Exhibit 4.1




	
  

  	
  THIS CERTIFIES
  THAT is the owner of CUSIP DATED COUNTERSIGNED AND REGISTERED: COMPUTERSHARE
  TRUST COMPANY, N.A. TRANSFER AGENT AND REGISTRAR, FULLY-PAID AND
  NON-ASSESSABLE SHARES OF ORDINARY SHARES OF OM Asset Management plc
  transferable in accordance with, and subject to, the Company’s articles of
  association on the books of the Company in person or by duly authorized
  attorney upon surrender of this certificate properly endorsed. This
  certificate is not valid unless countersigned by the Transfer Agent and
  registered by the Registrar. Witness the facsimile signatures of its duly
  authorized officers. ORDINARY SHARES NOMINAL VALUE $0.001 ORDINARY SHARES
  THIS CERTIFICATE IS TRANSFERABLE IN CANTON, MA, JERSEY CITY, NJ AND COLLEGE
  STATION, TX SEE REVERSE FOR CERTAIN DEFINITIONS Certificate Number Shares .
  OM ASSET MANAGEMENT PLC INCORPORATED UNDER THE LAWS OF ENGLAND AND WALES WITH
  COMPANY NUMBER 09062478 FACSIMILE SIGNATURE TO COME FACSIMILE SIGNATURE TO
  COME President Secretary By AUTHORIZED SIGNATURE
  ZQ|CERT#|COY|CLS|RGSTRY|ACCT#|TRANSTYPE|RUN#|TRANS# XXXXXX XX X DD-MMM-YYYY *
  * 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 ZQ00000000 Certificate Numbers
  1234567890/1234567890 1234567890/1234567890 1234567890/1234567890
  1234567890/1234567890 1234567890/1234567890 1234567890/1234567890 Total
  Transaction Num/No. 123456 Denom. 123456 Total 1234567 MR A SAMPLE
  DESIGNATION (IF ANY) ADD 1 ADD 2 ADD 3 ADD 4 OM Asset Management plc PO BOX
  43004, Providence, RI 02940-3004 CUSIP XXXXXX XX X Holder ID XXXXXXXXXX Insurance
  Value 1,000,000.00 Number of Shares 123456 DTC 12345678 123456789012345 

  






 


 












	
  

  	
  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. 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. 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
  Ordinary Shares represented by the within Certificate, and do hereby irrevocably
  constitute and appoint to transfer the said stock on the books of the
  within-named Company with full power of substitution in the premises. . OM
  ASSET MANAGEMENT PLC A FULL STATEMENT OF THE POWERS, DESIGNATIONS,
  PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF
  EACH CLASS OF SHARES OF THE COMPANY OR SERIES THEREOF AND THE QUALIFICATIONS,
  LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND/OR RIGHTS WILL BE
  FURNISHED BY THE COMPANY WITHOUT CHARGE TO ANY SHAREHOLDER WHO SO REQUESTS
  UPON APPLICATION TO THE TRANSFER AGENT NAMED ON THE FACE HEREOF OR TO THE
  OFFICE OF THE SECRETARY OF THE COMPANY. THE TRANSFER OF THESE SHARES
  REPRESENTED BY THIS CERTIFICATE REQUIRES THE COMPLETION OF A SPECIALIZED
  STOCK TRANSFER FORM AND MAY BE SUBJECT TO THE UNITED KINGDOM’S HM REVENUE AND
  CUSTOMS STAMP DUTY. PLEASE CONTACT THE TRANSFER AGENT FOR ADDITIONAL
  INFORMATION. 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. For US purposes 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
  (Cust) (Minor) TEN ENT - as tenants by the entireties under Uniform Gifts to
  Minors Act (State) JT TEN - as joint tenants with right of survivorship UNIF
  TRF MIN ACT - Custodian (until age ) and not as tenants in common (Cust)
  under Uniform Transfers to Minors Act (Minor) (State) Additional
  abbreviations may also be used though not in the above list.