Form of stock certificate for our Class A Common Stock




 Exhibit 4.1 

 

 

 CLASS A COMMON STOCK 

Certificate Number 

SC-009 

INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE 

SemGroup® 

CLASS A COMMON STOCK 

Shares 

CUSIP 81663A 105 

THIS CERTIFIES THAT 

SEE REVERSE SIDE FOR CERTAIN DEFINITIONS 

is the record holder of: 

FULLY PAID AND NON-ASSESSABLE SHARES OF CLASS A COMMON STOCK, $.01 PAR VALUE PER SHARE, OF 

SEMGROUP CORPORATION 

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. 
 WITNESS the facsimile seal of the Corporation and the facsimile signatures of
its duly authorized officers. 
 Dated: 

SECRETARY 

SEMGROUP CORPORATION 

CORPORATE 

SEAL 2005 

DELAWARE 

PRESIDENT AND CHIEF EXECUTIVE OFFICER 

PRECISE CORPORATE PRINTING, N.Y. 

COUNTERSIGNED AND REGISTERED: 

MELLON INVESTOR SERVICES LLC, 

TRANSFER AGENT AND REGISTRAR 

BY: 

AUTHORIZED OFFICER 








 A copy of the provisions setting forth the powers, designations, preferences and relative, participating,
optional or other special rights of each class of stock of the Corporation or series thereof and the qualifications, limitations or restrictions of such preferences and/or rights may be obtained without charge from the Transfer Agent or from the
Secretary of the Corporation. 
 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	  		 	(Cust)	 		 	(Minor)
	JT TEN	  	- as joint tenants with the right of survivorship	  		 	under Uniform Gifts to Minors Act
		  	  and not as tenants in common	  		 		 		 	
		  		  		 		 	  
	 	
		  		  		 		 	(State)	 	

 Additional abbreviations may also be used though not in the above list. 

FOR VALUE RECEIVED,
                                         
                                         
      sell, assign and transfer unto 
  

					
	 Please Insert Social Security or Other

Taxpayer Identification 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 stock on the books of the within named Corporation with full power of substitution in the premises. 

 

									
	Dated	 	
                    
     
	  		 	Signature(s)	 	  

		 		  		 		 	(THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THIS CERTIFICATE, IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT, OR ANY
CHANGE WHATSOEVER.)

  

					
	Signature Guaranteed By:	 	  
	 	
		 	THE SIGNATURE GUARANTEE MUST BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOANS ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN
APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17AD-15. A NOTARIZATION BY A NOTARY PUBLIC IS NOT ACCEPTABLE	 	

 **THIS CERTIFICATE IS TRANSFERABLE IN JERSEY CITY, NJ, NEW YORK, NY, AND PITTSBURGH, PA.