Date: __________________________


To: ____________________________



1.  On _________,19__, a bulk transfer of the goods of ______________________, of _________________, will be made to ________________, of ___________________.


2.  To the knowledge of the transferor, it has not done business under any other name   during the last three years.


3.  The debts of the transferor may not be paid in full as they fall due as a part of this bulk transfer.


4.  The goods to be transferred in bulk consist of ________________ and are presently located at ________________.


5.  The estimated total of the debts of transferor, is $__________.


6.  The schedule of the transferor's property and the list of his creditors as required by the Uniform Commercial Code in connection with this bulk transfer may be inspected at _________________.


7.  The bulk transfer contemplated is required to pay existing debts.  The existing debts of transferor total and consist of the following:


     Name of Creditor                                                                  Amount


1.  ____________________________________                     ___________________


2.  ____________________________________                     ___________________


3.  ____________________________________                     ___________________


8.  The bulk transfer contemplated is made for a new consideration.  _______________ of _______________ to be paid on __________, at ____________, at ____________.


9.  Creditors are directed to send all bills and claims to the following: