Document:

The
shares subscribed for may not be sold, offered for sale, pledged, hypothecated, or otherwise transferred in the absence of (a)
an effective registration statement under the act and any applicable state securities laws, or (b) an opinion of counsel acceptable
to counsel for the issuer that such registration is not required and that the proposed transfer may be made without violation
of the act and any applicable state securities law.

 

THE
ACQUISITION OF THE SECURITIES OFFERED HEREBY INVOLVES A HIGH DEGREE OF RISK AND SHOULD BE CONSIDERED ONLY BY PERSONS WHO CAN BEAR
THE RISK OF THE LOSS OF THEIR ENTIRE INVESTMENT. THE SHARES MAY BE SOLD IN JURISDICTIONS WHERE THEY MAY BE LAWFULLY SOLD. 

 

 

SUBSCRIPTION
AGREEMENT

 

AFS
Holdings, Inc.

310
Fourth Avenue South, Suite 7000

Minneapolis,
MN 55415

 

AFS
Holdings, Inc., a Nevada corporation (the "Company"), is offering up to Four Million (4,000,000) shares of its Common
Stock, which have been registered in the Company’s S-1 Registration Statement that became effective on _______________ at
$1.00 per share, for total maximum sale proceeds of Four Million Dollars ($4,000,000). This Offering shall be on a best efforts
basis and the Company reserves the right to use the funds received immediately upon receipt. There shall be no minimum purchase
amount. The Company desires to sell  shares of the Company’s Common Stock, (the “Shares”), par value
$0.001, to the undersigned for an aggregate purchase price of $ ($1.00 per share). The undersigned (the "Subscriber")
desires to purchase the Shares for the purchase price, which is set forth on the signature page of this Subscription Agreement
(the "Agreement"). Accordingly, the Company and Subscriber agree as follows:

 

1.Sale
and Purchase. Subject to the terms and conditions set forth in this Agreement, Subscriber hereby tenders the amount set forth
on the signature page of this Agreement for the purchase of the number of Shares set forth on said signature page.

 

2.Representations,
Warranties, and Agreements of Subscriber. In connection with this subscription, Subscriber hereby makes the following representations,
warranties, and agreements and confirms the following understandings, each of which are made or confirmed, as the case may be,
with respect to the Shares subscribed for herein:

 

(a)Investment
Purpose. Subscriber is acquiring Shares for Subscriber's own account and for investment purposes only and not with a view
to or for sale in connection with any distribution of the shares.

 

(b)Review
and Evaluation of Information Regarding the Company.

 

(i)Subscriber
is familiar with the Company’s financial condition and proposed operations. Without limiting the foregoing, the Subscriber
acknowledges that the undersigned has reviewed the corporate documents regarding the Company and the terms of this Offering.

 

(ii)In
addition to the foregoing, Subscriber acknowledges that Subscriber has conducted, or has been afforded the opportunity to conduct,
an investigation of the Company and has been offered the opportunity to ask representatives of the Company questions about the
Company’s financial condition and proposed business and that Subscriber has obtained the available information as Subscriber
has requested, to the extent Subscriber has deemed necessary, to permit Subscriber to fully evaluate the merits and risks of an
investment in the Company. Representatives of the Company have answered all inquiries that Subscriber has put to them concerning
the Company and its activities, and the offering and issuance of the Shares.

    	 	 -1-	 

    	 	 

    

 

(iii)Subscriber
has reviewed the Subscription Document and SEC Filings for AFS Holdings, Inc., including the Form S-1 Registration Statement that
became effective on _____________ and Prospectus filed on ________________ on Form 424(b)(3), both of which may be found at www.sec.gov,
or by contacting the Company and requesting a copy, and has been afforded the opportunity to ask any questions, or have addressed
any concerns, that may have arisen from such review. Subscriber acknowledges that he, she, or it is only relying on the information
provided in the Subscription Agreement and SEC Filings, and understands, that he, she, or it shall contact the company’s
President, Kent Rodriguez should he, she, or it be giving information that is contradictory to, or inconsistent with, the information
set forth in this Subscription Agreement. Subscriber further acknowledges that he, she, or it has not relied on any representations
or warranties (written or oral) not contained in this Subscription Agreement.

