Common use of Check if Exchange is from Restricted Definitive Note to beneficial interest in a Restricted Global Note Clause in Contracts

Check if Exchange is from Restricted Definitive Note to beneficial interest in a Restricted Global Note. In connection with the Exchange of the Owner’s Restricted Definitive Note for a beneficial interest in the [CHECK ONE] ¨ 144A Global Note, ¨ Regulation S Global Note with an equal principal amount, the Owner hereby certifies (i) the beneficial interest is being acquired for the Owner’s own account without transfer and (ii) such Exchange has been effected in compliance with the transfer restrictions applicable to the Restricted Global Notes and pursuant to and in accordance with the Securities Act, and in compliance with any applicable blue sky securities laws of any state of the United States. Upon consummation of the proposed Exchange in accordance with the terms of the Indenture, the beneficial interest issued will be subject to the restrictions on transfer enumerated in the Private Placement Legend printed on the relevant Restricted Global Note and in the Indenture and the Securities Act. This certificate and the statements contained herein are made for your benefit and the benefit of the Company. [Insert Name of Transferor] By: Name: Title: Dated: EXHIBIT D FORM OF CERTIFICATE FROM ACQUIRING INSTITUTIONAL ACCREDITED INVESTOR Acadia Healthcare Company, Inc. 000 Xxxxxxxx Xxxxxx Xxxxx, Xxxxx 000 Xxxxxxxx, Xxxxxxxxx 00000 Attention: Xxxxxxxxxxx Xxxxxx U.S. Bank National Association Global Corporate Trust Services 000 Xxxxxxxx Xxxxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxxxx 00000 Facsimile No.: (000) 000-0000 Attention: Xxxxx Xxxxx, CCTS Re: 6.125% Senior Notes due 2021 Reference is hereby made to the Indenture, dated as of March 12, 2013 (the “Indenture”), among Acadia Healthcare Company, Inc., a Delaware corporation (the “Company”), as issuer, the Guarantors party thereto and U.S. Bank National Association, as trustee. Capitalized terms used but not defined herein shall have the meanings given to them in the Indenture. In connection with our proposed purchase of $ aggregate principal amount of:

Check if Exchange is from Restricted Definitive Note to beneficial interest in a Restricted Global Note. In connection with the Exchange of the Owner’s 's Restricted Definitive Note for a beneficial interest in the [CHECK ONE] ¨ [ ] 144A Global Note, ¨ [ ] Regulation S Global Note with an equal principal amount, the Owner hereby certifies (i) the beneficial interest is being acquired for the Owner’s 's own account without transfer and (ii) such Exchange has been effected in compliance with the transfer restrictions applicable to the Restricted Global Notes and pursuant to and in accordance with the Securities Act, and in compliance with any applicable blue sky securities laws of any state of the United States. Upon consummation of the proposed Exchange in accordance with the terms of the Indenture, the beneficial interest issued will shall be subject to the restrictions on transfer enumerated in the Private Placement Legend printed on the relevant Restricted Global Note and in the Indenture and the Securities Act. This certificate and the statements contained herein are made for your benefit and the benefit of the Company. [Insert Name of Transferor] By: Name: Title: <PAGE> C-2 Dated: <PAGE> C-3 EXHIBIT D FORM OF CERTIFICATE FROM ACQUIRING INSTITUTIONAL ACCREDITED INVESTOR Acadia Healthcare Company, Inc. 000 Xxxxxxxx Xxxxxx XxxxxXxxxxxxxx Technologies Corporation 00000 XX 0xx Xxxxxx, Xxxxx 000 Xxxxxxxx, Xxxxxxxxx Xxxxxxxxxx 00000 Attention: Xxxxxxxxxxx Xxxxxx U.S. Bank National Association Global Corporate Trust Services 000 Xxxxxxxx Xxxxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxxxx 00000 Facsimile No.Facsimile: (000) 000-0000 Attention: Xxxxx Xxxxx, CCTS Xxxxxx X. Xxxxxx CUSIP: ____________ Re: 6.1257.75% Senior Subordinated Notes due 2021 2013 Reference is hereby made to the Indenture, dated as of March 12June 11, 2013 2003 (the “"Indenture”"), among Acadia Healthcare Company, Inc.between Xxxxxxxxx Technologies Corporation, a Delaware corporation (the “"Company”"), as issuer, the Subsidiary Guarantors party thereto and U.S. The Bank National Associationof New York, as trustee. Capitalized terms used but not defined herein shall have the meanings given to them in the Indenture. In connection with our proposed purchase of $ $____________ aggregate principal amount at maturity of:

Check if Exchange is from Restricted Definitive Note to beneficial interest in a Restricted Global Note. In connection with the Exchange of the Owner’s Restricted Definitive Note for a beneficial interest in the [CHECK ONE] ¨ 144A Global Note, ¨ Regulation S Global Note with an equal principal amount, the Owner hereby certifies (i) the beneficial interest is being acquired for the Owner’s own account without transfer and (ii) such Exchange has been effected in compliance with the transfer restrictions applicable to the Restricted Global Notes and pursuant to and in accordance with the Securities Act, and in compliance with any applicable blue sky securities laws of any state of the United States. Upon consummation of the proposed Exchange in accordance with the terms of the Indenture, the beneficial interest issued will shall be subject to the restrictions on transfer enumerated in the Private Placement Legend printed on the relevant Restricted Global Note and in the Indenture and the Securities Act. This certificate and the statements contained herein are made for your benefit and the benefit of the Company. [Insert Name of Transferor] By: Name: Title: Dated: EXHIBIT D FORM OF CERTIFICATE FROM ACQUIRING INSTITUTIONAL ACCREDITED INVESTOR Acadia Healthcare Company, Inc. Xxxxxxxxx Technologies Corporation 000 Xxxxxxxx 000xx Xxxxxx XxxxxXX, Xxxxx 000 0000 Xxxxxxxx, Xxxxxxxxx Xxxxxxxxxx 00000 Attention: Xxxxxxxxxxx Xxxxxx U.S. Bank National Association Global Corporate Trust Services 000 Xxxxxxxx Xxxxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxxxx 00000 Facsimile No.Facsimile: (000) 000-0000 Attention: Xxxxx Xxxxx, CCTS Xxxxxx X. Xxxxxx CUSIP: Re: 6.1257% Senior Notes due 2021 2020 Reference is hereby made to the Indenture, dated as of March 12August 2, 2013 2010 (the “Indenture”), among Acadia Healthcare Company, Inc.between Xxxxxxxxx Technologies Corporation, a Delaware corporation (the “Company”), as issuerthe Subsidiary Guarantors and Xxxxx Fargo Bank, the Guarantors party thereto and U.S. Bank National Association, as trustee. Capitalized terms used but not defined herein shall have the meanings given to them in the Indenture. In connection with our proposed purchase of $ aggregate principal amount at maturity of:

Check if Exchange is from Restricted Definitive Note to beneficial interest in a Restricted Global Note. In connection with the Exchange of the Owner’s Restricted Definitive Note for a beneficial interest in the [CHECK ONE] ¨ 144A Global Note, ¨ Regulation S Global Note with an equal principal amount, the Owner hereby certifies (i1) the beneficial interest is being acquired for the Owner’s own account without transfer and (ii2) such Exchange has been effected in compliance with the transfer restrictions applicable to the Restricted Global Notes and pursuant to and in accordance with the Securities Act, and in compliance with any applicable blue sky securities laws of any state of the United States. Upon consummation of the proposed Exchange in accordance with the terms of the Indenture, the beneficial interest issued will shall be subject to the restrictions on transfer enumerated in the Private Placement Legend printed on the relevant Restricted Global Note and in the Indenture and the Securities Act. This certificate and the statements contained herein are made for your benefit and the benefit of the Company. [Insert Name of Transferor] By: Name: Title: Dated: EXHIBIT D FORM OF CERTIFICATE FROM ACQUIRING INSTITUTIONAL ACCREDITED INVESTOR Acadia Healthcare CompanyXxxxx Xxxxx International, Inc. 000 c/o U.S. Bank Trust National Association as Trustee 00 Xxxxxxxx Xxxxxx 00xx Xxxxx, Xxxxx 000 XxxxxxxxXxxxxxxxx Trust Division Xxx Xxxx, Xxxxxxxxx XX 00000 Attention: Xxxxxxxxxxx Xxxxxx U.S. Bank National Association Global Corporate Trust Services 000 Xxxxxxxx Xxxxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxxxx 00000 Facsimile No.Xxxx CUSIP: (000) 000-0000 Attention: Xxxxx Xxxxx, CCTS Re: 6.1258 7/8% Senior Subordinated Notes due 2021 2013 Reference is hereby made to the Indenture, dated as of March 12September 22, 2013 2003 (the “Indenture”), among Acadia Healthcare Companybetween Xxxxx Xxxxx International, Inc., a Delaware Florida corporation (the “Company”), as issuer, the Subsidiary Guarantors party thereto and U.S. Bank Trust National Association, as trustee. Capitalized terms used but not defined herein shall have the meanings given to them in the Indenture. In connection with our proposed purchase of $ aggregate principal amount at maturity of:

Check if Exchange is from Restricted Definitive Note to beneficial interest in a Restricted Global Note. In connection with the Exchange of the Owner’s Restricted Definitive Note for a beneficial interest in the [CHECK ONE] ¨ G 144A Global Note, ¨ G Regulation S Global Note with an equal principal amount, the Owner hereby certifies (i) the beneficial interest is being acquired for the Owner’s own account without transfer and (ii) such Exchange has been effected in compliance with the transfer restrictions applicable to the Restricted Global Notes and pursuant to and in accordance with the Securities Act, and in compliance with any applicable blue sky securities laws of any state of the United States. Upon consummation of the proposed Exchange in accordance with the terms of the Indenture, the beneficial interest issued will shall be subject to the restrictions on transfer enumerated in the Private Placement Legend printed on the relevant Restricted Global Note and in the Indenture and the Securities Act. This certificate and the statements contained herein are made for your benefit and the benefit of the Company. [Insert Name of Transferor] By: Name: Title: Dated: EXHIBIT D FORM OF CERTIFICATE FROM ACQUIRING INSTITUTIONAL ACCREDITED INVESTOR Acadia Healthcare Company, Inc. 000 Cadmus Communications Corporation 0000 Xxxxxxxx Xxxxxx Xxxxx, Xxxxx 000 Xxxxxxxx, Xxxxxxxxx XX 00000 Attention: Xxxxxxxxxxx Xxxxxx U.S. Bank National Association Global Corporate Trust Services 000 Xxxxxxxx Xxxxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxxxx 00000 Facsimile No.Facsimile: (000) 000-0000 Attention: Xxxx X. Xxxxx Xxxxx, CCTS CUSIP: Re: 6.1258 3/8 % Senior Subordinated Notes due 2021 2014 Reference is hereby made to the Indenture, dated as of March 12June 15, 2013 2004 (the “Indenture”), among Acadia Healthcare Company, Inc.between Cadmus Communications Corporation, a Delaware Virginia corporation (the “Company”), as issuerthe Subsidiary Guarantors and Wachovia Bank, the Guarantors party thereto and U.S. Bank National Association, as trustee. Capitalized terms used but not defined herein shall have the meanings given to them in the Indenture. In connection with our proposed purchase of $ aggregate principal amount at maturity of: