Document:

exv4w2

 

Exhibit 4.2

NATURAL INNOVATIVE RENEWABLE ENERGY

SUBSCRIPTION AGREEMENT

Limited Liability Company Membership Units

$1,000 per Unit

Minimum Investment of 20 Units ($20,000)

1 Unit Increments Thereafter ($1,000)

     The undersigned subscriber, desiring to become a member of Natural Innovative Renewable
Energy, L.L.C., an Iowa limited liability company, with its principal place of business at 121 S.
2nd Street, P.O. Box 366, Akron, Iowa 51001, hereby subscribes for the purchase of the
membership units of Natural Innovative Renewable Energy (“Units”), and agrees to pay the related
purchase price, identified below.

A. SUBSCRIBER INFORMATION. Please print your individual or entity name, address and telephone
numbers. Joint subscribers should provide both names. If we accept your subscription, the
units will be titled in the name of the subscriber as it appears below. Your name, address and
telephone numbers will be recorded exactly as printed below.

	 	 	 	 	 
	1.

	 	Subscriber’s Printed Name:	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	2.

	 	Subscriber’s Address:	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	 

	 	Street	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	 

	 	City, State, Zip Code	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	 

	 	County	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	3.

	 	Home Telephone Number	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	4.

	 	Business Telephone Number	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	5.

	 	Mobile Telephone Number	 	 
	 

	 	 	 	 

B. NUMBER OF UNITS PURCHASED. You must purchase at least 20 Units. The minimum purchase by a
single investor is 20 Units ($20,000) and increments of 1 Unit thereafter. The maximum number of
units to be sold in the offering is 60,000. Indicate the number of units purchased in the box
below.

	 	 	 	 	 
	 

	 	

units     
	 	 

C. PURCHASE PRICE. Indicate the dollar amount of your investment (minimum investment is
$20,000).

	 	 	 	 	 	 	 	 	 
	1.
Total Purchase Price

	 	=
	 	2. Ten Percent (10%) 1st
	 	+
	 	3. Ninety Percent (90%) 2nd
	 

	 	 	 	Installment
	 	 	 	Installment
	($1,000 per unit
multiplied by number
of units in part B
above)

	 	 	 	(10% of the Total Purchase 

Price)                  
                
	 	 	 	(90% of the Total
Purchase 

Price)                  
                

	 

	 	=
	 	 	 	+	 	 

D. GENERAL INSTRUCTIONS FOR SUBSCRIBERS:

     You should read the Prospectus dated                     , 2007 (the “Prospectus”) in its entirety
including exhibits for a complete explanation of an investment in Natural Innovative Renewable
Energy. Read the instructions below on how to complete a subscription for our units.

1

 

INSTRUCTIONS IF YOU ARE SUBSCRIBING PRIOR TO NATURAL INNOVATIVE RENEWABLE ENERGY’S RELEASE
OF FUNDS FROM ESCROW: If you are subscribing prior to Natural Innovative Renewable Energy’s
release of funds from escrow, you must follow Steps 1 through 5 below:

     1. Complete all information required in this Subscription Agreement, and date and sign the
Subscription Agreement on page 6 and the Member Signature Page to our Operating Agreement attached
to this Subscription Agreement as Exhibit A.

     2. Immediately provide your personal (or business) check for the first installment of ten
percent (10%) of your investment amount made payable to “Security National Bank, Escrow Agent for
Natural Innovative Renewable Energy, L.L.C.” You will determine this amount in box C.2 on page 1
of this Subscription Agreement.

     3. Execute the Promissory Note and Security Agreement on page 8 of this Subscription Agreement
evidencing your commitment to pay the remaining ninety percent (90%) due for the Units subscribed
and grant Natural Innovative Renewable Energy a security interest in your units.

     4. Deliver each of the original executed documents referenced in Items 1 and 3 of these
Instructions, together with your personal or business check described in Item 2 of these
Instructions to either of the following:

	 	 	 
	Natural Innovative Renewable Energy, L.L.C.

	 	First National Bank
	Attn: John Lucken, Chairman

	 	For Credit To Account:
	121 S. 2nd Street

	 	Security National Bank, Escrow Agent for
	P.O. Box 366

	 	Natural Innovative Renewable Energy, L.L.C.
	Akron, IA 51001

	 	251 Reed Street

Akron, IA 51001

     5. Within 20 days of written notice from Natural Innovative Renewable Energy that your
subscription has been accepted, you must remit an additional personal (or business) check for the
second installment of ninety percent (90%) of your investment amount made payable to “Security
National Bank, Escrow Agent for Natural Innovative Renewable Energy, L.L.C.” in satisfaction of the
Promissory Note and Security Agreement. You will determine this amount in box C.3 on page 1 of
this Subscription Agreement. Deliver this check to the same address set forth above in Instruction
4 within twenty (20) days of the date of Natural Innovative Renewable Energy’s written notice. If
you fail to pay the second installment pursuant to the Promissory Note and Security Agreement,
Natural Innovative Renewable Energy shall be entitled to retain your first installment and to seek
other damages, as provided in the Promissory Note and Security Agreement. This means that if you
are unable to pay the 90% balance of your investment amount within 20 days of our notice, you may
have to forfeit the 10% cash deposit.

     Your funds will be placed in Natural Innovative Renewable Energy’s escrow account at Security
National Bank, Sioux City, Iowa. The funds will be released to Natural Innovative Renewable Energy
or returned to you in accordance with the escrow arrangements described in the Prospectus. Natural
Innovative Renewable Energy may, in its sole discretion, reject or accept any part or all of your
subscription. If Natural Innovative Renewable Energy rejects your subscription, your Subscription
Agreement and investment will be returned to you within 30 days of such rejection, plus nominal
interest, minus escrow fees. Natural Innovative Renewable Energy may not consider the acceptance
or rejection of your subscription until a future date near the end of this offering.

INSTRUCTIONS IF YOU ARE SUBSCRIBING AFTER NATURAL INNOVATIVE RENEWABLE ENERGY’S RELEASE OF
FUNDS FROM ESCROW: If you are subscribing after Natural Innovative Renewable Energy’s release of
funds from escrow, you must follow Steps 1 through 3 below:

     1. Complete all information required in this Subscription Agreement, and date and sign the
Subscription Agreement on page 6 and the Member Signature Page to our Operating Agreement attached
to this Subscription Agreement as Exhibit A.

     2. Immediately provide your personal (or business) check for the entire amount of your
investment (as determined in Box C.1 on page 1) made payable to “Natural Innovative Renewable
Energy, L.L.C.”

     3. Deliver the original executed documents referenced in Item 1 of these Instructions,
together with your personal or business check described in Item 2 of these Instructions to the
following:

2

 

Natural Innovative Renewable Energy, L.L.C.

P.O. Box 366

Akron, Iowa 51001

     If you are subscribing after we have released funds from escrow and we accept your investment,
your funds will be immediately at-risk as described in the Prospectus. Natural Innovative
Renewable Energy may, in its sole discretion, reject or accept any part or all of your
subscription. If Natural Innovative Renewable Energy rejects your subscription, your Subscription
Agreement and investment will be returned to you promptly, plus nominal interest, minus escrow
fees. Natural Innovative Energy may not consider the acceptance or rejection of your subscription
until a future date near the end of this offering.

You may direct your questions to any of our directors at (712) 568-1000.

F. Additional Subscriber Information. The Subscriber, named above, certifies the following under
penalties of perjury:

	 	1.	 	Form of Ownership. Check the appropriate box (one only) to indicate form of
ownership. If the subscriber is a Custodian, Corporation, Partnership or Trust, please
provide the additional information requested.

	 	 	 	 	 	 	 
	o	 	Individual
	o	 	Joint Tenants with Right of Survivorship (Both signatures must appear on page 6.)
	o	 	Corporation, Limited Liability Company or Partnership (Corporate
Resolutions, Operating Agreement or Partnership Agreement must be enclosed.)
	o	 	Trust
	 

	 	     Trustee’s Name:	 	 	 	 
	 

	 	 	 	 	 	 
	 

	 	     Trust Date:	 	 	 	 
	 

	 	 	 	 	 	 
	o	 	Other: Provide detailed information in the space immediately below.
	 
	 	 	 	 	 	 
	 	 	 	 	 
	 
	 	 	 	 	 	 
	 	 	 	 	 

	 	2.	 	Subscriber’s Taxpayer Information. Check the appropriate box if you are a
non-resident alien, a U.S. Citizen residing outside the United States, and/or subject
to backup withholding. All individual subscribers should provide their Social Security
Numbers. Trusts should provide the trust’s taxpayer identification number. Custodians
should provide the minor’s Social Security Number. Other entities should provide the
entity’s taxpayer identification number.

	 	 	 	 	 	 	 
	o	 	Check box if you are a non-resident alien
	o	 	Check box if you are a U.S. citizen residing outside of the United States
	o	 	Check this box if you are subject to backup withholding
	 	 	 	 	 
	Subscriber’s Social Security No.	 	 	 	 
	 

	 	 	 	 	 	 
	Joint Subscriber’s Social Security No.	 	 	 	 
	 

	 	 	 	 	 	 
	Taxpayer Identification No.	 	 	 	 
	 

	 	 	 	 	 	 

	 	3.	 	Member Report Address. If you would like duplicate copies of member reports
sent to an address that is different than the address identified in section A, please
complete this section.

	 	 	 	 	 
	Address:
	 	 	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	 

	 	 

	 	 

	 	4.	 	State of Residence.

	 	 	 	 	 
	State of Principal Residence:
	 	 	 	 
	 

	 	 	 	 
	State where driver’s license is issued:
	 	 	 	 
	 

	 	 	 	 
	State where resident income taxes are filed:
	 	 	 	 
	 

	 	 

	 	 

3

 

	 	 	 	 	 
	State(s) in which you have maintained your principal residence during the past three
years:

	 	 	 	 	 	 	 	 	 
	 	a.

	 	 	b.

	 	 	c.

	 
	 

	 	5.	 	Suitability Standards. You cannot invest in Natural Innovative Renewable
Energy unless you meet one of the following suitability tests (a or b) set forth below.
Please review the suitability tests and check the box next to the following
suitability test that you meet. For husbands and wives purchasing jointly, the tests
below will be applied on a joint basis.

For investors that reside in states other than Iowa:

a. o I (We) have annual income from whatever source of at least $45,000 and a net
worth of at least $45,000, exclusive of home, furnishings and automobiles; or

b. o I (We) have a net worth of at least $150,000, exclusive of home, furnishings
and automobiles.

For Iowa investors:

a. o I (We) have annual income from whatever source of at least
$70,000 and a net worth of at least $70,000, exclusive of home,
furnishings and automobiles; or

b. o I (We) have a net worth of at least $250,000, exclusive of
home, furnishings and automobiles.

I (We) certify that I (we) satisfy one of the suitability requirements set forth as
(a) and (b) above.

	 	 	 
	 

	 	 
	Signature of Individual Subscriber

	 	Signature of Joint Subscriber
	 

	 	(if applicable)

Subscriber’s Representations and Warranties. You must read and certify your representations and
warranties by placing your initials where indicated and by signing and dating this Subscription
Agreement. Joint subscribers are also required to initial and sign as indicated.

