Document:

EX-10.16

 Exhibit 10.16 

WAIVER AND FIRST AMENDMENT TO CREDIT AGREEMENT 

THIS WAIVER AND FIRST AMENDMENT TO CREDIT AGREEMENT (this “Amendment”) is entered into as of December 29, 2015, by and among
the lenders identified on the signature pages hereof (each of such lenders, together with its successors and permitted assigns, is referred to hereinafter as a “Lender”, as that term is hereinafter further defined), WELLS FARGO CAPITAL
FINANCE CORPORATION CANADA, an Ontario corporation, as administrative agent for each member of the Lender Group and the Bank Product Providers (in such capacities, together with its successors and assigns in such capacities,
“Agent”), POINTCLICKCARE CORP., an Ontario corporation (“Parent”) and WESCOM SOLUTIONS INC., an Ontario corporation as Borrower (as defined below). 

WHEREAS, Borrower, Parent, Agent, and Lenders are parties to that certain Credit Agreement dated as of June 30, 2015 (as amended, restated,
modified or supplemented from time to time, the “Credit Agreement”; capitalized terms used herein and not otherwise defined herein shall have the meanings ascribed to them in the Credit Agreement); 

WHEREAS, on October 1, 2015 Wescom Solutions Inc. amalgamated with Meal Metrics Inc. (the “Amalgamation”) and the amalgamated
entity is continuing bearing the name of Wescom Solutions Inc. and is the borrower under the Credit Agreement and the other Loan Documents (the “Borrower”); 

WHEREAS, an Event of Default exists under Section 8.2(a) of the Credit Agreement due to a breach under Section 6.14 of the Credit
Agreement as a result of Parent and Borrower’s failure to dissolve WHSC within ninety (90) days after the Closing Date (the “Existing Default”); and 

WHEREAS, Borrower has requested that Agent and Lenders agree to, among other things, (i) waive the Existing Default, and (ii) amend the
Credit Agreement, and Agent and Lenders have agreed to do so on the terms and subject to the conditions set forth herein; 
 NOW THEREFORE,
in consideration of the premises and mutual agreements herein contained, the parties hereto agree as follows: 
 1.
Waiver. Subject to the satisfaction of the conditions set forth in Section 5 below, in reliance upon the representations and warranties of Borrower set forth in Section 6 below, Agent and Lenders hereby waive the Existing
Default. The foregoing waiver shall not constitute: (a) except as expressly set forth herein, a modification or alteration of the terms, conditions or covenants of the Credit Agreement or any other Loan Document, (b) a waiver of, or consent to,
any breach of, or any Event of Default under, the Credit Agreement or any other Loan Document other than the Existing Default, or (c) except as expressly set forth herein, a waiver, release or limitation upon the exercise by Agent or any Lender of
any of its rights, legal or equitable, under the Credit Agreement, the other Loan Documents and applicable law. 
 2. Amendments to
Credit Agreement. Subject to the satisfaction of the conditions set forth in Section 5 below, in reliance upon the representations and warranties of Borrower set forth in Section 6 below, the Credit Agreement is hereby amended
as follows: 
 (a) Section 6.14 of the Credit Agreement is hereby amended and restated in its entirety as follows:  

6.14. Inactive Subsidiaries. Parent and Borrower will not permit any Inactive Subsidiary to (a) own any assets (other than assets of a
de minimis nature, obligations under Permitted Intercompany Advances and with respect to WHSC, 100% of the Equity Interests of Accu-Med Services, LLC, a Delaware limited liability company), 

 (b) have any liabilities (other than liabilities of a de minimis nature and obligations
under Permitted Intercompany Advances), (c) engage in any business activity, (d) continue in existence on or after the date that is one year after the Closing Date. 

