Date______

AUTOMATIC KNIFE RELEASE FORM You must read and fill out this form completely before Kai USA, Ltd. can sell to you, or ship to you, any Automatic Knives. Please mail or fax a signed copy of this form to us, stating that you are a dealer or other legal entity in compliance with the federal statutes shown below.

APPLICABLE FEDERAL STATUTES

18 U.S.C. § 1716 (G) (2) (1-4) provides, in summary: Switchblade (automatic) knives can be shipped to civilian and armed forces supply or procurement officers and employees of the federal government ordering or procuring or purchasing such knives in connection with activities of the Federal government; to supply or procurement officers in the National Guard, the Air National Guard or militia of the state or territory of the District of Columbia ordering, procuring or purchasing such knives in connections with the activities of such organizations; to supply or procurement officers or employees of the municipal government of the District of Columbia or the government of any state or territory of any county, city or other political subdivision of a state or territory ordering, procuring or purchasing such knives in connection with the activities of such government.

15 U.S.C. § 1244 provides, in summary: Knives can be shipped by common carrier; that sale, transportation or distribution, possession or introduction into interstate commerce of switchblade knives is authorized if it is pursuant to a contract with the armed forces; or, any member or employee thereof acting in the performance of his or her duty may possess switchblade knives and may have them shipped to him and sold to him or her. The possession and transportation upon his or her person of a switchblade knife or a blade 3 inches or less is authorized to any handicapped individual who has the use of only one arm.

STATE LAW PROVISIONS It would be impossible to provide an exhaustive review of the laws that may apply in the various fifty states and in the various counties, parishes, municipalities, and other political subdivisions within each state. By signing this form below, you will be certifying that in addition to complying with federal law, you have determined which, if any, state or local laws apply to you, and that you are acting in compliance with those laws.

ACKNOWLEDGEMENTS AND REPRESENTATIONS I/we ______have read code sections 18 U.S.C. § 1716 (G) (2) (1-4 ) and 15 U. S.C. § 1244, as stated above , or have obtained legal advice concerning the same, and will fully comply, and agree that I/we will not sell knives to the general public, but will sell only to those qualified under these laws to receive same. Moreover, I/we have familiarized myself/ourselves with any state and/or local laws that might apply to me/us, and will fully comply, and agree that I/we will not sell knives to the general public, but will sell only to those qualified under these laws to receive same.

Company Name______Address______City______State______Zip Code______Signature______

18600 SW Teton Avenue • Tualatin, OR 97062 • PHONE: 503.682.1966 • TOLL FREE: 800.325.2891 • FAX: 503.682.7168 • www.kaiusaltd.com