(Initial here) (Joint initials) By signing below the subscriber represents and warrants to Natural
Innovative Renewable Energy that he, she or it:

	 	 	 	 	 
	

 

	 	

 

	 	a. has received a copy of Natural Innovative Renewable
Energy’s Prospectus dated [DATE OF EFFECTIVENESS] and
the exhibits thereto or has received notice that this
sale has been made pursuant to a registration
statement in which a final prospectus would have been
required to have been delivered in the absence of Rule
172;
	 
	

 

	 	

 

	 	b. has been informed that the units of Natural Innovative
Renewable Energy are offered and sold in reliance upon
a federal securities registration; state registrations
in Iowa, South Dakota, North Dakota, Nebraska and
Colorado and understands that the units to be issued
pursuant to this subscription agreement can only be
sold to a person meeting requirements of suitability;
	 
	

 

	 	

 

	 	c. has been informed that the securities purchased
pursuant to this Subscription Agreement have not been
registered under the securities laws of any state
other than Iowa, South Dakota, North Dakota, Nebraska
and Colorado and that Natural Innovative Renewable
Energy is relying in part upon the representations of
the undersigned Subscriber contained herein;
	 
	

 

	 	

 

	 	d. has been informed that the securities subscribed for
have not been approved or disapproved by the SEC, or
the Iowa, South Dakota, North Dakota, Nebraska or
Colorado Securities Departments or any other
regulatory authority, nor has any regulatory authority
passed upon the accuracy or adequacy of the
Prospectus;
	 
	

 

	 	

 

	 	e. intends to acquire the units for his/her/its own
account without a view to public distribution or
resale and that he/she/it has no contract,
undertaking, agreement or arrangement to sell or
otherwise transfer or dispose of any units or any
portion thereof to any other person;
	 
	

 

	 	

 

	 	f. understands that there is no present market for
Natural Innovative Renewable Energy’s membership
units, that the membership units will not trade on an
exchange or automatic

4

 

	 	 	 	 	 
	

 

	 	

 

	 	quotation system, that no such
market is expected to develop in the future and that
there are significant restrictions on the
transferability of the membership units;
	 
	

 

	 	

 

	 	g. has been encouraged to seek the advice of his legal
counsel and accountants or other financial advisers
with respect to investor-specific tax and/or other
considerations relating to the purchase and ownership
of units;
	 
	

 

	 	

 

	 	h. has received a copy of the Natural Innovative
Renewable Energy Operating Agreement, dated April 14,
2006, as amended (the “Operating Agreement”) and
understands that upon closing the escrow by Natural
Innovative Renewable Energy, the subscriber and the
membership units will be bound by the provisions of
the Operating Agreement which contains, among other
things, provisions that restrict the transfer of
membership units;
	 
	

 

	 	

 

	 	i. understands that the units are subject to substantial
restrictions on transfer under certain tax and
securities laws along with restrictions in the Natural
Innovative Renewable Energy Operating Agreement, and
agrees that if the membership units or any part
thereof are sold or distributed in the future, the
subscriber shall sell or distribute them pursuant to
the terms of the Operating Agreement, and the
requirements of the Securities Act of 1933, as
amended, and applicable tax and securities laws;
	 
	

 

	 	

 

	 	j. meets the suitability test marked in Item E.5 above
and is capable of bearing the economic risk of this
investment, including the possible total loss of the
investment;
	 
	

 

	 	

 

	 	k. understands that Natural Innovative Renewable Energy
will place a restrictive legend on any certificate
representing any unit containing substantially the
following language as the same may be amended by the
Directors of Natural Innovative Renewable Energy in
their sole discretion:
	 
	 	 	 	 
	 

	 	 	 	      THE TRANSFERABILITY OF THE MEMBERSHIP UNITS REPRESENTED BY THIS
CERTIFICATE IS RESTRICTED. SUCH UNITS MAY NOT BE SOLD,
ASSIGNED, OR TRANSFERRED, AND NO ASSIGNEE, VENDEE, TRANSFEREE
OR ENDORSEE THEREOF WILL BE RECOGNIZED AS HAVING ACQUIRED ANY
SUCH UNITS FOR ANY PURPOSES, UNLESS AND TO THE EXTENT SUCH
SALE, TRANSFER, HYPOTHECATION, OR ASSIGNMENT IS PERMITTED BY,
AND IS COMPLETED IN STRICT ACCORDANCE WITH, APPLICABLE FEDERAL
AND STATE LAW AND THE TERMS AND CONDITIONS SET FORTH IN THE
OPERATING AGREEMENT OF THE COMPANY, AS AMENDED FROM TIME TO
TIME.

