TAX EXEMPT AFFIDAVIT

The undersigned declares, UNDER PENALTY OF PERJURY, that the otherwise taxable purchase of services, purchased without payment of taxes from

PONDEROSA LODGE, INC.

is to be paid, or has been paid, from the funds of below named tax exempt organization and that said organization has not, nor will not receive any reimbursement through direct payment, collection, or "donation" from any person or persons for the services of PONDEROSA LODGE, INC., and further, that the services so purchased were used in furtherance of the exempt purposes of said tax exempt organization on the

___________days of ________________, 2002.

_________________________________

Name of tax exempt organization

Tax exempt number (see note below): ___________________________

_______________________________________________________________

Signature and title of representative of tax exempt organization

__________________

date

Note: If your state does not issue numbers or you are not required to secure an exemption number from your state please indicate on the line above for tax exempt number. Please attach a copy of the document your state issued as evidence of your tax exempt status.

In the above text, the word "donation" is used in a special way to indicate any sham donation which amounts to a payment for the services. Donation, in this context does not mean regular donations made to organizations unless such donation is expected, or made as a form of payment for tax exempt services.