Exhibit 4.1


 




	
  

  	
  SG161 XXXXXX
  COMPUTERSHARE MR A SAMPLE MR B SAMPLE MR C SAMPLE MR D SAMPLE MR E SAMPLE THE
  PAVILIONS BRIDGWATER ROAD BRISTOL BS99 2GE All correspondence to:
  Computershare Investor Services PLC The Pavilions Bridgwater Road Bristol
  BS99 6ZZ Shareholder Helpline: +44 (0) 870 702 0000 You can check your
  holding at www.investorcentre.co.uk Share Certificate - Ordinary Shares of
  £0.001 Given under the signatures of a Director and the Company Secretary
  Shareholder Reference Number C0123456789 ISIN Certificate Class Broker Code
  Location Code GB00BVYV1687 OR1 250 C A company incorporated under the
  Companies Act 2006 in England and Wales with registered number 09338148
  Certificate Class OR1 Certificate No. 00032471 This certificate must be
  surrendered before any transfer of the whole or part of the shares herein
  mentioned can be registered. Registrar and Transfer Office: Computershare
  Investor Services PLC, The Pavilions, Bridgwater Road, Bristol BS99 6ZZ,
  Shareholder Helpline: +44 (0) 870 702 0000. You can check your holding at:
  www.investorcentre.co.uk L A M Number of Shares Issued 27 September 2002
  **17000** This is to certify that MR A SAMPLE MR B SAMPLE MR C SAMPLE MR D
  SAMPLE MR E SAMPLE is/are the Registered Holder(s) of seventeen thousand
  Ordinary Shares of £0.001, fully paid, in Adaptimmune Therapeutics plc
  subject to the Articles of Association of the Company. Adaptimmune
  Therapeutics plc Adaptimmune Therapeutics plc 001CS001_9999_CERT_SAMPLE/000001/000001/SG161/i
  *00000101010000* 000001 27 September 2002 seventeen thousand **17000**
  *17000*

  






 















	
  

  	
  Please check
  that your address details printed overleaf are correct. If you need to make
  any alterations or you are planning to move, you can let us know by
  registering with Investor Centre at www.investorcentre.co.uk. Once registered
  you can select the "Change of Address" option to amend your address
  details. Alternatively you can complete and sign the form below. Kindly Note:
  This form is issued only to the addressee(s) and is specific to the class of
  security and the unique designated account printed hereon. This personalised
  form is not transferable between different (i) account holders; (ii) classes
  of security; or (iii) uniquely designated accounts. The Company and
  Computershare Investor Services PLC accept no liability for any instruction
  that does not comply with these conditions. Computershare Investor Services
  PLC is Registered in England & Wales, No 3498808, Registered Office, The
  Pavilions, Bridgwater Road, Bristol BS13 8AE. Computershare Investor Services
  PLC is authorised and regulated by the Financial Conduct Authority In the
  case of joint holders ALL must sign. In the case of a corporation this form
  should be signed by two authorised signatories (e.g. Director & Company
  Secretary) stating their capacity. Alternatively, this form can be signed by
  a director of the company in the presence of a witness who attests the signature
  or under its common seal. T D A C0123456789 Computershare Investor Services
  PLC is Registered in England & Wales, No 3498808, Registered Office, The
  Pavilions, Bridgwater Road, Bristol BS13 8AE. Computershare Investor Services
  PLC is authorised and regulated by the Financial Conduct Authority Reference
  No. C0123456789 *C0123456789 Transfer No. GDT0077492 DUPLICATE Certificate
  No. 00032471 LSTSC *00032471* Number of Shares **17000** *00000017000* Date
  DD/MM/YY Signature (1) Signature (2) Signature (3) Signature (4) House Number
  Post Code Street/Road Name (BLOCK CAPITALS) Town/CITY (BLOCK CAPITALS)
  Country (BLOCK CAPITALS)