EX-4.1
from S-4
1 page
<page> Number Incorporated Under the Laws of the State of Delaware Shares Carlinville National Bank Shares, Inc. Total Authorized Issue See Reverse for 310,000 Shares Par Value $1.00 Each Certain Definitions This Is to Certify That Is the Owner of Fully Paid and Non-Assessable Shares of the Above Corporation 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. Witness, the Seal of the Corporation and the Signatures of Its Duly Authorized Officers. Dated Secretary President <page> 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. 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 Ten Ent -- As Tenants by the Entireties Jt Ten -- As Joint Tenants With Right of Survivorship and Not as Tenants in Common Unif Gift Min Act -- ........... Custodian ............. (Cust) (Minor) Under Uniform Gifts 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 - (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 19 in Presence Of
12/34/56