Form of Medium-Term Notes, Series K, Notes due December 19, 2029



 Exhibit 4.1 
 [Face of Note] 
 Unless this certificate is presented by an authorized
representative of The Depository Trust Company, a New York corporation (“DTC”), to the Company or its agent for registration of transfer, exchange or payment, and any certificate issued is registered in the name of Cede &
Co. or in such other name as requested by an authorized representative of DTC (and any payment is made to Cede & Co. or such other entity as is requested by an authorized representative of DTC), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR
VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL inasmuch as the registered owner hereof, Cede & Co., has an interest herein. 
  

			
	CUSIP NO. 94986RMG3	  	PRINCIPAL AMOUNT: $                
	REGISTERED NO.      	  	

 WELLS FARGO & COMPANY 

MEDIUM-TERM NOTE, SERIES K 
 Due Nine Months or More From Date of Issue 
 Notes due December 19,
2029 
 WELLS FARGO & COMPANY, a corporation duly organized and existing under the laws of the State of Delaware
(hereinafter called the “Company,” which term includes any successor corporation under the Indenture hereinafter referred to), for value received, hereby promises to pay to CEDE & Co., or registered assigns, the principal
sum
of                                         
            DOLLARS ($                ) on December 19, 2029 (the “Stated Maturity Date”) and
to pay interest thereon from December 19, 2012 or from the most recent Interest Payment Date to which interest has been paid or duly provided for quarterly on each March 19, June 19, September 19 and December 19, commencing
March 19, 2013 and ending at Maturity (each, an “Interest Payment Date”), at the rate per annum specified below until the principal hereof is paid or made available for payment. The interest so payable, and punctually paid or
duly provided for, on any Interest Payment Date will, as provided in the Indenture, be paid to the Person in whose name this Security (or one or more Predecessor Securities) is registered at the close of business on the Regular Record Date for such
interest next preceding such Interest Payment Date. The Regular Record Date for an Interest Payment Date shall be one Business Day prior to such Interest Payment Date. If an Interest Payment Date is not a Business Day, interest on this Security
shall be payable on the next day that is a Business Day, with the same force and effect as if made on such Interest Payment Date, and without any interest or other payment with respect to the delay. “Business Day” shall mean a day,
other than a Saturday or Sunday, that is neither a legal holiday nor a day on which banking institutions are authorized or required by law or regulation to close in New York, New York. 

Except as described below for the first Interest Period, on each Interest Payment Date, interest will be paid for the period commencing
on and including the immediately preceding 







 
Interest Payment Date and ending on and including the day immediately preceding that Interest Payment Date. This period is referred to as an “Interest Period.” The first Interest
Period will commence on and include December 19, 2012 and end on and include March 18, 2013. Interest on this Security will be computed on the basis of a 360-day year of twelve 30-day months. 

The interest rate on this Security that will apply during an Interest Period will be as follows: 

 

					
	 Commencing December 19, 2012 and

ending December 18, 2017
	  	 	3.00	% per annum 
	 Commencing December 19, 2017 and

ending December 18, 2022
	  	 	3.25	% per annum 
	 Commencing December 19, 2022 and

ending December 18, 2025
	  	 	3.75	% per annum 
	 Commencing December 19, 2025 and

ending December 18, 2027
	  	 	4.50	% per annum 
	 Commencing December 19, 2027 and

ending December 18, 2029
	  	 	6.00	% per annum 

 Any interest not punctually paid or duly provided for will forthwith cease to be payable to the Holder on
such Regular Record Date and may either be paid to the Person in whose name this Security (or one or more Predecessor Securities) is registered at the close of business on a Special Record Date for the payment of such Defaulted Interest to be fixed
by the Trustee, notice whereof shall be given to Holders of Securities of this series not less than 10 days prior to such Special Record Date, or be paid at any time in any other lawful manner not inconsistent with the requirements of any
securities exchange on which the Securities of this series may be listed, and upon such notice as may be required by such exchange, all as more fully provided in the Indenture. 

Payment of interest on this Security will be made in immediately available funds at the office or agency of the Company maintained for
that purpose in the City of Minneapolis, Minnesota in such coin or currency of the United States of America as at the time of payment is legal tender for payment of public and private debts; provided, however, that, at the option of the Company,
payment of interest may be paid by check mailed to the Person entitled thereto at such Person’s last address as it appears in the Security Register or by wire transfer to such account as may have been designated by such Person. Payment of
principal of and interest on this Security at Maturity will be made against presentation of this Security at the office or agency of the Company maintained for that purpose in the City of Minneapolis, Minnesota. Notwithstanding the foregoing, for so
long as this Security is a Global Security registered in the name of the Depositary, payments of principal and interest on this Security will be made to the Depositary by wire transfer of immediately available funds. 

This Security is redeemable at the option of the Company at any time on or after December 19, 2017, in whole or in part, on any
Interest Payment Date at a Redemption Price equal to 100% of the principal amount of this Security to be redeemed, plus any accrued but unpaid interest to, but excluding, the Redemption Date. Notice of any redemption will be mailed at least 5 but
not more than 30 days before the applicable Redemption Date to the Holder hereof. Unless the 

  
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Company defaults in the payment of the Redemption Price, on or after the Redemption Date, interest will cease to accrue on this Security or the portion hereof called for redemption. 

Except as set forth in the next sentence, this Security is not subject to repayment at the option of the Holder hereof prior to
December 19, 2029. This Security may be subject to repayment if requested by the authorized representative of a beneficial owner of this Security as described on the reverse hereof under “Repayment upon Exercise of Survivor’s
Option.” This Security is not entitled to any sinking fund. 
 Reference is hereby made to the further provisions of this
Security set forth on the reverse hereof, which further provisions shall for all purposes have the same effect as if set forth at this place. 
 Unless the certificate of authentication hereon has been executed by the Trustee referred to on the reverse hereof by manual signature or its duly authorized agent under the Indenture referred to on the
reverse hereof by manual signature, this Security shall not be entitled to any benefit under the Indenture or be valid or obligatory for any purpose. 
 [The remainder of this page has been left intentionally blank] 

  
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 IN WITNESS WHEREOF, the Company has caused this instrument to be duly executed under its
corporate seal. 
 DATED:
                         

 

			
	WELLS FARGO & COMPANY
		
	By:	 	 
		 	 
		 	Its:
                                         
                                         
     


 [SEAL] 
  

			
	Attest:	 	 
		 	 
		 	Its:
                                         
                                       



 TRUSTEE’S CERTIFICATE OF 
 AUTHENTICATION 
 This is one of the Securities of the 

series designated therein described 
 in the
within-mentioned Indenture. 
  

			
	CITIBANK, N.A.,
		 	as Trustee
		
	By:	 	 
		 	Authorized Signature
		
		 	OR
	
	 WELLS FARGO BANK, N.A.,
     as Authenticating Agent for the Trustee

		
	By:	 	 
		 	Authorized Signature


  
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 [Reverse of Note] 
 WELLS FARGO & COMPANY 
 MEDIUM-TERM NOTE, SERIES K

 Due Nine Months or More From Date of Issue 
 Notes due December 19, 2029 
 This Security is one of a duly
authorized issue of securities of the Company (herein called the “Securities”), issued and to be issued in one or more series under an indenture dated as of July 21, 1999, as amended or supplemented from time to time (herein
called the “Indenture”), between the Company and Citibank, N.A., as Trustee (herein called the “Trustee,” which term includes any successor trustee under the Indenture), to which Indenture and all indentures
supplemental thereto reference is hereby made for a statement of the respective rights, limitations of rights, duties and immunities thereunder of the Company, the Trustee and the Holders of the Securities, and of the terms upon which the Securities
are, and are to be, authenticated and delivered. This Security is one of the series of the Securities designated as Medium-Term Notes, Series K, of the Company, which series is limited to an aggregate principal amount or face amount, as applicable,
of $25,000,000,000 or the equivalent thereof in one or more foreign or composite currencies. The amount payable on the Securities of this series may be determined by reference to the performance of one or more equity-, commodity- or currency-based
indices, exchange traded funds, securities, commodities, currencies, statistical measures of economic or financial performance, or a basket comprised of two or more of the foregoing, or any other market measure or may bear interest at a fixed rate
or a floating rate. The Securities of this series may mature at different times, be redeemable at different times or not at all, be repayable at the option of the Holder at different times or not at all and be denominated in different currencies.

 Article Sixteen of the Indenture shall not apply to this Security. 