(b) Section 7(a) of the Credit Agreement is hereby amended and restated in its entirety as follows: 

(a) Minimum EBITDA. Prior to the Leverage Ratio Election Date, achieve EBITDA, measured on a quarter-end basis for the four
quarter period ended on the date set forth below of at least the required amount set forth in the following table for the applicable four quarter period ended on the date set forth opposite thereto: 

 

			
	 Applicable Amount
	  	 Applicable Period

	 - $5,000,000.00  
	  	October 31, 2015
	 - $6,000,000.00  
	  	January 31, 2016
	 - $6,500,000.00  
	  	April 30, 2016
	 - $3,500,000.00  
	  	July 31, 2016
	 - $3,250,000.00  
	  	October 31, 2016
	 - $1,250,000.00  
	  	January 31, 2017
	 $1,250,000.00
	  	April 30, 2017
	 $4,000,000.00
	  	July 31, 2017
	 $7,000,000.00
	  	October 31, 2017
	 $7,000,000.00
	  	January 31, 2018
	 $7,000,000.00
	  	April 30, 2018
	 $7,000,000.00
	  	July 31, 2018
	 $15,000,000.00
	  	October 31, 2018
	 $15,000,000.00
	  	January 31, 2019
	 $15,000,000.00
	  	April 30, 2019
	 $15,000,000.00
	  	July 31, 2019
	 $20,000,000.00
	  	October 31, 2019 and each fiscal quarter thereafter

 Notwithstanding the occurrence of a Leverage Ratio Election Date, EBITDA shall be reported on any applicable
Compliance Certificate delivered after the Leverage Ratio 

  
 -2- 

 
Election Date and tested with respect to an applicable quarter-end prior to the Leverage Ratio Election Date. 

(c) Section 7(b) of the Credit Agreement is hereby amended and restated in its entirety as follows: 

(b) Minimum Liquidity. At all times on or prior to the Fixed Charge Election Date, maintain Liquidity of at least the required
amount set forth in the following table for the applicable fiscal quarter period ended on the date set forth opposite thereto: 
  

			
	 Applicable Amount
	  	 Applicable Period End

	 $5,000,000.00
	  	October 31, 2015
	 $5,000,000.00
	  	January 31, 2016
	 $5,000,000.00
	  	April 30, 2016
	 $5,500,000.00
	  	July 31, 2016
	 $6,000,000.00
	  	October 31, 2016
	 $6,000,000.00
	  	January 31, 2017
	 $6,000,000.00
	  	April 30, 2017
	 $7,000,000.00
	  	July 31, 2017 and each fiscal quarter thereafter

 (d) Section 7(c) of the Credit Agreement is hereby amended and restated in its entirety as follows: 

(c) Fixed Charge Coverage Ratio. At all times on and after the Fixed Charge Election Date, (i) for each Fixed Charge Coverage
Ratio testing period ending on or before July 31, 2018, have a Fixed Charge Coverage Ratio of at least 1.25:1.00, measured for the applicable four quarter period ended on each fiscal quarter-end; and (ii) for each Fixed Charge Coverage Ratio testing
period ending on October 31, 2018 and thereafter, have a Fixed Charge Coverage Ratio of at least 1.50:1.00, measured for the applicable four quarter period ended on each fiscal quarter-end, in each case beginning on the first fiscal quarter after
the Fixed Charge Election Date; provided that if a Fixed Charge Election Date occurs after a fiscal quarter-end with respect to which Borrower has not delivered financial statements to Agent pursuant to Section 5.1, the Fixed Charge Coverage
Ratio shall be tested as of such fiscal quarter-end on the date the Borrower delivers financial statements to Agent with respect to such fiscal quarter-end pursuant to Section 5.1. 

(e) Section 7(d) of the Credit Agreement is hereby amended and restated in its entirety as follows: 

  
 -3- 

 (d) Leverage Ratio. At all times on and after the Leverage
Ratio Election Date, have a Leverage Ratio tested beginning on the first fiscal quarter-end after the Leverage Ratio Election Date and measured for the applicable four quarter period ended on each such fiscal quarter-end; provided that if a Leverage
Ratio Election Date occurs after a fiscal quarter-end with respect to which Borrower has not delivered financial statements to Agent pursuant to Section 5.1, the Leverage Ratio shall be tested as of such fiscal quarter-end on the date the
Borrower delivers financial statements to Agent with respect to such fiscal quarter-end pursuant to Section 5.1; and tested on each fiscal quarter-end thereafter during such Leverage Covenant Testing Period, of not greater than the applicable
ratio set forth in the following table for the applicable date set forth opposite thereto, and in each case, measured for the applicable four quarter period ended on each such fiscal quarter-end: 

 

			
	 Applicable Ratio
	  	 Applicable Period End

	 5.00 to 1.00
	  	January 31, 2016
	 5.00 to 1.00
	  	April 30, 2016
	 5.00 to 1.00
	  	July 31, 2016
	 5.00 to 1.00
	  	October 31, 2016
	 5.00 to 1.00
	  	January 31, 2017
	 5.00 to 1.00
	  	April 30, 2017
	 5.00 to 1.00
	  	July 31, 2017
	 5.00 to 1.00
	  	October 31, 2017
	 5.00 to 1.00
	  	January 31, 2018
	 5.00 to 1.00
	  	April 30, 2018
	 5.00 to 1.00
	  	July 31, 2018
	 4.00 to 1.00
	  	October 31, 2018
	 4.00 to 1.00
	  	January 31, 2019
	 4.00 to 1.00
	  	April 30, 2019
	 4.00 to 1.00
	  	July 31, 2019
	 3.00 to 1.00
	  	October 31, 2019 and each fiscal quarter thereafter

 (f) Exhibit C-2 (Form of Credit Amount Certificate) to the Credit Agreement is hereby amended and
restated in its entirety as set forth on Exhibit C-2 attached hereto. 

  
 -4- 

 (g) Schedule C-1 to the Credit Agreement is hereby amended and restated in its entirety as set
forth on Schedule C-1 attached hereto. 
 (h) Schedule 1.1 to the Credit Agreement is hereby amended by amending and restating the
definition of “Maximum Revolver Amount” therein in its entirety as follows: 
 “Maximum Revolver Amount” means
$50,000,000, as decreased by the amount of reductions in the Revolver Commitments made in accordance with Section 2.4(c) of the Agreement. 

(i) Schedule 1.1 to the Credit Agreement is hereby amended by amending and restating the definition of “Swing Loan Limit” therein in
its entirety as follows: 
 “Swing Loan Limit” means as of any date of determination the lesser of (a) $50,000,000 and (b)
the Revolver Commitment of WFCFCC. 
 3. Continuing Effect. Except as expressly set forth in Sections 1 and 2 of
this Amendment, nothing in this Amendment shall constitute a modification or alteration of the terms, conditions or covenants of the Credit Agreement or any other Loan Document, or a waiver of any other terms or provisions thereof, and the Credit
Agreement and the other Loan Documents shall remain unchanged and shall continue in full force and effect, in each case as amended hereby. 

4. Reaffirmation and Confirmation. Borrower hereby ratifies, affirms, acknowledges and agrees that, notwithstanding the
Amalgamation or this Amendment, the Credit Agreement and the other Loan Documents represent the valid, enforceable and collectible obligations of Borrower, and further acknowledges that there are no existing claims, defenses, personal or otherwise,
or rights of setoff whatsoever with respect to the Credit Agreement or any other Loan Document as of the date hereof. Borrower hereby agrees that this Amendment in no way acts as a release or relinquishment of the Liens and rights securing
payments of the Obligations. The Liens and rights securing payment of the Obligations are hereby ratified and confirmed by Borrower in all respects. 

5. Conditions to Effectiveness. This Amendment shall become effective upon the satisfaction of each of the following conditions
precedent, each in form and substance acceptable to Agent: 
 (a) Agent shall have received a fully executed copy of this Amendment,
including the Consent and Reaffirmation attached hereto, together with such other documents, agreements and instruments as Agent may require or reasonably request; 

(b) Agent shall have received a fully executed copy of a joinder agreement whereby Wescom Healthcare Solutions, Corp., a Delaware corporation,
shall join the US Guaranty and Security Agreement as a Grantor (as defined therein), together with such other documents, agreements and instruments as Agent may require or reasonably request in connection with such joinder agreement; 

(c) Borrower shall have paid to Agent an Amendment Fee of $100,000; and 

(d) No Default or Event of Default shall have occurred and be continuing on the date hereof or as of the date of the effectiveness of this
Amendment. 
 6. Representations and Warranties. In order to induce Agent and Lenders to enter into this Amendment, each of
Borrower and Parent hereby represents and warrants to Agent and Lenders that, after giving effect to this Amendment: 

  
 -5- 

 (a) All representations and warranties contained in the Credit Agreement and the other Loan
Documents are true and correct in all material respects (except that such materiality qualifier shall not be applicable to any representations and warranties that already are qualified or modified by materiality in the text thereof) on and as of the
date of this Amendment, in each case as if then made (except to the extent that such representations and warranties that expressly relate solely to an earlier date, in which case such representations and warranties were true and correct in all
material respects (except that such materiality qualifier shall not be applicable to any representations and warranties that already are qualified or modified by materiality in the text thereof) on and as of such earlier date); 

(b) No Default or Event of Default has occurred and is continuing; and 

(c) This Amendment and the Credit Agreement constitute legal, valid and binding obligations of Borrower and Parent and are enforceable against
Borrower and Parent in accordance with their respective terms. 
 7. Miscellaneous. 

(a) Canadian Guarantee and Security Agreement. In connection with the change of chief executive office and principal place of
business of the Canadian Loan Parties, Schedule 7 “Name; Chief Executive Office; Principal Place of Business; Collateral Locations; Tax Identification and Business Numbers and Organizational Numbers” attached hereto shall replace in
its entirety Schedule 7 to the Canadian Guarantee and Security Agreement and shall be deemed a part thereof for all purposes of the Canadian Guarantee and Security Agreement. 

(b) Expenses. Borrower agrees to pay on demand all Lender Group Expenses of Agent (including, without limitation, the fees and
expenses of outside counsel for Agent) in connection with the preparation, negotiation, execution, delivery and administration of this Amendment and all other instruments or documents provided for herein or delivered or to be delivered hereunder or
in connection herewith. All obligations provided herein shall survive any termination of this Amendment and the Credit Agreement. 

(c) Governing Law. Without limiting the applicability of any other provision of the Credit Agreement or any other Loan Document,
the terms and provisions set forth in Section 12 of the Credit Agreement are expressly incorporated herein by reference. 
 (d)
Counterparts. This Amendment may be executed in any number of counterparts, and by the parties hereto on the same or separate counterparts, and each such counterpart, when executed and delivered, shall be deemed to be an original, but
all such counterparts shall together constitute but one and the same Amendment. Delivery of an executed counterpart of this Amendment by facsimile or other electronic transmission (including a “.pdf” file) shall be equally effective
as delivery of an original executed counterpart of this Amendment. 
 (e) Amendment as Loan Document. Borrower hereby
acknowledges and agrees that this Amendment constitutes a “Loan Document” under the Credit Agreement. 
 8. Release. 

(a) In consideration of the agreements of Agent and Lenders contained herein and for other good and valuable consideration, the receipt and
sufficiency of which is hereby acknowledged, each of Borrower, Parent and each other Loan Party, by its execution and delivery of this Amendment and the Consent and Reaffirmation attached hereto (as applicable), on behalf of itself and its
successors, assigns, and other legal representatives, hereby absolutely, unconditionally and irrevocably releases, remises and forever discharges Agent and Lenders, and their successors and assigns, and their present and

  
 -6- 

 
former shareholders, affiliates, subsidiaries, divisions, predecessors, directors, officers, attorneys, employees, agents and other representatives (Agent, each Lender and all such other Persons
being hereinafter referred to collectively as the “Releasees” and individually as a “Releasee”), of and from all demands, actions, causes of action, suits, covenants, contracts, controversies, agreements, promises,
sums of money, accounts, bills, reckonings, damages and any and all other claims, counterclaims, defenses, rights of set-off, demands and liabilities whatsoever (individually, a “Claim” and
collectively, “Claims”) of every name and nature, which are known, both at law and in equity, which any such Borrower, Parent or other Loan Party or any of their respective successors, assigns, or other legal representatives may now
or hereafter own, hold, have or claim to have against the Releasees or any of them for, upon, or by reason of any circumstance, action, cause or thing whatsoever in relation to, or in any way in connection with any of the Credit Agreement, or any of
the other Loan Documents or transactions thereunder or related thereto, in each case, solely that arises at any time on or prior to the day and date of this Amendment. 

(b) Each of Borrower, Parent and each other Loan Party, by its execution and delivery of this Amendment and the Consent and Reaffirmation
attached hereto (as applicable), understands, acknowledges and agrees that the release set forth above may be pleaded as a full and complete defense and may be used as a basis for an injunction against any action, suit or other proceeding which may
be instituted, prosecuted or attempted in breach of the provisions of such release. 
 (c) Each of Borrower, Parent and each other Loan
Party agrees that no fact, event, circumstance, evidence or transaction which could now be asserted or which may hereafter be discovered shall affect in any manner the final, absolute and unconditional nature of the release set forth above. 

