EX-4.1 3 v74443a3ex4-1.txt EXHIBIT 4.1 EXHIBIT 4.1 [NORTHWEST BIOTHERAPEUTICS, INC. LOGO] [SEAL] [SEAL] NUMBER SHARES NWBT- INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE CUSIP 66737P 10 5 SEE REVERSE FOR CERTAIN RESTRICTIONS THIS CERTIFIES THAT SPECIMEN is the owner of FULLY PAID AND NONASSESSABLE SHARES OF COMMON STOCK, $0.001 PAR VALUE PER SHARE OF ----------------- ------------------------ ------------------ NORTHWEST BIOTHERAPEUTICS, INC. ------------------------- ----------------- ------------------------ 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. 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: [SEAL] /s/ ALTON L. BOYNTON /s/ DANIEL O. WILDS SECRETARY CHAIRMAN, PRESIDENT AND C.E.O. COUNTERSIGNED AND REGISTERED: MELLON INVESTOR SERVICES LLC TRANSFER AGENT AND REGISTRAR BY AUTHORIZED SIGNATURE NORTHWEST BIOTHERAPEUTICS, INC. 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 - at 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 under Uniform Gifts to Minors tenants in common Act _________________________ (State) UNIF TRF MIN ACT- _________ Custodian (until age ______) (Cust) ________under Uniform Transfer (Minor) to Minors Act ____________________ (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(S) _________________________________________________________________________ Shares of the Capital Stock represented by the within Certificate, and do(es) 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. Dated _________________ _______________________________ _______________________________ NOTICE: the signature to this assignment must correspond with the name as written upon the face of the certificate in every particular, without alternation or enlargement or any change whatever. Signature must be guaranteed. Signature(s) Guaranteed: By _________________________________________________ THE SIGNATURE(S) 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.