Document:

Exhibit 10.2

 

JAGUAR HEALTH, INC.

 

May 22, 2020

 

Holder of Common Stock Purchase Warrant

 

Re:       Inducement
Offer to Exercise Common Stock Purchase Warrants

 

Dear Holder:

 

Jaguar Health, Inc.
(the “Company”) is pleased to offer to you the opportunity to exercise all of the Common Stock Purchase Warrants
(the “Bridge Warrants”) of the Company set forth on the signature page hereto currently held by you (the “Holder”)
that were issued pursuant to that certain Securities Purchase Agreement entered into by the Company and Holder on _____ __, 2019
(the “Purchase Agreement”). The shares underlying the Bridge Warrants (“Bridge Warrant Shares”)
have been registered pursuant to the registration statement on Form S-1 (File No. 333-233989)(the “Registration Statement”).
The Registration Statement is currently effective and, upon exercise of the Bridge Warrants pursuant to this letter agreement (this
 “Agreement”), will be effective for the issuance or sale, as the case may be, of the Bridge Warrant Shares.
Capitalized terms not otherwise defined herein shall have the meanings set forth in the Purchase Agreement.

 

In consideration for
exercising some or all of the Bridge Warrants held by you and as set forth on the signature page hereto pursuant to the terms of
this Agreement (the “Warrant Exercise”), the Company hereby offers to issue you or your designees a new Series
3 Common Stock Purchase Warrant (each, a “New Warrant” and collectively, the “New Warrants”)
to purchase up to a number of shares of Common Stock equal to 100% of the number of Bridge Warrant Shares issued pursuant
to each Warrant Exercise, which New Warrant (as defined below) shall be substantially in the form as set forth in Annex A
hereto. The New Warrants will be initially exercisable beginning on the earlier of (1) the date upon which Stockholder Approval
(as defined below) is obtained or (2) six months following the date of issuance, have a term of exercise of 5 years thereafter,
and an exercise price equal to $0.53, subject to adjustment as provided in the New Warrants. Additionally the New Warrants shall
have a cashless exercise feature, wherein, following Stockholder Approval (as defined below), each New Warrant shall be exercisable
into one (1.0) share of Common Stock (subject to adjustment in the exercise price of the New Warrants as provided in the New Warrants)
for no consideration (the “Alternate Cashless Exercise”). A Warrant Exercise shall be effected through
the delivery by the Holder to the Company of a Notice of Exercise of a Bridge Warrant.

 

The New Warrant
certificates will be delivered within two Business Days (defined hereafter) following each Warrant Exercise pursuant to this
Agreement. For purposes of this Agreement, “Business Day” means any day except Saturday, any Sunday, any day
which is a federal legal holiday in the United States or any day on which banking institutions in the State of New York are
authorized or required by law or other governmental action to close. Notwithstanding anything herein to the contrary, in the
event a Warrant Exercise would otherwise cause the Holder to exceed the beneficial ownership limitations
(“Beneficial Ownership Limitation”) set forth in Section 1(d) of the Bridge Warrants, the Company shall
only issue such number of Bridge Warrant Shares to the Holder that would not cause the Holder to exceed the maximum number of
Bridge Warrant Shares permitted thereunder with the balance to be held in abeyance until notice from the Holder that the
balance (or portion thereof) may be issued in compliance with such limitations, which abeyance shall be evidenced through the
Bridge Warrants which shall be deemed prepaid thereafter, and exercised pursuant to a Notice of Exercise in the Bridge
Warrant (provided no additional exercise shall be payable).

 

    -1-

     

    

 

Expressly subject to
the paragraph immediately following this paragraph below, Holder may accept this offer by signing this Agreement below and effect
each Warrant Exercise by delivering one or more Notice of Exercises from time to time on or before 8:30 a.m. ET on May 22, 2020
(the “Termination Date”). Holder agrees to furnish to the Company a completed questionnaire in the form attached
as Annex B hereto within seven (7) days following the date hereof (a “Selling Stockholder Questionnaire”).
Holder further agrees that it shall not be entitled to be named as a selling stockholder in the registration statement described
in Section (i) of Annex C or use the prospectus contained in such registration statement for offers and resales of New Warrant
Shares at any time, unless Holder has returned to the Company a completed and signed Selling Stockholder Questionnaire in the time
frame described in the previous sentence.

 

Additionally, the Company
agrees to the representations, warranties and covenants set forth on Annex C attached hereto. 

 

From the date hereof
until the 60th day following the later of (a) Stockholder Approval and (b) the effectiveness of the registration statement
covering the resale of the shares underlying the New Warrants (the “Standstill Period”) other than in respect
of an Exempt Issuance (as defined below), neither the Company nor any subsidiary of the Company shall issue, enter into any agreement
to issue or announce the issuance or proposed issuance of any shares of Common Stock or any securities of the Company or any subsidiaries
which would entitle the holder thereof to acquire at any time Common Stock (“Common Stock Equivalents”), including,
without limitation, any debt, preferred stock, right, option, warrant or other instrument that is at any time convertible into
or exercisable or exchangeable for, or otherwise entitles the holder thereof to receive, Common Stock, other than the offer and
issuance of the New Warrant Shares to Other Holders (defined below) (the “Standstill”). For purposes of clarity, pursuant
to the Standstill, no shares of Common Stock or Common Stock Equivalents shall be issued in connection with a Section 3(a)(9) exchange,
a Section 3(a)(10) settlement, or any other similar settlement or exchange.

 

“Exempt
Issuance” means the issuance of (a) shares of Common Stock or Common Stock Equivalents, options, or other equity
awards to employees, officers, directors, or consultants of the Company pursuant to any stock or option plan or other equity
award plan duly adopted for such purpose by a majority of the non-employee members of the Board of Directors or a majority of
the members of a committee of non-employee directors established for such purpose, (b) securities upon the exercise or
exchange of or conversion of any securities exercisable or exchangeable for or convertible into shares of Common Stock issued
and outstanding on the date of this Agreement, solely at the election of the holder, provided that such securities have not
been amended since the date of this Agreement to increase the number of such securities or to decrease the exercise price,
exchange price or conversion price of such securities (except for such decreases in exercise, exchange or conversion price in
accordance with the terms of such securities) or to extend the term of such securities (c) an issuance of shares of Common
Stock under the Company’s equity line pursuant to the equity purchase agreement, dated March 24, 2020, between the
Company and Oasis Capital LLC (provided that, in the case of this clause (c), the issuance price of the Common Stock is equal
to or greater than $1.00 per share) and (d) securities pursuant to acquisitions or strategic transactions approved by a
majority of the disinterested directors of the Company, provided that such securities are issued as “restricted
securities” (as defined in Rule 144) and carry no registration rights that require or permit the filing of any
registration statement in connection therewith within the Standstill Period, and provided that any such issuance shall only
be to a Person (or to the equity holders of a Person) which is, itself or through its subsidiaries, an operating company or
an owner of an asset in a business synergistic with the business of the Company and shall provide to the Company additional
benefits in addition to the investment of funds, but shall not include a transaction in which the Company is issuing
securities primarily for the purpose of raising capital or to an entity whose primary business is investing in
securities.

 

    -2-

     

    

 

On or before 9:00 a.m.
ET on May 22, 2020, the Company shall issue a press release disclosing all material terms of the transactions contemplated hereunder.
From and after the issuance of such press release, the Company represents to you that it shall have publicly disclosed all material,
non-public information delivered to you by the Company, or any of their respective officers, directors, employees or agents in
connection with the transactions contemplated hereunder. In addition, effective upon the issuance of such press release, the Company
acknowledges and agrees that any and all confidentiality or similar obligations under any agreement, whether written or oral, between
the Company, any of its Subsidiaries or any of their respective officers, directors, agents, employees or Affiliates on the one
hand, and you and your Affiliates on the other hand, shall terminate. The Company represents, warrants and covenants that, upon
acceptance of this offer and delivery of a Notice of Exercise, the shares underlying the Bridge Warrants shall be issued free of
any legends or restrictions on resale by Holder and all of the Bridge Warrant Shares shall be delivered electronically through
the Depository Trust Company within 1 Business Day of the date the Company receives the applicable Warrants Exercise Price, subject
to the Beneficial Ownership Limitation (or “deliver versus payment” if coordinated through Ladenburg Thalmann &
Co. Inc.). The terms of the Bridge Warrants, including but not limited to the obligations to deliver the Bridge Warrant Shares,
shall otherwise remain in effect (including but not limited to any liquidated damages and compensation in the event of late delivery
of the Bridge Warrant Shares).

 

The Company covenants
that it shall use commercially reasonable efforts to hold a special meeting of stockholders (which may also be at the annual meeting
of stockholders) at the earliest practical date after the date hereof, and in any event on or before the 60th calendar
day following May 22, 2020, with the recommendation of the Company’s Board of Directors that a proposal allowing for the
Alternate Cashless Exercise be approved pursuant to the rules and regulations of the NASDAQ Capital Market, and the Company shall
solicit proxies from its stockholders in connection therewith in the same manner as all other management proposals in such proxy
statement and all management-appointed proxyholders shall vote their proxies in favor of such proposal. If the Company does not
obtain stockholder approval (“Stockholder Approval”) at the first meeting, the Company shall use commercially
reasonable efforts to call a meeting every 90 days thereafter to seek Stockholder Approval until the earlier of the date Stockholder
Approval is obtained or the New Warrants are no longer outstanding.

 

    -3-

     

    

 

Additionally, the Company
shall file with the Securities and Exchange Commission a Current Report on Form 8-K disclosing the material terms of the transactions
contemplated hereby, which shall include this form of Agreement.

 

The Company acknowledges
and agrees that the obligations of the Holders under this Agreement are several and not joint with the obligations of any other
holder or any other holders of Warrants to Purchase Common Stock of the Company (each, an “Other Holder”) under
any other agreement related to the exercise of such warrants (“Other Warrant Exercise Agreement”), and the Holder
shall not be responsible in any way for the performance of the obligations of any Other Holder or under any such Other Warrant
Exercise Agreement. Nothing contained in this Agreement, and no action taken by the Holders pursuant hereto, shall be deemed to
constitute the Holder and the Other Holders as a partnership, an association, a joint venture or any other kind of entity, or create
a presumption that the Holder and the Other Holders are in any way acting in concert or as a group with respect to such obligations
or the transactions contemplated by this Agreement and the Company acknowledges that the Holder and the Other Holders are not acting
in concert or as a group with respect to such obligations or the transactions contemplated by this Agreement or any Other Warrant
Exercise Agreement. The Company and the Holder confirm that the Holder has independently participated in the negotiation of the
transactions contemplated hereby with the advice of its own counsel and advisors. The Holder shall be entitled to independently
protect and enforce its rights, including, without limitation, the rights arising out of this Agreement, and it shall not be necessary
for any Other Holder to be joined as an additional party in any proceeding for such purpose.

 

If
a Holder exercises more than 1,000,000 Warrants to Purchase Common Stock of the Company in the aggregate, including Bridge
Warrants and any other warrants exercised by Holder pursuant to any Other Warrant Exercise Agreement that is executed
concurrently with this Agreement, then, from the date hereof until the earlier of (i) the date that is one year from the date
hereof and (ii) the consummation of a transaction resulting in a Change of Control of the Company, upon any issuance by the
Company or any of its Subsidiaries of New Securities for cash consideration, Indebtedness or a combination of units thereof
(a “Subsequent Financing”), subject to any prior such rights previously granted by the Company, such
Holder shall have the right to participate in up to an amount of the Subsequent Financing equal to 100% of such
Holder’s Pro Rata Portion of the Subsequent Financing on the same terms, conditions and price provided for in the
Subsequent Financing. At least two (2) Trading Days prior to the closing of the Subsequent Financing, the Company shall
deliver to each Holder a written notice of its intention to effect a Subsequent Financing (“Pre-Notice”),
which Pre-Notice shall ask such Holder if it wants to review the details of such financing (such additional notice, a
 “Subsequent Financing Notice”). Upon the request of a Holder, and only upon a request by such Holder, for
a Subsequent Financing Notice, the Company shall promptly, but no later than six (6) hours after such request, deliver a
Subsequent Financing Notice to such Purchaser. The Subsequent Financing Notice shall describe in reasonable detail the
proposed terms of such Subsequent Financing, the amount of proceeds intended to be raised thereunder and the Person or
Persons through or with whom such Subsequent Financing is proposed to be effected and shall include a term sheet or similar
document relating thereto as an attachment. Any Holder desiring to participate in such Subsequent Financing must provide
written notice to the Company by not later than 8:30 a.m. (New York City time) on the Trading Day following receipt of the
Subsequent Financing Notice. For purposes of this paragraph:

 

 

		(a)	“Change of Control” means, with respect to the Company, (i) a merger, consolidation, share exchange or other
similar transaction involving the Company and any third party where the Company is not the surviving entity, or (ii) the acquisition
by a third party, or a group of third parties acting in concert, of more than fifty percent (50%) of the outstanding voting equity
securities of the Company. For the purpose of this definition of Change of Control, (A) the term “group” includes any
group acting for the purpose of acquiring, holding, or disposing of securities within the meaning of Section 13(d) and 14(d) of
the United States Securities Exchange Act of 1934 and Rule 13d-5(b)(1) under the said Act), (B) the foregoing clauses do not include
any sale or transfer solely to an affiliate of the Company.

 

    -4-

     

    

 

		(b)	“New Securities” means any Common Stock or Common Stock Equivalents; provided, however, that the term “New
Securities” does not include:

 

		i.	shares of Common Stock (and/or options, warrants or rights therefor) granted or issued hereafter to employees, officers, directors,
contractors, consultants, or advisers to, the Company or any subsidiary pursuant to incentive agreements, stock purchase or stock
option plans, stock bonuses or awards, warrants, contracts or other arrangements that are approved by the Board of Directors;

 

		ii.	shares of Common Stock or preferred stock issued or issuable (or options, warrants or rights therefor) in connection with strategic
transactions involving the Company and other entities approved by a majority of the disinterested directors of the Company, including
without limitation joint ventures, equipment, manufacturing, marketing, distribution, technology transfer or development arrangements;
provided that such securities are issued as “restricted securities” (as defined in Rule 144) and carry no registration
rights that require or permit the filing of any registration statement in connection therewith during the Standstill Period, and
provided that any such issuance shall only be to a Person (or to the equityholders of a Person) which is, itself or through its
subsidiaries, an operating company or an owner of an asset in a business synergistic with the business of the Company and shall
provide to the Company additional benefits in addition to the investment of funds, but shall not include a transaction in which
the Company is issuing securities primarily for the purpose of raising capital or to an entity whose primary business is investing
in securities.

 

 

    -5-

     

    

  

	 	iii. 	shares of Common Stock or preferred stock (or options, warrants or rights therefor) issued pursuant to the acquisition of another
corporation or entity by the Company by consolidation, merger, purchase of all or substantially all of the assets, or other reorganization
in which the Company acquires, in a single transaction or series of related transactions, all or substantially all of the assets
of such other corporation or entity or fifty percent (50%) or more of the voting power of such other corporation or entity or
fifty percent (50%) or more of the equity ownership of such other entity; provided that such transaction or series of transactions
has been approved by a majority of the disinterested directors of the Company, or pursuant to the purchase of less than a fifty
percent (50%) equity ownership in connection with a joint venture or other strategic arrangement or other commercial relationship,
provided such an arrangement is approved by a majority of the disinterested directors of the Company; provided that such securities
are issued as “restricted securities” (as defined in Rule 144) and carry no registration rights that require or permit
the filing of any registration statement in connection therewith during the Standstill Period, and provided that any such issuance
shall only be to a Person (or to the equityholders of a Person) which is, itself or through its subsidiaries, an operating company
or an owner of an asset in a business synergistic with the business of the Company and shall provide to the Company additional
benefits in addition to the investment of funds, but shall not include a transaction in which the Company is issuing securities
primarily for the purpose of raising capital or to an entity whose primary business is investing in securities.

 

		iv.	shares of Common Stock or preferred stock issuable upon exercise of any options, warrants or rights to purchase any securities
of the Company outstanding as of the date hereof and any securities issuable upon the conversion or exercise thereof, provided
that such securities have not been amended since the date of this Agreement to increase the number of such securities or to decrease
the exercise price, exchange price or conversion price of such securities (except for such decreases in exercise, exchange or conversion
price in accordance with the terms of such securities) or to extend the term of such securities;

 

		v.	shares of Common Stock or preferred stock (or options, warrants or rights therefor) issued or issuable in a sale, lease, transfer,
exclusive license or other disposition, in a single transaction or series of related transactions, by the Company or any subsidiary
of the Company of all or substantially all the assets of the Company and its subsidiaries taken as a whole, or the sale or disposition
(whether by merger, consolidation or otherwise) of Napo Pharmaceuticals, Inc. (or any successor in interest) or one or more other
subsidiaries of the Company if substantially all of the assets of the Corporation and its subsidiaries taken as a whole are held
by such subsidiary or subsidiaries, except where such sale, lease, transfer, exclusive license or other disposition is to a wholly
owned subsidiary of the Company; or

 

		vi.	shares of Common Stock issuable under the Company’s equity line pursuant to the equity purchase agreement, dated March
24, 2020, between the Company and Oasis Capital LLC (including any extensions such equity line).

 

    -6-

     

    

 

	 	(c)	“Pro Rata Portion” means, for purposes of the participation right of the Holder in a Subsequent Financing,
a fraction, the numerator of which is the aggregate number of shares of Common Stock issuable upon exercise of Warrants to Purchase
Common Stock of the Company that are issued to the Holder pursuant to Warrant Exercise(s) under this Agreement and Other Warrant
Exercise Agreements, including the Bridge Warrant Shares, and the denominator of which is the aggregate number of shares of Common
Stock issuable upon exercise of Warrants to Purchase Common Stock of the Company issued to Holder pursuant to Warrant Exercise(s)
under this Agreement and Other Warrant Exercise Agreements and Other Holders pursuant to Warrant Exercises under Other Warrant
Exercise Agreements.

 

The Company hereby
represents and warrants as of the date hereof and covenants and agrees from and after the date hereof until 12 months following
the end of the Standstill Period (the “MFN Period”), that none of the terms offered to any Other Holder with
respect to any Other Warrant Exercise Agreement (or any amendment, modification or waiver thereof including Other Warrant Exercise
Agreements signed concurrently with this Agreement), is or will be more favorable to such Other Holder than those of the Holder
and this Agreement. If, and whenever on or after the date hereof during the MFN Period, the Company enters into an Other Warrant
Exercise Agreement, then (i) the Company shall provide notice thereof to the Holder promptly following the occurrence thereof and
(ii) the terms and conditions of this Agreement shall be, without any further action by the Holder or the Company, automatically
amended and modified in an economically and legally equivalent manner such that the Holder shall receive the benefit of the more
favorable terms and/or conditions (as the case may be) set forth in such Other Warrant Exercise Agreement (including the issuance
of additional BridgeWarrant Shares), provided that upon written notice to the Company at any time the Holder may elect not to accept
the benefit of any such amended or modified term or condition, in which event the term or condition contained in this Agreement
shall apply to the Holder as it was in effect immediately prior to such amendment or modification as if such amendment or modification
never occurred with respect to the Holder. The provisions of this paragraph shall apply similarly and equally to each Other Warrant
Exercise Agreement.

 

 

 

***************

 

    -7-

     

    

 

 

Within one Business
Day from the Holder’s execution of this Agreement and delivery of a Notice of Exercise, the Holder shall make available for
 “Delivery Versus Payment” to the Company immediately available funds equal to the sum of the number of Bridge Warrants
being exercised multiplied by $0.49 (the “Exercise Amount”) and the Company shall deliver the Bridge
Warrant Shares via “Delivery Versus Payment” to the Holder and shall deliver the New Warrant certificates registered
in the name of the Holder.

  

Please do not hesitate
to call me if you have any questions.

 

	 	Sincerely yours,
	 	 
	 	JAGUAR HEALTH, INC.
	 	 
	 	 
	 	By:	 
	 	Name: Lisa A. Conte
	 	Title: Chief Executive Officer

 

Accepted and Agreed to:

 

Name of Holder: _________________________________________________________

 

Signature of Authorized Signatory of
Holder: _________________________________

 

Name of Authorized Signatory: _______________________________________________

 

Title of Authorized Signatory: ________________________________________________

 

Bridge Warrant Shares to be exercised:
______________

 

DTC Instructions:

 

[NOTE THAT HOLDERS MUST DELIVER A NOTICE
OF EXERCISE FOR EACH WARRANT EXERCISE]

 

 

    -8-

     

    

 

Annex A

  

Form of Series 3 Warrant

 

    -9-

     

    

 

Annex B

  

Form of Selling Stockholder Questionnaire 

 

    1

     

    

 

Jaguar
health, inc.

 

Selling Stockholder Notice and Questionnaire

 

The undersigned beneficial
owner of securities of Jaguar Health, Inc., a Delaware corporation (the “Company”), understands that the Company
intends to file with the Securities and Exchange Commission (the “Commission”) a registration statement on Form
S-3 (the “Registration Statement”) for the registration and resale under the Securities Act of 1933, as amended
(the “Securities Act”), of shares of the Company’s common stock issuable upon exercise of a warrant (the
 “Registrable Securities”) issued pursuant to the Inducement Offer Letter, dated May ___, 2020, between the Company
and the undersigned (the “Inducement Offer Letter”). The undersigned understands that, pursuant to the Inducement
Offer Letter, the undersigned will be named as a selling stockholder (the “Selling Stockholder”) in the prospectus
that forms a part of the Registration Statement, and the Company will use the information that the undersigned provides in this
questionnaire to ensure the accuracy of the Registration Statement and the prospectus.

 

Please
note that if the entity completing this questionnaire is not a natural person, in addition to disclosing any material relationships
between the Company and that entity, you should also provide relevant information about any persons (whether they are entities
or natural persons) who exercise discretionary control over the entity completing this questionnaire, and who have had a material
relationship with the registrant or any of its predecessors or affiliates within the past three years.

 

Certain legal consequences
arise from being named as a selling stockholder in the Registration Statement and the related prospectus. Accordingly, holders
and beneficial owners of Registrable Securities are advised to consult their own securities law counsel regarding the consequences
of being named or not being named as a selling stockholder in the Registration Statement and the related prospectus.

  

NOTICE

 

The undersigned beneficial
owner of the Company’s securities acknowledges that by completing, dating, executing and returning this questionnaire to
the Company, the undersigned is giving written notice to the Company of its desire to have the securities disclosed in response
to Question 4(b) of this questionnaire included in the Registration Statement.

 

The undersigned hereby provides the following
information to the Company and represents and warrants that such information is accurate:

 

    2

     

    

 

QUESTIONNAIRE

 

Please
answer every question. If the answer to any question is “none” or “not applicable,” please so state.

 

 

		1.	Name.

 

		(a)	Full Legal Name of Selling Stockholder

 

	 	 	 

 

		(b)	Full Legal Name of Registered Holder (if not the same as (a) above) through which Registrable Securities
are held:

 

	 	 	 

 

		(c)	Full Legal Name of Natural Control Person (which means a natural person who directly or indirectly
alone or with others has power to vote or dispose of the securities covered by this Questionnaire):

 

	 	 	 

  

2. Address for Notices to Selling
Stockholder:

 

	 	 
	 	 
	 	 
	 	 
	 	 
	 	 
	Telephone:  	 
	 	 
	Fax:  	 
	 	 
	Email:	

 

3. Broker-Dealer Status:

 

		(a)	Are you a broker-dealer?