  
 -7- 

 IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be executed by their
respective officers thereunto duly authorized and delivered as of the date first above written. 
  

			
	BORROWER:
	
	WESCOM SOLUTIONS INC., an Ontario corporation, as Borrower
		
	By:	 	 /s/ Paul Rybecky

	Name:	 	Paul Rybecky
	Title:	 	CFO
	
	PARENT:
	
	POINTCLICKCARE CORP., an Ontario corporation, as Parent
		
	By:	 	 /s/ Paul Rybecky

	Name:	 	Paul Rybecky
	Title:	 	CFO

 
			
	AGENT:
	
	WELLS FARGO CAPITAL FINANCE CORPORATION CANADA, an Ontario corporation, as Agent and sole Lender
		
	By:	 	 /s/ David G. Phillips

	Name:	 	David G. Phillips
	Title:	 	Senior Vice President Credit Officer, Canada

 CONSENT AND REAFFIRMATION 

The undersigned hereby (i) acknowledges receipt of a copy of the foregoing Waiver and First Amendment to Credit Agreement (the
“Amendment”) (terms defined therein and used, but not otherwise defined, herein shall have the meanings assigned to them therein); (ii) consents to Borrower and Parent’s execution and delivery thereof; (iii) agrees to
be bound thereby, including Section 8 of the Amendment; and (iv) affirms that nothing contained therein shall modify in any respect whatsoever any Loan Documents (other than as specifically provided in the Amendment) to which the undersigned is
a party and reaffirms that the Loan Documents to which it is a party shall continue to remain in full force and effect. Although each undersigned has been informed of the matters set forth herein and has acknowledged and agreed to same,
Borrower, on behalf of each undersigned, acknowledges and agrees that each undersigned understands that Agent and Lenders have no obligation to inform the undersigned of such matters in the future or to seek the undersigned’s acknowledgment or
agreement to future consents, amendments or waivers, and nothing herein shall create such a duty. 
 [signature pages follow] 

 IN WITNESS WHEREOF, the undersigned has executed this Consent and Reaffirmation on and as of the
date of the Amendment. 
  

			
	2466553 ONTARIO CORP., an Ontario corporation
		
	By:	 	 /s/ Paul Rybecky

	Name:	 	Paul Rybecky
	Title:	 	CFO
	
	WESCOM SOLUTIONS, CORP. a Delaware corporation
		
	By:	 	 /s/ Paul Rybecky

	Name:	 	Paul Rybecky
	Title:	 	CFO
	
	ACCU-MED SERVICES LLC, a Delaware limited liability company
		
	By:	 	 /s/ Paul Rybecky

	Name:	 	Paul Rybecky
	Title:	 	CFO

 EXHIBIT C-2 

FORM OF CREDIT AMOUNT CERTIFICATE 
 Wells
Fargo Capital Finance Corporation Canada 
 c/o Wells Fargo Bank, National Association 

One Boston Place 
 201 Washington Street, Suite 1800 

Boston, Massachusetts 02108 
 Attn: PointClickCare
Relationship Manager 
  

	 	Re:	Credit Amount Certificate dated             , 20     

Ladies and Gentlemen: 
 Reference is made to
that certain Credit Agreement dated as of June 30, 2015 (as amended, restated, supplemented, or otherwise modified from time to time) by and among Pointclickcare Corp., an Ontario corporation as “Parent”, Wescom Solutions
Inc., an Ontario corporation, as “Borrower”, the lenders party thereto as “Lenders”, and Wells Fargo Capital Finance Corporation Canada, an Ontario corporation, as administrative agent for the Lenders (in such
capacity, together with its successors and assigns in such capacity, “Agent”). Capitalized terms used herein and not otherwise defined herein shall have the meanings ascribed to them in the Credit Agreement. 

Pursuant to Section 5.1 of the Credit Agreement, the undersigned officer of Borrower hereby certifies as of the date hereof that the
items set forth on Schedule 1 attached hereto, calculated in accordance with the terms and definitions set forth in the Credit Agreement for such items are true and correct, and that Borrower is in compliance with and, after giving effect to
any currently requested Loans, will be in compliance with, the terms, conditions, and provisions of the Credit Agreement. 
 [Remainder of
page intentionally left blank.] 

 
			
	Very truly yours,
	
	WESCOM SOLUTIONS INC., an Ontario corporation, as Borrower
		
	By:	 	  

	Name:	 	
	Title:	 	

 SCHEDULE 1 

Effective Date of Calculation:
                    ,             

 

																	
	A.    	  	Credit Amount Calculation	  				  			
					
		  	1.    	  	Credit Amount Multiple	  	 	0.45	  	  			
					
		  	2.	  	Aggregate Amount of the Recurring Revenue of the Borrower for the most recently completed trailing twelve consecutive month period for which Borrower has delivered financial statements to Agent	  	$	                	  	  			
					
		  	3.	  	Credit Amount (Item A.1 times Item A.2)	  				  	$	                	  
					
		  	4.	  	Availability Calculation	  				  			
							
		  		  	a.  	  	(i)	  	Maximum Revolver Amount	  	$	50,000,000	  	  			
							
		  		  		  	(ii)	  	USD Equivalent Amount of Letter of Credit Usage (from Item B.2)	  	$	                	  	  			
							
		  		  		  	(iii)  	  	USD Equivalent Amount of Outstanding Swing Loans and Revolving Loans	  	$	                	  	  			
							
		  		  		  	(iv)	  	Item A.4.a.(i) minus Item A.4.a.(ii) minus Item A.4.a.(iii) 	  	$	                	  	  			
							
		  		  	b.	  	(i)	  	Credit Amount (from Item A.3)	  	$	                	  	  			
							
		  		  		  	(ii)	  	USD Equivalent Amount of Letter of Credit Usage (from Item B.2)	  	$	                	  	  			
							
		  		  		  	(iii)	  	USD Equivalent Amount of Outstanding Swing Loans and Revolving Loans	  	$	                	  	  			
							
		  		  		  	(iv)	  	Item A.4.b.(i) minus Item A.4.b.(ii) minus Item A.4.b.(iii)	  	$	                	  	  			
						
		  		  	c.	  	lesser of Item A.4.a.(iv) and A.4.b.(iv)	  				  	$	                	  
				
	B.	  	Letters of Credit Calculation	  				  			

  
 Schedule 1 - Page 1 

to Credit Amount Certificate 

																	
					
		  	1.    	  	Letters of Credit permitted under Maximum Revolver Amount	  				  			
						
		  		  	a.  	  	Maximum Revolver Amount	  	$	50,000,000	  	  			
						
		  		  	b.	  	Current outstanding principal balance of the Revolving Loans (including Swing Loans and Protective Advances)	  	$	                	  	  			
						
		  		  	c.	  	Item B.1.a minus Item B.1.b 	  				  	$	                	  
					
		  	2.	  	USD Equivalent of Letter of Credit Usage	  				  	$	                	  
					
		  	3.	  	USD Equivalent Amount of Letter of Credit Usage plus the USD Equivalent Amount of any proposed Letters of Credit	  				  	$	                	  
					
		  	4.	  	No Letter of Credit availability if Item B.2 is greater than Item B.1.c. or if Item B.3 is greater than Item B.1.c.	  				  			

  
 Schedule 1 - Page 2 

to Credit Amount Certificate 

 Schedule C-1 

COMMITMENTS 
  

									
	 Lender
	  	Revolver
Commitment	 	  	Total Commitments	 
	 Wells Fargo Capital Finance Corporation Canada
	  	$	50,000,000	  	  	$	50,000,000	  
	 TOTAL
	  	$	50,000,000	  	  	$	50,000,000	  

 Schedule 7 

Name; Chief Executive Office; Principal Place of Business; Collateral Locations; Tax Identification and Business Numbers and Organizational
Numbers 
  
  

													
	 	 	 	 	 	 	 
	 Name of

Grantor
	 	 Chief

Executive

Office
	 	 Jurisdiction

of Formation
 and
Foreign
 Qualification
	 	 Principal

Place of

Business
	 	 Collateral

Locations
	 	 Organizational

Numbers
	 	 Tax

Identification
Number

	 	 	 	 	 	 	 
	 Wescom

Solutions
 Inc.
	 	5570 Explorer Drive,
 Mississauga,

ON, Canada
 L4W 0C4
	 	 Ontario 
 Foreign:
New

Hampshire,
 Minnesota

(pending)
	 	5570 Explorer Drive,
 Mississauga,

ON, Canada
 L4W 0C4
	 	7100 West Credit
 Avenue, 2nd Floor,

Mississauga,
 ON

 
 1905 Lunt Avenue,

Elk Grove Village,
IL, 60007
 Cages:

CH3:2:32220
 21 Canniff Street,

Toronto, ON,
 M5V 3G1 -7

cabinets
 (lockers)

1105-220;
 1105-230;

1105-240;
 1105-250;

1105-260;
 1106-240;

1106-250
 1800

Argentia Road,
 Mississauga, ON
	 	1942457	 	894500156
	 	 	 	 	 	 	 
	 PointClick

Care Corp.
	 	5570 Explorer Drive,
 Mississauga,

ON, Canada
 L4W 0C4
	 	Ontario	 	5570 Explorer Drive,
 Mississauga,

ON, Canada
 L4W 0C4
	 	N/A	 	1844484	 	819721473
	 	 	 	 	 	 	 
	 2466553

Ontario Corp.
	 	5570 Explorer Drive,
 Mississauga,

ON, Canada
 L4W 0C4
	 	Ontario	 	5570 Explorer Drive,
 Mississauga,

ON, Canada
 L4W 0C4
	 	N/A	 	2466553	 	821791365Form of Medium-Term Notes, Series K, Principal at Risk Securities  Linked

 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. 94986RN98 
	
FACE AMOUNT: $                   
          

 REGISTERED NO.      

WELLS FARGO & COMPANY 

MEDIUM-TERM NOTE, SERIES K 

Due Nine Months or More From Date of Issue 

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

WELLS FARGO & COMPANY, a corporation duly organized and existing under the laws of the State of Delaware (hereinafter
called the “Company,” which term includes any successor corporation under the Indenture hereinafter referred to), for value received, hereby promises to pay to CEDE & Co., or registered assigns, 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 June 20, 2018. If the Determination Date (as defined below) is postponed, the Stated Maturity Date will be postponed to the third 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 7, 2016. 

The “Initial Underlier Level” is 2,112.13, 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 “Discontinuance of The Underlier; Alteration of Method of Calculation” 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 2,393.888142, which is 113.34% of the Initial Underlier Level. 

The “Buffer Level” is 1,900.917, which is equal to 90% of the Initial Underlier Level. 

  
 2 

 The “Maximum Settlement Amount” is 120.01% of the Face Amount of
this Security. 
 The “Buffer Amount” is 10%. 

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

The “Upside Participation Rate” is 1.5. 

“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 June 15, 2018. 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 March 18, 2015
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. 

  
 3 

 Discontinuance Of The Underlier; Alteration Of Method Of Calculation 

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.

 If at any time the Underlier Sponsor makes a material change in the formula for or the method of calculating the
Underlier, or in any other way materially modifies the Underlier (other than a modification prescribed in that formula or method to maintain the Underlier in the event of changes in constituent stock and capitalization and other routine events),
then, from and after that time, the Calculation Agent will, at the close of business in New York, New York, on each date that the Closing Level of the Underlier is to be calculated, 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 change, but using only those securities that comprised the Underlier immediately prior to that change. Accordingly, if the method of calculating the Underlier
is modified so that the level of the Underlier is a fraction or a multiple of what it would have been if it had not been modified, then the Calculation Agent will adjust the Underlier in order to arrive at a level of the Underlier as if it had not
been modified. 

  
 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 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 June 20, 2018. 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
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

  
 9 

 [Reverse of Note] 

WELLS FARGO & COMPANY 

MEDIUM-TERM NOTE, SERIES K 

Due Nine Months or More From Date of Issue 

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

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

The Securities are issuable only in registered form without coupons and will be either
(a) book-entry securities represented by one or more Global Securities recorded in the book-entry system maintained by the Depositary or (b) certificated
securities issued to and registered in the names of, the beneficial owners or their nominees. 
 The Company agrees, to the
extent permitted by law, not to voluntarily claim the benefits of any laws concerning usurious rates of interest against a Holder of this Security. 

Modification and Waivers 

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

  
 10 

 
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 “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 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 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 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 

  
 11 

 
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 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, 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 & 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. 

  
 14

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