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<br />F-3 <br /> <br />12. Nothing herein is intended to modify in any way the terms of the Distributors <br />Washington Settlement, to which Governmental Entity hereby agrees. To the extent this <br />Participation Form is worded differently from Exhibit F to the Distributors Washington <br />Settlement or interpreted differently from the Distributors Washington Settlement in any <br />respect, the Distributors Washington Settlement controls. <br /> <br />I have all necessary power and authorization to execute this Participation Form on behalf of the <br />Governmental Entity. <br /> <br /> <br /> <br />Signature: _____________________________ <br /> <br />Name: ________________________________ <br /> <br />Title: _________________________________ <br /> <br />Date: _________________________________ <br /> <br />