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3 <br /> Settlement Participation Form <br /> Governmental Entity: State:North Carolina <br /> Authorized Signatory: <br /> Address 1: <br /> Address 2: <br /> City, State,Zip: <br /> Phone: <br /> Email: <br /> The governmental entity identified above ("Governmental Entity"),in order to obtain and in <br /> consideration for the benefits provided to the Governmental Entity pursuant to the Settlement <br /> Agreement dated July 21, 2021 ("Distributor Settlement"), and acting through the <br /> undersigned authorized official,hereby elects to participate in the Distributor Settlement, <br /> release all Released Claims against all Released Entities, and agrees as follows. <br /> 1. The Governmental Entity is aware of and has reviewed the Distributor Settlement, <br /> understands that all terms in this Election and Release have the meanings definedtherein, <br /> and agrees that by this Election,the Governmental Entity elects to participate in the <br /> Distributor Settlement and become a Participating Subdivision as provided therein. <br /> 2. The Governmental Entity shall,within 14 days of the Reference Date and prior to the <br /> filing of the Consent Judgment, dismiss with prejudice any Released Claims that it has <br /> filed. <br /> 3. The Governmental Entity agrees to the terms of the.Distributor Settlement <br /> pertaining to Subdivisions as defined therein. <br /> 4. By agreeing to the terms of the Distributor Settlement and becoming a Releasor,the <br /> Governmental Entity is entitled to the benefits provided therein, including, if applicable, <br /> monetary payments beginning after the Effective Date. <br /> 5. The Governmental Entity agrees to use any monies it receives through the <br /> Distributor Settlement solely for the purposes provided therein. <br /> 6. The Governmental Entity submits to the jurisdiction of the court in the Governmental <br /> Entity's state where the Consent Judgment is filed for purposes limited to that court's role <br /> as provided in, and for resolving disputes to the extent provided in,the Distributor <br /> Settlement. <br /> 7. The Governmental Entity has the right to enforce the Distributor Settlement as <br /> provided therein. <br />