1
Exhibit 4.1
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NUMBER SHARES
[LOGO OF CREDENTIALS SERVICES
CS INTERNATIONAL, INC.]
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INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
THIS CERTIFICATE IS TRANSFERABLE IN SEE REVERSE FOR CERTAIN
THE CITY OF CHICAGO OR THE CITY OF DEFINITIONS AND RESTRICTIONS
NEW YORK CUSIP 225307 10 7
COMMON STOCK
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THIS CERTIFIES THAT
IS THE RECORD HOLDER OF
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fully paid and non-assessable shares of Common Stock,
par value $.01 per share, of
CREDENTIALS SERVICES INTERNATIONAL, INC.
(the "Corporation"), a Delaware corporation. The shares represented by this
certificate are transferable only on the stock transfer books of the
Corporation by the holder of record hereof, or by his duly authorized attorney
or legal representative, upon the surrender of this certificate properly
endorsed. This certificate is not valid until countersigned and registered by
the Corporation's transfer agent and registrar. This security is not a deposit
or account and is not federally insured or guaranteed.
In Witness Whereof the Corporation has caused this certificate to be
executed by the facsimile signatures of its duly authorized officers and has
caused a facsimile of its corporate seal to be hereunto affixed.
DATED:
/s/ DAVID C. THOMPSON COUNTERSIGNED AND REGISTERED:
PRESIDENT AND LASALLE NATIONAL BANK
CHIEF EXECUTIVE OFFICER (CHICAGO)
TRANSFER AGENT
AND REGISTRAR
[CORPORATE SEAL OF CREDENTIALS SERVICES INTERNATIONAL, INC.]
/s/ ALLAN WEINSTEIN BY
SECRETARY AUTHORIZED SIGNATURE
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CREDENTIALS SERVICES INTERNATIONAL, INC.
A statement of the powers, designations, preferences and relative,
participating, optional or other special rights of each class of stock or
series thereof and the qualifications, limitations or restrictions of such
preferences and/or rights as established, from time to time, by the Certificate
of Incorporation of the Corporation and by any certificate of determination,
the number of shares constituting each class and series, and the designations
thereof, may be obtained by the holder hereof upon request and without charge
at the principal office of the Corporation.
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 ___________
TEN ENT - as tenants by the entireties (Cust) (Minor)
JT TEN - as joint tenants with right of Under Uniform Gifts to Minors
survivorship and not as tenants Act ____________________________
in common (State)
UNIF TRANS MIN ACT - __________Custodian ___________
(Cust) (Minor)
under Uniform Transfers to Minors
Act_____________________________
(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
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________________________________________________________________________________
(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE)
________________________________________________________________________________
________________________________________________________________________________
__________________________________________________________________________Shares
of Common Stock 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 NAMES AS
WRITTEN UPON THE FACE OF THE
CERTIFICATE IN EVERY PARTICULAR,
WITHOUT ALTERATION OR ENLARGEMENT OR
ANY CHANGE WHATEVER.
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.