Congratulations on you purchase of your new Husky industrial bicycle.
You have purchased a bicycle that has many features and qualities.
Please take a few minutes and r ead through this manual before you ri de
your bicycle for the first time. Learning about this product and safe riding
and maintenance wi ll return many years of enjoyment and useful life.
Throughout this manual, there are several important safety notes, which
we recommend you read very carefully. Riding a bicycle is a sport, and
like many sports, it involves taking the risk of injury and damage. Since
most injuries result from unsafe riding or lack of proper maintenance, t his
manual focuses on helping you learn about safe riding and how to keep
your bicycle in good riding condition.
This bicycle is designed for business and commercial use. The
performance and life of this product var y based on usage, riding surface
condition, environment, and carryi ng load weight. Proper maintenance,
regular inspection and r eplacement of worn-out components will not only
enhance the usef ul life and performance, but also will enhance the safety
to rider.
Cycling can be a hazardous act ivity.
You are responsib le for safe riding and
proper maintenance of your bicycle.
Failure to observe the safety rules and
warnings throughout this manual may
result in property damage, personal
injury or death.
ARNING!
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SPECIFICATIONS
Model HD-105, HD-105L, HD-120
Frame Size HD-105L (16”), HD-105/120 (19”)
Wheel Size 26 x 2.125”
Minimum Height 37” Ground to Saddle Top
Maxi mu m H e ig ht 45” “ “
Length 68”
Width 26”
Frame Hi Tensile Steel
Fork Steel tubin g with ca st steel crown
Rims Aluminum or steel 26” x 36-spoke
Spokes HD-105: 12-gauge UCP
Whether you use your bicycle for business or pleasure riding, your safety
should always be your #1 concern. Here are some of the general
common sense rules you should observe:
ALWAYS WEAR A SAFETY HELMET - In a work place, we recom mend
wearing a helmet or hard hat while riding your bicycle. Make sure your
helmet meets or exceeds ANSI and Snell safety standar ds. Look for
standard certification label inside the helmet. RIDI NG WITHOUT A
HELMET MAY RESULT IN SERIOUS INJURY IN THE EVENT OF AN
ACCIDENT.
KNOW ALL THE COMPONENTS OF THE BICYCLE AND THEIR
FUNCTION - In the next section of this manual, we have listed all the
components and thei r funct io ns. Read this secti o n and fam iliarize
yourself wi th th ese parts.
LEARN BIKE RIDING THOROUGHLY BEFORE RIDING ON A PUBLIC
ROAD OR STREET - Riding a bicycle requires balancing and
coordination skills. You need t o learn the basic concept of riding and
familiarize yourself with special handling and riding techniques that are
unique to this type of bicycle. Due to weight and size of these models,
the condi t ion of t he surface on which you ride yo ur bicycle aff ects the
performance of your bicycle. You must learn to handle the bicycle in
different surface conditions. Try riding the bicycle in low speed, steering
the handlebar and experiencing the performance in different maneuvers.
FAMILIARIZE YOURSELF WITH LOCAL AND STATE LAWS AND
ORDINANCES - If you plan to ride your bicycle on the streets or public
trails or bike rout es, you must learn about the laws regulating bicycle
riding as well as minimum safety equipment required. Most states and
cities require the use of hand si gnals by all bicycle riders. Learn these
signals and use t hem every time you are riding on a road or street.
ALWAYS RIDE SINGLE FILE ON A ROAD OR STREET.
If you plan to use bicycl e in a work p lace wh ere oth er work ers and
vehicles are present, we recommend you insta l l safet y devic es such as
horn, light, bell, mirror, and safety flag. Depending on the situation, you
may need one or more of these safety devices so that you can alert
others of your pr esence. Please c ontac t your H U SKY dealer if y ou need
more information on safety accessories.
CHECK YOUR BICYCLE BEFORE YOU RIDE to make sure it is in good
working condition. Check the air pressu re , ride the bike for a few minute s
and check the br akes and other safety equipment.
NEVER USE HEADPHONES OR DEVICES THAT MAY IMPAIR YOUR
HEARING ABILITY WHILE RIDING A BIKE - In many states it is illegal to
use headphones while riding a bi cycle.
