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Exhibit 4.1
COMMON STOCK [LOGO OF RITA MEDICAL] COMMON STOCK
RMS
INCORPORATED UNDER THE LAWS SEE REVERSE FOR
OF THE STATE OF DELAWARE CERTAIN DEFINITIONS
CUSIP 76774E 10 3
This Certifies that
is the record holder of
FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $0.001 PAR VALUE, OF
RITA MEDICAL SYSTEMS, 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 until countersigned by the Transfer
Agent and registered by the Registrar.
IN WITNESS WHEREOF the Corporation has caused this certificate to be signed
in facsimile by its duly authorized officers and a facsimile of its corporate
seal.
Dated:
/s/ Mark B. Weeks /s/ Barry Cheskin
SECRETARY PRESIDENT AND CHIEF EXECUTIVE OFFICER
[INCORPORATED SEAL OF RITA MEDICAL SYSTEMS, INC.]
COUNTERSIGNED AND REGISTERED:
U.S. STOCK TRANSFER CORPORATION
TRANSFER AGENT AND REGISTRAR
BY
AUTHORIZED SIGNATURE
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RITA MEDICAL SYSTEMS, INC.
THE CORPORATION WILL FURNISH WITHOUT CHARGE TO EACH STOCKHOLDER WHO SO
REQUESTS, A FULL STATEMENT OF THE DESIGNATIONS, RELATIVE RIGHTS, PREFERENCES
AND LIMITATIONS OF EACH CLASS OF STOCK OR SERIES THEREOF AUTHORIZED TO BE
ISSUED AND THE AUTHORITY OF THE BOARD OF DIRECTORS OF THE CORPORATION TO
DESIGNATE AND FIX THE RELATIVE RIGHTS, PREFERENCES AND LIMITATIONS OF CLASSES
OF PREFERRED STOCK IN 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
TEN ENT-as tenants by the entireties ------ -------
JT WROS-as joint tenants with right (Cust) (Minor)
of survivorship and not as under Uniform Gifts to
tenants in common 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
________________________________________________________________________________
________________________________________________________________________________
(Please print or typewrite name and address
including postal zip code of assignee)
________________________________________________________________________________
________________________________________________________________________________
__________________________________________________________________________Shares
of the 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 Coporation 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 SIGNATURE(S) MUST 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.