The Securities are issuable only in registered form without coupons and will be either (a) book-entry securities represented by one
or more Global Securities recorded in the book-entry system maintained by the Depositary or (b) certificated securities issued to and registered in the names of, the beneficial owners or their nominees. 

The Company agrees, to the extent permitted by law, not to voluntarily claim the benefits of any laws concerning usurious rates of
interest against a Holder of this Security. 
 Modification and Waivers 

The Indenture permits, with certain exceptions as therein provided, the amendment thereof and the modification of the rights and
obligations of the Company and the rights of the Holders of the Securities of each series to be affected under the Indenture at any time by the Company and the Trustee with the consent of the Holders of a majority in principal amount of the
Securities at the time Outstanding of all series to be affected, acting together as a class. The Indenture also contains 

  
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provisions permitting the Holders of a majority in principal amount of the Securities of all series at the time Outstanding affected by certain provisions of the Indenture, acting together as a
class, on behalf of the Holders of all Securities of such series, to waive compliance by the Company with those provisions of the Indenture. Certain past defaults under the Indenture and their consequences may be waived under the Indenture by the
Holders of a majority in principal amount of the Securities of each series at the time Outstanding, on behalf of the Holders of all Securities of such series. Any such consent or waiver by the Holder of this Security shall be conclusive and binding
upon such Holder and upon all future Holders of this Security and of any Security issued upon the registration of transfer hereof or in exchange herefor or in lieu hereof, whether or not notation of such consent or waiver is made upon this Security.

 Defeasance 
 Section 403 and Article Fifteen of the Indenture and the provisions of clause (ii) of Section 401(1)(B) of the Indenture, relating to defeasance at any time of (a) the entire
indebtedness on this Security and (b) certain restrictive covenants and certain Events of Default, upon compliance by the Company with certain conditions set forth therein, shall not apply to this Security. The remaining provisions of
Section 401 of the Indenture shall apply to this Security. 
 Authorized Denominations 

This Security is issuable only in registered form without coupons in denominations of $1,000 or any amount in excess thereof which is an
integral multiple of $1,000. 
 Repayment upon Exercise of Survivor’s Option 

The Company has agreed to repay beneficial ownership interests in this Security, if requested by the authorized representative of the
beneficial owner of such beneficial ownership interest following the death of the beneficial owner, so long as the beneficial ownership interest in this Security was acquired by the beneficial owner at least six months prior to the request (the
“Survivor’s Option”). 
 Upon the valid exercise of the Survivor’s Option and the proper tender of a
beneficial ownership interest in this Security for repayment, the Company will repay such beneficial ownership interest in this Security, in whole or in part, at a price equal to 100% of the principal amount of the deceased beneficial owner’s
beneficial interest in this Security, plus any accrued and unpaid interest to the date of repayment. 
 To be valid, the
Survivor’s Option must be exercised by or on behalf of the Person who has authority to act on behalf of a deceased beneficial owner of this Security under the laws of the applicable jurisdiction (including, without limitation, the personal
representative of or the executor of the estate of the deceased beneficial owner or the surviving joint owner with the deceased beneficial owner). 
 A beneficial owner of this Security is a Person who has the right, immediately prior to such Person’s death, to receive the proceeds from the disposition of such beneficial owner’s interest in
this Security, as well as the right to receive the principal amount of the deceased beneficial owner’s interest in this Security plus any accrued and unpaid interest thereon. 

