Document:

Schedule of Omitted Documents

 Exhibit 10.86 
 Schedule of Omitted Documents 
 of CNL Healthcare Properties, Inc.

 The following lease agreements were not filed as exhibits to this annual report on Form 10-K pursuant to Instruction 2 of
Item 601 of Regulation S-K. 
  

	 	1.	Primrose Retirement Community of Casper, Casper, Wyoming, Lease Agreement dated as of February 16, 2012, by and between CHT Casper WY Senior Living, LLC and TSMM
Management, LLC. 

  

	 	2.	Primrose Retirement Community of Grand Island, Grand Island, NE, Lease Agreement dated as of February 16, 2012, by and between CHT Grand Island NE Senior Living,
LLC and TSMM Management, LLC. 

  

	 	3.	Sweetwater Retirement Community, Billings, Montana, Lease Agreement dated as of February 16, 2012, by and between CHT Billings MT Senior Living, LLC and TSMM
Management, LLC. 

  

	 	4.	Primrose Retirement Community of Mansfield, Mansfield, OH, Lease Agreement dated as of February 16, 2012, by and between CHT Mansfield OH, LLC and TSMM Management,
LLC. 

  

	 	5.	Lease Agreement dated August 31, 2012, by and between Vinton IA Assisted Living Owner, LLC and Vinton IA Assisted Living Tenant, LLC. 

 

	 	6.	Lease Agreement dated August 31, 2012, by and between Nevada IA Assisted Living Owner, LLC and Nevada IA Assisted Living Tenant, LLC. 

 

	 	7.	Lease Agreement dated as of December 19, 2012, by and between CHT Lima OH Senior Living, LLC and TSMM Management, LLC. 

 

	 	8.	Lease Agreement dated as of December 19, 2012, by and between CHT Council Bluffs IA Senior Living, LLC and TSMM Management, LLC. 

 

	 	9.	Lease Agreement dated as of December 19, 2012, by and between CHT Decatur IL Senior Living, LLC and TSMM Management, LLC. 

 

	 	10.	Lease Agreement dated as of December 19, 2012, by and between CHT Aberdeen SD Senior Living, LLC and TSMM Management, LLC. 

The following agreements were not filed as exhibits to this annual report on Form 10-K pursuant to Instruction 2 of Item 601 of
Regulation S-K. 
  

	 	1.	Assignment and Assumption of Asset Purchase Agreement dated as of December 19, 2012, by and between CHT Partners, LP and CHT Lima OH Senior Living, LLC.

  

	 	2.	Assignment and Assumption of Asset Purchase Agreement dated as of December 19, 2012, by and between CHT Partners, LP and CHT Council Bluffs IA Senior Living, LLC.

  

	 	3.	Assignment and Assumption of Asset Purchase Agreement dated as of December 19, 2012, by and between CHT Partners, LP and CHT Decatur IL Senior Living, LLC.

  

	 	4.	Assignment and Assumption of Asset Purchase Agreement dated as of December 19, 2012, by and between CHT Partners, LP and CHT Aberdeen SD Senior Living, LLC.

 The following management agreements were not filed as exhibits to this annual report on Form
10-K pursuant to Instruction 2 of Item 601 of Regulation S-K. 
  

	 	1.	Management Agreement (Sunrise at Siegen) dated as of June 29, 2012, by and among Sunrise Senior Living Management, Inc., CHTSun Two Baton Rouge LA Senior Living,
LLC and CHTSUN Partners IV, LLC. 

  

	 	2.	Management Agreement (Sunrise of Gilbert) dated as of June 29, 2012, by and among Sunrise Senior Living Management, Inc., CHTSun Two Gilbert AZ Senior Living, LLC
and CHTSUN Partners IV, LLC. 

  

	 	3.	Management Agreement (Sunrise of Santa Monica) dated as of June 29, 2012, by and among Sunrise Senior Living Management, Inc., AL Santa Monica Senior Housing, LP
and CHTSUN Partners IV, LLC. 

  

	 	4.	Management Agreement ((Sunrise of Metairie) dated as of June 29, 2012, by and among Sunrise Senior Living Management, Inc., CHTSun Two Metairie LA Senior Living,
LLC and CHTSUN Partners IV, LLC. 

  

	 	5.	Management Agreement (Sunrise of Louisville) dated as of June 29, 2012, by and among Sunrise Senior Living Management, Inc., Sunrise Louisville KY Senior Living,
LLC and CHTSUN Partners IV, LLC. 

  

	 	6.	Management Agreement (Sunrise at Fountain Square) dated as of June 29, 2012, by and among Sunrise Senior Living Management, Inc., CHTSun Three Lombard IL Senior
Living, LLC and CHTSUN Partners IV, LLC. 

  

	 	7.	Management Services Agreement dated August 31, 2012, by and between Provision Living, LLC and Vinton IA Assisted Living Tenant, LLC. 

 

	 	8.	Management Services Agreement dated August 31, 2012, by and between Provision Living, LLC and Nevada IA Assisted Living Tenant, LLC. 

The following promissory notes were not filed as exhibits to this annual report on Form 10-K pursuant to Instruction 2 of Item 601
of Regulation S-K. 
  

	 	1.	Promissory Note ($9,769,000) (Sunrise at Siegen) dated June 29, 2012, made by Baton Rouge LA Senior Living Owner, LLC and CHTSUN Two Baton Rouge LA Senior Living,
LLC in favor of The Prudential Insurance Company of America. 

  

	 	2.	Promissory Note ($33,932,000) (Sunrise of Connecticut Avenue) dated June 29, 2012, made by Sunrise Connecticut Avenue Assisted Living Owner, L.L.C. (f/k/a Sunrise
Connecticut Avenue Assisted Living, L.L.C.) in favor of The Prudential Insurance Company of America.  

  

	 	3.	Promissory Note ($21,068,000) (Sunrise of Santa Monica) dated June 29, 2012, made by Santa Monica Assisted Living Owner, LLC and AL Santa Monica Housing, LP in
favor of The Prudential Insurance Company of America. 

  

	 	4.	Promissory Note ($13,839,000) (Sunrise of Metairie) dated June 29, 2012, made by Metairie LA Senior Living Owner, LLC and CHTSun Two Metairie LA Senior Living, LLC
in favor of The Prudential Insurance Company of America. 

  

	 	5.	Promissory Note ($11,674,000) (Sunrise of Louisville) dated June 29, 2012, made by Louisville KY Senior Living Owner, LLC and Sunrise Louisville KY Senior Living,
LLC in favor of The Prudential Insurance Company of America. 

  
 2 

	 	6.	Promissory Note ($17,657,000) (Sunrise at Fountain Square) dated June 29, 2012, made by Lombard IL Senior Living Owner, LLC and CHTSun Three Lombard IL Senior
Living, LLC in favor of The Prudential Insurance Company of America. 

  

	 	7.	Multifamily Note ($11,031,000.00) dated as of August 31, 2012, made by CHT Billings MT Senior Living, LLC and Keycorp Real Estate Capital Markets, Inc.

  

	 	8.	Multifamily Note ($12,758,000.00) dated as of August 31, 2012, made by CHT Casper WY Senior Living, LLC and Keycorp Real Estate Capital Markets, Inc.

  

	 	9.	Multifamily Note ($12,245,000.00) dated as of August 31, 2012, made by CHT Mansfield OH Senior Living, LLC and Keycorp Real Estate Capital Markets, Inc.

  

	 	10.	Multifamily Note ($10,157,000.00) dated as of August 31, 2012, made by CHT Marion OH Senior Living, LLC and Keycorp Real Estate Capital Markets, Inc.

  

	 	11.	Promissory Note ($15,052,100.00) (Symphony Manor) dated December 21, 2012, made by CHT Symphony Manor MD Owner, LLC and CHT Symphony Manor MD Tenant Corp. in favor
of The Prudential Insurance Company of America. 

  

	 	12.	Promissory Note ($7,782,000.00) (Curry House) dated December 21, 2012, made by CHT Curry House MI Owner, LLC and CHT Curry Hosue MI Tenant Corp. in favor of The
Prudential Insurance Company of America. 

  

	 	13.	Promissory Note ($8,127,300.00) (Tranquility at Fredericktowne) dated December 21, 2012, made by CHT Tranquility at Fredericktowne MD Owner, LLC and CHT
Tranquility at Fredericktowne MD Tenant Corp. in favor of The Prudential Insurance Company of America. 

  

	 	14.	Promissory Note ($9,357,300.00) (Woodholme Gardens) dated December 21, 2012, made by CHT Woodholme Gardens MD Owner, LLC and CHT Woodholme Gardens MD Tenant Corp.
in favor of The Prudential Insurance Company of America. 

 The following loan agreements/mortgages were not filed
as exhibits to this annual report on Form 10-K pursuant to Instruction 2 of Item 601 of Regulation S-K. 
  

	 	1.	Open-End Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated as of February 16, 2012, made by CHT Casper WY Senior Living, LLC, in favor of
KeyBank National Association. 

  

	 	2.	Open-End Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated as of February 16, 2012, made by CHT Grand Island NE Senior Living, LLC, in
favor of KeyBank National Association. 

  

	 	3.	Open-End Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dates as of February 16, 2012, made by CHT Billings MT Senior Living, LLC, LLC, in
favor of KeyBank National Association. 

  

	 	4.	Open-End Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated as of February 16, 2012, made by CHT Mansfield OH Senior Living, LLC, in favor
of KeyBank National Association. 

  

	 	5.	First Multiple Indebtedness Mortgage and Security Agreement (Sunrise at Siegen) dated as of June 29, 2012, made by Baton Rouge LA Senior Living Owner, LLC and
CHTSun Two Baton Rouge LA Senior Living, LLC (f/k/a MetSun Two Baton Rouge LA Senior Living, LLC) to The Prudential Insurance Company of America. 

  
 3 

	 	6.	First Amended and Restated Deed of Trust and Security Agreement (Sunrise of Connecticut Avenue) dated as of June 29, 2012, made by Sunrise Connecticut Avenue
Assisted Living Owner, L.L.C. (f/k/a Sunrise Connecticut Avenue Assisted Living, L.L.C.) to First American Title Insurance Company (Trustee) f/b/o the Prudential Insurance Company of America. 

 

	 	7.	First Amended and Restated Deed of Trust, Security Agreement and Fixture Filing (Sunrise of Santa Monica) dated as of June 29, 2012, made by Santa Monica Assisted
Living Owner, LLC and AL Santa Monica Senior Housing, LP to First American Title Insurance Company (Trustee) f/b/o The Prudential Insurance Company of America. 

 

	 	8.	First Multiple Indebtedness Mortgage and Security Agreement (Sunrise of Metairie) dated as of June 29, 2012, made by Metairie LA Senior Living Owner, LLC and
CHTSun Two Metairie LA Senior Living, LLC (f/k/a MetSun Two Metairie LA Senior Living, LLC) to The Prudential Insurance Company of America. 

  

	 	9.	First Mortgage and Security Agreement (Sunrise of Louisville) dated as of June 29, 2012, made by Louisville KY Senior Living Owner, LLC and Sunrise Louisville KY
Senior Living, LLC to The Prudential Insurance Company of America. 

  

	 	10.	First Mortgage and Security Agreement (Sunrise at Fountain Square) dated as of June 29, 2012, made by Lombard IL Senior Living Owner, LLC and CHTSun Three Lombard
IL Senior Living, LLC (f/k/a MetSun Three Lombard IL Senior Living, LLC) to The Prudential Insurance Company of America. 

  

	 	11.	Second Deed of Trust and Security Agreement (Sunrise of Gilbert) dated as of June 29, 2012 made by Gilbert AZ Senior Living Owner , LLC and CHTSun Two Gilbert AZ
Senior Living, LLC to First American Title Insurance Company (Trustee) f/b/o The Prudential Insurance Company of America. 

  

	 	12.	Second Multiple Indebtedness Mortgage and Security Agreement (Sunrise at Siegen) dated as of June 29, 2012, made by Baton Rouge LA Senior Living Owner, LLC and
CHTSun Two Baton Rouge LA Senior Living, LLC to The Prudential Insurance Company of America. 

  

	 	13.	Second Amended and Restated Deed of Trust and Security Agreement (Sunrise of Connecticut Avenue) dated as of June 29, 2012, made by Sunrise Connecticut Avenue
Assisted Living Owner, L.L.C. (f/k/a Sunrise Connecticut Avenue Assisted Living, L.L.C.) to First American Title Insurance Company (Trustee) f/b/o The Prudential Insurance Company of America. 

 

	 	14.	Second Amended and Restated Deed of Trust, Security Agreement and Fixture Filing (Sunrise of Santa Monica) dated as of June 29, 2012, made by Santa Monica Assisted
Living Owner, LLC and AL Santa Monica Senior Housing, LP to First American Title Insurance Company (Trustee) f/b/o The Prudential Insurance Company of America. 

 

	 	15.	Second Multiple Indebtedness Mortgage and Security Agreement (Sunrise at Metairie) dated as of June 29, 2012, made by Metairie LA Senior Living Owner, LLC and
CHTSun Two Metairie LA Senior Living, LLC (f/k/a MetSun Two Metairie LA Senior Living, LLC) to The Prudential Insurance Company of America. 

  

	 	16.	Second Mortgage and Security Agreement (Sunrise of Louisville) dated as of June 29, 2012, made by Louisville KY Senior Living Owner, LLC and Sunrise Louisville KY
Senior Living, LLC to The Prudential Insurance Company of America. 

  

	 	17.	Second Mortgage and Security Agreement (Sunrise at Fountain Square) dated as of June 29, 2012, made by Lombard IL Senior Living Owner, LLC and CHTSun Three Lombard
IL Senior Living, LLC (f/k/a MetSun Three Lombard IL Senior Living, LLC to The Prudential Insurance Company of America. 

  
 4 

	 	18.	Multifamily Deed of Trust, Assignment of Leases and Rents, Security Agreement and Fixture Filing (Nebraska) dated as of August 31, 2012, by CHT Grand Island NE
Senior Living, LLC to Chicago Title Insurance Company f/b/o Keycorp Real Estate Capital Markets, Inc. 

  

	 	19.	Multifamily Mortgage, Assignment of Leases and Rents, Security Agreement and Fixture Filing (Wyoming) dated as of August 31, 2012, by CHT Casper WY Senior Living,
LLC f/b/o Keycorp Real Estate Capital Markets, Inc. 

  

	 	20.	Open-End Multifamily Mortgage, Assignment of Leases and Rents, Security Agreement and Fixture Filing (Ohio) dated as of August 31, 2012, by CHT Mansfield OH Senior
Living, LLC f/b/o Keycorp Real Estate Capital Markets, Inc. 

  

	 	21.	Open-End Multifamily Mortgage, Assignment of Leases and Rents, Security Agreement and Fixture Filing (Ohio) dated as of August 31, 2012, by CHT Marion OH Senior
Living, LLC f/b/o Keycorp Real Estate Capital Markets, Inc. 

  

	 	22.	Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated August 31, 2012, made by Vinton IA Assisted Living Owner, LLC and Vinton IA Assisted
Living Tenant, LLC in favor of KeyBank National Association. 

  

	 	23.	Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated August 31, 2012, made by Nevada IA Assisted Living Owner, LLC and Nevada IA Assisted
Living Tenant, LLC in favor of KeyBank National Association. 

  

	 	24.	Open-End Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated December 19, 2012, made by CHT Lima OH Senior Living, LLC in favor of KeyBank
National Association. 

  

	 	25.	Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated December 19, 2012, made by CHT Council Bluffs IA Senior Living, LLC in favor of KeyBank
National Association. 

  

	 	26.	Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated December 19, 2012, made by CHT Decatur IL Senior Living, LLC in favor of KeyBank
National Association. 

  

	 	27.	Mortgage – One Hundred Eighty Day Redemption Mortgage – Collateral Real Estate Mortgage, Assignment of Rents, Security Agreement and Fixture Filing dated
December 19, 2012, made by CHT Aberdeen SD Senior Living, LLC in favor of KeyBank National Association. 

  

	 	28.	Mortgage and Security Agreement (First) dated December 21, 2012, made by CHT Curry House MI Owner, LLC and CHT Curry House MI Tenant Corp. to The Prudential
Insurance Company of America. 

  

	 	29.	Purchase Money Deed of Trust and Security Agreement (First) dated December 21, 2012, made by CHT Symphony Manor MD Owner, LLC and CHT Symphony Manor MD Tenant
Corp. to Kelley H. Butler, Esq., as trustee, for the benefit of The Prudential Insurance Company of America. 

  

	 	30.	Purchase Money Deed of Trust and Security Agreement (First) dated December 21, 2012, made by CHT Woodholme Gardens MD Owner, LLC and CHT Woodholme Gardens MD
Tenant Corp. to Kelley H. Butler, Esq., as trustee, for the benefit of The Prudential Insurance Company of America. 

  

	 	31.	Purchase Money Deed of Trust and Security Agreement (First) dated December 21, 2012, made by CHT Tranquility of Fredericktowne MD Owner, LLC and CHT Tranquility of
Fredericktowne MD Tenant Corp. to Kelley H. Butler, Esq., as trustee, for the benefit of The Prudential Insurance Company of America. 

  

	 	32.	Mortgage and Security Agreement (Second) dated December 21, 2012, made by CHT Curry House MI Owner, LLC and CHT Curry House MI Tenant Corp. in favor of The
Prudential Insurance Company of America. 

  
 5 

	 	33.	Purchase Money Deed of Trust and Security Agreement (Second) dated December 21, 2012, made by CHT Symphony Manor MD Owner, LLC and CHT Symphony Manor MD Tenant
Corp. to Kelley H. Butler, Esq., as trustee, for the benefit of The Prudential Insurance Company of America. 

  

	 	34.	Purchase Money Deed of Trust and Security Agreement (Second) dated December 21, 2012, made by CHT Woodholme Gardens MD Owner, LLC and CHT Woodholme Gardens MD
Tenant Corp. to Kelley H. Butler, Esq., as trustee, for the benefit of The Prudential Insurance Company of America. 

  

	 	35.	Purchase Money Deed of Trust and Security Agreement (Second) dated December 21, 2012, made by CHT Tranquility of Fredericktowne MD Owner, LLC and CHT Tranquility
of Fredericktowne MD Tenant Corp. to Kelley H. Butler, Esq., as trustee, for the benefit of The Prudential Insurance Company of America. 

  

	 	36.	Multifamily Loan and Security Agreement dated as of August 31, 2012, by and between CHT Billings MT Senior Living, LLC and Keycorp Real Estate Capital Markets,
Inc. 

  

	 	37.	Multifamily Loan and Security Agreement dated as of August 31, 2012, by and between CHT Casper WY Senior Living, LLC and Keycorp Real Estate Capital Markets, Inc.

  

	 	38.	Multifamily Loan and Security Agreement dated as of August 31, 2012, by and between CHT Mansfield OH Senior Living, LLC and Keycorp Real Estate Capital Markets,
Inc. 

  

	 	39.	Multifamily Loan and Security Agreement dated as of August 31, 2012, by and between CHT Marion OH Senior Living, LLC and Keycorp Real Estate Capital Markets, Inc.

 The following guaranties of lease agreements were not filed as exhibits to this annual report on Form 10-K
pursuant to Instruction 2 of Item 601 of Regulation S-K. 
  

	 	1.	Guaranty of Lease dated as of December 19, 2012, made by each of James L. Thares, Brian J. Morgan, William J. Schaefbauer II and Mark W. McNeary (Guarantors) and
TSMM Management, LLC (Tenant) for the benefit of CHT Lima OH Senior Living, LLC (Landlord) 

  

	 	2.	Guaranty of Lease dated as of December 19, 2012, made by each of James L. Thares, Brian J. Morgan, William J. Schaefbauer II and Mark W. McNeary (Guarantors) and
TSMM Management, LLC (Tenant) for the benefit of CHT Council Bluffs IA Senior Living, LLC (Landlord) 

  

	 	3.	Guaranty of Lease dated as of December 19, 2012 made by each of James L. Thares, Brian J. Morgan, William J. Schaefbauer II and Mark W. McNeary (Guarantors) and
TSMM Management, LLC (Tenant) for the benefit of CHT Decatur IL Senior Living, LLC (Landlord) 

  

	 	4.	Guaranty of Lease dated as of December 19, 2012, made by each of James L. Thares, Brian J. Morgan, William J. Schaefbauer II and Mark W. McNeary (Guarantors) and
TSMM Management, LLC (Tenant) for the benefit of CHT Aberdeen SD Senior Living, LLC (Landlord) 

 The following
recourse liabilities guaranties were not filed as exhibits pursuant to this annual report on Form 10-K pursuant to Instruction 2 of Item 601 of Regulation S-K. 
  

