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EXHIBIT K <br /> Subdivision Participation and Release Form <br /> Governmental Entity: Cco µmm State: -7�* <br /> Authorized Signatory: <br /> Address 1: <br /> Address 2: <br /> City, State,Zip: 5N�n M o—r C. (I -q2 <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 December 9, 2022 ("CVS Settlement"), and acting through the undersigned authorized <br /> official, hereby elects to participate in the CVS Settlement, release all Released Claims against all <br /> Released Entities, and agrees as follows. <br /> 1. The Governmental Entity is aware of and has reviewed the CVS Settlement, understands that all <br /> terms in this Participation and Release Form have the meanings defined therein, and agrees that <br /> by executing this Participation and Release Form, the Governmental Entity elects to participate <br /> in the CVS Settlement and become a Participating Subdivision as provided therein. <br /> 2. The Governmental Entity shall promptly, and in any event no later than 14 days after the <br /> Reference Date and prior to the filing of the Consent Judgment, dismiss with prejudice any <br /> Released Claims that it has filed. With respect to any Released Claims pending in In re <br /> National Prescription Opiate Litigation, MDL No. 2804, the Governmental Entity authorizes <br /> the Plaintiffs' Executive Committee to execute and file on behalf of the Governmental Entity a <br /> Stipulation of Dismissal with Prejudice substantially in the form found at <br /> https://national op i o i d settlement.co in. <br /> 3. The Governmental Entity agrees to the terms of the CVS Settlement pertaining to Participating <br /> Subdivisions as defined therein. <br /> 4. By agreeing to the terms of the CVS Settlement and becoming a Releasor, the Governmental <br /> Entity is entitled to the benefits provided therein, including, if applicable, monetary payments <br /> beginning after the Effective Date. <br /> 5. The Governmental Entity agrees to use any monies it receives through the CVS Settlement <br /> solely for the purposes provided therein. <br /> rol <br /> III W11 <br />