  
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 The death of a Person holding a beneficial ownership interest in this Security as a joint
tenant or tenant by the entirety with another Person, or as a tenant in common with the deceased holder’s spouse, will be deemed the death of a beneficial owner of that beneficial ownership interest in this Security, and the entire principal
amount of the deceased beneficial owner’s interest in this Security held in this manner will be subject to repayment by the Company upon exercise of the Survivor’s Option. However, the death of a Person holding a beneficial ownership
interest in this Security as tenant in common with a Person other than such deceased holder’s spouse will be deemed the death of a beneficial owner only with respect to such deceased Person’s interest in this Security, and only the
deceased beneficial owner’s percentage interest in that beneficial ownership interest in the principal amount of this Security will be subject to repayment. 
 The death of a Person who, during his or her lifetime, was entitled to substantially all of the beneficial ownership interests in this Security will be deemed the death of the beneficial owner of this
Security for purposes of the Survivor’s Option, regardless of whether that beneficial owner was the registered holder of this Security, if the beneficial ownership interest can be established to the satisfaction of the Paying Agent. A
beneficial ownership interest will be deemed to exist in typical cases of nominee ownership, ownership under the Uniform Transfers to Minors Act or Uniform Gifts to Minors Act, community property, or other joint ownership arrangements between a
husband and wife. In addition, the beneficial ownership interest in this Security will be deemed to exist in custodial and trust arrangements where one Person has all of the beneficial ownership interest in this Security during his or her lifetime.
In the case of a joint trust, the joint tenant rules above will apply to the respective beneficial ownership interests. 
 The
Company has the discretionary right to limit the aggregate principal amount of this Security as to which exercises of the Survivor’s Option will be accepted by the Company from the authorized representative for any individual deceased
beneficial owner of this Security in any calendar year to $250,000. In addition, the Company will not permit the exercise of the Survivor’s Option for any portion of this Security with a principal amount of less than $1,000, and the Company
will not permit the exercise of the Survivor’s Option if such exercise will result in this Security having a principal amount that is not an integral multiple of $1,000. 
 An otherwise valid election to exercise the Survivor’s Option may not be withdrawn. An election to exercise the Survivor’s Option will be accepted in the order that it was received by the Paying
Agent, except for any beneficial ownership interest in this Security the acceptance of which would contravene the limitation described above. Beneficial ownership interests in this Security accepted for repayment through the exercise of the
Survivor’s Option normally will be repaid on the first Interest Payment Date that occurs 20 or more calendar days after the date of the acceptance. Each tendered beneficial ownership interest in this Security that is not accepted in a calendar
year due to the application of the limitation described in the preceding paragraph will be deemed to be tendered in the following calendar year in the order in which all such beneficial interests were originally tendered. If a beneficial ownership
interest in this Security tendered through a valid exercise of the Survivor’s Option is not accepted, the Paying Agent will deliver a notice by first-class mail to the registered holder, at that registered holder’s last known address as
indicated in the Security Register, that states the reason that the beneficial ownership interest in this Security has not been accepted for repayment. 

  
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 Since this Security is a Global Security, DTC, as depository, or its nominee will be treated
as the holder of this Security and will be the only entity that can exercise the Survivor’s Option. To obtain repayment of this Security pursuant to exercise of the Survivor’s Option, the deceased beneficial owner’s authorized
representative must provide the following items to the broker or other entity through which the beneficial interest in this Security is held by the deceased beneficial owner: 

 

	 	•	appropriate evidence satisfactory to the Paying Agent that: 

  

	 	(a)	the deceased was a beneficial owner of this Security at the time of death and his or her interest in this Security was acquired by the deceased beneficial owner at
least six months prior to the request for repayment, 

  

	 	(b)	the death of the beneficial owner has occurred and the date of death, and 

  


	 	(c)	the representative has authority to act on behalf of the deceased beneficial owner; 


 

	 	•	if the beneficial interest in this Security is held by a nominee or trustee of, or custodian for, or other Person in a similar capacity to, the deceased beneficial
owner, a certificate satisfactory to the Paying Agent from the nominee, trustee, custodian or similar Person attesting to the deceased’s beneficial ownership in this Security; 


 

	 	•	a written request for repayment signed by the authorized representative of the deceased beneficial owner with the signature guaranteed by a member firm of a registered
national securities exchange or of the Financial Industry Regulatory Authority, Inc. or a commercial bank or trust company having an office or correspondent in the United States; 


 

	 	•	if applicable, a properly executed assignment or endorsement; 

  

	 	•	tax waivers and any other instruments or documents that the Paying Agent reasonably requires in order to establish the validity of the beneficial ownership in this
Security and the claimant’s entitlement to payment; and 

  

	 	•	any additional information the Paying Agent requires to evidence satisfaction of any conditions to the exercise of the Survivor’s Option or to document beneficial
ownership or authority to make the election and to cause the repayment of this Security. 

