Document:

WELLS FARGO & COMPANY 8-K

 

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. 95001H6C0	FACE AMOUNT: $__________

REGISTERED
NO. __

 

 

WELLS
FARGO FINANCE LLC

 

MEDIUM-TERM
NOTE, SERIES A

 

Fully
and Unconditionally Guaranteed by Wells Fargo & Company

 

Principal
at Risk Securities Linked to the S&P 500® Index

 

WELLS
FARGO FINANCE LLC, a limited liability company duly organized and existing under the laws of the State of Delaware (hereinafter
called the “Company,” which term includes any successor corporation under and as defined in the Indenture hereinafter
referred to), for value received, hereby promises to pay to CEDE & Co., or registered assigns, an amount equal to the
Cash Settlement Amount (as defined below), 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, on the Stated Maturity Date. The “Stated Maturity Date”
shall be August 12, 2021. If the Determination Date (as defined below) is postponed, the Stated Maturity Date will be postponed
to the second Business Day (as defined below) after the Determination Date as postponed. This Security shall not bear any interest.

Any
payments 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 and at any other office or agency maintained by the Company
for such purpose. 

“Face
Amount” shall mean, when used with respect to this Security, the amount set forth on the face of this Security as its
“Face Amount.”

Determination
of Cash Settlement Amount and Certain Definitions

The
“Cash Settlement Amount” of this Security will equal:

 

		•	if
                                         the Final Underlier Level is greater than or equal to the Cap Level, the Maximum Settlement
                                         Amount;

 

    	 	 	 

    	 

    

 

		•	if
                                         the Final Underlier Level is greater than the Initial Underlier Level but less than the
                                         Cap Level, the sum of (i) the Face Amount plus (ii) the product of (a) the
                                         Face Amount times (b) the Upside Participation Rate times (c) the Underlier
                                         Return;

 

		•	if
                                         the Final Underlier Level is equal to or less than the Initial Underlier Level but greater
                                         than or equal to the Buffer Level, the Face Amount; or

 

		•	if
                                         the Final Underlier Level is less than the Buffer Level, the sum of (i) the Face
                                         Amount plus (ii) the product of (a) the Buffer Rate times (b) the sum
                                         of the Underlier Return plus the Buffer Amount times (c) the Face Amount.

 

All
calculations with respect to the Cash Settlement Amount will be rounded to the nearest one hundred-thousandth, with five one-millionths
rounded upward (e.g., 0.000005 would be rounded to 0.00001); and the Cash Settlement Amount will be rounded to the nearest
cent, with one-half cent rounded upward.

 

The
“Underlier” shall mean the S&P 500® Index.

 

The
“Trade Date” shall mean June 28, 2019.

 

The
“Initial Underlier Level” is 2,941.76, the Closing Level of the Underlier on the Trade Date.

 

The
“Closing Level” of the Underlier on any Trading Day means the official closing level of the Underlier reported
by the Underlier Sponsor on such Trading Day, as obtained by the Calculation Agent on such Trading Day from the licensed third-party
market data vendor contracted by the Calculation Agent at such time; in particular, taking into account the decimal precision
and/or rounding convention employed by such licensed third-party market data vendor on such date, subject to the provisions set
forth below under “Adjustments to the Underlier,” “Discontinuance of the Underlier” and “Market
Disruption Events.”

 

The
“Final Underlier Level” will be the Closing Level of the Underlier on the Determination Date.

 

The
“Underlier Return” will be the quotient of (i) the Final Underlier Level minus the Initial Underlier Level
divided by (ii) the Initial Underlier Level, expressed as a percentage.

 

The
“Cap Level” is 3,368.3152, which is 114.50% of the Initial Underlier Level.

 

The
“Buffer Level” is 2,500.496, which is equal to 85% of the Initial Underlier Level.

 

The
“Maximum Settlement Amount” is 123.20% of the Face Amount of this Security.

 

The
“Buffer Amount” is 15%.

 

    	 	2	 

    	 

    

The
“Buffer Rate” is equal to the Initial Underlier Level divided by the Buffer Level.

 

The
“Upside Participation Rate” is 1.6.

 

“Underlier
Sponsor” shall mean S&P Dow Jones Indices LLC.

 

“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.

 

A
“Trading Day” means a day, as determined by the Calculation Agent, on which (i) the Relevant Stock Exchanges
with respect to each security underlying the Underlier are scheduled to be open for trading for their respective regular trading
sessions and (ii) each Related Futures or Options Exchange is scheduled to be open for trading for its regular trading session.

