I, __________________________  do hereby specifically state and affirm that the item or items listed

below have not been excavated, purchased, traded, or sold in violation of:

(1) Federal Antiquities Act of 1906

(2) Archaeological Resource Protection Act - 1979

(Indian Reservations, Bureau of Land Management, National Forest Land, National Parks, etc.)

(3) Native American Graves Protection and Repatriation Act of 1990

(4) State Archaeological Resource Protection Acts (to include all state lands)

(5) State imposed regulations to archaeological excavations on private deeded property,

and further that the seller of the below described property and items has legal title to the property

and items listed, such that, legal title transfers to and vests in the ulimate purchaser of the items and property listed.

DESCRIPTION OF PROPERTY AND ITEMS:

(Culture, Description, Condition (restoration, paint enhancement, if any), Location, General Comments)

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The above described article(s) are authentic and as described.

Seller: ____________________________________________________  Date: _____________