EX-4.1



 Exhibit 4.1 
  






 
 PROOF PROOF 
NUMBER SHARES

CIVITAS SOLUTIONS, INC. 
INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
SEE REVERSE FOR CERTAIN DEFINITIONS 
COMMON STOCK CUSIP 17887R 10 2 
THIS
CERTIFIES THAT: 
PROOF 
IS THE OWNER OF 
FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK OF $0.01 PAR VALUE EACH OF CIVITAS SOLUTIONS, INC. 
transferable on the books of the Corporation by the holder thereof in person or by duly authorized attorney upon surrender of this certificate duly endorsed or assigned. This
certificate and the shares represented hereby are subject to the laws of the State of Delaware, and to the Certificate of Incorporation and Bylaws of the Corporation, as now or hereafter amended. This certificate is not valid until countersigned by
the Transfer Agent. 
WITNESS the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers. 
DATED: 
COUNTERSIGNED: 
BROADRIDGE CORPORATE ISSUER SOLUTIONS, INC. 
1717 ARCH ST., STE. 1300, PHILADELPHIA, PA 19103

TRANSFER AGENT 
BY: 
AUTHORIZED SIGNATURE #1 
CIVITAS SOLUTIONS, INC. 
CORPORATE 
SEAL 
2007 
DELAWARE 
SECRETARY PRESIDENT 
©1990 COLUMBIA FINANCIAL PRINTING CORP. 







 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
	TEN ENT	 	-	 	as tenants by the entireties
	JT TEN	 	-	 	as joint tenants with right of survivorship and not as tenants in common

 


									
	UNIF GIFT MIN ACT -	 	  
	 	Custodian	 	  

		 	(Cust)	 		 	(Minor)
		 	under Uniform Gifts to Minors
		 	Act	 	  

		 		 	(State)

 
 

 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 TYPE NAME AND
ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE) 
  
  

 
  
  

			
	  
	 	Shares

 of the 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	 	  


  

			
		 	  

		 	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 WHATSOEVER.

 THE CORPORATION WILL FURNISH TO ANY STOCKHOLDER, UPON REQUEST AND WITHOUT CHARGE, A FULL STATEMENT OF THE DESIGNATIONS,
RELATIVE RIGHTS, PREFERENCES AND LIMITATIONS OF THE SHARES OF EACH CLASS AND SERIES AUTHORIZED TO BE ISSUED, SO FAR AS THE SAME HAVE BEEN DETERMINED, AND OF THE AUTHORITY, IF ANY, OF THE BOARD TO DIVIDE THE SHARES INTO CLASSES OR SERIES AND TO
DETERMINE AND CHANGE THE RELATIVE RIGHTS, PREFERENCES AND LIMITATIONS OF ANY CLASS OR SERIES. SUCH REQUEST MAY BE MADE TO THE SECRETARY OF THE CORPORATION OR TO THE TRANSFER AGENT NAMED ON THIS CERTIFICATE. 

 
 THE SIGNATURE TO THE ASSIGNMENT MUST CORRESPOND TO
THE NAME AS WRITTEN UPON THE FACE OF THIS CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER, AND MUST BE GUARANTEED BY A COMMERCIAL BANK OR TRUST COMPANY OR A MEMBER FIRM OF A NATIONAL OR REGIONAL OR OTHER
RECOGNIZED STOCK EXCHANGE IN CONFORMANCE WITH A SIGNATURE GUARANTEE MEDALLION PROGRAM. 
  

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