 

The
“Related Futures or Options Exchange” for the Underlier means an exchange or quotation system where trading
has a material effect (as determined by the Calculation Agent) on the overall market for futures or options contracts relating
to the Underlier.

 

The
“Relevant Stock Exchange” for any security underlying the Underlier means the primary exchange or quotation
system on which such security is traded, as determined by the Calculation Agent.

 

The
“Determination Date” shall be August 10, 2021. If the originally scheduled Determination Date is not a Trading
Day, the Determination Date will be postponed to the next succeeding Trading Day. The Determination Date is also subject to postponement
due to the occurrence of a Market Disruption Event (as defined below). See “–Market Disruption Events.”

 

“Calculation
Agent Agreement” shall mean the Calculation Agent Agreement dated as of May 18, 2018 between the Company and the Calculation
Agent, as amended from time to time.

 

“Calculation
Agent” shall mean the Person that has entered into the Calculation Agent Agreement with the Company providing for, among
other things, the determination of the Final Underlier Level and the Cash Settlement Amount, which term shall, unless the context
otherwise requires, include its successors under such Calculation Agent Agreement. The initial Calculation Agent shall be Wells
Fargo Securities, LLC. Pursuant to the Calculation Agent Agreement, the Company may appoint a different Calculation Agent from
time to time after the initial issuance of this Security without the consent of the Holder of this Security and without notifying
the Holder of this Security.

 

Adjustments
to the Underlier

If
at any time the method of calculating the Underlier or a Successor Underlier, or the closing level thereof, is changed in a material
respect, or if the Underlier or a Successor Underlier is in any other way modified so that such underlier does not, in the opinion
of the Calculation Agent, fairly represent the level of such underlier had those changes or modifications not been made, then
the Calculation Agent will, at the close of business in New York, New

    	 	3	 

    	 

    

York,
on each date that the closing level of such underlier is to be calculated, make such calculations and adjustments as, in the good
faith judgment of the Calculation Agent, may be necessary in order to arrive at a level of an underlier comparable to the Underlier
or Successor Underlier as if those changes or modifications had not been made, and the Calculation Agent will calculate the closing
level of the Underlier or Successor Underlier with reference to such underlier, as so adjusted. Accordingly, if the method of
calculating the Underlier or Successor Underlier is modified so that the level of such underlier is a fraction or a multiple of
what it would have been if it had not been modified (e.g., due to a split or reverse split in such equity underlier), then the
Calculation Agent will adjust the Underlier or Successor Underlier in order to arrive at a level of such underlier as if it had
not been modified (e.g., as if the split or reverse split had not occurred).

Discontinuance
of the Underlier

If
the Underlier Sponsor discontinues publication of the Underlier, and the Underlier Sponsor or another entity publishes a successor
or substitute equity index that the Calculation Agent determines, in its sole discretion, to be comparable to the Underlier (a
“Successor Underlier”), then, upon the Calculation Agent’s notification of that determination to the
Trustee and the Company, the Calculation Agent will substitute the Successor Underlier as calculated by the relevant Underlier
Sponsor or any other entity and calculate the Final Underlier Level as described above. Upon any selection by the Calculation
Agent of a Successor Underlier, the Company will cause notice to be given to the Holder of this Security.

In
the event that the Underlier Sponsor discontinues publication of the Underlier prior to, and the discontinuance is continuing
on, the Determination Date and the Calculation Agent determines that no Successor Underlier is available at such time, the Calculation
Agent will calculate a substitute Closing Level for the Underlier in accordance with the formula for and method of calculating
the Underlier last in effect prior to the discontinuance, but using only those securities that comprised the Underlier immediately
prior to that discontinuance. If a Successor Underlier is selected or the Calculation Agent calculates a level as a substitute
for the Underlier, the Successor Underlier or level will be used as a substitute for the Underlier for all purposes, including
the purpose of determining whether a Market Disruption Event exists.

If
on the Determination Date the Underlier Sponsor fails to calculate and announce the level of the Underlier, the Calculation Agent
will calculate a substitute Closing Level of the Underlier in accordance with the formula for and method of calculating the Underlier
last in effect prior to the failure, but using only those securities that comprised the Underlier immediately prior to that failure;
provided that, if a Market Disruption Event occurs or is continuing on such day, then the provisions set forth below under
“Market Disruption Events” shall apply in lieu of the foregoing.

    	 	4	 

    	 

    

Market
Disruption Events 

A
“Market Disruption Event” means any of the following events as determined by the Calculation Agent in its sole
discretion:

 

		(A)	The
                                         occurrence or existence of a material suspension of or limitation imposed on trading
                                         by the Relevant Stock Exchanges or otherwise relating to securities which then comprise
                                         20% or more of the level of the Underlier or any Successor Underlier at any time during
                                         the one-hour period that ends at the Close of Trading on that day, whether by reason
                                         of movements in price exceeding limits permitted by those Relevant Stock Exchanges or
                                         otherwise.

		(B)	The
                                         occurrence or existence of a material suspension of or limitation imposed on trading
                                         by any Related Futures or Options Exchange or otherwise in futures or options contracts
                                         relating to the Underlier or any Successor Underlier on any Related Futures or Options
                                         Exchange at any time during the one-hour period that ends at the Close of Trading on
                                         that day, whether by reason of movements in price exceeding limits permitted by the Related
                                         Futures or Options Exchange or otherwise.

		(C)	The
                                         occurrence or existence of any event, other than an early closure, that materially disrupts
                                         or impairs the ability of market participants in general to effect transactions in, or
                                         obtain market values for, securities that then comprise 20% or more of the level of the
                                         Underlier or any Successor Underlier on their Relevant Stock Exchanges at any time during
                                         the one-hour period that ends at the Close of Trading on that day.

		(D)	The
                                         occurrence or existence of any event, other than an early closure, that materially disrupts
                                         or impairs the ability of market participants in general to effect transactions in, or
                                         obtain market values for, futures or options contracts relating to the Underlier or any
                                         Successor Underlier on any Related Futures or Options Exchange at any time during the
                                         one-hour period that ends at the Close of Trading on that day.

		(E)	The
                                         closure on any Exchange Business Day of the Relevant Stock Exchanges on which securities
                                         that then comprise 20% or more of the level of the Underlier or any Successor Underlier
                                         are traded or any Related Futures or Options Exchange prior to its Scheduled Closing
                                         Time unless the earlier closing time is announced by the Relevant Stock Exchange or Related
                                         Futures or Options Exchange, as applicable, at least one hour prior to the earlier of
                                         (1) the actual closing time for the regular trading session on such Relevant Stock
                                         Exchange or Related Futures or Options Exchange, as applicable, and (2) the submission
                                         deadline for orders to be entered into the Relevant Stock Exchange or Related Futures
                                         or Options Exchange, as applicable, system for execution at such actual closing time
                                         on that day.

    	 	5	 

    	 

    

		(F)	The
                                         Relevant Stock Exchange for any security underlying the Underlier or Successor Underlier
                                         or any Related Futures or Options Exchange fails to open for trading during its regular
                                         trading session.

For
purposes of determining whether a Market Disruption Event has occurred:

		(1)	the
                                         relevant percentage contribution of a security to the level of the Underlier or any Successor
                                         Underlier will be based on a comparison of (x) the portion of the level of such
                                         underlier attributable to that security and (y) the overall level of the Underlier
                                         or Successor Underlier, in each case immediately before the occurrence of the Market
                                         Disruption Event;

		(2)	the
                                         “Close of Trading” on any Trading Day for the Underlier or any Successor
                                         Underlier means the Scheduled Closing Time of the Relevant Stock Exchanges with respect
                                         to the securities underlying the Underlier or Successor Underlier on such Trading Day;
                                         provided that, if the actual closing time of the regular trading session of any
                                         such Relevant Stock Exchange is earlier than its Scheduled Closing Time on such Trading
                                         Day, then (x) for purposes of clauses (A) and (C) of the definition of “Market
                                         Disruption Event” above, with respect to any security underlying the Underlier
                                         or Successor Underlier for which such Relevant Stock Exchange is its Relevant Stock Exchange,
                                         the “Close of Trading” means such actual closing time and (y) for purposes
                                         of clauses (B) and (D) of the definition of “Market Disruption Event” above,
                                         with respect to any futures or options contract relating to the Underlier or Successor
                                         Underlier, the “close of trading” means the latest actual closing time of
                                         the regular trading session of any of the Relevant Stock Exchanges, but in no event later
                                         than the Scheduled Closing Time of the Relevant Stock Exchanges;

		(3)	the
                                         “Scheduled Closing Time” of any Relevant Stock Exchange or Related
                                         Futures or Options Exchange on any Trading Day for the Underlier or any Successor Underlier
                                         means the scheduled weekday closing time of such Relevant Stock Exchange or Related Futures
                                         or Options Exchange on such Trading Day, without regard to after hours or any other trading
                                         outside the regular trading session hours; and

		(4)	an
                                         “Exchange Business Day” means any Trading Day for the Underlier or
                                         any Successor Underlier on which each Relevant Stock Exchange for the securities underlying
                                         the Underlier or any Successor Underlier and each Related Futures or Options Exchange
                                         are open for trading during their respective regular trading sessions, notwithstanding
                                         any such Relevant Stock Exchange or Related Futures or Options Exchange closing prior
                                         to its Scheduled Closing Time.

If
a Market Disruption Event occurs or is continuing on the Determination Date, then the Determination Date will be postponed to
the first succeeding Trading Day on which a Market Disruption Event has not occurred and is not continuing; however, if such first
succeeding Trading Day has not occurred as of the eighth Trading Day after the originally scheduled Determination Date, that eighth
Trading Day shall be deemed to be the Determination Date. If

    	 	6	 

    	 

    

the
Determination Date has been postponed eight Trading Days after the originally scheduled Determination Date and a Market Disruption
Event occurs or is continuing on such eighth Trading Day, the Calculation Agent will determine the Closing Level of the Underlier
on such eighth Trading Day in accordance with the formula for and method of calculating the Closing Level of the Underlier last
in effect prior to commencement of the Market Disruption Event, using the closing price (or, with respect to any relevant security,
if a Market Disruption Event has occurred with respect to such security, its good faith estimate of the value of such security
at the Scheduled Closing Time of the Relevant Stock Exchange for such security or, if earlier, the actual closing time of the
regular trading session of such Relevant Stock Exchange) on such date of each security included in the Underlier. As used herein,
“closing price” means, with respect to any security on any date, the Relevant Stock Exchange traded or quoted price
of such security as of the Scheduled Closing Time of the Relevant Stock Exchange for such security or, if earlier, the actual
closing time of the regular trading session of such Relevant Stock Exchange.

Calculation
Agent

The
Calculation Agent will determine the Cash Settlement Amount and the Final Underlier Level. In addition, the Calculation Agent
will (i) determine if adjustments are required to the Closing Level of the Underlier under the circumstances described in this
Security, (ii) if publication of the Underlier is discontinued, select a Successor Underlier or, if no Successor Underlier is
available, determine the Closing Level of the Underlier under the circumstances described in this Security, and (iii) determine
whether a Market Disruption Event or non-Trading Day has occurred.

The
Company covenants that, so long as this Security is Outstanding, there shall at all times be a Calculation Agent (which shall
be a broker-dealer, bank or other financial institution) with respect to this Security.

All
determinations made by the Calculation Agent with respect to this Security will be at the sole discretion of the Calculation Agent
and, in the absence of manifest error, will be conclusive for all purposes and binding on the Company and the Holder of this Security.

Tax
Considerations

The
Company agrees, and by acceptance of a beneficial ownership interest in this Security each Holder of this Security will be deemed
to have agreed (in the absence of a statutory, regulatory, administrative or judicial ruling to the contrary), for United States
federal income tax purposes to characterize and treat this Security as a prepaid derivative contract that is an “open transaction.”

Redemption
and Repayment

This
Security is not subject to redemption at the option of the Company or repayment at the option of the Holder hereof prior to August
12, 2021. This Security is not entitled to any sinking fund.

    	 	7	 

    	 

    

Acceleration

If
an Event of Default, as defined in the Indenture, with respect to this Security shall occur and be continuing, the Cash Settlement
Amount (calculated as set forth in the next sentence) of this Security may be declared due and payable in the manner and with
the effect provided in the Indenture. The amount payable to the Holder hereof upon any acceleration permitted under the Indenture
will be equal to the Cash Settlement Amount hereof calculated as provided herein as though the date of acceleration was the Determination
Date.

__________________

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]

 

 

    	 	8	 

    	 

    

IN
WITNESS WHEREOF, the Company has caused this instrument to be duly executed.

 

	DATED:	 
	 	 
	 	WELLS
FARGO FINANCE LLC
	 	 	 
	 	By:	 
	 	 	 
	 	 	Its:

 

	 	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	 

 

    	 	9	 

    	 

    

[Reverse
of Note]

 

 

WELLS
FARGO FINANCE LLC

 

MEDIUM-TERM
NOTE, SERIES A

 

Fully
and Unconditionally Guaranteed by Wells Fargo & Company

 

Principal
at Risk Securities Linked to the S&P 500® Index

 

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 April 25, 2018, as amended or supplemented from time to
time (herein called the “Indenture”), among the Company, as issuer, Wells Fargo & Company, as guarantor
(the “Guarantor”) 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 Guarantor,
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 A, of the Company.
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.

