Resale or Exemption Certificate

To: Lazy Rider / 3707 66^th Street / Lubbock, Texas 79413

Business :____________________________________

Address: ____________________________

City: _______________State: _____ Zip: ___________

Purchaser hereby certifies to the Seller that,

1. Purchaser holds a valid Permit No._________________, issued under the limited Sales Excise and Use Tax Act of the State of Texas, which permit has not been revoked or suspended. Other state ________________.

2. That the tangible personal property purchased on each unshipped order heretofore given you and on each order that we shall hereafter give you, unless such order otherwise specified, and until this notice and certification is revoked by us in writing is purchased for: Below, Check whichever is applicable

1. [X ] Resale, leasing or renting

2. [ ] To be incorporated as an ingredient or component part of other tangible personal property to be produced for ultimate sale at retail by manufacturing, processing or fabricating.

3. [ ] Other ground of exemption:

3. The general character of the tangible personal property sold, leased or rented by purchaser in the regular course if business is:

Motorcycle Backrest & Bag combination.

The undersigned purchaser further certifies that he will assume liability for the payment of any tax that may be due under the above described Act if this transaction in not exempt from such tax.

4. Dated: ___________, 19 ____

Signature (Dealer / Agent): _____________________