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<br />B-1 <br />4846-5351-8811v3/200434-0005 <br />EXHIBIT B <br />FORM OF REQUISITION <br />TO: [Trustee] City of Santa Ana Use Only <br /> Request No. __ <br />DISBURSEMENT REQUEST: REGARDING $__________ CITY OF SANTA ANA TAXABLE <br />PENSION OBLIGATION BONDS, SERIES 2021 <br />You are hereby requested to pay from the Costs of Issuance Fund established by the Trust Agreement <br />with respect to the above-referenced bonds, to the person, corporation or other entity designated <br />below as Payee, the sum set forth below such designation, in payment of all ( ) or a portion ( ) of the <br />Costs of Issuance described below. <br />Name of Payee: <br />Address: <br /> <br />Amount: $____________ <br />Method of Payment: ___________________ <br />Service Provided: <br />The undersigned hereby certifies that: <br />(i) s/he is an Authorized City Representative; <br />(ii) this requisition for payment is in accordance with the terms and provisions of <br />Section 6.01 of the Trust Agreement; <br />(iii) each item to be paid with the requisitioned funds represents either incurred or due and <br />payable Costs of Issuance; <br />(iv) such Costs of Issuance have not been paid from other funds withdrawn from the <br />Costs of Issuance Fund; and <br />(v) to the best of the signatory’s knowledge no Event of Default has occurred and is <br />continuing under the Trust Agreement. <br />Dated: _____________ CITY OF SANTA ANA <br />By: <br />Name: <br />Title: