[CLASS B COMMON STOCK CERTIFICATE]
CLASS B CLASS B
COMMON STOCK COMMON STOCK
INCORPORATED UNDER SEE REVERSE FOR
THE LAWS OF THE CERTAIN DEFINITIONS
STATE OF TENNESSEE
CUSIP 03232P 20 7
THIS CERTIFIES THAT
IS THE OWNER OF
Fully paid and non-assessable shares of the Class B Common Stock, no
par value, of AmSurg Corp transferable on the books of the Corporation
by the holder hereof in person or by Attorney upon surrender of this
certificate properly endorsed. This certificate is not valid unless
countersigned by the Transfer Agent and registered by the Registrar.
IN WITNESS WHEREOF, the said Corporation has caused this Certificate to be
signed by its duly authorized officers.
/s/ Claire M. Gulmi /s/ Ken P. McDonald
Secretary President and Chief
The Company will furnish the shareholder information regarding the
designations, relative rights, preferences, and limitations applicable to each
class and series and the variations in rights, preferences, and limitations for
each class and series of stock issued by the Company (and the authority of the
board of directors to determine variations for future classes or series) upon
writing and without charge.
The following abbreviations, when used in the inscription on the face of
this certificate, shall be construed as though they are 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
UNIF GIFT MIN ACT -- ____________________ Custodian _______________________
under Uniform Gifts to Minors Act
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 ZIP CODE OF ASSIGNEE
of the capital 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.
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.
SIGNATURE(S) GUARANTEED: _______________________________________________________
THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE
FINANCIAL INSTITUTION (BANK, STOCKBROKERS, SAVINGS
AND LOAN ASSOCIATIONS AND CREDIT UNIONS) WITH
MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION
PROGRAM, PURSUANT TO SEC RULE 17Ad-15.