	 
	 	 	 	 
	 

	 	 	 	      THE SECURITIES REPRESENTED BY THIS CERTIFICATE MAY NOT BE SOLD,
OFFERED FOR SALE OR TRANSFERRED IN THE ABSENCE OF AN EFFECTIVE
REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND
UNDER APPLICABLE STATE SECURITIES LAWS, OR AN OPINION OF
COUNSEL SATISFACTORY TO THE COMPANY THAT SUCH TRANSACTION IS
EXEMPT FROM REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS
AMENDED, AND UNDER APPLICABLE STATE SECURITIES LAWS.

	 
	 	 	 	 
	

 

	 	

 

	 	l. understands that, to enforce the above legend, Natural
Innovative Renewable Energy may place a stop transfer
order with its registrar and stock transfer agent (if
any) covering all certificates representing any of the
membership units;
	 
	

 

	 	

 

	 	m. may not transfer or assign this Subscription
Agreement, or any of the subscriber’s interest herein
without the prior written consent of Natural
Innovative Renewable Energy;
	 
	

 

	 	

 

	 	n. has written his, her, or its correct taxpayer
identification number under Item E.2 on this
Subscription Agreement;
	 
	

 

	 	

 

	 	o. is not subject to back up withholding either because
he, she or it has not been notified by the Internal
Revenue Service (“IRS”) that he, she or it is subject
to backup withholding as a result of a failure to
report all interest or dividends, or the IRS has
notified him, her or it that he is no longer subject
to backup withholding (Note this clause (p) should be
crossed out if the backup withholding box in Item E.2
is checked);
	 
	

 

	 	

 

	 	p. understands that execution of the attached Promissory
Note and Security Agreement will allow Natural
Innovative Renewable Energy or its assigns to pursue
the obligor for payment of the amount due thereon by any legal means, including, but not limited to,
acquisition of a

5

 

	 	 	 	 	 
	 

	 	 	 	judgment against the obligor in the event that the subscriber
defaults on that Promissory Note and Security Agreement; and
	 
	

 

	 	

 

	 	q. acknowledges that Natural Innovative
Renewable Energy may retain possession of
certificates representing subscriber’s units
to perfect its security interest in those
units.

By executing this Subscription Agreement below, the Subscriber agrees to be bound by all of the
terms, provisions, warranties, representations and conditions contained in this Subscription
Agreement.

Signature of Subscriber/Joint Subscriber:

Date:

	 	 	 
	Sign below if subscribing as an Individual or 

as joint tenants:

	 	Sign below if subscribing as a trust or other business

entity:
	 
	 	 
	 

	 	 
	      Name of Individual Subscriber (Please Print)

	 	      Name of Entity (Please Print)
	 
	 	 
	 

	 	 
	      Signature of Individual

	 	     Print Name and Title of Officer
	 
	 	 
	 

	 	 
	      Name of Joint Individual Subscriber (Please Print)

	 	     Signature of Officer
	 
	 	 
	 

      Signature of Joint Individual Subscriber

	 	 

ACCEPTANCE OF SUBSCRIPTION BY NATURAL INNOVATIVE RENEWABLE ENERGY, L.L.C.:

Natural Innovative Renewable Energy, L.L.C. hereby accepts the subscription for the above Units.

Dated this ___day of                                                             , 200___.

Natural Innovative Renewable Energy, L.L.C.

	 	 	 	 	 
	By:
	 	 	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	Its:
	 	 	 	 
	 

	 	 

	 	 

6

 

PROMISSORY NOTE AND SECURITY AGREEMENT

Date of Subscription Agreement:                                         , 200___.

$1,000 per Unit

Minimum Investment of 20 Units ($20,000); 1 Unit Increments Thereafter ($1,000 each)

	 	 	 	 	 	 	 	 	 
	 

	 	 	 	 	 	 	 	Number of Units Subscribed
	 	 	 
	 
	 

	 	 	 	 	 	 	 	Total Purchase Price ($1,000 per unit multiplied by number of units subscribed)
	 	 	 
	 
	(

	 	 	)	 	 	 	 	Less Initial Payment (10% of Principal Amount)
	 

	 	 	 	 	 	 	 
	 
	 

	 	 	 	 	 	 	 	Principal Balance
	 	 	 

     FOR VALUE RECEIVED, the undersigned obligor (the “Obligor”) hereby promises to pay to the
order of Natural Innovative Renewable Energy, L.L.C., a Iowa limited liability company (“Natural
Innovative Renewable Energy” or the “Company”), at its principal office located at P.O. Box 366,
121 S. 2nd Street, Akron, IA 51001, or at such other place as required by Natural
Innovative Renewable Energy, the Principal Balance set forth above, in one lump sum to be paid
without interest within 20 days following the call of the Natural Innovative Renewable Energy Board
of Directors, as described in the Subscription Agreement. In the event the undersigned fails to
timely make any payment owed, the entire balance of any amounts due under this full recourse
Promissory Note and Security Agreement shall be immediately due and payable in full with interest
at the rate of 12% per annum from the due date and any amounts previously paid in relation to the
obligation evidenced by this Promissory Note and Security Agreement, including the 10% installment
payment due upon subscription, may be forfeited at the discretion of Natural Innovative Renewable
Energy.

     The undersigned agrees to pay to Natural Innovative Renewable Energy on demand, all costs and
expenses incurred to collect any indebtedness evidenced by this Promissory Note and Security
Agreement, including, without limitation, reasonable attorneys’ fees. This Promissory Note and
Security Agreement may not be modified orally and shall in all respects be governed by, construed,
and enforced in accordance with the laws of the State of Iowa.

     The provisions of this Promissory Note and Security Agreement shall inure to the benefit of
Natural Innovative Renewable Energy and its successors and assigns. In the event that the
undersigned defaults on this on the obligations provided in this Promissory Note and Security
Agreement, Natural Innovative Renewable Energy or its assigns have the right to: (i) terminate
Obligor’s interests in Natural Innovative Renewable Energy, including redeeming Obligor’s
Membership Units and retaining as liquidated damages all sums paid to date; (ii) pursue collection
of the remaining balance due through legal proceedings, with Obligor paying all costs to collect
such balance, including reasonable attorneys’ fees; (iii) offer for sale the Obligor’s Membership
Units; and (iv) pursue any other remedy available to Natural Innovative Renewable Energy under law.

     The undersigned grants to Natural Innovative Renewable Energy its successors and assigns
(“Secured Party”), a purchase money security interest in all of the undersigned’s Membership Units
of Natural Innovative Renewable Energy now owned or hereafter acquired. This security interest is
granted as non-exclusive collateral to secure payment and performance on the obligation owed
Secured Party from the undersigned evidenced by this Promissory Note and Security Agreement. The
undersigned further authorizes Secured Party to retain possession of certificates representing such
Membership Units and to take any other actions necessary to perfect the security interest granted
herein.

     The undersigned waives presentment, demand for payment, notice of dishonor, notice of protest,
and all other notices or demands in connection with the delivery, acceptance, performance or
default of this Promissory Note and Security Agreement.

[Remainder of Page Intentionally Left Blank]

7

 

Dated:                                         , 200______.