 

	Yes  ̈ 	No  ̈

  

    3

     

    

 

	 	Note:	In general, the Company will be required to identify any registered broker-dealer or an affiliate as an underwriter in the prospectus.

 

		(b)	If “yes” to Section 3(a), did you receive your Registrable Securities as compensation
for investment banking services to the Company?

 

	Yes  ̈ 	No  ̈

 

		(c)	Are you an affiliate of a broker-dealer? If “Yes”, please identify the registered broker-dealer(s),
describe the nature of the affiliation(s) and answer subsection (d).

 

	Yes  ̈	No  ̈

 

		(d)	If you are an affiliate of a broker-dealer, do you certify that you purchased the Registrable Securities
in the ordinary course of business, and at the time of the purchase of the Registrable Securities to be resold, you had no agreements
or understandings, directly or indirectly, with any person to distribute the Registrable Securities?

 

	Yes  ̈ 	No  ̈

 

4. Beneficial Ownership of Securities
of the Company Owned by the Selling Stockholder.

 

This question covers beneficial
ownership of the Company’s securities. Please consult Appendix A to this Questionnaire for information as to the meaning
of “beneficial ownership.” State (a) the number of shares of the Company’s common stock (including any shares
issuable upon exercise of warrants or other convertible securities) that the selling securityholder beneficially owned as of the
date this Questionnaire is signed and (b) the number of such shares of the Company’s common stock (including any shares issuable
upon exercise of warrants or other convertible securities) that the selling securityholder wishes to have registered for resale
in the Registration Statement:

 

(a) Number
of shares of common stock and other equity securities owned (including any shares issuable upon exercise of warrants or other convertible
securities):

 

	 	 
	 	 
	 	 

 

 

    4

     

    

 

(b) Number of shares of common
stock and other equity securities owned (including any shares issuable upon exercise of warrants or other convertible securities)
to be registered for resale in the Registration Statement:

 

	 	 
	 	 
	 	 

 

(c) In
addition to the securities identified in paragraphs (a) and (b) of this question, please identify any additional equity securities
of the Company as to which there is any arrangement under which you have the right to receive any economic benefits of those securities.

 

	 	 
	 	 
	 	 

 

5. Relationships with the Company:

 

Except as set forth below,
neither the undersigned nor any of its affiliates, officers, directors or principal equity holders (owners of 5% of more of the
equity securities of the undersigned) has held any position or office or has had any other material relationship with the Company
(or its predecessors or affiliates) during the past three years.

 

State any exceptions here:

 

	 	 
	 	 
	 	 

 

The undersigned agrees
to promptly notify the Company of any material inaccuracies or changes in the information provided herein that may occur subsequent
to the date hereof at any time while the Registration Statement remains effective; provided, that the undersigned shall not be
required to notify the Company of any changes to the number of securities held or owned by the undersigned or its affiliates.

 

By
signing below, the undersigned consents to the disclosure of the information contained herein in its answers to Items 1 through
5 and the inclusion of such information in the Registration Statement and the related prospectus and any amendments or supplements
thereto. The undersigned understands that such information will be relied upon by the Company in
connection with the preparation or amendment of the Registration Statement and the related prospectus and any amendments or supplements
thereto.

 

    5

     

    

 

IN WITNESS WHEREOF
the undersigned, by authority duly given, has caused this Notice and Questionnaire to be executed and delivered either in person
or by its duly authorized agent.

 

	Date:	 	 	Beneficial Owner:

 

	 	By:	       
	 	 	Name:
	 	 	Title:       

 

PLEASE FAX A COPY (OR EMAIL A .PDF COPY)
OF THE COMPLETED AND EXECUTED NOTICE AND QUESTIONNAIRE TO: JWolin@jaguar.health with a copy to CHo@reedsmith.com 

  

    6

     

    

  

APPENDIX A

DEFINITION OF “BENEFICIAL OWNERSHIP”

 

		1.	A “Beneficial Owner” of a security includes any person who, directly or indirectly,
through any contract, arrangement, understanding, relationship or otherwise has or shares:

 

	(a)	Voting power which includes the power to vote, or to direct the voting of, such security; and/or
	 	 
	(b)	Investment power which includes the power to dispose, or direct the disposition of, such security.

 

Please note that either voting
power or investment power, or both, is sufficient for you to be considered the beneficial owner of shares.

 

		2.	Any person who, directly or indirectly, creates or uses a trust, proxy, power of attorney, pooling
arrangement or any other contract, arrangement or device with the purpose or effect of divesting such person of beneficial ownership
of a security or preventing the vesting of such beneficial ownership as part of a plan or scheme to evade the reporting requirements
of the federal securities acts shall be deemed to be the beneficial owner of such security.

 

		3.	Notwithstanding the provisions of paragraph (1), a person is deemed to be the “beneficial
owner” of a security if that person has the right to acquire beneficial ownership of such security within 60 days, including
but not limited to any right to acquire: (a) through the exercise of any option, warrant or right; (b) through the conversion of
a security; (c) pursuant to the power to revoke a trust, discretionary account or similar arrangement; or (d) pursuant to the automatic
termination of a trust, discretionary account or similar arrangement; provided, however, any person who acquires a security or
power specified in (a), (b) or (c) above, with the purpose or effect of changing or influencing the control of the issuer, or in
connection with or as a participant in any transaction having such purpose or effect, immediately upon such acquisition shall be
deemed to be the beneficial owner of the securities which may be acquired through the exercise or conversion of such security or
power.

 

 

    7

     

    

Annex C

 

Representations, Warranties and Covenants
of the Company. The Company hereby makes the following representations and warranties to the undersigned:

 

(a)              
Affirmation of Prior Representations, Warranties and Covenants. The Company hereby represents and warrants to the
undersigned that the Company’s representations and warranties as set forth in Section 4 of the Securities Purchase Agreement,
dated as of ____ __, 2019 (the “Purchase Agreement”), together with any updates in the Company’s SEC Reports
subsequent to the Purchase Agreement, are true and correct as of the date hereof and have been fully performed as of the
date hereof. Capitalized terms not otherwise defined herein shall have the meanings set forth in the Purchase Agreement.

 

(b)              
Authorization; Enforcement. The Company has the requisite corporate power and authority to enter into and to consummate
the transactions contemplated by this Agreement and otherwise to carry out its obligations hereunder and thereunder. The execution
and delivery of this Agreement by the Company and the consummation by the Company of the transactions contemplated hereby have
been duly authorized by all necessary action on the part of the Company and no further action is required by the Company, its board
of directors or its stockholders in connection therewith. This Agreement has been duly executed by the Company and, when delivered
in accordance with the terms hereof, will constitute the valid and binding obligation of the Company enforceable against the Company
in accordance with its terms, except (i) as limited by general equitable principles and applicable bankruptcy, insolvency, reorganization,
moratorium and other laws of general application affecting enforcement of creditors’ rights generally, (ii) as limited by
laws relating to the availability of specific performance, injunctive relief or other equitable remedies, and (iii) insofar as
indemnification and contribution provisions may be limited by applicable law.

 

(c)               No
Conflicts. The execution, delivery and performance of this Agreement by the Company and the consummation by the Company
of the transactions contemplated hereby do not and will not: (i) conflict with or violate any provision of the
Company’s certificate or articles of incorporation, bylaws or other organizational or charter documents; or (ii)
conflict with, or constitute a default (or an event that with notice or lapse of time or both would become a default) under,
result in the creation of any Lien upon any of the properties or assets of the Company in connection with, or give to others
any rights of termination, amendment, acceleration or cancellation (with or without notice, lapse of time or both) of, any
material agreement, credit facility, debt or other material instrument (evidencing Company debt or otherwise) or other
material understanding to which such Company is a party or by which any property or asset of the Company is bound or
affected; or (iii) subject to any required approvals, conflict with or result in a violation of any law, rule, regulation,
order, judgment, injunction, decree or other restriction of any court or governmental authority to which the Company is
subject (including federal and state securities laws and regulations), or by which any property or asset of the Company is
bound or affected, except, in the case of each of clauses (ii) and (iii), such as could not have or reasonably be expected to
result in a Material Adverse Effect (as defined in the Purchase Agreement).

 

    8

     

    

 

(d)              
Issuance of the New Warrants. The issuance of the New Warrants is duly authorized and, upon the execution of this
Agreement by the undersigned, will be duly and validly issued, fully paid and nonassessable, free and clear of all liens imposed
by the Company. The shares of Common Stock issuable upon exercise (including cashless exercise) of the New Warrants (the “New
Warrant Shares”), when issued in accordance with the terms of the New Warrants, will be validly issued, fully paid and
nonassessable, free and clear of all Liens imposed by the Company. The Company has reserved from its duly authorized capital stock
a number of shares of Common Stock for issuance of the New Warrant Shares in full.

 

(e)              
Equal Consideration. Except as set forth in this Agreement and the transactions described in the Company’s
Current Reports on Form 8-K filed on February 28, 2020 and March 26, 2020, no consideration has been offered or paid to any person
to amend or consent to a waiver, modification, forbearance or otherwise of any provision of any of the Purchase Agreement or the
Bridge Warrants.

 

(f)               
Legends and Transfer Restrictions.

 

(i)    
 The New Warrants and New Warrant Shares may only be disposed of in compliance with state and federal securities laws. In
connection with any transfer of New Warrants or New Warrant Shares other than pursuant to an effective registration statement or
Rule 144, to the Company or to an Affiliate of a undersigned or in connection with a pledge as contemplated in Section 4.1(b),
the Company may require the transferor thereof to provide to the Company an opinion of counsel selected by the transferor and reasonably
acceptable to the Company, the form and substance of which opinion shall be reasonably satisfactory to the Company, to the effect
that such transfer does not require registration of such transferred New Warrants and New Warrant Shares under the Securities Act.
As a condition of transfer, any such transferee shall agree in writing to be bound by the terms of this Agreement.

 

(ii) 
 The undersigned agrees to the imprinting, so long as is required by this Section (i), of a legend on any of the New Warrants
and New Warrant Shares in the following form:

 

NEITHER THIS
SECURITY NOR THE SECURITIES FOR WHICH THIS SECURITY IS EXERCISABLE HAVE BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE
COMMISSION OR THE SECURITIES COMMISSION OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT
OF 1933, AS AMENDED (THE “SECURITIES ACT”), AND, ACCORDINGLY, MAY NOT BE OFFERED OR SOLD EXCEPT PURSUANT TO AN
EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT
SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS. THIS
SECURITY AND THE SECURITIES ISSUABLE UPON EXERCISE OF THIS SECURITY MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN
ACCOUNT OR OTHER LOAN SECURED BY SUCH SECURITIES.

 

    9

     

    

 

The
Company acknowledges and agrees that the undersigned may from time to time pledge pursuant to a bona fide margin agreement with
a registered broker-dealer or grant a security interest in some or all of the New Warrants to a financial institution that is an
 “accredited investor” as defined in Rule 501(a) under the Securities Act and who agrees to be bound by the provisions
of this Agreement and, if required under the terms of such arrangement, the undersigned may transfer pledged or secured New Warrants
to the pledgees or secured parties. Such a pledge or transfer would not be subject to approval of the Company and no legal opinion
of legal counsel of the pledgee, secured party or pledgor shall be required in connection therewith. Further, no notice shall be
required of such pledge. At the appropriate undersigned’s expense, the Company will execute and deliver such reasonable documentation
as a pledgee or secured party of New Warrants may reasonably request in connection with a pledge or transfer of the New Warrants
or New Warrant Shares.

 

(iii)                        
Certificates evidencing the New Warrant Shares shall not contain any legend (including the legend set forth in Section
(f)(ii) hereof), (i) while a registration statement covering the resale of such security is effective under the Securities
Act, (ii) following any sale of such New Warrant Shares pursuant to Rule 144, (iii) if such New Warrant Shares are eligible
for sale under Rule 144, or (iv) if such legend is not required under applicable requirements of the Securities Act
(including judicial interpretations and pronouncements issued by the staff of the SEC). The Company shall cause its counsel
to issue a legal opinion to its transfer agent if required by the transfer agent to effect the removal of the legend
hereunder. If all or any portion of a New Warrant is exercised at a time when there is an effective registration statement to
cover the resale of the New Warrant Shares, or if such New Warrant Shares may be sold under Rule 144 and the Company is then
in compliance with the current public information required under Rule 144, or if the New Warrant Shares may be sold under
Rule 144 without the requirement for the Company to be in compliance with the current public information required under Rule
144 as to such New Warrant Shares or if such legend is not otherwise required under applicable requirements of the Securities
Act (including judicial interpretations and pronouncements issued by the staff of the SEC) then such New Warrant Shares shall
be issued free of all legends. The Company agrees that following such time as such legend is no longer required under this
Section (f), it will, no later than three Trading Days following the delivery by a undersigned to the Company (or its
transfer agent) of a certificate representing New Warrant Shares, as the case may be, issued with a restrictive legend (such
third Trading Day, the “Legend Removal Date”), deliver or cause to be delivered to the undersigned
a certificate representing such shares that is free from all restrictive and other legends. The Company may not make any
notation on its records or give instructions to the transfer agent that enlarge the restrictions on transfer set forth in
this Section (f). Certificates for New Warrant Shares subject to legend removal hereunder shall be transmitted by the
Transfer Agent to the undersigned by crediting the account of the undersigned’s prime broker with the Depository Trust
Company System as directed by the undersigned.

 

    10

     

    

 

(iv) In
addition to such undersigned’s other available remedies, the Company shall pay to an undersigned, in cash, (i) as partial
liquidated damages and not as a penalty, for each $1,000 of New Warrant Shares (based on the VWAP of the Common Stock on the date
such Securities are submitted to the Transfer Agent) delivered for removal of the restrictive legend and subject to Section 4.1(c),
$10 per Trading Day (increasing to $20 per Trading Day five (5) Trading Days after such damages have begun to accrue) for each
Trading Day after the Legend Removal Date until such certificate is delivered without a legend and (ii) if the Company fails to
(a) issue and deliver (or cause to be delivered) to a undersigned by the Legend Removal Date a certificate representing the Securities
so delivered to the Company by such undersigned that is free from all restrictive and other legends and (b) if after the Legend
Removal Date such undersigned purchases (in an open market transaction or otherwise) shares of Common Stock to deliver in satisfaction
of a sale by such undersigned of all or any portion of the number of shares of Common Stock, or a sale of a number of shares of
Common Stock equal to all or any portion of the number of shares of Common Stock that such undersigned anticipated receiving from
the Company without any restrictive legend, then, an amount equal to the excess of such undersigned’s total purchase price
(including brokerage commissions and other out-of-pocket expenses, if any) for the shares of Common Stock so purchased (including
brokerage commissions and other out-of-pocket expenses, if any) (the “Buy-In Price”) over the product of (A)
such number of New Warrant Shares that the Company was required to deliver to such undersigned by the Legend Removal Date multiplied
by (B) the lowest closing sale price of the Common Stock on any Trading Day during the period commencing on the date of the delivery
by such undersigned to the Company of the applicable New Warrant Shares (as the case may be) and ending on the date of such delivery
and payment under this clause (ii).

 

(g)               Public
Information Failure. At any time during the period commencing from the six (6) month anniversary of the date hereof and
ending at such time that all of the New Warrant Shares may be sold without the requirement for the Company to be in
compliance with Rule 144(c)(1) and otherwise without restriction or limitation pursuant to Rule 144, if the Company (i) shall
fail for any reason to satisfy the current public information requirement under Rule 144(c) or (ii) has ever been an issuer
described in Rule 144(i)(1)(i) or becomes an issuer in the future, and the Company shall fail to satisfy any condition set
forth in Rule 144(i)(2) (a “Public Information Failure”) then, in addition to the undersigned’s
other available remedies, the Company shall pay to the undersigned, in cash, as partial liquidated damages and not as a
penalty, by reason of any such delay in or reduction of its ability to sell the New Warrant Shares, an amount in cash equal
to two percent (2.0%) of the aggregate Exercise Price of the New Warrant of the undersigned’s Securities on the day of
a Public Information Failure and on every thirtieth (30th) day (pro-rated for periods totaling less than thirty days)
thereafter until the earlier of (a) the date such Public Information Failure is cured and (b) such time that such public
information is no longer required for the undersigned to transfer the New Warrant Shares pursuant to Rule 144. The payments
to which the undersigned shall be entitled pursuant to this Section (g) are referred to herein as “Public Information
Failure Payments.” Public Information Failure Payments shall be paid on the earlier of (i) the last day of the calendar
month during which such Public Information Failure Payments are incurred and (ii) the third (3rd) Business Day after the
event or failure giving rise to the Public Information Failure Payments is cured. In the event the Company fails to make
Public Information Failure Payments in a timely manner, such Public Information Failure Payments shall bear interest at the
rate of 1.5% per month (prorated for partial months) until paid in full. Nothing herein shall limit the undersigned’s
right to pursue actual damages for the Public Information Failure, and the undersigned shall have the right to pursue all
remedies available to it at law or in equity including, without limitation, a decree of specific performance and/or
injunctive relief.

 

    11

     

    

 

(h)              
Listing of Common Stock. The Company shall apply to list or quote all of the New Warrant Shares on the Trading Market
and promptly secure the listing of all of the New Warrant Shares on such Trading Market.

 

(i)                
Registration Statement. As soon as practicable (and in any event within 30 calendar days of the date of this Agreement),
the Company shall file a registration statement on Form S-3 (or other appropriate form if the Company is not then S-3 eligible)
providing for the resale by the Holders of the New Warrant Shares issued and issuable upon exercise of the New Warrants. 
The Company shall use commercially reasonable efforts to cause such registration to become effective within 45 days following the
date hereof and to keep such registration statement effective at all times until the earlier of (A) the time that no Holder owns
any New Warrants or New Warrant Shares issuable upon exercise thereof and (B) the time that
all of the remaining New Warrants or New Warrant Shares issuable upon exercise thereof are eligible to be sold by the Holders without
compliance with the volume limitations or public information requirements of Rule 144.

 

    12WELLS FARGO & COMPANY 8-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. 95001D7H7	PRINCIPAL AMOUNT: $_________
	REGISTERED NO. ___	 

          
                                   
                                   
             

WELLS FARGO & COMPANY

 

MEDIUM-TERM NOTE, SERIES T

 

Due Nine Months or More From Date of Issue

 

Notes due November 22, 2022

 

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, the principal sum of
______________________________________________________ DOLLARS ($___________) on November 22, 2022 (the “Stated
Maturity Date”) and to pay interest thereon from May 22, 2020 or from the most recent Interest Payment Date to
which interest has been paid or duly provided for monthly on the 22nd day of each month, commencing June 22, 2020, and at
Maturity (each, an “Interest Payment Date”), at the rate of 1.40% per annum until the principal hereof
is paid or made available for payment.  The interest so payable, and punctually paid or duly provided for, on any
Interest Payment Date will, as provided in the Indenture, be paid to the Person in whose name this Security (or one or more
Predecessor Securities) is registered at the close of business on the Regular Record Date for such interest next preceding
such Interest Payment Date.  The Regular Record Date for an Interest Payment Date shall be one Business Day prior to
such Interest Payment Date.  If an Interest Payment Date is not a Business Day, interest on this Security shall be
payable on the next day that is a Business Day, with the same force and effect as if made on such Interest Payment Date, and
without any interest or other payment with respect to the delay.  “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.

 

Except as described below for the first Interest Period, on each Interest Payment Date, interest will be paid for the period commencing on and including the immediately preceding Interest Payment Date and ending on and including the day immediately preceding that Interest Payment Date.  This period is referred to as an “Interest Period.”  The first Interest Period will

 

 

 

 

 

commence on and include May 22, 2020 and end on and include June 21, 2020.  Interest on this Security will be computed on the basis of a 360-day year of twelve 30-day months.

 

Any interest not punctually paid or duly provided for will forthwith cease to be payable to the Holder on such Regular Record Date and may either be paid to the Person in whose name this Security (or one or more Predecessor Securities) is registered at the close of business on a Special Record Date for the payment of such Defaulted Interest to be fixed by the Trustee, notice whereof shall be given to Holders of Securities of this series not less than 10 days prior to such Special Record Date, or be paid at any time in any other lawful manner not inconsistent with the requirements of any securities exchange on which the Securities of this series may be listed, and upon such notice as may be required by such exchange, all as more fully provided in the Indenture.

 

Payment of interest on this Security will be made in immediately available funds at the office or agency of the Company maintained for that purpose in the City of Minneapolis, Minnesota 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; provided, however, that, at the option of the Company, payment of interest may be paid by check mailed to the Person entitled thereto at such Person’s last address as it appears in the Security Register or by wire transfer to such account as may have been designated by such Person.  Payment of principal of and interest 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.  Notwithstanding the foregoing, for so long as this Security is a Global Security registered in the name of the Depositary, payments of principal and interest on this Security will be made to the Depositary by wire transfer of immediately available funds.

 

This Security is
redeemable at the option of the Company, in whole but not in part, on any Optional Redemption Date at a Redemption Price
equal to 100% of the principal amount of this Security to be redeemed, plus any accrued but unpaid interest to, but
excluding, the Redemption Date.  The “Optional Redemption Dates” are quarterly on the 22nd day of
each February, May, August and November, commencing May 22, 2021 and ending August 22, 2022.  Notice of any redemption
will be mailed at least 5 but not more than 30 days before the applicable Redemption Date to the Holder hereof.  Unless
the Company defaults in the payment of the Redemption Price, on or after the Redemption Date, interest will cease to accrue
on this Security or the portion hereof called for redemption.

 

This Security is not subject to repayment at the option of the Holder hereof prior to November 22, 2022.  This Security is not entitled to any sinking fund.

 

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]

 

 

2

 

 

IN WITNESS WHEREOF, the Company has caused this instrument to be duly executed.

 

DATED: 

 

	
 

	
WELLS FARGO & COMPANY

	
 

	
 

	
 

	
 

	
 

	
By:

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
Its:

	
 

 

	
 

	
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

	
 

	
 

	
 

	
 

	
 

 

 

3

 

 

 

[Reverse of Note]

 

WELLS FARGO & COMPANY

 

MEDIUM-TERM NOTE, SERIES T

 

Due Nine Months or More From Date of Issue

 

Notes due November 22, 2022

 

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 February 21, 2017, 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 T, of the Company.  The Securities of this series will 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.

 

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 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.  Any such consent or waiver by the Holder of this Security shall be conclusive and binding upon such Holder 

  

 

4

 

 

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, upon compliance by the Company with certain conditions set forth therein, shall not apply to this Security.  The remaining provisions of Section 401 of the Indenture shall apply to this Security.

 

Authorized Denominations

 

This Security is issuable only in registered form without coupons in denominations of $1,000 or any amount in excess thereof which is an integral multiple of $1,000.

 

Registration of Transfer

 

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

 

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

 

 

5

 

 

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 principal of and interest on this Security 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 principal of or the interest on this Security, or for any claim based hereon, or otherwise in respect hereof, or based on or in respect of the Indenture or any indenture supplemental thereto, against any incorporator, stockholder, officer or director, as such, past, present or future, of the Company or any successor corporation, whether by virtue of any constitution, statute or rule of law, or by the enforcement of any assessment or penalty or otherwise, all such liability being, by the acceptance hereof and as part of the consideration for the issuance hereof, expressly waived and released.

 

Defined Terms

 

All terms used in this Security which are defined in the Indenture shall have the meanings assigned to them in the Indenture unless otherwise defined in this Security.

 

Governing Law

 

This Security shall be governed by and construed in accordance with the law of the State of New York, without regard to principles of conflicts of laws.

 

 

6

 

 

 

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)

 

7

 

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.

 

8

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