Document:

EXHIBIT
10.1

 

SUBSCRIPTION
AND DEBT CANCELLATION AGREEMENT

 

Series
B Redeemable Convertible Preferred Stock of Kiwa Bio-Tech Products Group Corporation

 

The
undersigned, Wei Li (the “Purchaser”), hereby subscribes for the purchase of 811,148 shares (the “Shares”)
of Series B Redeemable Convertible Preferred Stock of Kiwa Bio-Tech Products Group Corporation, a Nevada corporation (the “Company”),
for an aggregate amount of $1,054,492 (the “Subscription Price”). In payment of the Subscription Price, the
Purchaser agrees to the concurrent cancellation of $1,054,492 amount of accrued salary owing to the Purchaser by the Company (“Debt
Cancellation”) in full payment for such Shares. In exchange for the Debt Cancellation, the Purchaser shall receive from
the Company 811,148 shares of Company Series B Redeemable Convertible Preferred Stock. The Purchaser agrees to execute this Subscription
and Debt Cancellation (the “Agreement”) and any other documentation required in connection with this investment
(collectively, the “Transaction Documents”).

 

Consummation
of the sale of the Shares to the Purchaser and to any other purchaser(s) of Company Shares shall be consummated on or before December
28, 2017 (the “Closing Date”), unless such Closing Date shall be extended by the mutual agreement of the parties
hereto.

 

1.
Certain Representations of the Subscriber 

 

In
connection with, and in consideration of, the sale of the Shares to the Purchaser, the Purchaser hereby represents and warrants
to the Company and its officers, directors, employees, agents and shareholders that the Purchaser:

 

(a)
Has had an opportunity to perform due diligence related to the Company and ask questions of an officer of the Company.

 

(b)
Realizes and accepts the personal financial risk attendant to the fact that that purchase of the Shares represents a speculative
investment involving a high degree of risk, and should not be purchased by any persons not prepared to lose their entire investment.

 

(c)
Can bear the economic risk of an investment in the Shares for an indefinite period of time, can afford to sustain a complete loss
of such investment, has no need for liquidity in connection with an investment in the Shares, and can afford to hold the Shares
indefinitely.

 

(d)
Realizes that the Shares have not been registered for sale under the Securities Act of 1933, as amended (the “Act”),
or applicable state securities laws (the “State Laws”), and they may be sold only pursuant to registration
under the Act and State Law, or an opinion of counsel that such registration is not required.

 

(e)
Is experienced and knowledgeable in financial and business matters, capable of evaluating the merits and risks of investing in
the Shares and does not need or desire the assistance of a knowledgeable representative to aid in the evaluation of such risks
(or, in the alternative, has a knowledgeable representative whom such investor intends to use in connection with a decision as
to whether to purchase the Shares).

 

    	 	 	 

     

    

 

(f)
Realizes that (a) there are substantial restrictions on the transfer of the Shares; (b) there is not currently a public market
for the Shares, and it is unlikely that in the future there will exist a public market for the Shares, and accordingly, for the
above and other reasons, the Purchaser may not be able to liquidate an investment in such Shares for an indefinite period.

 

2.
Investment Intent

 

The
Purchaser has been advised that the Shares have not been registered under the Act or relevant State Laws but are being offered,
and will be offered, and sold pursuant to exemptions from the Act and State Laws, and that the Company’s reliance upon such
exemption is predicated in part on the Purchaser’s representations contained herein. The Purchaser represents and warrants
that the Shares are being purchased for the Purchaser’s own account and for long term investment and without the intention
of reselling or redistributing the Shares; that the Purchaser has made no agreement with others regarding any of the Shares; and
that the Purchaser’s financial condition is such that it is not likely that it will be necessary for the Purchaser to dispose
of any of the Shares in the foreseeable future. The Purchaser is aware that (1) there is presently no public market for the Shares,
and in the view of the Securities and Exchange Commission a purchase of Shares with an intent to resell by reason of any foreseeable
specific contingency or anticipated change in market values, or any change in the liquidation or settlement of any loan obtained
for the acquisition of any of the Shares and for which the Shares were or may be pledged as security would represent an intent
inconsistent with the investment representations set forth above, and (2) the transferability of the Shares is restricted and
(a) requires the written consent of the Company, and (b) will be further restricted by a legend placed on the certificate(s) representing
the Shares containing substantially the following language:

 

The
Shares represented by this certificate have not been registered under either the Securities Act of 1933, as amended, or applicable
state securities laws and may not be sold, transferred, assigned, offered, pledged or otherwise distributed for value unless there
is an effective registration statement under such Act and such laws covering such Shares, or the Company receives an opinion of
counsel acceptable to the Company stating that such sale, transfer, assignment, offer, pledge or other distribution for value
is exempt from the registration and prospectus delivery requirements of such Act and such laws.

