution in the premises.

Dated ______________________________________

 

   
   
   
In the presence of  
   
   
   

 

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.