Disclosure Dissemination Agent Agreement (Conduit Quarterly Form) Instructions for Completion 1.

Insert the date of the Disclosure Agreement.

2.

Insert the name of the Obligated Person of the Bonds.

3.

Insert the name of the contact person that the Obligated Person has designated will be responsible for providing disclosure information to DAC.

4.

If there is only one series of bonds covered by the Disclosure Agreement, delete the language in the brackets. If more than one series of bonds is covered by the Disclosure Agreement, include the language inside the brackets.

5.

If there is only one series of bonds covered by the Disclosure Agreement, delete the language in the brackets. If more than one series of bonds is covered by the Disclosure Agreement, include the language inside the brackets. (Also use for 5 in Section 8)

6.

Insert the actual day [month and day] by which the Obligated Person will have to provide the Annual Report required under the Disclosure Agreement.

7.

Insert the ending date of the Obligated Person’s fiscal year that closes after the date of the Disclosure Agreement. (For example, if the Obligated Person’s fiscal year ends June 30 and the date of the Disclosure Agreement is December 15, 2010, then the date entered would be June 30, 2011, or, if the fiscal year ends June 30 and the Disclosure Agreement is dated May 1, 2011, then the date would be June 30, 2011.)

8.

Insert the number of days after the end of each quarter that the Obligated Person will have to provide the Quarterly Report required under the Disclosure Agreement.

9.

Insert the last day of the quarter immediately following the date of the Disclosure Agreement. (For example, if the Obligated Person’s quarters ends on January 31, April 30, July 31 and October 31 and the date of the Disclosure Agreement is December 15, 2010, then the date entered would be January 31, 2011.)

10.

Insert the actual calendar dates by which the Quarterly Report should be filed. (For example, if the Obligated Person’s first filing date is 45 days after the end of a quarter, calculate the 45th day following each successive quarter, e.g., February 14 following December 31, May 15 following March 31, August 14 following June 30 and November 14 following September 30.)

11.

Specifically list every heading in the Official Statement(s) that contain(s) information that will be updated in each Annual Report. If there is more than one Official Statement referenced in the Disclosure Agreement, clearly indicate which sections correspond to each Official Statement.

AM 47331764.2

Revised 4/2015

12.

Indicate the basis of accounting used in the preparation of the audited financial statements. If audited financial statements will NOT be provided as part of the Annual Report, delete the first sentence of this paragraph and indicate the standard of accounting that will be used in preparation of the unaudited financial statements.

13.

Insert the information which is to be provided in the Quarterly Report but which is not set forth in the Official Statement.

14.

Specifically list every heading in the Official Statement(s) that contain(s) information that will be updated in each Quarterly Report. If there is more than one Official Statement referenced in the Disclosure Agreement, clearly indicate which sections correspond to each Official Statement.

AM 47331764.2

Revised 4/2015

Numbers A1-A7 correspond to Exhibit A of the Disclosure Agreement A1. Insert the name of the Issuer of the Bonds. A2. Insert the name of the Obligated Person. A3. Insert the full name of the Bond issue. (If there is more than one series of bonds in an issue, please refer to Number A7 below.) A4. Insert the date on which the Bonds were issued. A5. Insert the date of the Official Statement prepared by the Issuer or Obligated Person in connection with the Bonds listed under Number A3. A6. List the nine-digit CUSIP number(s) of all Bonds in the issue named in Number A3, above. A7. If there is more than one issue of Bonds to be covered by the Disclosure Agreement, fill out this section for each issue according to the directions provided in Numbers A1-A6, above. If there is more than one series of bonds in the same issue, treat each series of bonds as if it were a separate issue and list it accordingly.

AM 47331764.2

Revised 4/2015

Numbers B1-B10 correspond to Exhibit B of the Disclosure Agreement B1. Insert the name of the Issuer of the Bonds. B2. Insert the name of the Obligated Person. For clarification see Number A2, above B3. Insert the full name of the bond issue for which the Obligated Person has failed to file an Annual Report. B4. Insert the date on which the Bonds were issued. B5. Insert the date of the Disclosure Agreement. B6. Insert the Issuer’s six-digit CUSIP Number that applies to all issues of all bonds of the Issuer. B7. Insert the date by which the Disclosure Representative has indicated that the Obligated Person will file its Annual Report (as set forth in Section 2(b) of the Disclosure Agreement). DAC will omit the bracketed language if Section 2(c) is in effect. B8. Insert the current date on which the Notice is being filled out. B9. Insert the name of the contact person that the Issuer has designated will be responsible for providing disclosure information to DAC. B10. Insert the name and title of the contact person that the Obligated Person has designated will be responsible for providing disclosure information to DAC.

AM 47331764.2

Revised 4/2015

Numbers C1-C12 correspond to Exhibit C of the Disclosure Agreement. C1. Insert the name of the Issuer and the name of the Obligated Person. C2. Insert the Issuer’s six-digit CUSIP Number that applies to all issues of all bonds of the Issuer. C3. Insert the nine-digit CUSIP Number(s) for all Bonds to which the Cover Sheet relates. C4. Indicate the number of pages attached to the Cover Sheet. C5. Fill out this section pursuant to Section 2(e)(iv) of the Disclosure Agreement, placing a check next the appropriate number. C6. If a “Failure to File” notice is being sent with respect to an Annual Report, then this box would be checked. CQ6. If a “Failure to File” notice is being sent with respect to a Quarterly Report, then this box would be checked. C7. Insert the name of the DAC Employee who fills out the Cover Sheet. C8. Insert the title of the DAC Employee who fills out the Cover Sheet. C9. Insert date on which the cover sheet and accompanying text is being filed with the MSRB. C10. Insert the date of the Disclosure Agreement pursuant to which the disclosure is voluntarily being sent. C11. Complete this section pursuant to Section 2(e)(vi) of the Disclosure Agreement, placing a check next the appropriate number. C12. Complete this section pursuant to Section 2(e)(vii) of the Disclosure Agreement, placing a check next the appropriate number.

AM 47331764.2

Revised 4/2015

Numbers D1-D10 correspond to Exhibit D of the Disclosure Agreement D1. Insert the name of the Issuer of the Bonds. D2. Insert the name of the Obligated Person. For clarification see Number A2, above D3. Insert the full name of the bond issue for which the Obligated Person has failed to file an Annual Report. D4. Insert the date on which the Bonds were issued. D5. Insert the date of the Disclosure Agreement. D6. Insert the Issuer’s six-digit CUSIP Number that applies to all issues of all bonds of the Issuer. D7. Insert the date by which the Disclosure Representative has indicated that the Obligated Person will file its Quarterly Report (as set forth in Section 2Q(b) of the Disclosure Agreement). DAC will omit the bracketed language if Section 2Q(c) is in effect. D8. Insert the current date on which the Notice is being filled out. D9. Insert the name of the contact person that the Issuer has designated will be responsible for providing disclosure information to DAC. D10. Insert the name and title of the contact person that the Obligated Person has designated will be responsible for providing disclosure information to DAC.

AM 47331764.2

Revised 4/2015