Document:

Form of Medium-Term Notes, Series K, 0.125% Equity Basket Linked Notes

 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. 94986RJ28
	  	 	PRINCIPAL AMOUNT: $                        	  
	 REGISTERED NO.       
	  			

 WELLS FARGO & COMPANY 

MEDIUM-TERM NOTE, SERIES K 

Due Nine Months or More From Date of Issue 

0.125% Equity Basket Linked Notes due March 29, 2021 

Linked to a Basket of Shares 

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 its registered assigns, an amount equal to the
Stated Maturity Payment Amount (as defined below) due with respect to the principal amount of FIVE MILLION TWO HUNDRED TWENTY-FIVE THOUSAND DOLLARS ($5,225,000) on March 29, 2021 (the “Stated Maturity Date”), subject to
postponement due to the occurrence of a Market Disruption Event (as defined below) as set forth below under “Payment at Stated Maturity” unless the Company has exercised the Redemption Right (as defined and described below), and to pay
interest on the principal amount of this Security from March 29, 2016 or from the most recent Interest Payment Date (as defined below) to which interest has been paid or duly provided for, as the case may be, at the rate of 0.125% per
annum, payable on each Interest Payment Date. Interest shall be calculated on the basis of a year of 360 days with twelve 30-day months. 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 Payment Date;
provided that the interest payable on the Stated Maturity Date shall be paid to the Person to whom the Stated Maturity Payment Amount is paid. The “Regular Record Date” for an Interest Payment Date shall be the

 
date one Business Day (as defined below) prior to such Interest Payment Date. The “Interest Payment Dates” shall be each March 29 and September 29, commencing
September 29, 2016, and ending on the Stated Maturity Date. 
 The amount payable on this Security at Maturity will be
based upon the value of a basket of stocks (the “Basket”) consisting of shares of common stock of the following four companies (with the initial weightings noted parenthetically): Celgene Corporation (40%); Amgen Inc. (20%); Gilead
Sciences, Inc. (20%); and Regeneron Pharmaceuticals, Inc. (20%) (each, a “Basket Stock” and collectively, the “Basket Stocks”). The issuers of the Basket Stocks are sometimes referred to herein individually as
a “Basket Stock Issuer” and collectively as the “Basket Stock Issuers.” 
 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 the Holder of this Security 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 this Security may be listed, and upon such notice as may be required by such exchange, all as more fully provided in the Indenture. 

All amounts payable on this Security shall be payable 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. Payments of interest on this Security shall be payable at the office or agency of the Company maintained for such purpose in the City of Minneapolis, Minnesota and at any other
office or agency maintained by the Company for such purpose; provided, however, that at the option of the Company payment of interest may be made by check mailed to the address of the Person entitled thereto as such address shall appear in the
Security Register or by wire transfer to such account as may have been appropriately designated by such Person. Amounts payable on this Security at Maturity shall be paid 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 in the form of a Global Security registered in the name of the Depositary, all payments on this Security will be made
to the Depositary by wire transfer of immediately available funds. 
 Payment at Stated Maturity 

On the Stated Maturity Date, for each $1,000 principal amount of this Security, if this Security has not been previously
redeemed by the Company, the Holder of this Security shall receive an amount in cash equal to the greater of $1,000 and Parity (such amount, the “Stated Maturity Payment Amount”), as determined on the Final Determination Date (as
defined below), plus any accrued and unpaid interest. “Parity” on any Trading Day equals the sum of the products of the Closing Price (as defined below) of each Basket Stock and its Share Ratio (as defined below) on such Trading
Day. “Principal amount” shall mean, when used with respect to this Security, the amount set forth on the face of this Security as its “Principal Amount.” 

  
 2 

 The “Share Ratio” for each Basket Stock is equal to:
(i) with respect to Celgene Corporation, 3.65809; (ii) with respect to Amgen Inc., 1.24305; (iii) with respect to Gilead Sciences, Inc., 2.00220; and (iv) with respect to Regeneron Pharmaceuticals, Inc., 0.49689. The Share Ratio
for each Basket Stock will remain constant for the term of this Security unless adjusted for certain corporate events relating to the issuer of that Basket Stock, including changes in dividend payments. See “—Adjustment Events” below.

 The “Final Determination Date” is March 22, 2021. If the originally scheduled Final Determination
Date is not a Trading Day, the Final Determination Date will be postponed to the next succeeding Trading Day. The Final Determination Date is also subject to postponement due to the occurrence of a Market Disruption Event. 

If a Market Disruption Event occurs or is continuing with respect to a Basket Stock on the Final Determination Date, such
Final Determination Date for such Basket Stock will be postponed to the first succeeding Trading Day on which a Market Disruption Event for such Basket Stock has not occurred and is not continuing. If such first succeeding Trading Day has not
occurred as of the eighth scheduled Trading Day after the scheduled Final Determination Date, that eighth scheduled Trading Day shall be deemed the Final Determination Date for such Basket Stock. If the Final Determination Date has been postponed
eight scheduled Trading Days after the scheduled Final Determination Date and such eighth scheduled Trading Day is not a Trading Day, or if a Market Disruption Event occurs or is continuing with respect to a Basket Stock on such eighth scheduled
Trading Day, the Calculation Agent (as defined below) will determine the Closing Price of such Basket Stock on such eighth scheduled Trading Day using its good faith estimate of the Closing Price that would have prevailed for such Basket Stock on
such date. Notwithstanding a postponement of the Final Determination Date for a particular Basket Stock due to a Market Disruption Event with respect to that Basket Stock, the originally scheduled Final Determination Date will remain the Final
Determination Date for a Basket Stock not affected by a Market Disruption Event. 
 If a Market Disruption Event has
occurred or is continuing on the Final Determination Date, and such Final Determination Date is postponed so that it falls less than three Business Days (as defined below) prior to the Stated Maturity Date, the Stated Maturity Date will be postponed
to the third Business Day following the Final Determination Date as postponed. 
 Redemption Right 

The Company may redeem this Security, in whole but not in part, for settlement on any day from and including March 29,
2019, to and including the Stated Maturity Date, for an amount in cash for each $1,000 principal amount of this Security equal to the greater of (i) $1,000 and (ii) Parity determined by the Calculation Agent on the Trading Day prior to the
Redemption Notice Date (the “Redemption Determination Date”). This right of the Company to redeem this Security is referred to herein as the “Redemption Right.” 

If the Company redeems this Security, the Company will specify the Redemption Date in its notice of redemption. The
“Redemption Date” will be 10 days following the day on which the Company gives its notice of redemption (the “Redemption Notice Date”), unless the 10th day
following the Redemption Notice Date is not a Business Day, in which case the Redemption Date 

  
 3 

 
will be the immediately following day that is a Business Day. If the Company redeems this Security, the Holder of this Security will not receive any accrued but unpaid interest on the Redemption
Date. 
 Business Day Adjustments 

If the Stated Maturity Date, any Interest Payment Date or the Redemption Date is not a Business Day, any payments due on this
Security on such day will be made on the next succeeding Business Day with the same force and effect as if made on such day and no interest on such payment will accrue from and after the Stated Maturity Date or such Interest Payment Date, as
applicable. 
 Certain Definitions 

“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. 

“Calculation Agent” shall mean the Person that has entered into the Calculation Agent Agreement with the
Company, 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. 

“Calculation Agent Agreement” shall mean the Calculation Agent Agreement dated as of March 18, 2015
between the Company and the Calculation Agent, as amended from time to time. 
 The “Closing Price” for one
share of a Basket Stock (or one unit of any other security for which a Closing Price must be determined) on any Trading Day means: 
  

	 	•	 	 if the Basket Stock (or any such other security) is listed or admitted to trading on a national securities exchange, the official closing price on
such day published by the principal United States securities exchange registered under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), on which the Basket Stock (or any such other security) is listed or
admitted to trading; 

  

	 	•	 	 if the Basket Stock (or any such other security) is not listed or admitted to trading on any national securities exchange but is included in the
OTC Bulletin Board Service (the “OTC Bulletin Board”) operated by the Financial Industry Regulatory Authority, Inc. (“FINRA”), the last reported sale price of the principal trading session on the OTC Bulletin Board
on such day. 