	 	1.	Recourse Liabilities Guaranty (Sunrise at Siegen) dated June 29, 2012, given by CNL Healthcare Trust, Inc. and Sunrise Senior Living Investments, Inc. f/b/o The
Prudential Insurance Company of America. 

  

	 	2.	Amended and Restated Recourse Liabilities Guaranty (Sunrise of Connecticut Avenue) dated June 29, 2012, given by CNL Healthcare Trust, Inc. and Sunrise Senior
Living Investments, Inc. f/b/o The Prudential Insurance Company of America. 

  

	 	3.	Amended and Restated Recourse Liabilities Guaranty (Sunrise of Santa Monica) dated June 29, 2012, given by CNL Healthcare Trust, Inc. and Sunrise Senior Living
Investments, Inc. f/b/o The Prudential Insurance Company of America. 

  
 6 

	 	4.	Recourse Liabilities Guaranty (Sunrise of Metairie) dated June 29, 2012, given by CNL Healthcare Trust, Inc. and Sunrise Senior Living Investments, Inc. f/b/o The
Prudential Insurance Company of America. 

  

	 	5.	Recourse Liabilities Guaranty (Sunrise of Louisville) dated June 29, 2012, given by CNL Healthcare Trust, Inc. and Sunrise Senior Living Investments, Inc. f/b/o
The Prudential Insurance Company of America. 

  

	 	6.	Recourse Liabilities Guaranty (Sunrise at Fountain Square) dated June 29, 2012, given by CNL Healthcare Trust, Inc. and Sunrise Senior Living Investments, Inc.
f/b/o The Prudential Insurance Company of America. 

  

	 	7.	Recourse Liabilities Guaranty (Curry House) dated December 21, 2012, given by CNL Healthcare Trust, Inc. f/b/o The Prudential Insurance Company of America.

  

	 	8.	Recourse Liabilities Guaranty (Symphony Manor) dated December 21, 2012, given by CNL Healthcare Trust, Inc. f/b/o The Prudential Insurance Company of America.

  

	 	9.	Recourse Liabilities Guaranty (Woodholme Gardens) dated December 21, 2012, given by CNL Healthcare Trust, Inc. f/b/o The Prudential Insurance Company of America.

  

	 	10.	Recourse Liabilities Guaranty (Tranquility at Fredericktowne) dated December 21, 2012, given by CNL Healthcare Trust, Inc. f/b/o The Prudential Insurance Company
of America. 

 The following non-recourse obligations were not filed as exhibits to this annual report on Form
10-K pursuant to Instruction 2 of Item 601 of Regulation S-K. 
  

	 	1.	Guaranty of Non-Recourse Obligations dated as of August 31, 2012, given by CNL Healthcare Trust, Inc. f/b/o Keycorp Real Estate Capital Markets, Inc.

  

	 	2.	Guaranty of Non-Recourse Obligations dated as of August 31, 2012, given by CNL Healthcare Trust, Inc. f/b/o Keycorp Real Estate Capital Markets, Inc.

  

	 	3.	Guaranty of Non-Recourse Obligations dated as of August 31, 2012, given by CNL Healthcare Trust, Inc. f/b/o Keycorp Real Estate Capital Markets, Inc.

  

	 	4.	Guaranty of Non-Recourse Obligations dated as of August 31, 2012, given by CNL Healthcare Trust, Inc. f/b/o Keycorp Real Estate Capital Markets, Inc.

  
 7Form of Medium-Term Notes, Series K, Securities Linked to the MSCI EAFE Index

 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. 94986RPC9	  	 FACE AMOUNT:
$                    

	REGISTERED NO.         	  	

 WELLS FARGO & COMPANY 

MEDIUM-TERM NOTE, SERIES K 
 Due Nine Months or More From Date of Issue 

Securities Linked to the MSCI EAFE 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 Redemption 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 “Initial Stated Maturity Date” shall be March 25, 2015. If no Market Disruption Event (as defined below) occurs or is continuing with respect to the Index (as defined
below) on the scheduled Calculation Day (as defined below), the Initial Stated Maturity Date will be the “Stated Maturity Date.” If a Market Disruption Event occurs or is continuing with respect to the Index on the scheduled
Calculation Day, the “Stated Maturity Date” shall be the later of (i) three Business Days (as defined below) after the postponed Calculation Day and (ii) the Initial Stated Maturity Date. 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 Redemption Amount 

The “Redemption Amount” of this Security will equal: 

 

	 	•	 	 if the Ending Level is greater than the Starting Level: the lesser of: 

 

	 	(i)	the Face Amount plus: 

  

 
  

	 	(ii)	the Capped Value; 

  

	 	•	 	 if the Ending Level is less than or equal to the Starting Level, but greater than or equal to the Threshold Level: the Face Amount; or

  

	 	•	 	 if the Ending Level is less than the Threshold Level: 

 
 

 
 “Index” shall mean the MSCI EAFE Index®. 
 The “Pricing Date” shall mean March 20, 2013. 
 The
“Starting Level” is 1689.37, the Closing Level of the Index on the Pricing Date. 
 The “Closing
Level” of the Index on any Trading Day means the official closing level of the Index as reported by the Index Sponsor on such Trading Day. 
 The “Ending Level” will be the Closing Level of the Index on the Calculation Day. 
 The “Threshold Level” is 1435.9645, which is equal to 85.0% of the Starting Level. 
 The “Capped Value” is 123.25% of the Face Amount of this Security. 
 The “Participation Rate” is 150%. 
 The
“Multiplier” is equal to the Starting Level divided by the Threshold Level. 
 “Index Sponsor”
shall mean MSCI Inc. 
 “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. 

  
 2 

 A “Trading Day” with respect to the Index means a day, as determined by the
Calculation Agent, on which (i) the Relevant Exchanges with respect to each security underlying the Index are scheduled to be open for trading for their respective regular trading sessions and (ii) each Related Exchange is scheduled to be
open for trading for its regular trading session. 
 The “Related Exchange” for the Index 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 Index. 
 The “Relevant Exchange” for any security then underlying the Index means the primary exchange or quotation system on which such security is traded, as determined by the Calculation Agent.

 The “Calculation Day” shall be March 20, 2015 or, if such day is not a Trading Day, the next succeeding
Trading Day. The Calculation Day is 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 Index on the Calculation Day, such Calculation Day will be
postponed to the first succeeding Trading Day on which a Market Disruption Event has not occurred and is not continuing. If such first succeeding Trading Day has not occurred as of the eighth Trading Day after the originally scheduled Calculation
Day, that eighth Trading Day shall be deemed the Calculation Day. If the Calculation Day has been postponed eight Trading Days after the originally scheduled Calculation Day and a Market Disruption Event occurs or is continuing with respect to the
Index on such eighth Trading Day, the Calculation Agent will determine the Closing Level of the Index on such eighth Trading Day in accordance with the formula for and method of calculating the Closing Level of the Index last in effect prior to
commencement of the Market Disruption Event, using the closing price (or, with respect to any of the relevant securities, if a Market Disruption Event has occurred, its good faith estimate of the value of such securities at the Scheduled Closing
Time (as defined below) on the Relevant Exchanges) on such date of each security included in the Index. See “—Market Disruption Events.” As used herein, “closing price” means, with respect to any security on any date,
the relevant exchange traded or quoted price of such security as of the Close of Trading (as defined below) on such date. 

“Calculation Agent Agreement” shall mean the Calculation Agent Agreement dated as of May 29, 2012 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 Ending Level and the Redemption 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 Index; Alteration Of Method Of Calculation 