 

The
Purchaser further represents and agrees that if contrary to the Purchaser’s foregoing intentions, the Purchaser should later
desire to dispose of or transfer any of the Shares in any manner, the Purchaser shall not do so without first obtaining (1) an
opinion of counsel satisfactory to the Company that such proposed disposition or transfer may be made lawfully without the registration
of such Shares pursuant to the Act and applicable State Laws, or (2) registration of such Shares (it being expressly understood
that the Company shall not have any obligation to register such Shares except as explicitly provided by written agreement).

 

3.
Residence

 

The
Purchaser represents and warrants that the Purchaser is a bona fide resident of the Peoples Republic of China and that
the Shares are being accepted by the Purchaser in the Purchaser’s name solely for the Purchaser’s own beneficial interest
and not as nominee for, on behalf of, for the beneficial interest of, or with the intention to transfer to, any other person,
trust or organization.

 

PARAGRAPHS
4 AND 5 BELOW ARE REQUIRED IN CONNECTION WITH EXEMPTIONS FROM THE ACT AND APPLICABLE STATE SHARES LAWS BEING RELIED ON BY THE
COMPANY WITH RESPECT TO OFFER AND SALE OF THE SHARES. ALL OF SUCH INFORMATION WILL BE KEPT CONFIDENTIAL AND WILL BE REVIEWED ONLY
BY THE COMPANY AND ITS COUNSEL. THE PURCHASER AGREES TO FURNISH ANY ADDITIONAL INFORMATION WHICH THE COMPANY OR ITS COUNSEL DEEMS
NECESSARY IN ORDER TO VERIFY THE RESPONSES SET FORTH ABOVE.

 

    	 	 	 

     

    

 

4.
Accredited/Non-Accredited Status

 

The
Purchaser represents and warrants as follows (check if applicable):

 

a.
Accredited Investor Status: Individual

 

(1)_______
The Purchaser is an individual with a net worth, or a joint net worth together with his or her spouse, in excess of $1,000,000.
(In calculating net worth, you may include equity in personal property and real estate, including your principal residence, cash,
short term investments, stock and Shares. Equity in personal property and real estate should be based on the fair market value
of such property minus debt secured by such property.);

 

(2)________
The Purchaser is an individual who had an individual income in excess of $200,000 in each of the prior two years and reasonably
expects an income in excess of $200,000 in the current year;

 

(3)________
The Purchaser is an individual who had with his/her spouse joint income in excess of $300,000 in each of the prior two years and
reasonably expects an income in excess of $300,000 in the current year; or

 

(4)___x_____
Items 4(a)(1)-(3) are not applicable and the Purchaser is NOT an accredited investor.

 

(5)________
The Purchaser is a director or executive officer of the Company.

 

b.
Accredited Investor Status: Entity

 

(1)________
The Purchaser is an entity all of whose equity owners meet one of the tests set forth in part a., above.

 

(2)________
The Purchaser is an entity and is an “Accredited Investor” as defined in Rule 501(a) of Regulation D under the Act.
This representation is based on the following (check one or more, as applicable):

 

(a)______
The Purchaser (or in the case of a trust, the Purchaser trustee) is a bank or savings and loan association as defined in Sections
3(a)(2) and 3(a)(5)(A) of the Act, acting either in its individual or fiduciary capacity;

 

(b)______
The Purchaser is an insurance company as defined in Section 2(13) of the Act;

 

(c)_______
The Purchaser is an investment company registered under the Investment Company Act of 1940 or a business development company as
defined in Section 2(a)(48) of that Act;

 

    	 	 	 

     

    

 

(d)________
The Purchaser is a Small Business Investment Company licensed by the U.S. Small Business Administration under Section 301(c) or
(d) of the Small Business Investment Act of 1958;

 

(e)________
The Purchaser is an employee benefit plan within the meaning of Title I of the Employee Retirement Income Security Act of 1974
and either (check one of more, as applicable):

 

(i)________
the investment decision is made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either a bank, savings
and loan association, insurance company, or registered investment advisor; or

 

(ii)________
the employee benefit plan has total assets in excess of $5,000,000; or

 

(iii)________
the plan is a self-directed plan with investment decisions made solely by persons who are “Accredited Investors” as
defined under the 1933 Act.

 

(f)________
The Purchaser is a private business development company as defined in Section 202(a)(22) of the Investment Advisors Act of 1940.

 

(g)________
The Purchaser has total assets in excess of $5,000,000, was not formed for the specific purpose of acquiring the Shares and
is one or more of the following (check one or more, as appropriate):

 

(i)________an
organization described in Section 501(c)(3) of the Internal Revenue Code; or

 

(ii)________
a corporation; or

 

(iii)________
a Massachusetts or similar business, trust; or

 

(iv)________
a partnership.

 

(h)_________
The Purchaser is a trust with total assets exceeding $5,000,000, which was not formed for the specific purpose of acquiring the
Shares and whose purchase is directed by a person who has such knowledge and experience in financial and business matters that
he/she is capable of evaluating the merits and risks of the investment in the Shares. IF
ONLY THIS RESPONSE IS CHECKED, PLEASE CONTACT THE COMPANY TO RECEIVE AND COMPLETE AN INFORMATION STATEMENT BEFORE THIS SUBSCRIPTION
CAN BE CONSIDERED BY THE COMPANY.

 

(3)________Items
4(b)(1)-(2) are not applicable and the Purchaser is NOT an accredited investor.

 

5.
Entities

 

If
the Purchaser is an entity, the individual signing on behalf of the entity and the entity jointly and severally agree and certify
that:

 

	 	a.	the
    Purchaser was not organized for the specific purpose of acquiring the Shares; and
	 	 	 
	 	b.	this
    Agreement has been duly authorized by all necessary action on the part of the Purchaser, and is a legal, valid, and binding
    obligation of the Purchaser enforceable in accordance with its terms.

 

    	 	 	 

     

    

 

6.
Manner in Which Title Is To Be Held

 

Please
check one:

 

___x___Individual

 

______Joint
Tenant with Right of Survivorship

 

______Partnership

 

______Tenants
in Common

 

______Corporation

 

______Other
(Specify_____________________)

 

7.
Miscellaneous

 

(a)
The Purchaser agrees that the Purchaser understands the meaning and legal consequences of the agreements, representations, and
warranties contained herein; agrees that such agreements, representations and warranties shall survive and remain in full force
and effect after the consummation of the transactions contemplated hereby; and further agrees to indemnify and hold harmless the
Company, each current and future officer, director, employee, agent and shareholder from and against any and all loss, damage
or liability due to, or arising out of, a breach of any agreement, representation or warranty of the Purchaser contained herein.

 

(b)
The respective representations, warranties, agreements and covenants of the Company and the Investor set forth in this Agreement
shall survive until the second anniversary of the Closing Date.

 

(c)
This Agreement shall inure to the benefit of and be binding upon Investor and the Company and their respective successors and
legal representatives, and nothing expressed or mentioned in this Agreement is intended or shall be construed to give any other
person any legal or equitable right, remedy or claim under or in respect of this Agreement, or any provisions herein contained;
this Agreement and all conditions and provisions hereof being intended to be and being for the sole and exclusive benefit of such
persons and for the benefit of no other person. Neither the Company nor any Investor may assign this Agreement or any rights or
obligation hereunder without the prior written consent of the other party.

 

(d)
No failure or delay on the part of the Company or Investor in exercising any right, power or remedy hereunder shall operate as
a waiver thereof, nor shall any single or partial exercise of any such right, power or remedy preclude any other or further exercise
thereof or the exercise of any other right, power or remedy. The remedies provided for herein are cumulative and are not exclusive
of any remedies that may be available to the Company or Investor at law or in equity or otherwise. No waiver of or consent to
any departure by the Company or Investor from any provision of this Agreement shall be effective unless signed in writing by the
party entitled to the benefit thereof, provided that notice of any such waiver shall be given to each party hereto as set forth
below. Except as otherwise provided herein, no amendment, modification or termination of any provision of this Agreement shall
be effective unless signed in writing by or on behalf of each of the Company and the Investor. Any amendment, supplement or modification
of or to any provision of this Agreement, any waiver of any provision of this Agreement, and any consent to any departure by the
Company or Investor from the terms of any provision of this Agreement shall be effective only in the specific instance and for
the specific purpose for which made or given. Except where notice is specifically required by this Agreement, no notice to or
demand on the Company in any case shall entitle the Company to any other or further notice or demand in similar or other circumstances.

 

    	 	 	 

     

    

 

(e)
This Agreement, together with Transaction Documents, constitutes the entire agreement among the parties hereto and supersedes
all prior agreements, understandings and arrangements, oral or written, among the parties hereto with respect to the subject matter
hereof and thereof.

 

(f)
If any provision of this Agreement is held to be invalid or unenforceable in any respect, the validity and enforceability of the
remaining terms and provisions of this Agreement shall not in any way be affected or impaired thereby.

 

(g)
THE VALIDITY AND INTERPRETATION OF THIS AGREEMENT, AND THE TERMS AND CONDITIONS SET FORTH HEREIN SHALL BE GOVERNED BY AND CONSTRUED
IN ACCORDANCE WITH THE LAWS OF THE STATE OF CALIFORNIA, WITHOUT GIVING EFFECT TO PROVISIONS RELATING TO CONFLICTS OF LAW TO THE
EXTENT THE APPLICATION OF THE LAWS OF ANOTHER JURISDICTION WOULD BE REQUIRED THEREBY. THE PARTIES HEREBY IRREVOCABLY AND UNCONDITIONALLY
AGREE THAT ACTIONS, SUITS OR PROCEEDINGS ARISING OUT OF OR RELATING TO THIS AGREEMENT MAY BE BROUGHT ONLY IN STATE OR FEDERAL
COURTS LOCATED IN THE CITY OF ATLANTA, GEORGIA AND HEREBY SUBMIT TO THE EXCLUSIVE JURISDICTION OF SUCH COURTS FOR SUCH PURPOSE.

 

(h)
This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together
shall constitute one and the same instrument.

 

(i)
The Company will not, by amendment of its Certificate of Incorporation, or through any reorganization, re-capitalization, transfer
of assets, consolidation, merger, dissolution, issue or sale of Shares or any other voluntary action, avoid or seek to avoid the
observance or performance of any of the terms to be observed or performed hereunder by the Company, or take any action which would
dilute or adversely affect the ownership interest of Investor in the Company upon conversion, but will at all times in good faith
assist in carrying out of all of the provisions of this Agreement, and to take all such actions as may be necessary or appropriate
in order to protect and issue the conversion rights of Investor against impairment.

 

(j)
Facsimile signatures shall be construed and considered original signatures for purposes of enforcement of the terms of this agreement.

 

[Signature
page follows – the balance of this page intentionally left blank]

 

    	 	 	 

     

    

 

INDIVIDUAL
SUBSCRIBERS:

 

	/s/
    Wei Li	 
	Signature	 
	Wei
    Li	 
	Name
    (Typed or Printed)	 
	Room
    4108, Tower A Xintian Business Center, Shixia North 2th Street,	 
	Futian
    District, Shenzhen City, Guangdong Province, China	 
	N/A	 
	Social
    Security Number	 

 

    	 	 	 

     

    

 

Kiwa
Bio-Tech Products Group Corporation hereby acknowledges receipt of the Subscription Price and accepts this subscription of 811,148
Shares of Series B Redeemable Convertible Preferred Stock as of December 28, 2017.

 

	 	Kiwa
    Bio-Tech Products Group Corporation
	 	 
	 	/s/
    Yvonne Wang
	 	Yvonne
    Wang, PresidentForm of Medium-Term Notes, Series K

 Exhibit 4.1 

[Face of Note] 

Unless this certificate is presented by an authorized representative of The Depository Trust Company, a New York corporation
(“DTC”), to the Company or its agent for registration of transfer, exchange or payment, and any certificate issued is registered in the name of Cede & Co. or in such other name as requested by an authorized representative
of DTC (and any payment is made to Cede & Co. or such other entity as is requested by an authorized representative of DTC), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL inasmuch as the
registered owner hereof, Cede & Co., has an interest herein. 
  

					
	 CUSIP NO. 94988U565
	  	PRINCIPAL AMOUNT: $	                    	 
	 REGISTERED NO.     
	  			

 WELLS FARGO & COMPANY 

MEDIUM-TERM NOTE, SERIES K 

Due Nine Months or More From Date of Issue 

Leveraged Index Return Notes® Linked to the Dow Jones Industrial Average® 
 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
December 23, 2022 (the “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. 
 “Principal Amount” shall mean, when used with respect to this Security, the
amount set forth on the face of this Security as its “Principal Amount.” 

 Determination of Redemption Amount 

The “Redemption Amount” of this Security will equal: 

 

	 	•	 	 if the Ending Value is greater than the Starting Value: the Principal Amount plus:

  

																																	
		 		 		 		 		 		 		 		 		 		 		 		 		 		 		 		 	
		 		 		 		 	 	 	Principal Amount    	 	×        Participation Rate    ×    	 	 	 	Ending Value – Starting Value	 	 	 		 	 	 		 		 		 		 	
		 		 		 		 	 	 	 	 	 	 	Starting Value	 	 	 		 	 	 		 		 		 		 	 ;

  

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

  

	 	•	 	 if the Ending Value is less than the Threshold Value: the Principal Amount minus:

  

																											
		 		 		 		 		 		 		 		 		 		 		 		 		 	
		 		 		 		 	 	 	Principal Amount	 	  ×    	 	Threshold Value – Ending Value	 	 	 		 		 		 		 	
		 		 		 		 	 	 	 	 	Starting Value	 	 	 		 		 		 		 	

 All calculations with respect to the Redemption 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 Redemption Amount will be rounded to the nearest cent, with one-half cent rounded upward. 
 “Index” shall mean the Dow Jones Industrial
Average®. 
 The “Pricing Date” shall mean
December 21, 2017. 
 The “Starting Value” is 24,782.29, the Closing Level of the Index on the Pricing
Date. 
 The “Closing Level” of the Index on any Market Measure Business Day means the official closing
level of the Index reported by the Index Publisher on such Market Measure Business Day, subject to the provisions set forth below under “Discontinuance of the Index,” “Adjustments to the Index” and “Market Disruption
Events.” 
 The “Ending Value” will be the average of the Closing Levels of the Index on each
Calculation Day (as defined below) occurring during the Maturity Valuation Period (as defined below), subject to the provisions set forth below under “Market Description Events.” 

The “Threshold Value” is 19,825.83, which is equal to 80% of the Starting Value, rounded to two decimal
places. 
 The “Participation Rate” is 109%. 

  
 2 

 A “Market Measure Business Day” means a day on which
(1) the New York Stock Exchange (the “NYSE”) and The NASDAQ Stock Market, or their successors, are open for trading and (2) the Index or any Successor Index (as defined below) is calculated and published. 

“Index Publisher” shall mean S&P Dow Jones Indices LLC. 

“Maturity Valuation Period” means each of December 14, 2022, December 15, 2022, December 16,
2022, December 19, 2022 and December 20, 2022, subject to the provisions set forth below under “Market Disruption Events.” 

“Calculation Day” means any Market Measure Business Day during the Maturity Valuation Period on which a
Market Disruption Event (as defined below) has not occurred. 
 “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. 

“Joint Calculation Agency Agreement” shall mean the Joint Calculation Agency Agreement dated as of
July 18, 2015 between the Company and the Calculation Agents, as amended from time to time. 
 “Calculation
Agents” shall mean the Persons that have entered into the Joint Calculation Agency Agreement with the Company providing for, among other things, the determination of the Ending Value and the Redemption Amount, which term shall, unless the
context otherwise requires, include their successors under such Joint Calculation Agency Agreement. The initial Calculation Agents shall be Wells Fargo Securities, LLC and Merrill Lynch, Pierce, Fenner & Smith Incorporated. Pursuant to the
Joint Calculation Agency Agreement, the Company may appoint a different Calculation Agent from time to time after the initial issuance of this Security without the consent of the Holder of this Security and without notifying the Holder of this
Security. 
 Adjustments to the Index 

If, after the Pricing Date, the Index Publisher makes a material change in the method of calculating the Index or in another
way that changes the Index such that it does not, in the opinion of the Calculation Agents, fairly represent the level of the Index had those changes or modifications not been made, the Calculation Agents will, at the close of business in New York,
New York, on each date that the Closing Level is to be calculated, make adjustments to the Index. Those adjustments will be made in good faith as necessary to arrive at a calculation of a level of the Index as if those changes or modifications had
not been made, and the Calculation Agents shall calculate the Closing Level of the Index, as so adjusted. 
 Discontinuance of the Index 

If, after the Pricing Date, the Index Publisher discontinues publication of the Index, and the Index Publisher or another
entity then publishes a substitute index that the Calculation Agents determine, in their sole discretion, to be comparable to the original Index (a “Successor Index”), the 

  
 3 

 
Calculation Agents will substitute the Successor Index as calculated by the relevant Index Publisher or any other entity and calculate the Ending Value as described in the definition of
“Ending Value” above. If the Calculation Agents select a Successor Index, the Calculation Agents will give written notice of the selection to the Trustee, to the Company, and to the Holder hereof. 

If the Index Publisher discontinues publication of the Index before the end of the Maturity Valuation Period and the
Calculation Agents do not select a Successor Index, then on each day that would have been a Calculation Day, until the earlier to occur of: 
  

	 	•	 	 the determination of the Ending Value; and 

 

	 	•	 	 a determination by the Calculation Agents that a Successor Index is available, 

the Calculation Agents will compute a substitute level for the Index in accordance with the procedures last used to calculate the Index before
any discontinuance as if that day were a Calculation Day. The Calculation Agents will make available to the Holder hereof information regarding those levels by means of Bloomberg L.P., Thomson Reuters, a website, or any other means selected by the
Calculation Agents in their reasonable discretion. 
 If a Successor Index is selected or the Calculation Agents calculate a
level as a substitute for the Index, the Successor Index or level will be used as a substitute for all purposes, including for the purpose of determining whether a Market Disruption Event exists. 

Market Disruption Events 

“Market Disruption Event” means one or more of the following events, as determined by the Calculation Agents
in their sole discretion: 
  

	 	(A)	 the suspension of or material limitation on trading, in each case, for more than two consecutive hours of
trading, or during the one-half hour period preceding the close of trading, on the primary exchange where the securities included in the Index trade (without taking into account any extended or after-hours
trading session), in 20% or more of the securities which then compose the Index or any Successor Index; and 

  

	 	(B)	 the suspension of or material limitation on trading, in each case, for more than two consecutive hours of
trading, or during the one-half hour period preceding the close of trading, on the primary exchange that trades options contracts or futures contracts related to the Index (without taking into account any
extended or after-hours trading session), whether by reason of movements in price otherwise exceeding levels permitted by the relevant exchange or otherwise, in options contracts or futures contracts related to the Index, or any Successor Index.

 For the purpose of determining whether a Market Disruption Event has occurred: 

 

	 	1)	 a limitation on the hours in a trading day and/or number of days of trading will not constit5ute a Market
Disruption Event if it results from an announced change in the regular business hours of the relevant exchange; 

  
 4 

	 	2)	 a decision to permanently discontinue trading in the relevant futures or options contracts related to the
Index, or any Successor Index, will not constitute a Market Disruption Event; 

  

	 	3)	 a suspension in trading in a futures or options contract on the Index, or any Successor Index, by a major
securities market by reason of (a) a price change violating limits set by that securities market, (b) an imbalance of orders relating to those contracts, or (c) a disparity in bid and ask quotes relating to those contracts will
constitute a suspension of or material limitation on trading in futures or options contracts related to the Index; 

  

	 	4)	 a suspension of or material limitation on trading on the relevant exchange will not include any time when that
exchange is closed for trading under ordinary circumstances; and 

  

	 	5)	 if the Index has component securities listed on the NYSE, for the purpose of clause (A) above, any
limitations on trading during significant market fluctuations under NYSE Rule 80B, or any applicable rule or regulation enacted or promulgated by the NYSE or any other self-regulatory organization or the Securities and Exchange Commission of
similar scope as determined by the Calculation Agents, will be considered “material.” 

 If
(i) a Market Disruption Event occurs on a scheduled Calculation Day during the Maturity Valuation Period or (ii) any scheduled Calculation Day is determined by the Calculation Agents not to be a Market Measure Business Day by reason of an
extraordinary event, occurrence, declaration, or otherwise (any such day in either (i) or (ii) being a “Non-Calculation Day”), the Closing Level of the Index for the applicable Non-Calculation Day will be the Closing Level of the Index on the next Calculation Day that occurs during the Maturity Valuation Period. For example, if the first and second scheduled Calculation Days during the
Maturity Valuation Period are Non-Calculation Days, then the Closing Level of the Index on the next Calculation Day will also be the Closing Level for the Index on the first and second scheduled Calculation
Days during the Maturity Valuation Period. If no further Calculation Days occur after a Non-Calculation Day, or if every scheduled Calculation Day during the Maturity Valuation Period is a Non-Calculation Day, then the Closing Level of the Index for that Non-Calculation Day and each following Non-Calculation Day (or for
all the scheduled Calculation Days during the Maturity Valuation Period, if applicable) will be determined (or, if not determinable, estimated) by the Calculation Agents in a commercially reasonable manner on the last scheduled Calculation Day
during the Maturity Valuation Period, regardless of the occurrence of a Market Disruption Event on that last scheduled Calculation Day. 
 Calculation
Agent 
 The Calculation Agents have the sole discretion to make all determinations regarding this Security as
described in this Security, including determinations regarding the Starting Value, the Threshold Value, the Ending Value, the Index, the Redemption Amount, any Market Disruption Events, a Successor Index, Market Measure Business Days, Business Days,
Calculation Days, Non-Calculation Days, and determinations related to the discontinuance of the Index. Absent manifest error, all determinations of the Calculation Agents will be conclusive for all purposes
and final and 

  
 5 

 
binding on the Holder hereof and the Company, without any liability on the part of the Calculation Agents. 

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

This Security is not subject to redemption at the option of the Company or repayment at the option of the Holder hereof prior
to December 23, 2022. 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 described under “Determination of Redemption Amount,” determined as if the date of acceleration were the sole 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. 

  
 6 

 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

  
 7 

 [Reverse of Note] 

WELLS FARGO & COMPANY 

MEDIUM-TERM NOTE, SERIES K 

Due Nine Months or More From Date of Issue 

Leveraged Index Return Notes® Linked to the Dow Jones Industrial Average® 
 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 

  
 8 

 
time Outstanding of all series to be affected, acting together as a class. The Indenture also contains provisions permitting the Holders of a majority in principal amount of the Securities of all
series at the time Outstanding affected by certain provisions of the Indenture, acting together as a class, on behalf of the Holders of all Securities of such series, to waive compliance by the Company with those provisions of the Indenture. Certain
past defaults under the Indenture and their consequences may be waived under the Indenture by the Holders of a majority in principal amount of the Securities of each series at the time Outstanding, on behalf of the Holders of all Securities of such
series. Solely for the purpose of determining whether any consent, waiver, notice or other action or Act to be taken or given by the Holders of Securities pursuant to the Indenture has been given or taken by the Holders of Outstanding Securities in
the requisite aggregate principal amount, the principal amount of this Security will be deemed to be equal to the amount set forth on the face hereof as the “Principal Amount” hereof. Any such consent or waiver by the Holder of this
Security shall be conclusive and binding upon such Holder and upon all future Holders of this Security and of any Security issued upon the registration of transfer hereof or in exchange herefor or in lieu hereof, whether or not notation of such
consent or waiver is made upon this Security. 
 Defeasance 

Section 403 and Article Fifteen of the Indenture and the provisions of clause (ii) of Section 401(1)(B) of the
Indenture, relating to defeasance at any time of (a) the entire indebtedness on this Security and (b) certain restrictive covenants and certain Events of Default, upon compliance by the Company with certain conditions set forth therein,
shall not apply to this Security. The remaining provisions of Section 401 of the Indenture shall apply to this Security. 
 Authorized
Denominations 
 This Security is issuable only in registered form without coupons in denominations of $10 or any
amount in excess thereof which is an integral multiple of $10. 
 Registration of Transfer 

Upon due presentment for registration of transfer of this Security at the office or agency of the Company in the City of
Minneapolis, Minnesota, a new Security or Securities of this series, with the same terms as this Security, in authorized denominations for an equal aggregate Principal Amount will be issued to the transferee in exchange herefor, as provided in the
Indenture and subject to the limitations provided therein and to the limitations described below, without charge except for any tax or other governmental charge imposed in connection therewith. 

This Security is exchangeable for definitive Securities in registered form only if (x) the Depositary notifies the
Company that it is unwilling or unable to continue as Depositary for this Security or if at any time the Depositary ceases to be a clearing agency registered under the Securities Exchange Act of 1934, as amended, and a successor depositary is not
appointed within 90 days after the Company receives such notice or becomes aware of such ineligibility, (y) the Company in its sole discretion determines that this Security shall be exchangeable for definitive Securities in registered form
and notifies the Trustee thereof or (z) an Event of Default with respect 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 

  
 9 

 
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. 

  
 10 

 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)

  
 11 

 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. 

  
 12

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