 In turn, the broker or other entity
will deliver each of these items to the Paying Agent and will certify to the Paying Agent that the broker or other entity represents the deceased beneficial owner. 
 The Company retains the right to limit the aggregate principal amount of this Security as to which exercises of the Survivor’s Option will be accepted by the Company from the authorized
representative for any individual deceased beneficial owner in this Security in any calendar year as described above. All other questions regarding the eligibility or validity of any 

  
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exercise of the Survivor’s Option will be determined by the Paying Agent, in its sole discretion, which determination will be final and binding on all parties. 

The broker or other entity will be responsible for disbursing payments received from the Paying Agent to the authorized representative.
Forms for the exercise of the Survivor’s Option may be obtained from the Paying Agent. 
 Registration of Transfer

 Upon due presentment for registration of transfer of this Security at the office or agency of the Company in the City
of Minneapolis, Minnesota, a new Security or Securities of this series, with the same terms as this Security, in authorized denominations for an equal aggregate principal amount will be issued to the transferee in exchange herefor, as provided in
the Indenture and subject to the limitations provided therein and to the limitations described below, without charge except for any tax or other governmental charge imposed in connection therewith. 

This Security is exchangeable for definitive Securities in registered form only if (x) the Depositary notifies the Company that it
is unwilling or unable to continue as Depositary for this Security or if at any time the Depositary ceases to be a clearing agency registered under the Securities Exchange Act of 1934, as amended, and a successor depositary is not appointed within
90 days after the Company receives such notice or becomes aware of such ineligibility, (y) the Company in its sole discretion determines that this Security shall be exchangeable for definitive Securities in registered form and notifies the
Trustee thereof or (z) an Event of Default with respect to the Securities represented hereby has occurred and is continuing. If this Security is exchangeable pursuant to the preceding sentence, it shall be exchangeable for definitive Securities
in registered form, bearing interest at the same rate, having the same date of issuance, Stated Maturity Date and other terms and of authorized denominations aggregating a like amount. 

This Security may not be transferred except as a whole by the Depositary to a nominee of the Depositary or by a nominee of the Depositary
to the Depositary or another nominee of the Depositary or by the Depositary or any such nominee to a successor of the Depositary or a nominee of such successor. Except as provided above, owners of beneficial interests in this Global Security will
not be entitled to receive physical delivery of Securities in definitive form and will not be considered the Holders hereof for any purpose under the Indenture. 
 Prior to due presentment of this Security for registration of transfer, the Company, the Trustee and any agent of the Company or the Trustee may treat the Person in whose name this Security is registered
as the owner hereof for all purposes, whether or not this Security be overdue, and neither the Company, the Trustee nor any such agent shall be affected by notice to the contrary. 
 Obligation of the Company Absolute 
 No reference herein to the
Indenture and no provision of this Security or the Indenture shall alter or impair the obligation of the Company, which is absolute and unconditional, to pay the principal of and interest on this Security at the times, place and rate, and in the
coin or currency, herein prescribed, except as otherwise provided in this Security. 

  
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 No Personal Recourse 
 No recourse shall be had for the payment of the principal of or the interest on this Security, or for any claim based hereon, or otherwise in respect hereof, or based on or in respect of the Indenture or
any indenture supplemental thereto, against any incorporator, stockholder, officer or director, as such, past, present or future, of the Company or any successor corporation, whether by virtue of any constitution, statute or rule of law, or by the
enforcement of any assessment or penalty or otherwise, all such liability being, by the acceptance hereof and as part of the consideration for the issuance hereof, expressly waived and released. 

Defined Terms 

All terms used in this Security which are defined in the Indenture shall have the meanings assigned to them in the Indenture unless
otherwise defined in this Security. 
 Governing Law 
 This Security shall be governed by and construed in accordance with the law of the State of New York, without regard to principles of conflicts of laws. 

  
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 ABBREVIATIONS 

The following abbreviations, when used in the inscription on the face of this instrument, 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, the undersigned hereby sell(s) and transfer(s) unto 
 Please Insert Social Security or 
 Other Identifying Number of Assignee 

	
	
	  

  
  

 
  
  

 
 (PLEASE
PRINT OR TYPE NAME AND ADDRESS INCLUDING POSTAL ZIP CODE OF ASSIGNEE)


  
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 the within Security of WELLS FARGO & COMPANY and does hereby irrevocably constitute and
appoint                             attorney to transfer the said Security on the books of the Company, 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 within
instrument in every particular, without alteration or enlargement or any change whatever. 

  
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