EX-4.3
from S-3
2 pages
016570| 003590|127c|restricted||4|057-423 Common Stock No Par Value Common Stock This Certificate Is Transferable in Canton, Ma and New York, Ny Certificate Number Zq 000000 Cti Biopharma Corp. Incorporated Under the Laws of the State of Washington This Certifies That Mr. Sample & Mrs. Sample & Mr. Sample & Mrs. Sample Cusip 12648l 10 6 See Reverse for Certain Definitions Shares * * 000000 * * * * * * * * * 000000 * * * * * * * * * 000000 * * * * * * * * * 000000* * * * * * * * * 000000* * Is the Owner of ***Zero Hundred Thousand Zero Hundred and Zero*** Fully-Paid and Non-Assessable Shares of Common Stock, No Par Value, of Cti Biopharma Corp. (Hereinafter Called the “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. This Certificate Is Not Valid Until Countersigned and Registered by the Transfer Agent and 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. President and Chief Executive Officer Executive Vice President, Finance and Administration Cti Biopharma Corp. Corporate 1991 Seal Washington Dated <<month Day, Year>> Countersigned and Registered: Computershare Trust Company, N.A. Transfer Agent and Registrar, by Authorized Signature Security Instructions on Reverse Cti Biopharma Corp. Po Box 43004, Providence, Ri 02940-3004 Mr a Sample Designation (If Any) Add 1 Add 2 Add 3 Add 4 Cusip Holder Id Insurance Value Number of Shares Dtc Certificate Numbers 1234567890/1234567890 1234567890/1234567890 1234567890/1234567890 1234567890/1234567890 1234567890/ 1234567890 1234567890/1234567890 Total Transaction 12648l 10 6 Xxxxxxxxxx 1,000,000.00 123456 12345678 123456789012345 Num/No. Denom. Total 123456 123456 1234567 1234567 CTI BioPharma Corp
12/34/56