 

(c)Risks.
Subscriber recognizes that the purchase of Shares involves a high degree of risk and is suitable only for persons of adequate
financial means who have no need for liquidity in this investment in that (i) Subscriber may not be able to liquidate the investment
in the event of an emergency; (ii) transferability is limited; and (iii) in the event of a disposition, Subscriber could sustain
a complete loss of his or her entire investment. The Subscriber agrees that he or she acknowledges the risks and has reviewed
the section titled “Risk Factors” in the Form S-1 Registration Statement that became effective on ________________.

 

(d)Risk
of Loss. The Subscriber represents and warrants that the Subscriber: (a) is able to bear the loss of the Subscriber’s
entire investment without any material adverse effect on the Subscriber’s economic stability; (b) understands that an investment
in the Company involves substantial risks; and (c) has such knowledge and experience in financial and business matters that the
Subscriber is capable of evaluating the merits and risks of the investment to be made by the Subscriber pursuant to this Agreement.

 

(e)Subscriber's
Financial Experience. If Subscriber is not an accredited investor, Subscriber is sufficiently experienced in financial
and business matters to be capable of evaluating the merits and risks of an investment in the Company.

 

(f)Suitability
of Investment. Subscriber has evaluated the merits and risks of Subscriber's proposed investment in the Company, including
those risks particular to Subscriber's situation, and has determined that this investment is suitable for Subscriber. Subscriber
has adequate financial resources for an investment of this character, and at this time Subscriber can bear a complete loss of
Subscriber's investment. Further, Subscriber will continue to have, after making an investment in the Company, adequate means
of providing for Subscriber's current needs, the needs of those dependent on Subscriber, and possible personal contingencies.

 

(g)Absence
of Official Evaluation. Subscriber understands that neither the securities regulatory agencies of any State, nor the United
States Securities and Exchange Commission has made any finding or determination as to the fairness of the terms of an investment
in the Company, or any recommendation for, or endorsement of, the Shares offered hereby.

 

(h)Additional
Financing. Subscriber further acknowledges that nothing hereunder shall preclude the Company from seeking and/or procuring
additional equity and/or debt financing. Subscriber understands that it may become necessary for the Company to seek additional
financing in the future, which could dilute the Subscriber’s interest in the Company.

 

(i)Professional
Advice. Subscriber has either secured independent tax advice with respect to an investment in the Shares, upon which he,
she or it is relying, or he, she or it is sufficiently familiar with the income taxation of corporations and investments that
he, she or it deemed such independent advice to be unnecessary. The Subscriber has had the opportunity to consult with his, her,
or its tax, legal, and financial adviser to determine the benefits and risks of subscribing for the Shares, and is not, in any
way, relaying on the Company or its employees or agents, for advice in making this decision.

 

    	 	 -2-	 

    	 	 

    

(j)Acceptance.
Subscriber acknowledges that the Company shall, in its sole discretion, have the right to accept or reject this subscription,
in whole or in part, for any reason or for no reason. If Subscriber’s subscription is accepted by the Company, Subscriber
shall, and Subscriber hereby elects to, execute any and all further documents necessary in the opinion of the Company to complete
his subscription and become a shareholder of the Company.

 

(k)Authority
to Enter into Agreement. Subscriber has the full right, power, and authority to execute and deliver this Agreement and
perform Subscriber's obligations hereunder.

 

(l)Prohibitions
on Cancellation, Termination, Revocation, Transferability, and Assignment. Subscriber hereby acknowledges and agrees that,
except as may be specifically provided herein or by applicable law, Subscriber is not entitled to cancel, terminate, or revoke
this Agreement, and this Agreement shall survive Subscriber's death or disability or any assignment of Shares. Subscriber further
agrees that Subscriber may not transfer or assign Subscriber's rights under this Agreement, and Subscriber understands that, if
Subscriber's subscription is accepted, the transferability of Shares will be restricted.

 

(m)Obligation.
This Agreement constitutes a valid and legally binding obligation of Subscriber and neither the execution of this Agreement nor
the consummation of the transactions contemplated herein will constitute a violation of or default under, or conflict with, any
judgment, decree, statute or regulation of any governmental authority applicable to Subscriber, or any contract, commitment, agreement,
or restriction of any kind to which Subscriber is a party or by which Subscriber's assets are bound. The execution and delivery
of this Agreement does not, and the consummation of the transactions described herein will not, violate applicable laws, or any
mortgage, lien, agreement, indenture, lease or understanding (whether oral or written) of any kind outstanding relative to Subscriber.

 

(n)Required
Approvals. No approval, authorization, consent, order, or other action of, or filing with, any person, firm or corporation
or any court, administrative agency or other governmental authority is required in connection with the execution and delivery
of this Agreement by Subscriber or the purchase of the Shares.

 

(o)No
Solicitation. The Subscriber represents and warrants that the Subscriber was not solicited to purchase the Shares by any
means of general solicitation, including but not limited to the following: (a) any advertisement, article, notice or other communication
published in any newspaper, magazine, or similar media, or broadcast over television or radio; or (b) any meeting where attendees
were invited by any general solicitation or general advertising.

 

3.Representations,
Warranties and Agreements of the Company. In connection with this subscription, the Company makes the following representations,
warranties and agreements and confirms the following understandings:

 

(a)Company's
Good Standing. The Company is a corporation organized and validly existing under the laws of the State of Nevada, and
it has all corporate authority and power to conduct its business and to own its properties.

 

(b)Corporate
Authority. The issuance of the Shares to the Subscriber has been duly authorized by all necessary corporate action on
the part of the Company.

 

(c)Corporate
Records. The corporate records of the Company are complete and accurate and all corporate proceedings and actions reflected
therein have been conducted or taken in compliance with all applicable laws and with the Certificate of Incorporation and Bylaws
of the Company.

    	 	 -3-	 

    	 	 

    

(d)Valid
and Binding Obligation. This Agreement and the transactions contemplated herein have been duly and validly authorized
by all requisite corporate action of the Company. The Company has full right, power and capacity to execute, deliver and perform
its obligations under this Agreement. No governmental license, permit or authorization and no registration or filings with any
court, governmental authority or regulatory agency is required in connection with the Company's execution, delivery and/or performance
of this Agreement, other than any filings required by applicable federal and state securities laws. The execution, delivery and
performance of this Agreement, the consummation of the transactions herein contemplated and the compliance with the terms of this
Agreement by the Company will not violate or conflict with any provision of the Articles of Incorporation, as amended or By-laws
of the Company, or any agreement, instrument, law or regulation to which the Company is a party or by which the Company may be
bound. This Agreement, upon execution and delivery by the Company, will represent the valid and binding obligation of the Company
enforceable in accordance with its terms.

 

(e)Taxes.
The Company has paid all taxes which are due and payable within the time required by applicable law, and has paid all assessments
and reassessments it has received with respect to taxes. There are no claims, actions, suits, audits, proceedings, investigations
or other action pending or threatened in writing against the Company with respect to taxes. The Company has filed or caused to
be filed with the appropriate governmental entities, within the times and in the manner prescribed by applicable law, all federal
and local foreign tax returns which are required to be filed by or with respect to it.

 

(f)
Resale of Shares. Subscriber acknowledges that the Shares may only be resold pursuant to a Registration Statement
filed under the Act, to which the Shares are subject, or pursuant to an exemption from the Act, and under the terms set forth
herein. Subscribers are advised to consult with their own legal counsel or advisors to determine the resale restrictions that
may be applicable to them.

 

(g)Voting
Trusts and Shareholder Agreements. There are no voting trusts or shareholder agreements between any of the principals,
employees or directors of the Company or among any shareholders representing, in the aggregate, voting control of the Company.

 

(h)Other
Material Agreements. There are no internal or other agreements with third parties that are material in nature to the business
of the Company which have not been disclosed herein.

 

4.Survival
of Representations, Warranties, Agreements and Acknowledgments. The representations, warranties, agreements, and acknowledgments
of the Company and Subscriber shall survive the offering and purchase of Shares.

 

5.Indemnification
of the Company. Subscriber agrees to indemnify and hold harmless the Company against and in respect of any and all loss, liability,
claim, damage, deficiency, and all actions, suits, proceedings, demands, assessments, judgments, costs and expenses whatsoever
(including, but not limited to, attorneys' fees reasonably incurred in investigating, preparing, or defending against any litigation
commenced or threatened or any claim whatsoever through all appeals) arising out of or based upon any false representation or
warranty or breach or failure by Subscriber to comply with any covenant or agreement made by Subscriber herein or in any other
document furnished by Subscriber in connection with this subscription.

 

6.Miscellaneous.

 

(a)Entire
Agreement. This Agreement constitutes all of the understandings and agreements existing between the parties hereto concerning
the specific subject matter hereof and the rights and obligations created hereunder. Moreover, this Agreement supersedes and novates
all prior agreements and communications, whether oral or written, and the parties have relied on no other material.

 

(b)Amendment
and Modification. Subject to applicable law, this Agreement may be amended, modified or supplemented only by a written
agreement signed by the Company and Subscriber.

    	 	 -4-	 

    	 	 

    

 

(c)Notices.
Any notice, demand, or other communication that any party hereto may be required, or may elect, to give to anyone interested hereunder
shall be deemed given on the date initially received if delivered by facsimile transmission followed by registered or certified
mail confirmation; on the date delivered by an overnight courier service; on the third business day after it is mailed if mailed
by registered or certified mail, postage prepaid.

 

(d)Agreement
Binding. This Agreement shall be binding upon the heirs, executors, administrators, successors and assigns of the parties
hereto.

 

(e)Governing
Law, Arbitration. This Agreement and the rights and obligations of the parties shall be interpreted under and governed
exclusively by the laws of the State of Minnesota, without regard to its conflicts of laws principles. Further, in the event that
any dispute were to arise in connection with this Agreement or with the undersigned’s investment in the Company, the undersigned
agrees, prior to seeking any other relief at law or equity, to submit the matter to binding arbitration in accordance with the
rules of the American Arbitration Association at a place to be designated by the Company.

 

(f)
Waiver of Compliance; Consents. Any failure of any party to comply with any obligation, covenant, agreement
or condition herein may be waived by the party entitled to the performance of such obligation, covenant or agreement or who has
the benefit of such condition, but such waiver or failure to insist upon strict compliance with such obligation, covenant, agreement
or condition will not operate as a waiver of, or estoppel with respect to, any subsequent other failure.

 

Whenever
this Agreement requires or permits consent by or on behalf of any party hereto, such consent will be given in a manner consistent
with the requirements for a waiver of compliance as set forth above.

 

(g)Severability.
The invalidity, illegality, or unenforceability of any provision or provisions of this Agreement will not affect any other provision
of this Agreement, which will remain in full force and effect, nor will the invalidity, illegality, or unenforceability of a portion
of any provision of this Agreement affect the balance of such provision. In the event that any one or more of the provisions contained
in this Agreement or any portion thereof shall for any reason be held to be invalid, illegal, or unenforceable in any respect,
this Agreement shall be reformed, construed, and enforced as if such invalid, illegal, or unenforceable provision had never been
contained herein.

 

(h)Attorney
Fees. In the event suit or action is brought by any party under this Agreement to enforce any of its terms, and in any
appeal therefrom, it is agreed that the prevailing party shall be entitled to reasonable attorney fees to be fixed by the trial
court and/or appellate court.

 

(i)Counterparts.
This Agreement may be executed in one or more counterparts, each of which will be deemed an original and all of which together
will constitute one and the same instrument.

 

(j)Tax
Liability. Purchasing Shares under this Subscription Agreement could result in tax liability. All Subscribers are responsible
for any tax liability incurred pursuant to this Agreement, and each Subscriber should discuss any tax liability issues with his
or her own attorney or tax specialist.

 

(k)Further
Assurances. The Parties hereto will execute and deliver such further instruments and do such further acts and things as
may be reasonably required to carry out the intent and purposes of this Agreement.

 

The
undersigned Subscriber recognizes that the sale of the Shares to the undersigned will be based upon the representations and warranties
set forth hereinabove, information provided to the Company and the statements made herein, and the undersigned hereby agrees to
indemnify the Company its attorneys, agents, representatives and each of its managers and to hold them harmless from and against
any and all loss, damage, liability or expense, including costs and reasonable attorney’s fees, to which they may be put
or which they may incur by reason of, or in connection with, any misrepresentation made in this Subscription Agreement, any breach
by the undersigned of my warranties and/or failure by me to fulfill any of my covenants or agreements set forth herein or arising
out of the sale or distribution of any Shares by me in violation of the Securities Act of 1933, as amended, or any other applicable
securities or “Blue Sky” laws.

 

The
undersigned Subscriber (1) attests he, she or it is a bona fide resident of, or is domiciled in, the state listed as subscriber’s
address below; (2) certifies that the information contained in this Subscription Agreement is complete, true and correct; (3)
affirms that the subscriber’s income is derived in no part from illegal or criminal activities; and (4) states that the
investment will not be used for any type of money laundering or other such activities in violation of any state or Federal regulation.

 

    	 	 -5-	 

    	 	 

    

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Signature
Page To Follow]

 

 

IN
WITNESS WHEREOF, the undersigned has caused this Agreement to be executed as of the  day of , 2015.
By executing this Subscription Agreement, the Subscriber certifies that the Subscriber and any beneficial subscriber for whom
the Subscriber is acting is a resident of the jurisdiction shown in the “Address” section below.

 

 

Total
Number of Shares:

Total
Purchase Price: $

 

 

	

        (Name
        of Subscriber)
	 	 

        (Signature
        of Subscriber)

	 

         

        (Name
        of Subscriber)
	 	 

         

        (Signature
        of Subscriber)

	 

         

        (Address)
	 	 

         

        (Signature
        of Authorized Representative)

	 

         

        (Address)
	 	 

         

        (Print
        Name and Title of

        Authorized
        Representative)

	 

        (Telephone
        Number)
	 	 
	 

         

        (E-mail
        Address)
	 	 
	 

         

        (Social
        Security Number/

        Federal
        Employer Identification Number)
	 	 

         

 

 

The
Subscriber hereby tenders to AFS Holdings, Inc., the amount above indicating the number of Shares subscribed for. Checks
should be made payable to “AFS Holdings, Inc.”
 Wire transfers are also acceptable and upon request, the Company will provide wiring instructions.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACCEPTANCE
OF SUBSCRIPTION

 

 

APPROVED
AND ACCEPTED in accordance with the terms of this Subscription Agreement on this   day of ______________, 2015.

 

 

AFS
HOLDINGS, INC.

A
Nevada Corporation

 

 

By:

    
Kent Rodriguez, PresidentForm of Medium-Term Notes, Series K, Principal at Risk Securities

 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. 94986RZP9	 	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 

iShares® MSCI Emerging Markets ETF 

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 January 5, 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 iShares MSCI
Emerging Markets ETF. 
 The “Trade Date” shall mean October 16, 2015. 

The “Initial Underlier Level” is $36.25, the Fund Closing Price of the Underlier on the Trade Date. 

The “Final Underlier Level” will be the Fund Closing Price 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
$45.095, which is equal to 124.40% of the Initial Underlier Level. 
 The “Buffer Level” is $30.8125, which
is equal to 85% of the Initial Underlier Level. 
 The “Maximum Settlement Amount” is 136.60% of the Face
Amount of this Security. 
 The “Buffer Amount” is 15%. 

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

The “Upside Participation Rate” is 1.5. 

The “Fund Closing Price” with respect to the Underlier on any Trading Day means the product of (i) the
Closing Price of one share of the Underlier (or one unit of any other security for which a Fund Closing Price must be determined) on such Trading Day and (ii) the Adjustment Factor on such Trading Day. 

The “Closing Price” with respect to a share of the Underlier (or one unit of any other security for which a
Closing Price must be determined) on any Trading Day means the price, at the scheduled weekday closing time, without regard to after hours or any other trading outside 

  
 2 

 
the regular trading session hours, of the share on the principal United States securities exchange registered under the Securities Exchange Act of 1934, as amended, on which the share (or any
such other security) is listed or admitted to trading. 
 The “Adjustment Factor” means, with respect to a
share of the Underlier (or one unit of any other security for which a Fund Closing Price must be determined), 1.0, subject to adjustment in the event of certain events affecting the shares of the Underlier. See “—Anti-dilution Adjustments
Relating to the Underlier; Alternate Calculation —Anti-dilution Adjustments” below. 
 The “Underlying
Index” shall mean the MSCI Emerging Markets Index. 
 “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 the Relevant Stock Exchange (as
defined below) and each Related Futures or Options Exchange (as defined below) with respect to the Underlier, or any successor thereto, if applicable, are scheduled to be open for trading for their respective regular trading sessions. 

The “Relevant Stock Exchange” for the Underlier means the primary exchange or quotation system on which
shares (or other applicable securities) of the Underlier are traded, as determined by the Calculation Agent. 
 The
“Related Futures or Options Exchange” for the Underlier means each 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 “Determination Date” shall be January 2, 2018. If the originally
scheduled Determination Date is not a Trading Day, the Determination Date shall 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. If a Market
Disruption Event occurs or is continuing with respect to the Underlier on the Determination Date, such 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 the Determination
Date has been postponed eight Trading Days after the originally scheduled Determination Date and a Market Disruption Event occurs or is continuing with respect to the Underlier on such eighth Trading Day, the Calculation Agent will determine the
Closing Price of the Underlier on such eighth Trading Day based on its good faith estimate of the value of the shares (or other applicable securities) of the Underlier as of the Close of Trading (as defined below) on such eighth Trading Day. 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. 

  
 3 

 “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. 
 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 Exchange or otherwise relating to
the shares (or other applicable securities) of the Underlier or any Successor Underlier (as defined below) on the Relevant Stock Exchange at any time during the one-hour period that ends at the Close of Trading on such day, whether by reason of
movements in price exceeding limits permitted by such Relevant Stock Exchange 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 shares (or other applicable securities) of 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, shares (or other applicable securities) of the Underlier or any Successor Underlier on the Relevant Stock Exchange 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 shares (or other applicable securities) of 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 of the Relevant Stock Exchange or any Related Futures or Options Exchange with respect to the Underlier or any Successor Underlier
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, 

  
 4 

	 	 
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 the Close of Trading on that day. 

 

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

  

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

  

	 	(1)	 “Close of Trading” means the Scheduled Closing Time of the Relevant Stock Exchange with respect to the Underlier or any Successor
Underlier; and 

  

	 	(2)	 the “Scheduled Closing Time” of the Relevant Stock Exchange or any 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. 

 Anti-dilution Adjustments Relating to the Underlier; Alternate Calculation 

Anti-dilution Adjustments 

The Calculation Agent will adjust the Adjustment Factor with respect to the Underlier as specified below if any of the events
specified below occurs with respect to the Underlier and the effective date or ex-dividend date, as applicable, for such event is after the Trade Date and on or prior to the Determination Date. 

The adjustments specified below do not cover all events that could affect the Underlier. The Calculation Agent may, in its
sole discretion, make additional adjustments to any terms of this Security upon the occurrence of other events that affect or could potentially affect the market price of, or shareholder rights in, the Underlier, with a view to offsetting, to the
extent practical, any such change, and preserving the relative investment risks of this Security. In addition, the Calculation Agent may, in its sole discretion, make adjustments or a series of adjustments that differ from those described herein if
the Calculation Agent determines that such adjustments do not properly reflect the economic consequences of the events specified herein or would not preserve the relative investment risks of this Security. All determinations made by the Calculation
Agent in making any adjustments to the terms of this Security, including adjustments that are in addition to, or that differ from, those described herein, will be made in good faith and a commercially reasonable manner, with the aim of ensuring an
equitable result. In determining whether to make any adjustment to the terms of this Security, the Calculation Agent may consider any adjustment made by the Options Clearing Corporation or any other equity derivatives clearing organization on
options contracts on the Underlier. 

  
 5 

 For any event described below, the Calculation Agent will not be required to
adjust the Adjustment Factor unless the adjustment would result in a change to the Adjustment Factor then in effect of at least 0.10%. The Adjustment Factor resulting from any adjustment will be rounded up or down, as appropriate, to the nearest
one-hundred thousandth. 
  

	 	(A)	Stock Splits and Reverse Stock Splits 

  

	 	    	 If a stock split or reverse stock split has occurred, then once such split has become effective, the Adjustment Factor will be adjusted to equal
the product of the prior Adjustment Factor and the number of securities which a holder of one share (or other applicable security) of the Underlier before the effective date of such stock split or reverse stock split would have owned or been
entitled to receive immediately following the applicable effective date. 

  

	 	(B)	 Stock Dividends 

  

	 	    	 If a dividend or distribution of shares (or other applicable securities) to which this Security is linked has been made by the Underlier ratably to
all holders of record of such shares (or other applicable security), then the Adjustment Factor will be adjusted on the ex-dividend date to equal the prior Adjustment Factor plus the product of the prior Adjustment Factor and the number of shares
(or other applicable security) of the Underlier which a holder of one share (or other applicable security) of the Underlier before the ex-dividend date would have owned or been entitled to receive immediately following that date; provided, however,
that no adjustment will be made for a distribution for which the number of securities of the Underlier paid or distributed is based on a fixed cash equivalent value. 

 

	 	(C)	 Extraordinary Dividends 

  

	 	    	 If an Extraordinary Dividend (as defined below) has occurred, then the Adjustment Factor will be adjusted on the ex-dividend date to equal the
product of the prior Adjustment Factor and a fraction, the numerator of which is the Closing Price per share (or other applicable security) of the Underlier on the Trading Day preceding the ex-dividend date, and the denominator of which is the
amount by which the Closing Price per share (or other applicable security) of the Underlier on the Trading Day preceding the ex-dividend date exceeds the Extraordinary Dividend Amount (as defined below). 

 

	 	    	 For purposes of determining whether an Extraordinary Dividend has occurred: 

 

	 	(1)	“Extraordinary Dividend” means any cash dividend or distribution (or portion thereof) that the Calculation Agent determines, in its sole discretion, is extraordinary or special; and 

 

	 	(2)	 “Extraordinary Dividend Amount” with respect to an Extraordinary Dividend for the securities of the Underlier will equal the amount
per share (or other applicable security) of the Underlier of the applicable cash 

  
 6 

	 	 
dividend or distribution that is attributable to the Extraordinary Dividend, as determined by the Calculation Agent in its sole discretion. 

 

	 	    	 A distribution on the securities of the Underlier described below under the section entitled “—Reorganization Events” below that
also constitutes an Extraordinary Dividend will only cause an adjustment pursuant to that “—Reorganization Events” section. 

  

	 	(D)	 Other Distributions 

  

	 	    	 If the Underlier declares or makes a distribution to all holders of the shares (or other applicable security) of the Underlier of any non-cash
assets, excluding dividends or distributions described under the section entitled “—Stock Dividends” above, then the Calculation Agent may, in its sole discretion, make such adjustment (if any) to the Adjustment Factor as it deems
appropriate in the circumstances. If the Calculation Agent determines to make an adjustment pursuant to this paragraph, it will do so with a view to offsetting, to the extent practical, any change in the economic position of a holder of this
Security that results solely from the applicable event. 

  

	 	(E)	 Reorganization Events 

  

	 	    	 If the Underlier, or any Successor Underlier, is subject to a merger, combination, consolidation or statutory exchange of securities with another
exchange traded fund, and the Underlier is not the surviving entity (a “Reorganization Event”), then, on or after the date of such event, the Calculation Agent shall, in its sole discretion, make an adjustment to the Adjustment
Factor or the method of determining the Cash Settlement Amount or any other terms of this Security as the Calculation Agent determines appropriate to account for the economic effect on this Security of such event, and determine the effective date of
that adjustment. If the Calculation Agent determines that no adjustment that it could make will produce a commercially reasonable result, then the Calculation Agent may deem such event a Liquidation Event (as defined below). 

Liquidation Events 

If the Underlier is de-listed, liquidated or otherwise terminated (a “Liquidation Event”), and a successor or
substitute exchange traded fund exists that the Calculation Agent determines, in its sole discretion, to be comparable to the Underlier, then, upon the Calculation Agent’s notification of that determination to the Trustee and the Company, any
subsequent Fund Closing Price for the Underlier will be determined by reference to the Fund Closing Price of such successor or substitute exchange traded fund (such exchange traded fund being referred to herein as a “Successor
Underlier”), with such adjustments as the Calculation Agent determines are appropriate to account for the economic effect of such substitution on the holder of this Security. 

If the Underlier undergoes a Liquidation Event prior to, and such Liquidation Event is continuing on, the date that any Fund
Closing Price of the Underlier is to be determined and the Calculation Agent determines that no Successor Underlier is available at such time, then the 

  
 7 

 
Calculation Agent will, in its discretion, calculate the Fund Closing Price for the Underlier on such date by a computation methodology that the Calculation Agent determines will as closely as
reasonably possible replicate the Underlier, provided that if the Calculation Agent determines in its discretion that it is not practicable to replicate the Underlier (including but not limited to the instance in which the sponsor of the index
underlying the Underlier discontinues publication of that index), then the Calculation Agent will calculate the Fund Closing Price for the Underlier in accordance with the formula last used to calculate such Fund Closing Price before such
Liquidation Event, but using only those securities that were held by the Underlier immediately prior to such Liquidation Event without any rebalancing or substitution of such securities following such Liquidation Event. 

If a Successor Underlier is selected or the Calculation Agent calculates the Fund Closing Price as a substitute for the
Underlier, such Successor Underlier or Fund Closing Price will be used as a substitute for the Underlier for all purposes, including for purposes of determining whether a Market Disruption Event exists. 

If any event is both a Reorganization Event and a Liquidation Event, such event will be treated as a Reorganization Event for
purposes of this Security unless the Calculation Agent makes the determination referenced in the last sentence of the section entitled “—Anti-dilution Adjustments—Reorganization Events” above. 

Alternate Calculation 

If at any time the method of calculating the Underlier or a Successor Underlier, or the Underlying Index, is changed in a
material respect, or if the Underlier or a Successor Underlier is in any other way modified so that the Underlier does not, in the opinion of the Calculation Agent, fairly represent the price of the securities of the Underlier or such Successor
Underlier had such changes or modifications not been made, then the Calculation Agent may, at the close of business in New York City on the date that any Fund Closing Price is to be determined, make such calculations and adjustments as, in the good
faith judgment of the Calculation Agent, may be necessary in order to arrive at a Closing Price of an exchange traded fund comparable to the Underlier or such Successor Underlier, as the case may be, as if such changes or modifications had not been
made, and calculate the Fund Closing Price and the Cash Settlement Amount with reference to such adjusted Closing Price of the Underlier or such Successor Underlier, as applicable. 

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 Fund Closing Price and/or the Adjustment Factor under the circumstances described in this Security, (ii) if the Underlier undergoes a Liquidation Event, select a Successor
Underlier or, if no Successor Underlier is available, determine the Fund Closing Price of the Underlier, and (iii) determine whether a Market Disruption Event or non-Trading Day has occurred. 

  
 8 

 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 treat this Security as a prepaid derivative contract that is an “open transaction.” 
 Redemption and
Repayment 
 This Security is not subject to redemption at the option of the Company or repayment at the option of
the Holder hereof prior to January 5, 2018. This Security is not entitled to any sinking fund. 
 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] 

  
 9 

 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

  
  
  

 
  

  
 10 

 [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 iShares® MSCI 

Emerging Markets ETF 

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 

  
 11 

 
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 “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 

  
 12 

 
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. 

  
 13 

 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)

  
 14 

 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. 

  
 15

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00250-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00250-of-00352.parquet"}]]