If the Index Sponsor discontinues publication of the Index, and the Index 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 Index (a “Successor Equity Index”), then, upon the Calculation Agent’s notification of that determination to the Trustee and
the Company, the Calculation Agent will substitute the Successor Equity Index as calculated by the relevant Index Sponsor or any other entity and calculate the Ending Level as described above. Upon any selection by the Calculation Agent of a
Successor Equity Index, the Company will cause notice to be given to the Holder of this Security. 
 In the event that the Index
Sponsor discontinues publication of the Index prior to, and the discontinuance is continuing on, the Calculation Day and the Calculation Agent determines that no Successor Equity Index is available at such time, the Calculation Agent will calculate
a substitute Closing Level for the Index in accordance with the formula for and method of calculating the Index last in effect prior to the discontinuance, but using only those securities that comprised the Index immediately prior to that
discontinuance. If a Successor Equity Index is selected or the Calculation Agent calculates a level as a substitute for the Index, the Successor Equity Index or level will be used as a substitute for the Index for all purposes, including the purpose
of determining whether a Market Disruption Event exists. 
 If on the Calculation Day the Index Sponsor of the Index fails to
calculate and announce the level of the Index, the Calculation Agent will calculate a substitute Closing Level of the Index in accordance with the formula for and method of calculating the Index last in effect prior to the failure, but using only
those securities that comprised the Index immediately prior to that failure; provided that, if a Market Disruption Event occurs or is continuing on such day, then the provisions set forth above under the definition of “Calculation
Day” shall apply in lieu of the foregoing. 
 If at any time the Index Sponsor makes a material change in the formula for
or the method of calculating the Index, or in any other way materially modifies the Index (other than a modification prescribed in that formula or method to maintain the Index 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 Index is to be calculated, calculate a substitute Closing Level of the Index in
accordance with the formula for and method of calculating the Index last in effect prior to the change, but using only those securities that comprised the Index immediately prior to that change. Accordingly, if the method of calculating the Index is
modified so that the level of the Index 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 Index in order to arrive at a level of the Index as if it had not been modified.

  
 4 

 Market Disruption Events 

A “Market Disruption Event” means, with respect to the Index, 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 Exchanges or otherwise relating to securities which then
comprise 20% or more of the level of the Index or any Successor Equity Index 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
Exchanges or otherwise. 

  

	 	(B)	The occurrence or existence of a material suspension of or limitation imposed on trading by any Related Exchange or otherwise in futures or options contracts relating
to the Index or any Successor Equity Index on any Related 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 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 Index or any Successor Equity Index on their Relevant 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 Index or any Successor Equity Index on any Related 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 Exchanges on which securities that then comprise 20% or more of the level of the Index or any Successor Equity
Index are traded or any Related Exchange prior to its Scheduled Closing Time unless the earlier closing time is announced by the Relevant Exchange or Related 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 Exchange or Related Exchange, as applicable, and (2) the submission deadline for orders to be entered into the Relevant Exchange or Related Exchange, as applicable, system for
execution at the Close of Trading on that day. 

  

	 	(F)	The Relevant Exchange for any security underlying the Index or Successor Equity Index or any Related Exchange fails to open for trading during its regular trading
session. 

  
 5 

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

 

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

 

	 	(2)	the “Close of Trading” means the Scheduled Closing Time of the Relevant Exchanges with respect to the securities underlying the Index or any Successor
Equity Index; 

  

	 	(3)	the “Scheduled Closing Time” of any Relevant Exchange or Related Exchange on any Trading Day for the Index or any Successor Equity Index means
the scheduled weekday closing time of such Relevant Exchange or Related 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 Index or any Successor Equity Index on which each Relevant Exchange for the securities
underlying the Index or any Successor Equity Index and each Related Exchange are open for trading during their respective regular trading sessions, notwithstanding any such Relevant Exchange or Related Exchange closing prior to its Scheduled Closing
Time. 

 Calculation Agent 
 The Calculation Agent will determine the Redemption Amount and the Ending Level. In addition, the Calculation Agent will (i) determine if adjustments are required to the Closing Level of the Index
under the circumstances described in this Security, (ii) if publication of the Index is discontinued, select a Successor Equity Index or, if no Successor Equity Index is available, determine the Closing Level of the Index under the
circumstances described in this Security, and (iii) determine whether a Market Disruption Event 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. All percentages and other amounts resulting from any calculation with respect to this Security will be rounded at
the Calculation Agent’s discretion. 
 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, 

  
 6 

 
regulatory, administrative or judicial ruling to the contrary), for United States federal income tax purposes to characterize and treat this Security as a pre-paid derivative contract in respect
of the Index. 
 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 March 25, 2015. 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 Redemption 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 Redemption Amount hereof calculated as provided
herein as though the date of acceleration was the Calculation Day. 
  

 
 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] 

  
 7 

 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

  
 8 

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

 Due Nine Months or More From Date of Issue 

Securities Linked to the MSCI EAFE 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 

  
 9 

 
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 

  
 10 

 
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 Redemption 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 Redemption 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. 

  
 11 

 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)

  
 12 

 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. 

  
 13

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