 If the Basket Stock (or any such other security) is listed or admitted to trading on any national
securities exchange but the official closing price is not available pursuant to the preceding sentence, then the Closing Price for one share of the Basket Stock (or one unit of any such other 

  
 4 

 
security) on any Trading Day will mean the last reported sale price of the principal trading session on the over-the-counter market as reported on the OTC Bulletin Board on such day. 

If the official closing price or the last reported sale price, as applicable, for the Basket Stock (or any such other
security) is not available pursuant to either of the two preceding sentences, then the Closing Price per share for any Trading Day will be the mean, as determined by the Calculation Agent, of the bid price for the Basket Stock (or any such other
security) obtained from as many recognized dealers in such security, but not exceeding three, as will make such bid prices available to the Calculation Agent. Bids of Wells Fargo Securities, LLC or any of its affiliates may be included in the
calculation of such mean, but only to the extent that any such bid is the highest of the bids obtained. The term “OTC Bulletin Board Service” will include any successor service thereto or, if the OTC Bulletin Board Service is
discontinued and there is no successor thereto, the OTC Reporting Facility operated by FINRA. 
 A “Market
Disruption Event” means, with respect to a Basket Stock, the occurrence or existence of any of the following events: 
  

	 	•	 	 a suspension, absence or material limitation of trading in such Basket Stock on its primary market for more than two hours of trading or during the
one-half hour before the close of trading in that market, as determined by the Calculation Agent in its sole discretion; 

  

	 	•	 	 a suspension, absence or material limitation of trading in option or futures contracts relating to such Basket Stock, if available, in the primary
market for those contracts for more than two hours of trading or during the one-half hour before the close of trading in that market, as determined by the Calculation Agent in its sole discretion; 

 

	 	•	 	 such Basket Stock does not trade on the New York Stock Exchange, the NASDAQ Global Select Market, the NASDAQ Global Market or what was the primary
market for such Basket Stock, as determined by the Calculation Agent in its sole discretion; or 

  

	 	•	 	 any other event, if the Calculation Agent determines in its sole discretion that the event materially interferes with the Company’s ability or
the ability of any of its affiliates to unwind all or a material portion of a hedge with respect to this Security that the Company or its affiliates have effected or may effect. 

The following events will not be Market Disruption Events: 

 

	 	•	 	 a limitation on the hours or number of days of trading in such Basket Stock in its primary market, but only if the limitation results from an
announced change in the regular business hours of the relevant market; and 

  

	 	•	 	 a decision to permanently discontinue trading in the option or futures contracts relating to such Basket Stock. 

For this purpose, a “suspension, absence or material limitation of trading” in the applicable market will not include any time when
that market is itself closed for trading under 

  
 5 

 
ordinary circumstances. In contrast, a “suspension, absence or material limitation of trading” in the applicable market for a Basket Stock or option or futures contracts relating to a
Basket Stock, as applicable, by reason of any of: 
  

	 	•	 	a price change exceeding limits set by that market; 

  

	 	•	 	an imbalance of orders relating to that Basket Stock or those contracts; or 

  

	 	•	 	a disparity in bid and asked quotes relating to that Basket Stock or those contracts 

 will
constitute a “suspension, absence or material limitation of trading” in that Basket Stock or those contracts, as the case may be, in the applicable market. 

A “Trading Day” means a day, as determined by the Calculation Agent, on which trading is generally conducted
on the principal trading market for each of the Basket Stocks (as determined by the Calculation Agent, in its sole discretion), the Chicago Mercantile Exchange and the Chicago Board Options Exchange and in the over-the-counter market for equity
securities in the United States. 
 Calculation Agent 

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. All percentages and other amounts resulting from any calculation with respect to this Security
will be rounded at the Calculation Agent’s discretion. 
 Events of Default and Acceleration 

In case an Event of Default, as defined in the Indenture, with respect to this Security has occurred and is continuing, the
amount payable to the Holder of this Security upon any acceleration permitted by this Security, with respect to each $1,000 principal amount of this Security, will be equal to the greater of (i) $1,000 and (ii) Parity determined by the
Calculation Agent on the date of acceleration. 
 Adjustment Events 

The Share Ratios of the Basket Stocks are subject to adjustment by the Calculation Agent as a result of the dilution and
reorganization events described in this section. 
 How adjustments will be made 

If one of the events described below occurs with respect to any Basket Stock and the Calculation Agent determines that the
event has a dilutive or concentrative effect on the market price of such Basket Stock, the Calculation Agent will calculate a corresponding adjustment to the Share Ratio for such Basket Stock as the Calculation Agent deems appropriate to account for
that dilutive or concentrative effect. For example, if an adjustment is required because of a two-for-one stock split, then the Share Ratio for such Basket Stock will be adjusted by the Calculation Agent by

  
 6 

 
multiplying the existing Share Ratio by a fraction whose numerator is the number of shares of such Basket Stock outstanding immediately after the stock split and whose denominator is the number
of shares of such Basket Stock outstanding immediately prior to the stock split. Consequently, the Share Ratio will be adjusted to double the prior Share Ratio, due to the corresponding decrease in the market price of such Basket Stock. Adjustments
will be made for events with an effective date or Ex-Dividend Date (as defined below), as applicable, from but excluding March 21, 2016 to and including the Redemption Determination Date or the Final Determination Date, as applicable (the
“Adjustment Period”). 
 The Calculation Agent will also determine the effective date of that adjustment,
and the replacement of the Basket Stock, if applicable, in the event of a consolidation or merger or certain other events in respect of the Basket Stock Issuer. Upon making any such adjustment, the Calculation Agent will give notice as soon as
practicable to the Trustee and the Paying Agent, stating the adjustment to the Share Ratio with respect to such Basket Stock. In no event, however, will an antidilution adjustment to the Share Ratio during the term of this Security be deemed to
change the principal amount of this Security. 
 If more than one event requiring adjustment occurs with respect to a Basket
Stock, the Calculation Agent will make an adjustment for each event in the order in which the events occur, and on a cumulative basis. Thus, having made an adjustment for the first event, the Calculation Agent will adjust the Share Ratio for the
second event, applying the required adjustment to the Share Ratio of any such Basket Stock as already adjusted for the first event, and so on for any subsequent events. 

For any dilution event described below, other than a consolidation or merger, the Calculation Agent will not have to adjust
the Share Ratio unless the adjustment would result in a change to the Share Ratio of any such Basket Stock then in effect of at least 0.10%. The Share Ratio with respect to such Basket Stock resulting from any adjustment will be rounded up or down,
as appropriate, to the nearest one-hundred thousandth. 
 If an event requiring an antidilution adjustment occurs, the
Calculation Agent will make the adjustment with a view to offsetting, to the extent practical, any change in the economic position of the Holder of this Security relative to this Security that results solely from that event. The Calculation Agent
may, in its sole discretion, modify the antidilution adjustments as necessary to ensure an equitable result. 
 The
Calculation Agent will make all determinations with respect to antidilution adjustments, including any determination as to whether an event requiring adjustment has occurred, as to the nature of the adjustment required and how it will be made or as
to the value of any property distributed in a Reorganization Event (as defined below), and will do so in its sole discretion. In the absence of manifest error, those determinations will be conclusive for all purposes and will be binding on the
Holder of this Security and the Company, without any liability on the part of the Calculation Agent. The Holder of this Security will not be entitled to any compensation from the Company for any loss suffered as a result of any of these
determinations by the Calculation Agent. The Calculation Agent will provide information about the adjustments that it makes upon the written request of the Holder of this Security. 

  
 7 

 If any of the adjustments specified below is required to be made with respect to
an amount or value of any cash or other property that is distributed by any Basket Stock Issuer organized outside the United States, such amount or value will be converted to U.S. dollars, as applicable, and will be reduced by any applicable foreign
withholding taxes that would apply to such distribution if such distribution were paid to a U.S. person that is eligible for the benefits of an applicable income tax treaty, if any, between the United States and the jurisdiction of organization of
such Basket Stock Issuer, as determined by the Calculation Agent, in its sole discretion. 
 No adjustments will be made for
certain other events, such as offerings of common stock by any Basket Stock Issuer for cash or in connection with the occurrence of a partial tender or exchange offer for any Basket Stock by the issuer of such Basket Stock or any other person. 

Ordinary Dividend Adjustments 

In addition to any adjustments to the Share Ratio described herein, the Share Ratio for each Basket Stock will be adjusted for
changes (whether positive or negative) in the regular quarterly cash dividend payable to holders of such Basket Stock relative to its Base Quarterly Dividend (as defined below). If the issuer of a Basket Stock pays a regular quarterly cash dividend
for which the Ex-Dividend Date is within the Adjustment Period and the amount of such regular quarterly cash dividend (the “Current Quarterly Dividend”) differs from the Base Quarterly Dividend payable to the holders of such Basket
Stock, the Share Ratio with respect to such Basket Stock will be adjusted (an “Ordinary Dividend Adjustment”) on such Ex-Dividend Date so that the new Share Ratio will equal the prior Share Ratio multiplied by the Ordinary Dividend
Adjustment Factor. If a Basket Stock Issuer with a positive Base Quarterly Dividend (as specified below) declares that it will pay no dividend in any quarter, other than in connection with a Payment Period Adjustment as defined and discussed below,
an adjustment will be made in accordance with this paragraph on the date determined by the Calculation Agent that, but for the discontinuation of the regular quarterly cash dividend in such quarter, would have been the Ex-Dividend Date in such
quarter, corresponding to the Ex-Dividend Date in the immediately prior dividend payment period during which a regular quarterly cash dividend was paid (or, if such date is not a Trading Day, the next day that is a Trading Day). If a Reorganization
Event occurs, no Ordinary Dividend Adjustment will be made in respect of any New Stock (other than Spin-Off Stock), Successor Stock or Replacement Stock (each as defined below). 

The “Ordinary Dividend Adjustment Factor” will equal a fraction, the numerator of which is the Closing Price
of such Basket Stock on the Trading Day preceding the Ex-Dividend Date for the payment of the Current Quarterly Dividend (such Closing Price, the “Ordinary Dividend Base Closing Price”), and the denominator of which equals the
Ordinary Dividend Base Closing Price of such Basket Stock on the Trading Day preceding the Ex-Dividend Date minus the Dividend Differential. If the Dividend Differential is negative (because the Current Quarterly Dividend is less than the Base
Quarterly Dividend), then the Ordinary Dividend Adjustment Factor will be less than 1, and the corresponding adjustment to the Share Ratio will result in a reduction of the Share Ratio. 

The “Dividend Differential” equals the amount of the Current Quarterly Dividend minus the Base Quarterly
Dividend. 

  
 8 

 The “Base Quarterly Dividend” means (i) with respect to the
common stock of Celgene Corporation, a quarterly dividend of $0.00 per share; (ii) with respect to Amgen Inc., a quarterly dividend of $1.00 per share; (iii) with respect to Gilead Sciences, Inc., a quarterly dividend of $0.43 per share;
and (iv) with respect to Regeneron Pharmaceuticals, Inc., a quarterly dividend of $0.00 per share; provided that (x) if there occurs any corporate event with respect to a Basket Stock that requires an adjustment to such Basket Stock’s
Share Ratio as described in this section “Adjustment Events” or (y) if a Basket Stock effects a change in the periodicity of its dividend payments (e.g., from quarterly payments to semi-annual payments) (a “Payment Period
Adjustment”), then in each case the Calculation Agent will make an appropriate adjustment to the Base Quarterly Dividend with respect to the applicable Basket Stock with a view to offsetting, to the extent practical, any change in the
Holder’s economic position relative to this Security that results solely from that event, and references in this section to a quarter or a quarterly dividend shall be deemed to refer instead to such other period or periodic dividend, as
appropriate. In the event of a spin-off with respect to any Basket Stock, the Base Quarterly Dividend for such Basket Stock will remain unchanged and the Base Quarterly Dividend with respect to the spin-off stock will be $0.00 per share. 

Stock Splits and Reverse Stock Splits 

A stock split is an increase in the number of a corporation’s outstanding shares of stock without any change in its
stockholders’ equity. Each outstanding share will be worth less as a result of a stock split. 
 A reverse stock split
is a decrease in the number of a corporation’s outstanding shares of stock without any change in its stockholders’ equity. Each outstanding share will be worth more as a result of a reverse stock split. 

If any Basket Stock is subject to a stock split or a reverse stock split, then once the split has become effective the
Calculation Agent will adjust the Share Ratio with respect to such Basket Stock to equal the product of the prior Share Ratio of such Basket Stock and the number of shares issued in such stock split or reverse stock split with respect to one share
of such Basket Stock. 
 Stock Dividends 

In a stock dividend, a corporation issues additional shares of its stock to all holders of its outstanding stock in proportion
to the shares they own. Each outstanding share will be worth less as a result of a stock dividend. 
 If any Basket Stock is
subject to a stock dividend payable in shares of such Basket Stock that is given ratably to all holders of shares of such Basket Stock, then once the dividend has become effective the Calculation Agent will adjust the Share Ratio for such Basket
Stock on the Ex-Dividend Date to equal the sum of the prior Share Ratio for such Basket Stock and the product of: 
  

	 	●	 	 the number of shares issued with respect to one share of such Basket Stock, and 

 

	 	●	 	 the prior Share Ratio for such Basket Stock. 

The “Ex-Dividend Date” for any dividend or other distribution is the first day on and after which such Basket
Stock trades without the right to receive that dividend or distribution. 

  
 9 

 No Adjustments for Other Dividends and Distributions 

The Share Ratio will not be adjusted to reflect dividends, including cash dividends, or other distributions paid with respect
to any Basket Stock, other than: 
  

	 	●	 	 Ordinary Dividend Adjustments described above, 

  

	 	●	 	 stock dividends described above, 

  

	 	●	 	 issuances of transferable rights and warrants as described in “ — Transferable Rights and Warrants” below, 

 

	 	●	 	 distributions that are spin-off events described in “ — Reorganization Events” below, and 

 

	 	●	 	 Extraordinary Dividends described below. 

An “Extraordinary Dividend” means each of (a) the full amount per share of a Basket Stock of any cash
dividend or special dividend or distribution that is identified by the issuer of a Basket Stock as an extraordinary or special dividend or distribution, (b) the excess of any cash dividend or other cash distribution (that is not otherwise
identified by the issuer of such Basket Stock as an extraordinary or special dividend or distribution) distributed per share of such Basket Stock over the immediately preceding cash dividend or other cash distribution, if any, per share of such
Basket Stock that did not include an Extraordinary Dividend (as adjusted for any subsequent corporate event requiring an adjustment as described herein, such as a stock split or reverse stock split) if such excess portion of the dividend or
distribution is more than 5.00% of the Closing Price of such Basket Stock on the Trading Day preceding the Ex-Dividend Date for the payment of such cash dividend or other cash distribution (such Closing Price, the “Extraordinary Dividend
Base Closing Price”) and (c) the full cash value of any non-cash dividend or distribution per share of a Basket Stock (excluding Marketable Securities, as defined below). 

If any Basket Stock is subject to an Extraordinary Dividend, then once the Extraordinary Dividend has become effective the
Calculation Agent will adjust the Share Ratio for such Basket Stock on the Ex-Dividend Date to equal the product of: 
  

	 	●	 	 the prior Share Ratio for such Basket Stock, and 

  

	 	●	 	 a fraction, the numerator of which is the Extraordinary Dividend Base Closing Price of such Basket Stock on the Trading Day preceding the
Ex-Dividend Date and the denominator of which is the amount by which the Extraordinary Dividend Base Closing Price of such Basket Stock on the Trading Day preceding the Ex-Dividend Date exceeds the Extraordinary Dividend. 

Notwithstanding anything herein, the initiation by the issuer of a Basket Stock of an ordinary dividend on such Basket Stock
or any announced increase in the ordinary dividend on the such Basket Stock will not constitute an Extraordinary Dividend requiring an adjustment. 

  
 10 

 To the extent an Extraordinary Dividend is not paid in cash or is paid in a
currency other than U.S. dollars, the value of the non-cash component or non-U.S. currency will be determined by the Calculation Agent, in its sole discretion. A distribution on a Basket Stock that is a dividend payable in shares of such Basket
Stock, an issuance of rights or warrants or a spin-off event and also an Extraordinary Dividend will result in an adjustment to the number of shares of a Basket Stock only as described in “—Stock Dividends” above,
“—Transferable Rights and Warrants” below or “—Reorganization Events” below, as the case may be, and not as described here. 

Transferable Rights and Warrants 

If the issuer of a Basket Stock issues transferable rights or warrants to all holders of such Basket Stock to subscribe for or
purchase such Basket Stock at an exercise price per share that is less than the Closing Price of such Basket Stock on the Trading Day before the Ex-Dividend Date for the issuance, then the Share Ratio for such Basket Stock will be adjusted to equal
the product of: 
  

	 	●	 	 the prior Share Ratio for such Basket Stock, and 

  

	 	●	 	 a fraction, (1) the numerator of which will be the number of shares of such Basket Stock outstanding at the close of trading on the Trading
Day before the Ex-Dividend Date (as adjusted for any subsequent event requiring an adjustment hereunder) plus the number of additional shares of such Basket Stock offered for subscription or purchase pursuant to the rights or warrants and
(2) the denominator of which will be the number of shares of such Basket Stock outstanding at the close of trading on the Trading Day before the Ex-Dividend Date (as adjusted for any subsequent event requiring an adjustment hereunder) plus the
number of additional shares of such Basket Stock (referred to herein as the “Additional Shares”) that the aggregate offering price of the total number of shares of such Basket Stock so offered for subscription or purchase pursuant
to the rights or warrants would purchase at the Closing Price on the Trading Day before the Ex-Dividend Date for the issuance. 

The number of Additional Shares will be equal to: 
  

	 	●	 	 the product of (1) the total number of additional shares of such Basket Stock offered for subscription or purchase pursuant to the rights or
warrants and (2) the exercise price of the rights or warrants, divided by 

  

	 	●	 	 the Closing Price of such Basket Stock on the Trading Day before the Ex-Dividend Date for the issuance. 

If the number of shares of the Basket Stock actually delivered in respect of the rights or warrants differs from the number of
shares of the Basket Stock offered in respect of the rights or warrants, then the Share Ratio for such Basket Stock will promptly be readjusted to the Share Ratio for such Basket Stock that would have been in effect had the adjustment been made on
the basis of the number of shares of the Basket Stock actually delivered in respect of the rights or warrants. 

  
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 Reorganization Events 

Each of the following is a “Reorganization Event”: 

 

	 	●	 	 a Basket Stock is reclassified or changed (other than in a stock split or reverse stock split), 

 

	 	●	 	 the issuer of a Basket Stock has been subject to a merger, consolidation or other combination and either is not the surviving entity or is the
surviving entity but all outstanding shares of such Basket Stock are exchanged for or converted into other property, 

  

	 	●	 	 a statutory share exchange involving outstanding shares of a Basket Stock and the securities of another entity occurs, other than as part of an
event described above, 

  

	 	●	 	 a Basket Stock Issuer sells or otherwise transfers its property and assets as an entirety or substantially as an entirety to another entity,

  

	 	●	 	 a Basket Stock Issuer effects a spin-off, other than as part of an event described above (in a spin-off, a corporation issues to all holders of its
common stock equity securities of another issuer), or 

  

	 	●	 	 the issuer of a Basket Stock is liquidated, dissolved or wound up or is subject to a proceeding under any applicable bankruptcy, insolvency or
other similar law, or another entity completes a tender or exchange offer for all the outstanding shares of such Basket Stock. 

Adjustments for Reorganization Events 

If a Reorganization Event occurs with respect to a Basket Stock Issuer, then the Calculation Agent will adjust the applicable
Share Ratio to reflect the amount and type of property or properties—whether cash, securities, other property or a combination thereof—that a holder of one share of the applicable Basket Stock would have been entitled to receive in
relation to the Reorganization Event. This new property is referred to as the “Reorganization Property.” 

Reorganization Property can be classified into two categories: 

 

	 	●	 	 an equity security listed on a national securities exchange, which is generally referred to as a “Marketable Security” and, in
connection with a particular Reorganization Event, “New Stock,” which may include any tracking stock, any stock received in a spin-off (“Spin-Off Stock”) or any Marketable Security received in exchange for the
Basket Stock; and 

  

	 	●	 	 cash and any other property, assets or securities other than Marketable Securities (including equity securities that are not listed, that are
traded over the counter or that are listed on a non-U.S. securities exchange), which is referred to as “Non-Stock Reorganization Property.” 

  
 12 

 For the purpose of making an adjustment required by a Reorganization Event, the
Calculation Agent, in its sole discretion, will determine the value of each type of the Reorganization Property. For purposes of valuing any New Stock, the Calculation Agent will use the Closing Price of the security on the relevant Trading Day. The
Calculation Agent will value Non-Stock Reorganization Property in any manner it determines, in its sole discretion, to be appropriate. In connection with a Reorganization Event in which Reorganization Property includes New Stock, for the purpose of
determining the Share Ratio for any New Stock as described below, the term “New Stock Reorganization Ratio” means the product of (i) the number of shares of the New Stock received with respect to one share of the applicable
Basket Stock and (ii) the Share Ratio for such Basket Stock on the Trading Day immediately prior to the effective date of the Reorganization Event. 

If a holder of shares of the applicable Basket Stock may elect to receive different types or combinations of types of
Reorganization Property in the Reorganization Event, the Reorganization Property will consist of the types and amounts of each type distributed to a holder of shares of such Basket Stock that makes no election, as determined by the Calculation Agent
in its sole discretion. 
 If any Reorganization Event occurs with respect to a Basket Stock Issuer, then on and after the
effective date for such Reorganization Event (or, if applicable, in the case of spinoff stock, the Ex-Dividend Date for the distribution of such spinoff stock) the term “Basket Stock” herein will be deemed to mean the following in
respect of the applicable original Basket Stock, and for each share of Basket Stock, New Stock and/or Replacement Stock so deemed to constitute Basket Stock, the applicable Share Ratio will be equal to the applicable number indicated: 

 

	 	(a)	 if the Basket Stock continues to be outstanding: 

  

	 	(1)	 that Basket Stock (if applicable, as reclassified upon the issuance of any tracking stock) at the Share Ratio in effect for that Basket Stock on
the Trading Day immediately prior to the effective date of the Reorganization Event; and 

  

	 	(2)	 if the Reorganization Property includes New Stock, a number of shares of New Stock equal to the New Stock Reorganization Ratio;

 provided that, if any Non-Stock Reorganization Property is received in the Reorganization Event,
the results of (a)(1) and (a)(2) above will each be multiplied by the “Gross-Up Multiplier,” which will be equal to a fraction, the numerator of which is the Closing Price of the Basket Stock on the Trading Day immediately prior to
the effective date of the Reorganization Event and the denominator of which is the amount by which such Closing Price of the Basket Stock exceeds the value of the Non-Stock Reorganization Property received per share of Basket Stock as determined by
the Calculation Agent as of the close of trading on such Trading Day; or  

  
 13 

	 	(b)	 if the Basket Stock is surrendered for Reorganization Property: 

 

	 	(1)	 that includes New Stock, a number of shares of New Stock equal to the New Stock Reorganization Ratio; provided that, if any Non-Stock
Reorganization Property is received in the Reorganization Event, such number will be multiplied by the Gross-Up Multiplier; or 

  

	 	(2)	 that consists exclusively of Non-Stock Reorganization Property: 

 

	 	(i)	 if the surviving entity has Marketable Securities outstanding following the Reorganization Event and either (A) such Marketable Securities
were in existence prior to such Reorganization Event or (B) such Marketable Securities were exchanged for previously outstanding Marketable Securities of the surviving entity or its predecessor (“Predecessor Stock”) in
connection with such Reorganization Event (in either case of (A) or (B), the “Successor Stock”), a number of shares of the Successor Stock determined by the Calculation Agent on the Trading Day immediately prior to the
effective date of such Reorganization Event equal to the Share Ratio in effect for the Basket Stock on the Trading Day immediately prior to the effective date of such Reorganization Event multiplied by a fraction, the numerator of which is the value
of the Non-Stock Reorganization Property per share of the Basket Stock on such Trading Day and the denominator of which is the Closing Price of the Successor Stock on such Trading Day (or, in the case of Predecessor Stock, the Closing Price of the
Predecessor Stock multiplied by the number of shares of the Successor Stock received with respect to one share of the Predecessor Stock); or 

  

	 	(ii)	 if the surviving entity does not have Marketable Securities outstanding, or if there is no surviving entity (in each case, a “Replacement
Stock Event”), a number of shares of Replacement Stock (selected as defined below) with an aggregate value on the effective date of such Reorganization Event equal to the value of the Non-Stock Reorganization Property multiplied by the
Share Ratio in effect for the Basket Stock on the Trading Day immediately prior to the effective date of such Reorganization Event. 

If a Reorganization Event occurs with respect to the shares of a Basket Stock and the Calculation Agent adjusts the Share
Ratio of such Basket Stock to reflect the Reorganization Property in the event as described above, the Calculation Agent will make further antidilution adjustments for any later events that affect the Reorganization Property, or any component of the
Reorganization Property, comprising the new Share Ratio. The Calculation Agent will do so to the same extent that it would make adjustments if the shares of such Basket Stock were outstanding and were affected by the same kinds of events. If a
subsequent Reorganization Event affects only a particular component of the number of shares of such Basket Stock, the required 

  
 14 

 
adjustment will be made with respect to that component as if it alone were the number of shares of such Basket Stock. 

For purposes of adjustments for Reorganization Events, in the case of a consummated tender or exchange offer or going-private
transaction involving Reorganization Property of a particular type, Reorganization Property will be deemed to include the amount of cash or other property paid by the offeror in the tender or exchange offer with respect to such Reorganization
Property (in an amount determined on the basis of the rate of exchange in such tender or exchange offer or going-private transaction). In the event of a tender or exchange offer or a going-private transaction with respect to Reorganization Property
in which an offeree may elect to receive cash or other property, Reorganization Property will be deemed to include the kind and amount of cash and other property received by offerees who elect to receive cash. 

Replacement Stock Events 

Following the occurrence of a Replacement Stock Event described in paragraph (b)(2)(ii) above or in “—Delisting of
American Depositary Shares or Termination of American Depositary Receipt Facility” below, the amount of cash payable on this Security upon redemption or at Maturity will be determined by reference to a Replacement Stock and a Share Ratio
(subject to any further antidilution adjustments) for such Replacement Stock as determined in accordance with the following paragraphs. 

The “Replacement Stock” will be the stock having the closest “Option Period Volatility” to the
Basket Stock among the stocks that then comprise the Replacement Stock Selection Index (or, if publication of such index is discontinued, any successor or substitute index selected by the Calculation Agent in its sole discretion) with the same GICS
Code (as defined below) as the issuer of such Basket Stock; provided, however, that a Replacement Stock will not include (i) any stock that is subject to a trading restriction under the trading restriction policies of the Company, the hedging
counterparties of the Company or any of their affiliates that would materially limit the ability of the Company, the hedging counterparties of the Company or any of their affiliates to hedge this Security with respect to such stock or (ii) any
stock for which the aggregate number of shares to be referenced (equal to the product of (a) the Share Ratio that would be in effect immediately after selection of such stock as the Replacement Stock and (b) the principal amount of this
Security outstanding divided by $1,000) exceeds 25% of the ADTV (as defined in Rule 100(b) of Regulation M under the Exchange Act) for such stock as of the effective date of the Replacement Stock Event (an “Excess ADTV Stock”).

 If a Replacement Stock is selected in connection with a Reorganization Event, the Share Ratio with respect to such
Replacement Stock will be equal to the number of shares of such Replacement Stock with an aggregate value, based on the Closing Price on the effective date of such Reorganization Event, equal to the product of (a) the value of the Non-Stock
Reorganization Property received per share of the Basket Stock and (b) the Share Ratio in effect for such Basket Stock on the Trading Day immediately prior to the effective date of such Reorganization Event. If Replacement Stock is selected in
connection with an ADS Termination Event (as defined below), the Share Ratio with respect to such Replacement Stock will be equal to the number of shares of such Replacement Stock with an aggregate value, based on the Closing Price on the Change
Date (as defined below), equal to the product of (x) the Closing Price of the Basket Stock on the Change 

  
 15 

 
Date and (y) the Share Ratio in effect for such Basket Stock on the Trading Day immediately prior to the Change Date. 

The “Option Period Volatility” means, in respect of any Trading Day, the volatility (calculated by referring
to the Closing Price of the Basket Stock on its primary exchange) for a period equal to the 125 Trading Days immediately preceding the announcement date of the Reorganization Event, as determined by the Calculation Agent. 

“GICS Code” means the Global Industry Classification Standard (“GICS”) sub-industry code
assigned to the Basket Stock Issuer; provided, however, if (i) there is no other stock in the Replacement Stock Selection Index in the same GICS sub-industry or (ii) a Replacement Stock (a) for which there is no trading restriction
and (b) that is not an Excess ADTV Stock cannot be identified from the Replacement Stock Selection Index in the same GICS sub-industry, the GICS Code will mean the GICS industry code assigned to such Basket Stock Issuer. If no GICS Code has
been assigned to such Basket Stock Issuer, the applicable GICS Code will be determined by the Calculation Agent to be the GICS sub-industry code assigned to companies in the same sub-industry (or, subject to the proviso in the preceding sentence,
industry, as applicable) as such Basket Stock Issuer at the time of the relevant Replacement Stock Event. 
 The
“Replacement Stock Selection Index” means the S&P 500® Index. 

Delisting of American Depositary Shares or Termination of American Depositary Receipt Facility. If a Basket Stock is an
ADS and such Basket Stock is no longer listed or admitted to trading on a U.S. securities exchange registered under the Exchange Act or included in the OTC Bulletin Board Service operated by the FINRA, or if the American depositary receipt facility
between the issuer of such Basket Stock and the depositary is terminated for any reason (each, an “ADS Termination Event”), then, on the last Trading Day on which such Basket Stock is listed or admitted to trading or the last
Trading Day immediately prior to the date of such termination, as applicable (the “Change Date”), a Replacement Stock Event shall be deemed to occur. 
  

 

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] 

  
 16 

 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

  
 17 

 [Reverse of Note] 

WELLS FARGO & COMPANY 

MEDIUM-TERM NOTE, SERIES K 

Due Nine Months or More From Date of Issue 

0.125% Equity Basket Linked Notes due March 29, 2021 

Linked to a Basket of Shares 

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 

  
 18 

 
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 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. 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 “Principal 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 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. 
 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 

  
 19 

 
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 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 make the payments on this Security at the times, place and rate, and in the coin or currency or shares of the Basket Stocks, as the case may be, herein prescribed, except as otherwise provided
in this Security. 
 No Personal Recourse 

No recourse shall be had for the payment of amounts payable 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. 

  
 20 

 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)

  
 21 

 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. 

  
 22trtc_ex42.htm

EXHIBIT 4.2
 
AMENDED AND RESTATED
CERTIFICATE OF DESIGNATION
OF
SERIES B PREFERRED STOCK
OF
TERRA TECH CORP.
 
Terra Tech Corp. (the "Corporation"), a Nevada corporation, does hereby certify:
 
		1. 	The name of the Corporation is Terra Tech Corp.

			
		2. 	On February 28, 2012, the Corporation filed a Certificate of Designation of Series B Preferred Stock with the Secretary of State of the State of Nevada (the "Initial Series B Certificate"), which included an attachment setting forth the rights of the Series B Preferred Stockholders.

			
		3. 	On April 23, 2013, the Corporation filed an Amendment to Certificate of Designation of Series B Preferred Stock with the Secretary of State of the State of Nevada (the "First Amendment," and, together with the Initial Series B Certificate, the "Series B Certificate").

			
		4. 	The stockholders holding a majority of the currently issued and outstanding shares of Series B Preferred Stock have approved of the changes to the Series B Certificate as set forth in this Amended and Restated Certificate of Designation of Series B Preferred Stock of Terra Tech Corp. (the "Second Amendment") in accordance with the provisions of Section 78.207 of the Nevada Revised Statutes.

 
NOW, THEREFORE, BE IT RESOLVED, that, pursuant to the authority expressly granted to and vested in the Board of Directors of the Corporation by the provisions of the Corporation's Articles of Incorporation, as amended (the "Articles") and Section 78.207 of the Nevada Revised Statutes, the Series B Certificate be, and hereby is, amended, as follows:
 
Section 1. Designation and Amount. This series of Preferred Stock shall be comprised of Twenty-four Million Nine Hundred Sixty-Eight Thousand Eight Hundred (24,968,800) shares and shall be designated as "Series B Preferred Stock." As used herein, the term "Series B Preferred Stock" shall refer to shares of the Corporation's Series B Preferred Stock, and the term "Common Stock" shall refer to the Corporation's Common Stock, $0.001 par value per share. The Corporation shall from time to time in accordance with the laws of the State of Nevada increase the authorized amount of its Common Stock if at any time the number of shares of Common Stock remaining unissued and available for issuance shall not be sufficient to permit conversion of the Series B Preferred Stock.
 
Section 2. Dividends. No dividends shall be paid on the Series B Preferred Stock.
 
	 
	1

	

	 

 
Section 3. Liquidation Preference. In any liquidation or winding up of the Corporation, the holders of the Series B Preferred Stock shall be entitled to receive (a) in preference (but pari passu with the holders of the Corporation's Series Z Preferred Stock) to the holders of the Common Stock and the holders of the Corporation's Series Q Preferred Stock, but (b) subordinate in preference to any sum that the holders of the shares of the Corporation's Series A Preferred Stock shall be entitled, an amount equal to $0.005384325537 per share (subject to appropriate adjustment in the event of any stock dividend, forward stock split, or other similar recapitalization). After payment of such sums, (i) the holders of the Series B Preferred Stock, (ii) the holders of the Series Z Preferred Stock on an as-converted basis assuming conversion of the Series Z Preferred Stock into Series B Preferred Stock, (iii) the holders of the Common Stock, and (iv) the holders of the Series Q Preferred Stock on an as-converted basis assuming conversion of the Series Q Preferred Stock into Common Stock, shall be entitled to receive any remaining assets of the Corporation on a pro rata, as-converted basis assuming conversion of the Series B Preferred Stock into Common Stock, the Series Z Preferred Stock into Series B Preferred Stock and then into Common Stock, and the Series Q Preferred Stock into Common Stock, all at the then-current conversion rates.
 
Section 4. Voting Rights. Except as expressly provided herein, or as provided by applicable law, the holders of the Series B Preferred Stock shall have the same voting rights as the holders of the Common Stock and shall be entitled to notice of any stockholders' meeting in accordance with the Bylaws of the Corporation, and the holders of Common Stock and Series B Preferred Stock shall vote together as a single class on all matters. Each holder of Common Stock shall be entitled to one vote for each share of Common Stock held, and each holder of Series B Preferred Stock shall be entitled to that number of votes equal to one hundred (100) shares of Common Stock. Fractional votes shall not be permitted. Any fractional voting rights resulting from the above formula (after aggregating all shares into which shares of Series B Preferred Stock held by each holder could be converted) shall be rounded to the nearest whole number (with one-half being rounded upward). In the event the Corporation shall at any time subdivide (by any stock split, stock dividend, or otherwise) its outstanding shares of Common Stock into a greater number of shares, the number of shares of Common Stock of which are equal in voting power to each share of Series B Preferred Stock, as in effect immediately prior to such subdivision, shall be proportionately increased.
 
Section 5. Conversion. The holders of the Series B Preferred Stock shall have the following conversion rights (the "Conversion Rights"):
 
		(a) 	Right to Convert. From and after the day on which the Corporation receives payment in full for the Series B Preferred Stock from and issues shares of Series B Preferred Stock to a particular holder of Series B Preferred Stock (the "Issuance Date"), each one share of Series B Preferred Stock held by that holder shall be initially convertible at the option of the holder into 5.384325537 shares of Common Stock (such number of shares of Common Stock into which each share of Series B Preferred Stock is convertible, the initial "Conversion Rate"). For purposes of clarification, the initial Conversion Rate shall be the quotient obtained by dividing (i) 1.00 initially by (ii) 5.384325537. Such "initial quotient" is 0.185726703. The number of shares of Common Stock to be issued upon conversion of Series B Preferred Stock shall be determined by dividing the number of shares of Series B Preferred Stock to be converted by 0.185726703. The Conversion Rate shall be subject to appropriate adjustment in the event of any stock dividend, forward stock split, or other similar recapitalization as set forth herein. Accordingly, if the Conversion Rate has been adjusted, the then-current Conversion Rate shall be utilized in lieu of 0.185726703.

			
		(b) 	Method of Conversion. In order to convert Series B Preferred Stock into shares of Common Stock, a holder of Series B Preferred Stock shall:

 
		i. 	complete, execute, and deliver to the Corporation and the Corporation's transfer agent (the "Transfer Agent"), the conversion certificate attached hereto as Exhibit A (the "Notice of Conversion"), and

 
	 
	2

	

	 

 
		ii. 	surrender the certificate or certificates representing the Series B Preferred Stock being converted (the "Converted Certificate") to the Corporation.

 
			The Notice of Conversion shall be effective and in full force and effect for a particular date if delivered to the Corporation and the Transfer Agent on that particular date prior to 5:00 p.m., Pacific Standard Time, by facsimile transmission or otherwise, provided, however, that if such particular date is a business day, and provided that the original Notice of Conversion and the Converted Certificate are delivered to and received by the Transfer Agent within three (3) business days thereafter at current business address of the Transfer Agent (each such date shall be referred to herein as the "Conversion Date"). The person or persons entitled to receive the shares of Common Stock to be issued upon conversion shall be treated for all purposes as the record holder or holders of such shares of Common Stock as of the Conversion Date. If the original Notice of Conversion and the Converted Certificate are not delivered to and received by the Transfer Agent within three (3) business days following the Conversion Date, the Notice of Conversion shall become null and void as if it were never given and the Corporation shall, within two (2) business days thereafter, instruct the Transfer Agent to return to the holder by overnight courier any Converted Certificate that may have been submitted in connection with any such conversion. In the event that any Converted Certificate submitted represents a number of shares of Series B Preferred Stock that is greater than the number of such shares that is being converted pursuant to the Notice of Conversion delivered in connection therewith, the Transfer Agent shall advise the Corporation to deliver a certificate representing the remaining number of shares of Series B Preferred Stock not converted.

 
		(c) 	Legend. Each certificate issued representing the shares of Common Stock issued upon a conversion shall bear a legend substantially in the following form:

	 
	 
	 

	 
	 
	THIS SECURITY HAS NOT BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES COMMISSION OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT"), AND, ACCORDINGLY, MAY NOT BE OFFERED OR SOLD EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS AS EVIDENCED BY A LEGAL OPINION OF COUNSEL TO THE TRANSFEROR TO SUCH EFFECT, THE SUBSTANCE OF WHICH SHALL BE REASONABLY ACCEPTABLE TO THE COMPANY. THIS SECURITY MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT WITH A REGISTERED BROKER-DEALER OR OTHER LOAN WITH A FINANCIAL INSTITUTION THAT IS AN "ACCREDITED INVESTOR" AS DEFINED IN RULE 501(a) UNDER THE SECURITIES ACT OR OTHER LOAN SECURED BY SUCH SECURITIES.

 
		(d) 	Absolute Obligation to Issue Common Stock. Upon receipt of a Notice of Conversion, the Corporation shall absolutely and unconditionally be obligated to cause a certificate or certificates representing the number of shares of Common Stock to which a converting holder of Series B Preferred Stock shall be entitled as provided herein, which shares shall constitute fully paid and non-assessable shares of Common Stock and shall be issued to, delivered by overnight courier to, and received by such holder by the fifth (5th) business day following the Conversion Date. Such delivery shall be made at such address as such holder may designate therefor in its Notice of Conversion or its written instructions submitted together therewith.

 
	 
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		(e) 	Minimum Conversion. No less than fifty (50) shares of Series B Preferred Stock may be converted at any one time by a particular holder, unless the holder then holds less than 50 shares and converts all such shares held by it at that time.

			
		(f) 	Fractional Shares. No fractional shares of Common Stock shall be issued upon conversion of the Series B Preferred Stock. In lieu of any fractional shares to which the holder would otherwise be entitled, the Corporation shall round the fraction to the next whole number of shares of Common Stock. Such number of whole shares of Common Stock to be issued upon the conversion of one share of Series B Preferred Stock shall be multiplied by the number of shares of Series B Preferred Stock submitted for conversion pursuant to the Notice of Conversion to determine the total number of shares of Common Stock to be issued in connection with any one particular conversion.

			
		(g) 	Costs. The Corporation shall pay all documentary, stamp, transfer, or other transactional taxes attributable to the issuance or delivery of shares of Common Stock upon conversion of any shares of Series B Preferred Stock; provided, however, that the Corporation shall not be required to pay any taxes that may be payable in respect of any transfer involved in the issuance or delivery of any certificate for such shares in a name other than that of the holder of the shares of Series B Preferred Stock in respect of which such shares are being issued.

			
		(h) 	Valid Issuance. All shares of Common Stock that shall be issued upon conversion of shares of Series B Preferred Stock into shares of Common Stock will, upon issuance by the Corporation in accordance with this Certificate of Designation, be duly and validly issued, fully paid, and non-assessable and free from all taxes, liens, and charges with respect to the issuance thereof.

 
Section 6. Adjustments to Conversion Rate
 
		(a) 	Adjustments for Reverse Stock Splits and Combinations. There shall be no adjustment to the Conversion Rate or the number of shares of Common Stock issuable upon conversion of the Series B Preferred Stock with respect to any reverse stock split or combination.

			
		(b) 	Adjustments for Forward Stock Splits. If the Corporation shall at any time or from time to time after the Issuance Date effect a subdivision of the outstanding Common Stock (also known as a forward stock split), the Conversion Rate (expressed as a quotient) in effect immediately before that subdivision shall be proportionately decreased so that the number of shares of Common Stock issuable on conversion of each share of Series B Preferred Stock shall be increased in proportion to such increase in the aggregate number of shares of Common Stock outstanding. Any adjustments under this Section 6(b) shall be effective at the close of business on the date the forward stock split becomes effective.

 
	 
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		(c) 	Adjustments for Certain Dividends and Distributions. If the Corporation shall at any time or from time to time after the Issuance Date make or issue or set a record date for the determination of holders of Common Stock entitled to receive a dividend or other distribution payable in shares of Common Stock, then, and in each event, the Conversion Rate (expressed as a quotient) shall be decreased as of the time of such issuance or, in the event such record date shall have been fixed, as of the close of business on such record date, by multiplying the Conversion Rate then in effect by a fraction:

 
		i. 	the numerator of which shall be the total number of shares of Common Stock issued and outstanding immediately prior to the time of such issuance or the close of business on such record date; and

			
		ii. 	the denominator of which shall be the total number of shares of Common Stock issued and outstanding immediately prior to the time of such issuance or the close of business on such record date plus the number of shares of Common Stock issuable in payment of such dividend or distribution.

 
		(d) 	Adjustments for Other Dividends and Distributions. If the Corporation shall at any time or from time to time after the Issuance Date make or issue or set a record date for the determination of holders of Common Stock entitled to receive a dividend or other distribution payable in securities of the Corporation other than shares of Common Stock, then, and in each event, an appropriate revision to the applicable Conversion Rate shall be made and provision shall be made (by adjustments of the Conversion Rate or otherwise) so that the holders of Series B Preferred Stock shall receive upon conversion thereof, in addition to the number of shares of Common Stock receivable thereon, the number of securities of the Corporation that they would have received had their Series B Preferred Stock been converted into Common Stock on the date of such event and had thereafter, during the period from the date of such event to and including the date the Series B Preferred Stock was converted, retained such securities (together with any distributions payable thereon during such period), giving application to all adjustments called for during such period under this Section 6(d) with respect to the rights of the holders of the Series B Preferred Stock; provided, however, that, if such record date shall have been fixed and such dividend is not fully paid or if such distribution is not fully made on the date fixed therefor, the Conversion Rate shall be adjusted pursuant to this paragraph as of the time of actual payment of such dividends or distributions; and provided, further, however, that no such adjustment shall be made if the holders of Series B Preferred Stock simultaneously receive (i) a dividend or other distribution of shares of Common Stock in a number equal to the number of shares of Common Stock as they would have received if all outstanding shares of Series B Preferred Stock had been converted into Common Stock on the date of such event or (ii) a dividend or other distribution of shares of Series B Preferred Stock that are convertible, as of the date of such event, into such number of shares of Common Stock as is equal to the number of additional shares of Common Stock being issued with respect to each share of Common Stock in such dividend or distribution.

			
		(e) 	Adjustments for Reclassification, Exchange, and Substitution. If the Common Stock issuable upon conversion of the Series B Preferred Stock at any time or from time to time after the Issuance Date shall be changed to the same or different number of shares of any class or classes of stock, whether by reclassification, exchange, substitution, or otherwise (other than by way of a forward stock split of shares or stock dividends provided for in Sections 6(b), (c), and (d)), then, and in each event, an appropriate adjustment to the Conversion Rate shall be made and provisions shall be made (by adjustments of the Conversion Rate or otherwise) so that the holder of each share of Series B Preferred Stock shall have the right thereafter to convert such share of Series B Preferred Stock into the kind and amount of shares of stock and other securities receivable upon reclassification, exchange, substitution, or other change, by holders of the number of shares of Common Stock into which such shares of Series B Preferred Stock might have been converted immediately prior to such reclassification, exchange, substitution, or other change, all subject to further adjustment as provided herein.

