Exhibit
4.1


 




	
  i

   

   

  	
  THIS CERTIFIES
  THAT is the owner of CUSIP DATED COUNTERSIGNED AND REGISTERED: COMPUTERSHARE
  TRUST COMPANY, N.A. TRANSFER AGENT AND REGISTRAR, COMMON STOCK PAR VALUE
  $0.01 COMMON STOCK THIS CERTIFICATE IS TRANSFERABLE IN CANTON, MA AND NEW
  YORK, NY SEE REVERSE FOR CERTAIN DEFINITIONS Certificate Number Shares . By
  AUTHORIZED SIGNATURE FULLY PAID AND NONASSESSABLE SHARES OF COMMON STOCK PAR
  VALUE $0.01 EACH, OF Planet Payment, Inc. (the “Corporation”), transferable
  on the books of the Corporation by the said owner in person, or by duly
  authorized attorney, upon surrender of this Certificate together with a duly
  executed transfer instrument. This Certificate and the shares represented
  hereby are subject to all the terms, conditions and limitations of the
  Certificate of Incorporation and Bylaws and all amendments thereto and
  supplements thereof. This certificate is not valid until countersigned by the
  Transfer Agent and Registrar. WITNESS the facsimile seal of the Corporation
  and the facsimile signatures of the Corporation’s duly authorized officers.
  PLANET PAYMENT, INC. INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
  President Secretary ISIN US7270431015 016570| 003590|127C|RESTRICTED||4|057-423
  727043 101 <<Month Day, Year>> * * 000000* * * * * * * * *
  000000* * * * * * * * * 000000* * * * * * * * * 000000* * * * * * * * *
  000000* * ** Mr. Alexander David Sample **** Mr. Alexander David Sample ****
  Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander
  David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
  **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr.
  Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander
  David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
  **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr.
  Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander
  David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
  **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr.
  Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander
  David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
  **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr.
  Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander
  David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
  **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr.
  Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander
  David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
  **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr.
  Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander
  David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample
  **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr.
  Alexander David Sample **** Mr. Sample **** Mr. Sample
  **000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares***
  *000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****
  000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****0
  00000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****00
  0000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000
  000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****0000
  00**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****00000
  0**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000
  **Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000*
  *Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**
  Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**S
  ***ZERO HUNDRED THOUSAND ZERO HUNDRED AND ZERO*** MR. SAMPLE & MRS.
  SAMPLE & MR. SAMPLE & MRS. SAMPLE NNNNN ZQ 000000

  






 










 


 




	
  

  	
  The IRS
  requires that we report the cost basis of certain shares acquired after
  January 1, 2011. If your shares were covered by the legislation and you have
  sold or transferred the shares and requested a specific cost basis
  calculation method, we have processed as requested. If you did not specify a
  cost basis calculation method, we have defaulted to the first in, first out
  (FIFO) method. Please visit our website or consult your tax advisor if you
  need additional information about cost basis. If you do not keep in contact
  with us or do not have any activity in your account for the time periods
  specified by state law, your property could become subject to state unclaimed
  property laws and transferred to the appropriate state. . 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 under Uniform Gifts to Minors Act . . . . . . . . .
  . . . . JT TEN - as joint tenants with right of survivorship UNIF TRF MIN ACT
  . . . . . . . . . . . . . . .Custodian (until age. . . ). . . . . . . . . . .
  and not as tenants in common (Cust) (Minor) under Uniform Transfers 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
  _______________________________________________________________________________________________________________________________
  _______________________________________________________________________________________________________________________________
  _______________________________________________________________________________________________________________________________
  _______________________________________________________________________________________________________________________
  Shares
  _______________________________________________________________________________________________________________________
  Attorney Dated: __________________________________________20__________________
  Signature: ____________________________________________________________
  Signature: ____________________________________________________________
  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. (Cust) (Minor) (State) PLEASE INSERT
  SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE (PLEASE PRINT OR
  TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE) of the
  common stock represented by the within Certificate, and do hereby irrevocably
  constitute and appoint to transfer the said stock on the books of the
  within-named Corporation with full power of substitution in the premises.
  PLANET PAYMENT, INC. THE COMPANY WILL FURNISH WITHOUT CHARGE TO EACH
  SHAREHOLDER WHO SO REQUESTS, A SUMMARY OF THE POWERS, DESIGNATIONS,
  PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF
  EACH CLASS OF STOCK OF THE COMPANY AND THE QUALIFICATIONS, LIMITATIONS OR
  RESTRICTIONS OF SUCH PREFERENCES AND RIGHTS, AND THE VARIATIONS IN RIGHTS,
  PREFERENCES AND LIMITATIONS DETERMINED FOR EACH SERIES, WHICH ARE FIXED BY
  THE CERTIFICATE OF INCORPORATION OF THE COMPANY, AS AMENDED, AND THE
  RESOLUTIONS OF THE BOARD OF DIRECTORS OF THE COMPANY, AND THE AUTHORITY OF
  THE BOARD OF DIRECTORS TO DETERMINE VARIATIONS FOR FUTURE SERIES. SUCH
  REQUEST MAY BE MADE TO THE OFFICE OF THE SECRETARY OF THE COMPANY OR TO THE
  TRANSFER AGENT. THE BOARD OF DIRECTORS MAY REQUIRE THE OWNER OF A LOST OR
  DESTROYED STOCK CERTIFICATE, OR HIS LEGAL REPRESENTATIVES, TO GIVE THE
  COMPANY A BOND TO INDEMNIFY IT AND ITS TRANSFER AGENTS AND REGISTRARS AGAINST
  ANY CLAIM THAT MAY BE MADE AGAINST THEM ON ACCOUNT OF THE ALLEGED LOSS OR
  DESTRUCTION OF ANY SUCH CERTIFICATE. Signature(s) Guaranteed: Medallion
  Guarantee Stamp THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE
  GUARANTOR INSTITUTION (Banks, 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.