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SAFE RIDING AT NIGHT
We do not recommend riding your bicycle at night. If you have to ride at
night, please follow these rules:
LIGHTS - You should equip your bicycle with a high quality bicycle head
light for the front, usually mounted on the handle bar, and a blinking red
light mounted on the rear, normally below the saddl e.
REFLECTORS - Yo ur bicycle is equipp ed with a s et of ref lectors,
mounted on the f r ont and rear as well as on the wheel spokes. Your
bicycle should r eflect light from all dir ections. Make sure your refl ectors
are clean and mounted correctly. Please r efer to Standard Parts and
Component section of this Manual for more information about the
reflectors. Your bicycle also comes with reflector-mounted pedals.
REFLECTIVE GEAR - We recommend you use additional reflective gear
such as reflective safety vest, reflective helmet, or safety flag. Always
wear light color appar el when riding at night.
Remember, the objective is to see and be seen at distance when riding at
night.
SAFETY FLAGS - Safety flags are excellent for riding in high traffic
areas. Mounted on the rear axl e and extending about 6 f eet above the
ground, they allow others to spot a rider from far distance. Safety flags
are available at your HUSKY dealers.
SAFE RIDING IN WET CONDITIONS
You never know when you may get caught in a rainstorm or an afternoon
summer shower. If you ride your bicycle in your work place, you may run
into wet or slippery spots from time to time. Here are a few tips to help
make riding in wet or slick condition saf er:
RIDE SLOWER - Your brakes performance is great ly reduced in wet
conditions. Lower speed hel ps you control the bike if you have to make a
sudden brake. If you live in an area where there is fr equent rain or
showers, you m ay want to consult with your bicycle dealer about usi ng
tires more suitable for wet conditions.
SPECIAL NOTE ON REAR COASTER BRAKE - Your bicycle is
equipped with a rear coaster brake (foot brake). It is important that you
minimize the chances of your foot slipping off the pedal when braking. Do
not ride in standing position in wet condition. Wearing shoes with nonslip rubber soles or use of non-slip pedals is highly recom m ended for
areas with high rate of precipitation.
ENHANCE YOUR HANDLEBAR GRIP - The handlebar is the pr im ary
control component of your bicycle and you m ust be sure you have a firm
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grip of the handlebar in all conditions. Using gl oves when riding your bike
helps minimize loss of grip in wet conditions.
FENDERS - HUSKY offers fenders as standard equipm ent for most of its
products. Fenders protect the rider from water and mud splashes.
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SAFE RIDING ON STREETS
LEARN ABOUT YOUR STATE AND LOCAL BICYCLING LAWS - You
should obtain a copy of your local and state bicycling laws. Many bike
shops have a copy of the laws. You can also obtain a copy at your
nearest highway patrol office or your area cycling club. Lear n these laws
thoroughly; they can save you life.
DO NOT RIDE AGAINST TRAFFIC - Stay as far right as possible and
allow room for cars to pass you as easily as possible. Try avoiding twolane roads with narrow shoulder or highways with high traffic.
RIDE DEFENSSIVELY - Always give right of way to autos, and never get
int o a cont est with an aut omobil e driver. Be on th e look ou t for cars
coming into the road from drivew ays, p arking lots, or side streets. Make
an ey e cont act with the dri ver to make sur e he/she can see you.
WATCH FOR PEDESTRIANS - Use your hor n or bell to make sure
pedestrians can hear you are coming or passing from behind.
WATCH OUT FOR ROAD HAZARDS - One of the most common road
hazards are pot hol es, cracks in the asphalt or concrete pavement
railroad tracks, and objects such as rocks, wires, tree l imbs, or sand and
loose gravel. Any one of these hazards can cause you to lose control. If
necessary, dismount and walk your bike over or around the hazard. Do
not ride on railroad tracks.
BE CAREFUL AROUND PARKED CARS - When approaching parked
cars, be on t he look out for p eople gettin g in or out of parked cars. Allo w
a safe distance between your bike and parked cars with passengers to
avoid possible collision with open door s.
OBEY ALL TRAFFIC SIGNS - Stop at stop signs, red lights, and yield
signs. Use hand signals when turning or stopping.
DO NOT HITCH A RIDE ON A BIKE - Never hold on to another vehicle in
order to hitch a ride.
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Cargo Carrying Recommendations
CARRYING CARGO - Your Husky bicycle is desi gned to carry light
cargo. Weight distribution of cargo is very important.
cargo too high. Whether you use a basket, or carrier rack, make sure that
the weight is not hampering your control of t he bike. Spread the l oad
evenly in the car go area and secure all loose parts or boxes. Basket
liners help keep small parts and objects from falling through the basket .
Your HUSKY dealer can assist you in choosing a basket liner to fit your
basket.
Do not attempt to jump a curb or a speed bump. Riding on uneven
surface or jumping curb may damage the frame or fork, especially when
your bicycle is l oaded.
Avoid roads or ramps with steep downhill.
When riding down a ramp or hill, exercise
extreme caution and slow down, using your
foot brake.
Avoid sharp turns at high speeds.
ARNING!
Do not stack
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CAUTION ABOUT BICYCLE ASSEMBLY
Your bicycle is shi pped from factory 60% assembled. For your safety, we
recommend that you purchase t his product fully assembled. The price
you pay for this bicycle may include assembly. Most authorized Husky
dealer can perform full assembly and initial adjustments free of charge. If
there are no authori zed Husky dealers in your area, any bicycle mechanic
can perform the i nstallation for a small charge. Almost all dealers provide
free follow up adj ustments after you have used your bicycle for a few
week s. Take advantage of t heir services and expertise.
Along with this m anual, you will find an A SSEMBLY GUIDE. This guide
is prepared for experienced mechanics to assist them through the
ass embly process. The guide ass umes that the person performing the
assembly has the basic knowledge of bicycle assem bly and adjustments.
FRAME AND FORK
Your HUSKY bicycle is cl assified as an “adult bicycle”, suitable f or riding
on paved or hard packed dirt surfaces. Because of the special design of
the frame and fork, this product off ers maximum comfort at lower speed.
The frame and fork is not designed for racing, jumping, riding over rough
terrain, or climbing steep hills. Heavy use of the bike in highly cor r osive
environments such as coastal areas, chemical plants, r ef ineri es, etc.
requires frequent ins pection of the f rame for signs of corrosion, fatigue,
dents, bends, or cracks. If you see any such signs, have your dealer
inspect these com ponents immediately and stop riding the bicycle until
the dealer can verify that it is s a fe to ride.
HANDLEBAR AND HANDLEBAR STEM
The handlebar is designed so that you can enj oy riding your bicycle
without having to bend or lean forward, thus reducing pressure on back
and neck muscles. The position of the handlebar can be adjusted to raise
or lower the grip for max imum comfort.
The handlebar is one of the most important components of your bicycle.
A damaged handlebar can affect your control of the bicycle. You should
inspect the bar for any sign of fatigue, rust, crack or dents.
The handlebar must be securely at t ached to the handlebar stem. The
stem is attached to the fork steer tube by a stem wedge bolt. To adjust
the height of the handlebar, loosen the wedge bol t by turning the center
bolt using a 6mm Allen or a 13mm box wrench about 3 or 4 turns. Using
a rubber mallet, tap the loosened bolt down to release the wedge from the
steer tube. You can now raise or lower the stem to t he desired height.
CAUSION: Never raise the stem beyond the maximum level
(i nsertion mar k) stamped on th e stem.
The stem is clamped to the handlebar, with a stem binder bolt. The bolt
must be tight enough to avoid twisting of the bar . You can adjust the
angle of the handlebar by l oosening the binder bolt, twisting the bar to the
desired angle.
HEADSET
The headset is a very important part of the st eering mechanism of your
bicycle. It distributes weight to the fork and frame evenly and allows the
fork to pivot inside the frame’s head tube f r eely and with minimum friction.
A typical headset consists of two sets of ball bearings, two bearing cups
attached to each end of the frame’s head tube, bear ing cones - one
stationary and the other an adjusting cone, a key washer, and a lock nut.
Take the following steps to make sure the headset is operating correctly:
1. Hold the handlebar tightly and in straight pos ition. Rock the bike
side-to-side, and forward and backward and check f or any rattling or
sounds coming from the bearings. If you hear rattling or observe
loose bearings, AVOID RIDING THE BIKE, until a bicycle technician
can make the proper adjustments using speci al headset tools.
2. If the steering mechanism is too tight or you feel resistance when
making turns, the headset may be too tight or the bearings are worn
out or need lubrication.
Special headset wrench is needed to adjust the headset. Cont act your
HUSKY dealer for more informatio n on the right size wrench for your
headset.
SADDLE AND SEAT POST
The saddle is attached to the seat post with a seat clamp. The cl amp’s
binder bolt must be tight in order to prevent any movement of saddle while
riding. The clamp’s mechanism allows for the saddl e position to be
adjusted. Once you adjust the saddle’s nose position for your maximum
riding comfort, you should not need further adjustments.
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The saddle’s height can be adjusted by loosening the seat post binder
bolt located on the frame’s seat tube. To adj ust the saddle height, twist
and pull the seat post up to the desired point and tighten the binder bolt,
making sure that the saddle’s nose is straight.
CAUSION: Do not raise the seat post above the maximum height
stamped on the seat post. If the maximum height is not m ar ked or
not visible, make sure t hat at least 2-1/2” of the post remains inside
the seat tube. Failure to observe t he maximum height may result in
serious injury, death, or damage to the bike.
WHEELS, TIRES & TUBES
It is important to check the condition of your wheels and tires frequently.
About 70% of the overall perform ance of the bike depends on the
condition of the wheels and tires.
Inspect the wheels for visible signs of corro sion, dents, broken spokes,
loose spokes, and wobbling. If a wheel wobbles during a ride or has gone
out of round, you may need to “true” or replace the wheel. Truing a wheel
is a complicated procedure and is best performed by experienced bicycle
technicians. If you observe a loose spoke, you can tighten it by using a
spo ke nipp le wren ch. Spoke wrenches ar e available in different s izes an d
types. The size of the wrench depends on the gauge of the spoke. You
can buy spokes from bicycle shops. Wheel axles may also become
loose over t ime. Make sure t hat the axle nuts binding the wheel to the
fork are tight. Al so check for any movement of axle inside the hub body.
Axle bearings may need replacement or bearing cones may need
adjustment.
Components of front hub axle (bearings not shown)
Check your tires by observing any cuts, cracks on the side wall, air
pressure, and amount of wear on the thread. A worn-out tire is not safe
for riding and is m ore vulnerable to road hazards.
To p r olong t he life o f the tires, keep the ti re inflated with at least 25 PSI of
air when the bike is being stored or not used. It is best to keep the tires
off the ground in storage. If t ires are left flat on the floor, the wei ght of the
bike will press th e ti re and tube and will cause cracks on the tire’s
sidewall.
To inflate the tire, read the recomm ended pressure on the sidewall
not exceed the level indicated. Use a hand or foot pump suitable for
bicycles. CAUSION: Do not use a high-pressure air compressor
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and do
normally found at auto service stations as the high pressure may
cause a blow out.
Check the tire pressure using a pressure gauge specifically made for
bicycles. Automotive pressure gauges may not be suitable for bicycles.
When airing the t ire, stop and make sure that the tire bead is properly
seated in the rim. If any part of the tire is not seated well, let some ai r out,
squeeze the sidewall while pressing the tire into the rim.
PEDALS
Your bicycle is equi pped with a set of pedal s. Pedals should spin freely
around the center spindle, which is attached to the cr ank arms. If pedals
fail to spin or the spindle is not tightly attached to the crank arm, do not
ride the bike until the pedal is secured to the crank arm.
CRANK SET AND BOTTOM BRACKET
The crank set and bottom bracket is the main driving compon ent of the
bicycle. To check the crank f or condition, have someone li ft the rear end
of the bicycle. You should be able to crank the bike and spin the rear
wheel with one hand. If you are not able to crank using one hand or you
feel too much resi stanc e, or if the crank w obbles inside t he bottom
bracket, you may have a component
failure in your drive system. Have
the bicycle inspect ed at a bike shop.
CAUSION: Keep your hands and
fingers away from the spinning
wheel, the moving chain, or the
sprockets at all times to prevent
injury.
CHAIN AND CHAIN GUARD
The chain is the li nk between your crank set and the rear wheel. When
riding your bicycle, the chain is under constant pressure and tension. I f
the chain i s too loose, it may jump off the sprocket and br eak the link
between the crank set and rear wheel. If the chain is too tight, it may
warp the crank set, or come apart. A broken chai n can become tangled
in the rear wheel and cause damage to the bike or serious injury. Have a
technician inspect the chain regul arly.
The chain guard protects your legs and clothes from con tact with moving
chain and sprocket. If the chain rubs against the chain guar d or you hear
rattling, you can adj ust the position by loosening the anchor bolts or
slightly bending the chain guard.
COASTER BRAKE
Your bicycle is equipped with a foot operated coast er brake. Coaster
brakes provide saf e braking by using reverse force of the legs. Maximum
braking power is achieved in the 3 and 9 o’clock pedal positions. Coaster
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brakes are maintenance free and need no adjustment. If you have
difficulty braking or using your coaster brake, take your bi ke to a bike
dealer for inspection. The coaster brake ar m is attached to the fr ame with
a bolt and nut. For the coaster brake to perform, the arm must be
secured tightly at all times. INSPECT THE COASTER BRAKE ARM
ATTACHMENT REGULARLY FOR TIGHTNESS OF THE BO LT AND
NUT.
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BASIC MAINTENANCE
You have made a wise decision on purchasing a HUSKY bicycle. To
make sure that it stays in good condition for many years of service and
ri ding pleasur e, we suggest the foll owing:
CLEANING AND LUBRICATION
Keeping your bicycl e clean not only enhances the appearance of your
bike, but also helps maintain the performance of vital components. The
following is the recommended procedure for cleaning your bike:
1. Do not wipe off dry dirt or mud as it can scratch the painted surface .
First wet your bike thoroughly with clean water, and then wipe off dirt
with a sponge or cloth.
2. Remove loose dirt on the gears, chain, hubs and wheels.
3. W ipe off wet parts with a clean dry cloth.
4. Excess grease or gum deposits on chain and sprockets can be
cleaned using chain cleaning fluids and degreasers available at your
Husky dealer.
All moving component s of the bike require lubrication. Certain
components such as headset, bottom bracket, and hub bearings
should be taken apart by an experienced bicycle technician and
lubricated with special bearing grease. Oil or other lubricants for
such parts should not be used.
You can lub r icate the chain usi ng speci al chain lubricants available at
your authorized HUSKY dealer. Refer to the lubricant manufacturer’s
instructions for proper application.
SCHEDULED MAINTENANCE
If you a do-it-yourselfer, possess t echnical skills, and have the proper
tools for repair or maintenance of your bike, you can perfo r m most bas ic
routine maintenance such as lubrication, tire/tube maintenance, adjusting
chain tension, and t ightening loose nuts and bol ts. We do recom mend
that you take your bicycle to an authorized HUSKY dealer for all major
adjustments, wheel ali gnm ent and truing, component replacement, tire
repair or replacement.
If you ride your bicycle for more than 20 hours a month, we recommend
that you follow a r egular inspection and maintenance schedule. Consult
with your authorized HUSKY dealer for a maintenance schedule that fit
your riding style and time.
FIXING A FLAT TIRE
There will be a time when you need to fix a flat tire. You can either take
the bike to a bicycle shop o r f ix the flat yourself . You can fix a flat
fol lowing these simpl e steps:
TOOLS NEEDED: 2 tire levers, one frame mounted bicycle pump, axle
nut wrench, a rag or cloth, and a tube patch kit.
1. Remove th e w heel with a flat tire. If you a re removing th e front
wheel, you will need to disconnect the front brake cable and brake
arm fro m th e fork.
2. Open the valve and squeeze the remaining air out of the tube. To
open the valve, using a small scr ew driver or tip of a tire lever, press
on the valv e pin.
3. Loosen the tire bead from the rime by squeezing t he flat tire and
pushing it inward. Repeat this all around the tire, making sure that
the bead is loose.
4. Pry one side of the tire bead up over the edge and insert the tire lever
under the bead by about 1/4”. DO NO T USE ANY LEVERS WITH SHARP POINTS SUCH AS A SCREW DRIVER OR A KNIFE.
5. Pull the tube from under the tire, leaving the tire on the rim.
If you are on the ro ad with a flat ti re, we recomm end you carry a
spare tube with you. It is much more convenient. You can patch the
flat tube later when you get back home and keep it for later use.
6. Follow patch kit’s instructions for patching the leak. Inflate the tube
before putting the tube back to check for any other leaks. If no other
leaks are found, deflate the tube. Dismount the tire from th e r im.
Rub your hand around the inside of the tire to find the cause. Check
the rim for any damage or sharp objects. Wipe the rim and inside the
tire clean.
7. Work one side of the tire over the edge of t he rim. The other side
should hang out. Inflate the tube slightly to form a round shape.
Start working the t ube under the tire by fi rst inserting the valve into
the valve h ole.
8. W hen the tube is mounted over the rim and under one side of the tire,
try pushing the other side of tire bead over the edge of the rim. Once
you reach the last 2 inches use the palm of your hand t o slide the rest
of the tire over the rim. Try not using the tire lever at this time as the
lever can pinch t he tube and cause a puncture. Most tires can be
mounted on the rim without the use of a tool.
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9. Check the bead of the tire and make sure you do not see any part of
the tube left out or pinched under. The bead must be seated wi t hin
the wall of the rim.
10. Inflate the tire by pum pi ng 4 or 5 strokes. Check the tire seating and
make sure the bead is not hanging out of t he edge of the rim.
11. You can now inflat e the tire to th e proper pressure indicated on the
sidewall. If you do not have a pressure gauge, inflate until you
cannot press the tir e in more than 1/8”.
12. Screw the valve cap on the valve and install the wheel back on the
bike. When instal ling t he front wheel , make su re that the wheel is
centered on the f ork as you tighten the axle nuts.
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HUSKY LIMITED WARRANTY
Husky models HD-105, HD-105L, and HD-120 are warranted to be free
from defects in materials and workmanship with the following l imitation:
TIME PERIOD
This warranty covers defective parts, materials, and labor for a period of
one year from the date of original ret ail purchase. Proof of original retail
purchase from an aut horized HUSKY dealer is required on all
warranty claims.
EXCLUSIONS
This warranty does not cover:
• Normal wear and tear to parts and components,
• Damage to the bicycle caused by casualty, accident, misuse,
neglect, abuse, improper assembly, improper repair, modification
of any parts and components, or failure to follow the instructi ons
in this manual.
•This bicycle is not designed for racing, j umping, stunt riding, or
high speed down hill riding. Any damage or failure to the parts
or components as a result of such activities is not covered by this
warrant y.
•Any bending of the fork, frame, handlebar, seat post, or rims, as
a result of overloading, misuse, or modification of any parts or
components are not covered by this warranty.
LIMITED WARRANTY
This is the only warranty offered for your HUSKY Bicycle. There are
no other warranties, whether express or implied by operation of law
or otherwise, including but not limited to any express or implied
warranties of merchantab ility, fitne ss to spe cific use, or performance .
HUSKY’s liability under this warranty is expressly limited to the
replacement of defecti ve parts and labor to correct any defect or
failure, or at HUSKY’s sole election, replace the defective product.
HUSKY shall, in no event, be liable for any incidental or
consequential damages, losses, or expenses with connection with
thi s bicycle.
Some of the foregoing limitations or exclusions may not apply to you
if you purchased y our bicycle i n a state where some or all of such
limitations or exclusions are not permi tted.
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MAKING A WARRANTY CLAIM
To make a claim under this warranty, follow these steps:
1. Do not perform any repair or replacement of any parts until an
authorized HUSKY dealer insp ects your bicycl e or the dealer or
manufact urer authorizes such repl acemen t . If ther e are no
Husky dealers in your area, contact Husky customer serv ice at
(800) 392-3337 or send an email to support@huskybicycles.com
for instructions or r eturn authorization.
2. Take your bicy cl e to an authorized HUSKY dealer together with
the original copy of the proof of purchase. No warranty work can
be performed without present i ng the proof of purchase. The cost
of transportation of the bicycle to and from an authorized HUSKY
dealer is the responsibility of the owner.
3. HUSKY, at its sol e option, may repair or r eplace th e defectiv e
product. In the even HUSKY decides to repair the defect or
replace the defective part, the work will be performed based on
parts and labor availability. Husky reserves the right to
substitute parts or components of different make or origin for the
defective parts.
4. W arranty work shall not extend the original warranty period.
However, parts and component s replaced under this war r anty
are guaranteed to be free of defect for a period of one year from
the date of installation.
If you have any questions about the warr anty policy, see your
authorized HUSKY dealer or write to HUSKY Bicycles, LLC.,
Technical Service Dept., 1812 Brittmoore, Suite 214, Houston,
TX 77043.
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OWNER’S RECORD
Date of Purchase ______________________
Dealer ______________________
Dealer Address ______________________