California State Board of Pharmacy Fax (916) 574-8618 DEPARTMENT OF CONSUMER AFFAIRS CERTIFICATE FOR DRAWING Name of Financial Institution (ISSUER): Address: City, State, Zip: Name of Applicant/Licensee: Address: City, State, Zip: IRREVOCABLE STANDBY LETTER OF CREDIT NO. Beneficiary: California State Board of Pharmacy The undersigned, a duly Authorized Representative of the California State Board of Pharmacy (Board) (as defined in the above referenced CREDIT), hereby certifies to the ISSUER that: 1.An Event of Default has occurred as defined in section 4 of the Agreement.2.The undersigned is authorized under the terms of the above-referenced CREDIT to present thisCERTIFICATE as the sole means of demanding payment on the CREDIT.3.The Board is therefore making a drawing under the above-referenced CREDIT in the amount of$.4.The amount demanded does not exceed the Principal Sum.5.Sums received shall be used by the Board in accordance with the terms of the Agreement.THEREFORE, the undersigned has executed and delivered this CERTIFICATE as of the day of , 20. CALIFORNIA STATE BOARD OF PHARMACYByVIRGINIA K. HEROLDExecutiveOfficer American LegalNet, Inc. www.FormsWorkFlow.com