Specimen Common Stock Certificate



 Exhibit 4.1 

 

	
	





 016570| 003590|127C|RESTRICTED||4|057-423 

COMMON STOCK 
 NO PAR VALUE 
 COMMON STOCK 

THIS CERTIFICATE IS TRANSFERABLE IN 
 CANTON, MA AND NEW YORK, NY 
 Certificate

 Number 
 ZQ 000000 
 * * 600620* * * * * * 

* * * 600620* * * * * 
 * * * * 600620* * * * 
 * * * * * 600620* * *

 * * * * * * 600620* * 
 ADVANCED EMISSIONS SOLUTIONS, INC. 
 INCORPORATED
UNDER THE LAWS OF THE STATE OF DELAWARE 
 THIS CERTIFIES THAT 

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 * * * SIX HUNDRED THOUSAND 
 SIX HUNDRED AND TWENTY* * * 
 is the owner of

 FULLY-PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK OF 

Advanced Emissions Solutions, Inc. (hereinafter called the “Company”), transferable on the books of the Company
in person or by duly authorized attorney, upon surrender of this Certificate properly endorsed. This Certificate and the shares represented hereby, are issued and shall be held subject to all of the provisions of the Certificate of Incorporation, as
amended, and the Bylaws, as amended, of the Company (copies of which are on file with the Company and with the Transfer Agent), to all of which each holder, by acceptance hereof, assents. This Certificate is not valid unless countersigned and
registered by the Transfer Agent and Registrar. 
 Witness the facsimile seal of the Company and the facsimile
signatures of its duly authorized officers. 
 DATED <<Month Day, Year>> 

COUNTERSIGNED AND REGISTERED: 
 COMPUTERSHARE TRUST COMPANY, N.A. 
 TRANSFER AGENT
AND REGISTRAR, 
 President & CEO 
 By 
 AUTHORIZED SIGNATURE 

ADVANCED EMISSIONS SOLUTIONS, INC. 
 PO BOX 43004, Providence, RI 02940-3004 
 MR A
SAMPLE 
 DESIGNATION (IF ANY) 
 ADD 1 
 ADD 2 

ADD 3 
 ADD 4 
 CUSIP XXXXXX XX X 

Holder ID XXXXXXXXXX 
 Insurance Value 1,000,000.00 
 Number of Shares
123456 
 DTC 12345678 123456789012345 
 Certificate Numbers 
 1234567890/1234567890

 1234567890/1234567890 
 1234567890/1234567890 
 1234567890/1234567890

 1234567890/1234567890 
 1234567890/1234567890 
 Total Transaction

 Num/No. 
 123456 
 Denom. 

123456 
 Total 
 1234567