EX-4.1 3 a2195768zex-4_1.htm EXHIBIT 4.1

EXHIBIT 4.1

 

VOID VOID VOID

NUMBER

 

UNITS

 

 

*1**********

GS98

SPROTT PHYSICAL GOLD TRUST

**1*********

 

 

***1********

 

ESTABLISHED UNDER THE LAWS OF THE PROVINCE OF ONTARIO

*****1******

 

THIS CERTIFIES THAT

 

**SPECIMEN** 1 Class A **CUSIP**Certificate GS98****SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**

 

is the registered owner of

 

**SPECIMEN** 1 Class A **CUSIP**Certificate GS98****SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**Certificate GS98**SPECIMEN** 1 Class A **CUSIP**

 

FULLY PAID AND NON-ASSESSABLE UNITS OF

 

SPROTT PHYSICAL GOLD TRUST

 

transferable only on the books of the Trust by the registered holder in person or by duly authorized Attorney on surrender of this Certificate properly endorsed.

 

This Certificate is not valid until countersigned and registered by the Transfer Agent and Registrar of the Trust.

 

IN WITNESS WHEREOF the Trust has caused this Certificate to be signed by its duly authorized signatories.

 

SPROTT ASSET MANAGEMENT LP,

DATED 2007/03/24

by its General Partner, SPROTT ASSET MANAGEMENT GP INC.

 

 

COUNTERSIGNED AND REGISTERED BY

 

Equity Transfer & Trust Company Toronto, Ontario, Canada.

 

Transfer Agent and Registrar

 

 

 

Eric S. Sprott

Steven Rostowsky

By:

 

Chief Executive Officer

Chief Financial Officer

 

AUTHORIZED OFFICER

 

The Units represented by this Certificate are transferable at the offices of Equity Transfer & Trust Company, Toronto, Ontario, Canada

 

SECURITY INSTRUCTIONS ON REVERSE   VOIR LES INSTRUCTIONS DE SECURITE AU VERSO

 


 

FORM OF GOLD REDEMPTION NOTICE

 

FORM OF CASH REDEMPTION NOTICE

 

FOR VALUE RECEIVED.

 

 

 

 

 

 

DATE:

 

 

 

DATE:

 

 

 

 

 

 

 

hereby sell, assign and transfer unto

TO:   Equity Transfer & Trust Company (“Equity Transfer”), as the registrar and transfer agent of the Sprott Physical Gold Trust (the “Trust”)

 

TO:   Equity Transfer & Trust Company (“Equity Transfer”), as the registrar and transfer agent of the Sprott Physical Gold Trust (the “Trust”)

 

 

 

 

 

 

 

 

 

 

 

PLEASE INSERT SOCIAL INSURANCE NUMBER OF TRANSFEREE

Ticker Symbol

 

Ticker Symbol

 

 

 

 

 

 

 

 

 

 

 

(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS OF ASSIGNEE)

CUSIP number

 

CUSIP number

 

 

 

 

 

 

 

 

Attention

 

Attention

 

 

 

 

 

 

 

 

Fax No

 

Fax No

 

Shares of the Capital Stock represented by the within Certificate, and do hereby irrevocably constitute and appoint

AND TO: Sprott Asset Management LP, as the manager of the Trust (the “Manager”)

 

AND TO: Sprott Asset Management LP, as the manager of the Trust (the “Manager”)

 

 

RE:  Gold Redemption Notice under Section 6.1 of the Trust Agreement of the Trust

 

RE:  Cash Redemption Notice under Section 6.3 of the Trust Agreement of the Trust

 

Attorney to transfer the said Stock on the Books of the within named Corporation, with full power of substitution in the premises.

The undersigned, the holder of                                    units of the Trust (the “Units”) designated above by its Toronto Stock Exchange or New York Stock Exchange Arca Ticker symbol and CUSIP number, requests the redemption for physical gold bullion of the aforementioned Units in accordance with, and subject to the terms and conditions set forth in, an amended and restated trust agreement of the Trust dated as of December 7, 2009, as the same may be further amended, restated or supplemented from time to time, and directs Equity Transfer to cancel such units on  

 

The undersigned, the holder of                                    units of the Trust (the “Units”) designated above by its Toronto Stock Exchange or New York Stock Exchange Arca Ticker symbol and CUSIP number, requests the redemption for cash of the aforementioned Units in accordance with, and subject to the terms and conditions set forth in, an amended and restated trust agreement of the Trust dated as of December 7, 2009, as the same may be further amended, restated or supplemented from time to time, and directs Equity Transfer to cancel such units on 

 

 

Dated

 

 

 

 

 

 

 

 

 

Signature

 

 

 

 

 

 

 

 

 

NOTICE:  THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THE CERITIFICATE.  IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT, OR ANY CHANGE WHATSOEVER, AND MUST BE GUARANTEED BY A SCHEDULE 1 CANADIAN CHARTERED BANK OR AN ELIGIBLE GUARANTOR INSTITUTION WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM.

 

 

 

 

All physical gold bullion shall be delivered to the following address by armored transportation service carrier, which the undersigned hereby authorizes the Manager or its agent to retain on the undersigned’s behalf.

 

 

 

 

 

Wiring Instructions:

 

 

Delivery Instructions:

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Unitholder

 

Signature of Unitholder

 

 

 

 

 

Signature of Guarantee

 

Signature of Guarantee

 

 

 

 

 

 

Print Name

 

Print Name

 

 

 

 

 

 

 

Print Address

 

Print Address

 

Guaranteed by

 

 

 

 

 

NOTE:  The name and address of the  Unitholder set forth in this Gold Redemption Notice must correspond with the name and address as recorded on the register of the Trust maintained by  Equity Transfer.  The signature of the person executing this Gold Redemption Notice must be guaranteed by a Canadian chartered bank, or by a medallion signature guarantee from a member of a recognized Signature Medallion Guarantee Program.

 

NOTE:  The name and address of the  Unitholder set forth in this Cash Redemption Notice must correspond with the name and address as recorded on the register of the Trust maintained by  Equity Transfer.  The signature of the person executing this Cash Redemption Notice must be guaranteed by a Canadian chartered bank, or by a medallion signature guarantee from a member of a recognized Signature Medallion Guarantee Program.

 

RESTRICTIONS