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Form Me - Notice Of Claim Of Exemption From Registration For Certain Municipal Securities Page 3

___ (j)

An issue of bonds of a district issued to the Colorado water resources and power

development authority which evidences a loan from said authority to the district. (If

no Official Statements prepared related to this bond, a copy of the “Governmental

Agency Bond” will suffice.)

___ (k) An issue of bonds by a district that contains territory subject to an

intergovernmental annexation agreement between the City and county of Denver

and Adams County dated April 21, 1988, made pursuant to section 30-6-109.5,

C.R.S.

___ (59-10.3) An issue of bonds by a district issued in denominations of not less than

$500,000 of not less than $1,000 each.

___ (59-10.4.A) An issue of bonds for which the Issuer complied with the requirements of

section 11-59-110(2) and were, at the time of initial issue, exempt from registration

under Rule 59-10.3 or section 11-59-110(1)(g), C.R.S., and which now qualify for

an exemption pursuant to one of the following sections: (Check one)

11-59-110(1) _____(c)*, _____(d), _____(e), _____(f)*, _____(i).

*If the noted applicable qualification under section 11-59-110(1)(c) or (f) is

utilized due to secondary market insurance, provide the following:

CUSIP number(s) ________________________________,

Total size of the bonds affected ______________________.

___ (59-10.4.B) An issue of general obligation bonds for which the Issuer complied with the

requirement of section 11-59-110(2) and were, at the time of initial issue, exempt

from registration under Rule 59-10.3 or section 11-59-110(1)(g), C.R.S. and

subsequently, where the total obligation represented by the issue together with any

other general obligations of the district does not exceed the greater of two million

dollars or fifty percent of the valuation for assessment of the taxable property in the

district as certified by the assessor.

_________________________________

______________________

_____

___

District Name

Signature

__________

___________________________

_______________________

Type Name and Title

Date

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FORM ME (Rev 7/06)

Form Me - Notice Of Claim Of Exemption From Registration For Certain Municipal Securities Page 3