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Exhibit 4.1
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<S> <C> <S>
COMMON STOCK COMMON STOCK
---------------- ----------------
NUMBER SHARES
[INSYNQ LOGO APPEARS HERE]
---------------- ----------------
INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE CUSIP 45809X 10 5
SEE REVERSE FOR
CERTAIN DEFINITIONS
THIS CERTIFIES THAT
is the record holder of
FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $.001 PAR VALUE PER SHARE, OF
------------------------------------- INSYNQ, Incorporated -----------------------------------------
transferable on the books of the Corporation in person or by duly authorized attorney upon
surrender of the Certificate properly endorsed. This Certificate is not valid until
countersigned by the Transfer Agent and registered by the Registrar.
Witness the facsimile seal of the Corporation and the facsimile signatures of its duly
authorized officers.
Dated:
/s/ M. Carroll Benton [CORPORATE SEAL] /s/ John P. Gorst
SECRETARY AND TREASURER CHAIRMAN AND CHIEF EXECUTIVE OFFICER
COUNTERSIGNED AND REGISTERED:
COLONIAL STOCK TRANSFER COMPANY
TRANSFER AGENT
AND REGISTRAR
AUTHORIZED SIGNATURE
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INSYNQ, Incorporated
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:
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<S> <C> <C> <C>
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 TRF MIN ACT -- __________ Custodian (until age ___)
(Cust)
____________ under Uniform Transfers
(Minor)
to Minors Act ______________________
(State)
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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(es) hereby
irrevocably constitute and appoint
_______________________________________________________________________ Attorney
to transfer the said stock on the books of the within named Corporation with
full power of substitution in the premises.
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<S> <C>
Dated ___________________________________
X ________________________________________________
X ________________________________________________
NOTICE: THE SIGNATURE(S) TO THIS ASSIGNMENT MUST
CORRESPOND WITH THE NAME(S) AS WRITTEN UPON THE
FACE OF THE CERTIFICATE IN EVERY PARTICULAR
WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE
WHATEVER.
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Signature(s) Guaranteed:
By _____________________________________________________________________
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.