California Antique Slots, Inc. – (805) 583-0785 (805) 404-9160

www.california-antique-slots.com

California Antique Slots, Inc.

Purchase Agreement (Page 1 of 7)

Sold To: ______

______

______

Identification Used:

California Driver’s License:______

(or California ID card) ______

______

Other Photo Identification:

______

______

______

Description of Machine:

______

______

Model Number:______

Serial Number:______

California Antique Slots, Inc.

Purchase Agreement (Page 2 of 7)

To the buyer: your private information listed in this Purchase Agreement will NEVER be shared with anyone beyond the company of California Antique Slots unless this information is required by State or Federal Law.

______Keep this and other records of the sale

of your slot machine. When (if) you

decide to sell your slot machine, this information must accompany it.

______Please refer to the attached sheet(s)

showing the status of slot machine ownership in the United States.

______You may NOT bring your machine into a

state that has PROHIBITED such machines.


California Antique Slots, Inc.

Purchase Agreement (page 3 of 7)

The use and transportation of gaming device(s) which you, as the Purchaser, are buying from California Antique Slots, is/are subject to Federal and State laws, which are applicable to, among other things, the following:

______The transportation of gaming devices in

interstate commerce;

______The private and/or public use of said

gaming device(s);

______The laws of the State of California and

all other applicable State and Federal

Laws.

______The Purchaser is hereby placed on notice

that such laws exist and that the Purchaser should consult these laws or competent legal counsel before: any use, repair, sale and/or transportation of said gaming device(s).

______This sale is made upon the condition that

you, the Purchaser, will not ILLEGALLY use, operate, transfer or transport the gaming device(s), and upon Purchaser’s representation of the following:

______That the Purchaser is 21 (twenty one)

years of age or older;

California Antique Slots, Inc.

Purchase Agreement (Page 4 of 7)

______That the gaming device(s) sold to

Purchaser is/are for private use only, and will NOT be made available for play by the general public;

______That the gaming device(s) is/are sold to

the Purchaser with a 90 (ninety) day (parts/labor) warranty from California Antique Slots, and that all repairs are done at Purchaser’s residence where the slot machine will be/is located.

______That the Purchaser has no intention of

moving said gaming device(s) into any State or Country wherein such device(s) is/are not legal.

I,______, certify that the product(s) purchased will be shipped directly to the following address:

______

______

wherein such product(s) is/are legal.

California Antique Slots, Inc.

Purchase Agreement (Page 5 of 7)

I understand that I am responsible for the shipment of this/these product(s), as identified above. I agree to indemnify and hold harmless California Antique Slots, from any liability it may have with respect to the shipment and/or sale of this/these machine(s).

I declare under penalty of perjury that the foregoing is true and correct.

Executed this ______day of ______, 200____, at

______, California.

______

(Signature of Purchaser)

______

(Printed Name of Purchaser)


California Antique Slots, Inc.

Purchase Agreement (Page 6 of 7)

Price of machine: $______

Plus California State Sales Tax: (%) ______

$______

Plus Shipping $______

Total Cost: $______

Form of payment: CASH or (CASHIER’S CHECK payable to)

California Antique Slots

Amount of CASH or CASHIER’S CHECK:

$______

I acknowledge receipt of the cashier’s check for the above amount.

Thomas R. Baker ______

California Antique Slots (signature)

______

(date)

California Antique Slots, Inc.

Purchase Agreement (Page 7 of 7)

All slot machines sold by California Antique Slots are unique (one-of-a-kind) collectibles. Hence, there are no refunds, exchanges or returns. All sales are final.

Please note that since these machines are collectibles, parts may be difficult to find and/or acquire. These machines are designed to run 24/7 in a casino environment. Any machine you purchase from California Antique Slots will give you many reliable years in your game/rec room. If you have any questions, we are just a phone call away!

Thank you for purchasing from California Antique Slots!