 
	 
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		(f) 	Adjustment for Reorganizations, Mergers, Consolidations, or Sales of Assets. If at any time or from time to time there shall be a capital reorganization of the Corporation (other than by way of a forward stock split of shares or stock dividends or distributions provided for in Sections 6(b), (c), and (d), or a reclassification, exchange, or substitution of shares provided for in Section 6(e)), or a merger or consolidation of the Corporation with or into another entity where the holders of the outstanding voting securities prior to such merger or consolidation do not own more than 50% of the outstanding voting securities of the merged or consolidated entity, immediately after such merger or consolidation, or the sale of all or substantially all of the Corporation's properties or assets to any other person (each an "Organic Change"), then as a part of such Organic Change an appropriate revision to the Conversion Rate shall be made if necessary and provision shall be made if necessary (by adjustments of the Conversion Rate or otherwise) so that the holder of each share of Series B Preferred Stock shall have the right thereafter to convert such share of Series B Preferred Stock into the kind and amount of shares of stock and other securities or property of the Corporation or any successor corporation resulting from such Organic Change. In any such case, appropriate adjustment shall be made in the application of the provision of this Section 6(f) with respect to the rights of the holders of the Series B Preferred Stock after such Organic Change to the end that the provisions of this Section 6(f) (including any adjustment in the Conversion Rate then in effect and the number of shares of stock or other securities deliverable upon conversion of the Series B Preferred Stock) shall be applied after that event in as nearly an equivalent manner as may be practicable.

			
		(g) 	No Impairment. The Corporation shall not, by amendment of its Articles of Incorporation or this Certificate of Designation, or through any reorganization, transfer of assets, consolidation, merger, dissolution, issue or sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms to be observed or performed hereunder by the Corporation, but shall at all times in good faith assist in the carrying out of all the provisions of this Section 6 and in the taking of all such action as may be necessary or appropriate in order to provide the Conversion Rights of the holders of the Series B Preferred Stock against impairment. In the event a holder shall elect to convert any shares of Series B Preferred Stock as provided herein, the Corporation cannot refuse conversion based on any claim that such holder or any one associated or affiliated with such holder has been engaged in any violation of law, unless (i) an order from the Securities and Exchange Commission prohibiting such conversion shall have been issued or (ii) an injunction from a court, on notice, restraining and/or enjoining conversion of all or of said shares of Series B Preferred Stock shall have been issued and the Corporation posts a surety bond for the benefit of such holder in an amount equal to 120% of the liquidation preference amount of the Series B Preferred Stock such holder has elected to convert, which bond shall remain in effect until the completion of arbitration/litigation of the dispute and the proceeds of which shall be payable to such holder in the event it obtains judgment.

 
	 
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		(h) 	Certificates as to Adjustments. Upon occurrence of each adjustment or readjustment of the Conversion Rate pursuant to this Section 6, the Corporation, at its expense, shall promptly compute such adjustment or readjustment in accordance with the terms hereof and furnish to each holder of such Series B Preferred Stock a certificate setting forth such adjustment and readjustment, showing in detail the facts upon which such adjustment or readjustment is based. The Corporation shall, upon written request of the holder of such affected Series B Preferred Stock, at any time, furnish or cause to be furnished to such holder a like certificate setting forth such adjustments and readjustments, the Conversion Rate in effect at the time, and the number of shares of Common Stock and the amount, if any, of other securities or property that at the time would be received upon the conversion of a share of such Series B Preferred Stock. Notwithstanding the foregoing, the Corporation shall not be obligated to deliver a certificate unless such certificate would reflect an increase or decrease of at least one percent of the Conversion Rate in effect immediately prior to such adjustment.

 
Section 7. Reservation of Stock to be Issued Upon Conversion. The Corporation shall at all times reserve and keep available out of its authorized but unissued shares of Common Stock, solely for the purpose of effecting the conversion of the shares of Series B Preferred Stock, such number of its shares of Common Stock as shall from time to time be sufficient, based on the Conversion Rate then in effect, to effect the conversion of all the then outstanding shares of Series B Preferred Stock, which shall also include all shares of Series B Preferred Stock issuable upon conversion of the then outstanding shares of Series Z Preferred Stock. If at any time the number of authorized but unissued shares of Common Stock shall not be sufficient to effect the conversion of all the then outstanding shares of Series B Preferred Stock and the then outstanding shares of Series Z Preferred Stock, which are convertible into Series B Preferred Stock and then into shares of Common Stock, then, in addition to all rights, claims, and damages to which the holder of the Series B Preferred Stock shall be entitled to receive at law or in equity as a result of such failure by the Corporation to fulfill its obligations to the holders hereunder, the Corporation shall take any and all corporate or other action as may, in the opinion of its counsel, be helpful, appropriate, or necessary to increase its authorized but unissued shares of Common Stock to such number of shares as shall be sufficient for such purpose.
 
Section 8. Notices. All notices and other communications hereunder shall be in writing and shall be deemed given if delivered personally or by facsimile or e-mail or three (3) business days following being mailed by certified or registered mail, postage prepaid, return-receipt requested, addressed to the holder of record at its address appearing on the books of the Corporation. The Corporation shall give written notice to each holder of Series B Preferred Stock at least twenty (20) days prior to the date on which the Corporation closes its books or takes a record (i) with respect to any dividend or distribution upon the Common Stock or (ii) for determining rights to vote with respect to any Organic Change, dissolution, liquidation, or winding-up and in no event shall such notice be provided to such holder prior to such information being made known to the public.
 
	 
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EXHIBIT A
 
CONVERSION CERTIFICATE
 
TERRA TECH CORP.
 
Series B Preferred Stock
 
The undersigned holder (the "Holder") is surrendering to Terra Tech Corp., a Nevada Corporation (the "Corporation"), one or more of the Holder's certificates that, immediately prior to the Conversion (as defined in the Certificate of Designation of the Series B Preferred Stock (the "Certificate of Designation")), represented shares of Series B Preferred Stock of the Corporation (the "Series B Preferred Stock") in connection with the conversion of all or a portion of such Series B Preferred Stock owned of record and beneficially by the Holder as of the Conversion Date (as defined in the Certificate of Designation) into that number of shares of Common Stock, $0.001 per value per share, of the Corporation (the "Common Stock") as set forth below.
 
		1. 	The Holder understands that the Series B Preferred Stock was issued by the Corporation pursuant to the exemption from registration under the Securities Act of 1933, as amended (the "SecuritiesAct"), provided by Section 4(a)(2) of the Securities Act or by Rule 506 of Regulation D, promulgated thereunder.

			
		2. 	The Holder represents and warrants that the exchange of the Common Stock for the Series B Preferred Stock in favor of the Holder upon the Conversion shall be made pursuant to an exemption from registration under the Securities Act.

 
Number of Shares of Series B Preferred Stock Being Converted: _______________________
 
Number of Shares of Common Stock to be Issued: _________________________________
 
Conversion Date: _______________________
 
Delivery Instructions for Certificates of Common Stock and for new certificates representing any remaining shares of Series B Preferred Stock: _____________________________________________________
_____________________________________________________________________________________________________.
 
Name of Holder, Printed:_________________________________________
 
Signature of Holder: ____________________________________________
 
Telephone Number of Holder:_____________________________________
 
[remainder of page intentionally left blank]   

 
	 
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IN WITNESS WHEREOF, the Corporation has caused this Amended and Restated Certificate of Designation of Series B Preferred Stock to be duly executed on and as of March 25, 2016.  
 
	 
	TERRA TECH CORP.	 

	 	 	 	 
		By:	/s/ Derek Peterson 
	 

	 
	 
	Derek Peterson
	 

	 
	 
	President and Chief Executive Officer
	 

 
 
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