	 	 	 	 	 	 	 	 	 	 	 
	OBLIGOR/DEBTOR:	 	 	 	JOINT OBLIGOR/DEBTOR:	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 
	Printed or Typed Name of Obligor	 	 	 	Printed or Typed Name of Joint Obligor	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	By:

	 	 	 	 	 	By:	 	 	 	 
	 

	 	 
	 	 	 	 	 	 	 	 
	 

	 	      Signature
	 	 	 	 	 	     Signature
	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	Officer Title if Obligor is an Entity	 	 	 	 	 	 	 	 

	 	 	 	 	 
	Address of Obligor:
	 	 	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	 

	 	 

	 	 

8

 

EXHIBIT “A”

MEMBER SIGNATURE PAGE

ADDENDA

TO THE

OPERATING AGREEMENT OF

NATURAL INNOVATIVE RENEWABLE ENERGY, L.L.C.

     The undersigned does hereby represent and warrant that the undersigned, as a condition to
becoming a Member in Natural Innovative Renewable Energy, LLC, has received a copy of the Operating
Agreement, dated April 14, 2006, and, if applicable, all amendments and modifications thereto, and
does hereby agree that the undersigned, along with the other parties to the Operating Agreement,
shall be subject to and comply with all terms and conditions of said Operating Agreement in all
respects as if the undersigned had executed said Operating Agreement on the original date thereof
and that the undersigned is and shall be bound by all of the provisions of said Operating Agreement
from and after the date of execution hereof.

	 	 	 
	Individuals:

	 	Entities:
	 
	 	 
	 

	 	 
	      Name of Individual Member (Please Print)

	 	      Name of Entity (Please Print)
	 
	 	 
	 

	 	 
	      Signature of Individual Member

	 	      Print Name and Title of Officer
	 
	 	 
	 

	 	 
	     Name of Joint Individual Member (Please Print)

	 	      Signature of Officer
	 
	 	 
	 

      Signature of Joint Individual Member

	 	 

Agreed and accepted on behalf of the

Company and its Members:

NATURAL INNOVATIVE RENEWABLE ENERGY, L.L.C.

	 	 	 	 	 
	By:
	 	 	 	 
	 

	 	 	 	 
	 
	 	 	 	 
	Its:Ex-4.1

 

EXHIBIT
4.1

	COMMON SHARES Pharmacy Benefits Manager

	NATIONAL MEDICAL HEALTH CARD SYSTEMS, INC.

	CUSIP 63918l 30 2

	INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE

	THIS CERTIFIES THAT

	SPECIMEN

	IS THE OWNER OF

	FULLY PAID AND NON-ASSESSABLE COMMON SHARES, PAR VALUE $.001 PER SHARE, OF

	transferable only on the
certifilate properly endorsed. This certificate and the shares represenyed hereby issued and
shall l%e|held subject to all the provisions of the certificateir If the Corporation and and
amendments thereto to all of whichthe holder of certificate by acceptance hereof asents.
This Certificates is not valid unless countersigned registered by the Transfer.

	Witness the facsimile seal of the Corporation and the facsimile signatures of its duly
authorized officers.

	NATIONAL MEDICAL HEALTH CARD SYSTEM, INC,

	CORPORATE SEAL

	2001

	Dated:

	CORPORATE SECRETARY CHAIRMAN OF THE BOARD

 

 

	The Corporation will furnish to any shareholder, upon request and without charge, a
full statement of the designation, relative rights,

	preferences, and limitations of the shares of each class of stock of the Corporation
authorized to be issued and the designation, relative rights, preferences, and
limitations of each series of Preferred Shares so far as they have been fixed by the
Board of Directors of the Corporation pursuant to authority heretofore granted to it.

	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
TENENT  — 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 (Stale)
Additional abbreviations may also be used though not in the above list. • .
PLEASE INSERT SOCIAL SECURITY OR OTHER

	IDENTIFYING NUMBER OF ASSIGNEE

	(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE)

	• * . »

	Signature(s) Guaranteed:

	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.

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