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.

Guarantee

The
Securities of this series are fully and unconditionally guaranteed by the Guarantor as and to the extent set forth in the Indenture.

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 Guarantor and the rights of the Holders of the Securities of each series to be affected under the Indenture
at any time by the

    	 	10	 

    	 

    

Company,
the Guarantor 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 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
or the Guarantor 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. Solely for the purpose of determining whether any consent, waiver,
notice or other action or Act to be taken or given by the Holders of Securities pursuant to the Indenture has been given or taken
by the Holders of Outstanding Securities in the requisite aggregate principal amount, the principal amount of this Security will
be deemed to be equal to the amount set forth on the face hereof as the “Face Amount” hereof. 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, upon
compliance by the Company or the Guarantor 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.

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 Face 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

    	 	11	 

    	 

    

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, 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 Guarantor, the Trustee and any agent of the
Company, the Guarantor 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 Guarantor, 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 Cash Settlement Amount at the times, place and rate, and in the coin
or currency, herein prescribed, except as otherwise provided in this Security.

No
Personal Recourse

No
recourse shall be had for the payment of the Cash Settlement Amount, 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 or of the Guarantor 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.

    	 	12	 

    	 

    

 

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)

 

    	 	13	 

    	 

    

the
within Security of WELLS FARGO FINANCE LLC 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.

 

 

    	 	14Exhibit 10.1

 

CONFIDENTIAL SEPARATION AGREEMENT

AND GENERAL RELEASE

 

This Confidential Separation Agreement
and General Release (“Agreement”) is made and entered into effective September 30, 2019 (the “Effective
Date”) by and between Dennis Andrews (“Andrews”) and Otelco Inc., (“Otelco” or the “Company”)
(each a “Party” and together the “Parties”).

 

WHEREAS, Andrews
has been employed by Otelco as its Senior Vice President of Billing, CABS/Revenue Assurance, & Human Resources pursuant to
the terms of an Amended and Restated Employment Agreement between the Parties dated August 24, 2006 , as amended on December 17,
2008 and March 4, 2011 (the “Employment Agreement”); and

 

WHEREAS, Andrews’s
position is being eliminated effective as of the Effective Date, resulting in a termination Without Cause for purposes of the Employment
Agreement, and Otelco wishes to honor Andrews’s service to the Company with a separation package on the terms set forth herein;

 

NOW, THEREFORE,
for the valuable and sufficient consideration described in this Agreement, the receipt and adequacy of which the Parties acknowledge,
the Parties agree as follows:

                    

1.             Separation. Andrews’s employment with Otelco shall end on the Effective Date. Andrews agrees that he shall
execute all documents required by the Company to effectuate his resignation as an officer of the Company. Except as set forth herein,
all privileges and benefits of employment will end as of the Effective Date.

 

2.             Consideration.
In exchange for Andrews’s release of claims and other promises and covenants contained in this Agreement, and provided that
Andrews executes this Agreement and does not timely revoke his release of the federal Age Discrimination in Employment Act (“ADEA”)
claims pursuant to Section 6, Otelco will (a) provide Andrews with a lump sum payment in the total gross amount of $110,750, equal
to six (6) months of his base salary in effect as of the Effective Date (the “Separation Payment”), less tax
withholdings, which shall be paid on the first ordinary Company pay date that is at least five (5) calendar days after the expiration
of the rescission period set forth in Section 6, provided Andrews does not timely rescind his release of ADEA claims; (b) a lump
sum amount equal to the bonus Andrews would have received had Andrews remained employed by the Company through the end of the fiscal
year, prorated for the number of days Andrews was employed in 2019 to be paid at the same time that similar bonuses are paid to
the Company’s other employees, and (c) accelerate vesting of 100% of Andrews’s outstanding unvested equity grants as
of the Effective Date, subject to the terms and conditions of the Otelco Inc 2014 Stock Incentive Plan and Otelco Inc 2018 Stock
Incentive Plan (together, the “Separation Benefits”).

 

In addition to the
Separation Benefits, Andrews will (a) be paid his base salary through and including the Effective Date, (b) receive payment for
all unused vacation as of the Effective Date, and (c) be eligible for bonus compensation for 2019 pursuant to the terms of the
Otelco Inc 2019 Stock Incentive Plan and prorated per Section 2 (b), with any equity grants awarded pursuant to the 2018 Stock
Incentive Plan vesting immediately upon award.

 

3.             No
Other Rights. Andrews agrees that the Separation Benefits are valid and sufficient consideration in exchange for entering into
and performing this Agreement, and that as of the Effective Date, Andrews has been paid all other amounts due and owing to him
by the Company and is not entitled to any additional compensation, including but not limited to salary, bonuses, vacation or paid
time off, stock options or other equity, deferred compensation or reimbursement of expenses. Andrews’s receipt of the Separation
Benefits shall not entitle him to additional compensation or benefits of any kind, including but not limited to benefits under
any company bonus, incentive, or benefit plan or agreement.

 

     

     

    

 

4.             Tax
Treatment. Andrews agrees that the Separation Benefits will be treated as income subject to W-2 reporting and withholdings
pursuant to state and federal laws. Andrews will be solely responsible for paying any and all taxes owing on any payment provided
to him under this Agreement, other than the amount of withholdings by Otelco. It is understood that Otelco makes no representations
or warranties with respect to the tax consequences of the payments and benefits contemplated by this Agreement.

 

5.             Andrews’
Release of Claims. Andrews, on behalf of himself and his successors, heirs, and assigns, hereby forever releases and discharges
Otelco and its parents, subsidiaries, and affiliates; their respective benefits plans; and/or the owners, directors, officers,
employees, agents, predecessors, successors, assigns, shareholders and insurers of any of them (the “Released Parties”)
to the fullest extent permitted by law from any and all claims, debts, liabilities, demands, promises, agreements (including the
Employment Agreement), costs and expenses (including but not limited to attorneys’ fees), damages (including liquidated,
consequential or punitive damages), actions, and causes of action, of whatever kind or nature, whether known or unknown, suspected
or unsuspected, fixed or contingent, arising out of any act or omission occurring before Andrews’s execution of this Agreement,
including but not limited to: (a) any claims based on, arising out of, or related to Andrews’s employment with, or the conclusion
of Andrews’s employment with, Otelco, and any claims for compensation of any kind, including without limitation, amounts
due under any contract, all salary, expenses, distributions, earned but unused vacation, bonuses and incentive compensation; (b)
any claims for additional severance or other payments upon separation of employment pursuant to the Employment Agreement; (c) any
claims arising from rights under any federal, state and/or local laws, including but not limited to those related to any form of
retaliation, harassment or discrimination on any basis (including any and all claims under the federal Age Discrimination in Employment
Act), or related to protected leave or sick time, or accommodations, or any related cause of action, and any labor code provisions;
(d) any claims grounded in contract or tort theories, including but not limited to claims for wrongful discharge, breach of express
or implied contract; breach of implied covenant of good faith and fair dealing; tortious interference with contractual relations
or prospective economic benefit; promissory estoppel; breach of promise; breach of manuals or other policies; violation of public
policy; fraud; misrepresentation; defamation, including libel, slander, and self-publication defamation; negligence; negligent
hiring, supervision or retention; assault; battery; invasion of privacy; false imprisonment; infliction of emotional distress;
harassment; or any other wrongful or unlawful acts, omissions, statements or practices; and/or (e) any other claim of any kind
whatsoever, including but not limited to any claim for damages or declaratory or injunctive or equitable relief of any kind.

 

Nothing in this Agreement
is intended to: (1) waive any vested benefits under Otelco’s benefits policies or plans, (2) waive Andrews’s right
to elect benefits continuation under COBRA; (3) waive Andrews’s right to indemnification for claims made by third parties
under any applicable insurance policy or the Company’s bylaws; (4) waive Andrews’s right to file an administrative
charge with the Equal Employment Opportunity Commission or any other administrative agency under applicable law, or participate
in any agency investigation, although Andrews does waive and release his right to recover any monetary or other damages under such
applicable law, including but not limited to compensatory, liquidated or punitive damages or attorneys’ fees and costs; or
(5) prevent or interfere with Andrews’s right to provide truthful testimony, if under subpoena or court order to do so, or
respond as otherwise provided by law.

 

Andrews understands
and agrees that, except as expressly stated in this Agreement, any and all claims which he has, had, or might have had against
any of the Released Parties occurring up through the date he signs this Agreement are fully released and discharged by this Agreement.

 

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6.             Acceptance;
Right to Revoke. Andrews has been informed of his right to review and consider this Agreement for 21 calendar days, if he so
chooses. Andrews further agrees and acknowledges that (a) his waiver of rights under this Agreement is knowing and voluntary as
required under the Age Discrimination in Employment Act (“ADEA”); (b) in signing this Agreement, Andrews does not rely
on nor has Andrews relied on any representation or statement, written or oral, not specifically set forth in this Agreement by
the Company or by any of the Company’s agents, representatives, or attorneys with regard to the subject matter, basis, or
effect of this Agreement or otherwise; (c) he understands the terms of this Agreement; (d) Otelco advises him to consult with an
attorney prior to executing this Agreement; and (e) he may revoke this Agreement insofar as it extends to potential claims under
the ADEA by providing written notice to Otelco within seven (7) calendar days after the date of his signature below. To be effective,
the revocation must be in writing and delivered to Otelco either by hand or by mail within the 7-day period. If delivered by mail,
the revocation must be: (i) postmarked within the 7-day period; properly addressed to Curtis Garner, 505 Third Avenue East, Oneonta,
Alabama 35121; and (iii) sent by certified mail, return receipt requested. If Andrews timely exercises his right to revoke his
release of claims under the ADEA, Otelco may, at its option, either nullify this Agreement in its entirety, or keep it in effect
in all respects other than as to that portion of the Agreement that Andrews has revoked. If Otelco chooses to nullify the Agreement
in its entirety, Otelco will have no obligations under this Agreement to Andrews or to any others whose rights derive from him,
but Andrews’s employment with the Company shall nonetheless conclude on the Effective Date.

 

8.             Acknowledgement
of Legal Compliance. Andrews represents and warrants that in the course of the performance of his duties for Otelco, Andrews
has not committed, and he further agrees and represents that, as of the date he signs this Agreement, he is not aware of, any violations
of federal, state or local law, rule or regulation, or any Otelco policy, by Otelco or any of its current or former employees,
representatives or agents, and that he is not aware of any facts which would constitute a violation of any federal, state or local
law, rule or regulation or any Otelco policy.

 

9.             Continuing
Obligations. The Parties agree that, notwithstanding any other provision of this Agreement to the contrary, Andrews will continue
to be bound by the provisions of Sections 6 through 9 of his Employment Agreement, which shall remain in effect through and after
the Effective Date, and which are incorporated by reference, as if set forth fully herein.

 

Notwithstanding the
foregoing, the Company hereby notifies Andrews, pursuant to the Defend Trade Secrets Act ("DTSA"),
that he will not be held criminally or civilly liable under any federal or state trade secret law for the disclosure of a trade
secret that: (i) is made (x) in confidence to a federal, state or local government official, either directly or indirectly, or
to an attorney; and (y) solely for the purpose of reporting
or investigating a suspected violation of law; or (ii) is made in a complaint or other document that is filed under seal in a
lawsuit or other proceeding. The Company further notifies
Andrews that if he files a lawsuit for retaliation by the Company for reporting a suspected violation of law, Andrews may disclose
the Company's trade secrets to his attorney and use the trade secret information in the court proceeding if he: (i) files any
document containing the trade secret under seal; and (ii) does not disclose the trade secret, except pursuant to court order.
Andrews further understands that certain whistleblower laws permit him to communicate directly with governmental or regulatory
authorities about possible violations of law. Andrews acknowledges that he is not required to seek the Company’s permission
or notify the Company of any communications made in compliance with applicable whistleblower laws, and that the Company will not
consider such communications to violate this Agreement or any prior agreements between Andrews and the Company.

 

10.           Confidentiality
of this Agreement. Andrews promises and agrees not to disclose any information concerning the provisions of this Agreement
to any person or entity. These confidentiality provisions are subject to the following exceptions: Andrews may disclose the provisions
of this Agreement to his spouse, attorney(s) and tax advisor(s), and he also may disclose the provisions of this Agreement pursuant
to a legitimate subpoena or similar legal process, or pursuant to an administrative investigation or regulatory requirement. Andrews
further agrees that, if any information concerning the provisions of this Agreement is disclosed as permitted by this section,
Andrews will inform the recipient of the information that all details and information related to it are confidential.

 

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11.           Non-Admission.
This Agreement does not, and is not intended to, constitute an admission by Otelco of any liability to, or wrongdoing of any kind
against, Andrews, and Andrews agrees that he will never contend that it does constitute such an admission. Otelco specifically
disclaims any liability to, or wrongful acts against, Andrews or any other person.

 

12.           Section
409A. For purposes of this Agreement, Andrews’s termination shall be a “Separation from Service” under I.R.C.
Section 409A and the regulations thereunder. It is the intent of the parties that payments and benefits under this Agreement comply
with Section 409A and this Agreement shall be interpreted and administered in accordance with such intent. The Company makes no
representation that any or all of the payments described in this Agreement will be exempt from or comply with Section 409A, and
Andrews agrees to pay all taxes and similar governmental charges (including, without limitations, any tax attributable to Section
409A and any social security and similar charges) imposed on him by reason of rights granted and payments made under this Agreement,
including any related interest or penalty

 

13.           Governing
Law, Jurisdiction, and Forum. Andrews and Otelco agree that this Agreement will be governed by the laws of the State of Maine
without regard to conflicts of law principles. The parties further agree that any and all legal actions or proceedings brought
to interpret or enforce this Agreement or in any other way arising out of or in relation to this Agreement shall be brought exclusively
in the state or federal courts in and/or for Maine.

 

14.           Severability.
Whenever possible, each provision of this Agreement shall be interpreted in such a manner as to be effective and valid under applicable
law and to carry out each provision herein to the greatest extent possible, but if any provision of this Agreement is held to be
void, invalid, illegal or for any other reason unenforceable, the parties agree that the validity, legality and enforceability
of the remaining provisions of this Agreement will not be affected or impaired thereby, and will be interpreted so as to effect,
as closely as possible, the intent of the parties hereto. Further, any provision found to be invalid, illegal, or unenforceable
shall be deemed, without further action on the part of the parties hereto, to be modified, amended, and/or limited to the minimum
extent necessary to render such clauses and/or provisions valid and enforceable. However, if Andrews’ release of claims set
forth in this Agreement or the Supplemental Release is held invalid, illegal, or unenforceable, Otelco may void this Agreement.

 

15.           Cooperation.
Andrews agrees that Andrews shall, to the extent reasonably requested in writing, cooperate with the Company in any pending
or future litigation in which the Company is a party, and regarding which Andrews, by virtue of Andrews’s employment, has
factual knowledge or information relevant to said litigation. Andrews further agrees that in any such litigation, Andrews shall,
without the necessity for subpoena, provide, in any jurisdiction in which the Company requests, truthful testimony relevant to
said litigation. The Company will reimburse Andrews for any reasonable, out-of-pocket expenses associated with providing such
cooperation.

 

16.           Return
of Property. As of the Effective Date, Andrews shall have returned to the Company all files, papers, records, documents, compilations,
summaries, lists, reports, notes, databases, tapes, sketches, drawings, memoranda, passwords, cell phones, laptops, computers,
vehicles and other tangible property that belong to or relate to the Company.

 

17.           Assignment.
This Agreement is personal to Andrews and may not be assigned by him. It is binding upon Andrews and upon his heirs, administrators,
representatives, and executors. This Agreement shall inure to the benefit of and be binding upon Otelco and its successors.

 

18.           Entire
Agreement. This Agreement contains the entire understanding between Andrews and Otelco with respect to the subject matter of
this Agreement. This Agreement may not be modified, altered, or amended except by an instrument in writing, signed by Andrews and
an authorized officer of Otelco.

 

19.           Counterparts.
This Agreement may be signed in single or separate counterparts, and on facsimile reproductions, each of which shall constitute
an original.

 

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By signing below, Andrews acknowledges
and affirms that he has read this Agreement completely. He also acknowledges and affirms that he has had a sufficient period of
at least twenty-one (21) days within which to consider whether or not to accept this Agreement; the provisions of this Agreement
are understandable to him; he has had an opportunity to consult with an attorney of his choice, Otelco has encouraged him to do
so, and he has freely exercised that opportunity to the extent desired; and he has entered into this Agreement freely and voluntarily.

 

IN WITNESS WHEREOF, the parties
have executed this Confidential Separation Agreement and General Release by their signatures below:

 

	Dated:  	June 30, 2019	 	/s/ 	Dennis Andrews	 
	 	 	 	 	Dennis Andrews	 
	 	 	 	 	 
	Dated:	July 1, 2019	 	Otelco Inc.	 
	 	 	 	 	 
	 	 	 	By 	/s/ Richard A. Clark	 
	 	 	 	 	 	 
	 	 	 	its 	President & Chief Operating Officer	 

 

 

 

*** Signature page to the Confidential Separation Agreement
and General Release between Dennis Andrews and Otelco Inc.*** 

    5

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