EX-4.J 11 dex4j.txt FORM OF PREFERRED STOCK CERTIFICATE Exhibit 4(j) INCORPORATED UNDER THE LAWS OF THE STATE OF MINNESOTA NUMBER SHARES SPECIMEN SPECIMEN H.B. FULLER COMPANY Series _ [Cumulative] Preferred Stock $.01 Par Value Per Share This Certifies that SPECIMEN is the owner and ---------------------------------- registered holder of SPECIMEN Shares of ----------------------------------------- Series _ [Cumulative] Preferred Stock, $.01 par value per share, of H.B. Fuller Company, subject to the terms and conditions printed on the back of this certificate and made a part hereof 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 unless countersigned by the Transfer Agent and registered by the Registrar. IN WITNESS WHEREOF, the said corporation has caused this certificate to be signed by its duly authorized officers and to be sealed with the seal of the corporation this _________ day of ________________, 20_______. COUNTERSIGNED AND REGISTERED: President [____________________________] TRANSFER AGENT AND REGISTRAR Secretary BY SEAL AUTHORIZED SIGNATURE H.B. FULLER COMPANY The corporation will furnish to any shareholder upon request and without charge, a full statement of the designations, preferences, limitations, and relative rights of the shares of each class or series authorized to be issued, so far as they have been determined, and the authority of the Board of Directors to determine the relative rights and preferences of subsequent classes or series. _____________________ 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 ------------------------------------ (Cust) (Minor) TEN ENT -as tenants by the entireties Under Uniform Gifts to Minors Act JT TEN -as joint tenants with right of survivorship and not as ________________________________________ tenants 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 POSTAL ZIP CODE OF ASSIGNEE ____________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________ Shares represented by the within Certificate, and do 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 this Certificate in every particular, without alteration or enlargement or any change whatever.