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Ontario wi luai i\j and MinesDeclaration of Assessment Work Performed on Mining LandMining Act, Subsection 65(2) and 66(3), R.S.O. 1990

Transaction Number (office use)

Assessment Files Research Imaging

Personal information f " Mining Act, the inform Questions about this 933 Ramsey Lake Ro.

' 66(3) of the Mining Act. Under section 8 of the rork and co Northern C

42A14SE00402.17731 MANN

Instructions: - f^ — ™x-..., - . Please type or print in ink.

900

1. Recorded holder(s) (Attach a list if necessary)

useforrfCJ240.JUL'lT

PORCUPINE MINING DIVISIONName Client Number

Address Telephone Number

7Fax Number

Name Client Number

Address Telephone Number

Fax Number

2. Type of work performed: Check ( v ) and report on only ONE of the following groups for this declaration.

DWork

Geotechnical: prospecting, surveys, rr^Physical: drilling, stripping, assays and work under section 18 (regs) i — l trenching and associated assays

™*Kc^l?APerformed' From ^ i 3^ Pft ft*

Day 1 Month | YevGlobal Positioning System Data (if available)

——————— .-.- - - . . -

T^?6 To /f \ w nifs

Day | Month YearTownship/Area

/vi/f/v/i/ 7"w P *M or G-Plan Number

if 3 ? 3*7

Office

DUse

Rehabilitation

Commodity

Total S Value of ^*o Work Claimed /^"^^?,

NTS Reference '

Mining Division //v. .

Resident Geologist District f

/AJ/rrtsmj/yt C

Please remember to: -obtain a work permit from the Ministry of Natural Resources as required; ,,. ~ ,, , .; . - provide proper notice to surface rights holders before starting work; '' " - complete and attach a Statement of Costs, form 0212;

- provide a map showing contiguous mining lands that are linked for assigning work; . -include two copies of your technical report. -^

3. Person or companies who prepared the technical report (Attach a list if necessary)Name

Address '

*J-H1 tttftff 77 MM /A/5* 0 A/7'Name

Address

Name

Address

Telephone Number* 70

Fax Number

Telephone Number

Fax Number

Telephone Number

Fax Number

4. Certification by Recorded Holder or Agent

l,. '

Z P \tfrfrt P(Print Name)

do hereby certify that

forth in this Declaration of Assessment Work having caused the work to or after its completion and, to the best of my knowledge, the annexed re|

Signature of Recorded Holder or Agent

Agenf s Addres* ~——

knowledge of the facts set

ame during

m K,- Date

FajfNui, /v h r

Telephone Number

Ocf 15/9^

Work to be recorded and distributed. Work can only be assigned to claims that are contiguous (adjoining) to

; mining land where work was performed, at the time work was performed. A map showing the contiguous link

jst accompany this form.

ning Claim Number. Or if

rk was done on other eligible

ning land, show in this

lumn the location number

dicated on the claim map. ,-~ V *- l i . '

"M

eg

eg s1

eg

\!\2-

3 -

4

5 -

6 -

7 -

8 -

9

10

11

12

13

14

K15

••'.' - - - V.-' t-. . A,.i

TB7827 ;

W ^1231867" l

1234568 j

i.- y.'i.iji-AjiAb^UJfciu-'.-}lZfctff-~~^fi ^ 6C9--

ff^Ytd'

nw b HH W tt*'

tt ft 61 1 */fw6O-ti^fe^'tifttn -nsii** -tt w fa \ -a f 4^2- \ttzmf -itfit&z "(HoZo f ^

Number of Claim Units. For other mining land, list hectares.

16 ha

12

2

i1i1

\r

Column Totals

Value of work performed on this

claim or other mining land.

S26, 825

- -x.-t. Q.

S 8, 892

0

x/01^^

*lfltt*W

0±1

\

^~^~\

/

Value of work applied to this claim.

N/A

S24.000\

S 4,000

'•.'^''^.vi/tes ff&o* Y

1?^,^

b fi Q. i

c

^j^

^

JyJ,y^ ,^.Vy///i

Value of work assigned to other mining claims.

S24,000

:.".: . ; :' , Q " :'-*

0

!i rtsatIA: ^ps-:;;.

**sfr *:m&t- v

Bank. Value of work

to be distributed at a future date.

S2,825

Vi- -'M.,'/.' ,..' '^}

S4.892-•^'•i

vV,, X ,

1^*

K

l, l-&O Mtftfl) fi D W/ftffl ft (rr t jo hereby certify that the above work credits are eligible under

(Print Full Name)

subsection 7 (1) of the Assessment Work Regulation 6/96 for assignment to contiguous claims or for application to

the claim where the work was done.

Signature of Recorded Holder 6Y AgerjJ Authorizetfjh Writing p

L ''* ' f * ^

Date

6. instructions for cutting back credits that are not approved.

Some of the credits claimed in this declaration may be cut back. Please check ( ^ ) in the boxes below to show how

you wish to prioritize the deletion of credits: -

Qa 1. Credits are to be cut back from the Bank first, followed by option 2 or 3 or 4 as indicated.

D 2. Credits are to be cut back starting with the claims listed last, working backwards; or

d 3. Credits are to be cut back equally over all claims listed in this declaration; or

0Q 4. Credits are to be cut back as prioritized on the attached appendix or as follows (describe):

((5*63^3-

Note: If you have not indicated how your credits are to be deleted, credits will be cut back from the Bank first,

followed by option mimhpr ? if ntt jssary.

For OfficeReceived

Deemed Approved Date

Date Approved

Date Notification Sent

Total Value of Credit Approved

Ontario Ministry ofNorthern Developmentand Mines

Statement of Costs for Assessment Credit

Transaction Number (office use)

Personal information collected on this form is obtained under the authority of subsection 6(1) of the Assessment Work Regulation 6/96. Under section 8 of the Mining Act, the information is a public record. This information will be used to review the assessment work and correspond with the mining land holder. Questions about this collection should be directed to the Chief Mining Recorder, Ministry of Northern Development and Mines, 6th Floor, 933 Ramsey Lake Road, Sudbury, Ontario, P3E 6B5.

Work TypeUnits of Work

Depending on the type of work, list the number of hours/days worked, metres of drilling, kilo metres of grid line, number of samples, etc.

Cost Per Unit of work

Total Cost

* A t** t M tr

Acw r f 1*5.00

JL

Associated Costs (e.g. supplies, mobilization and demobilization).

Transportation Costs

/71/VU'AFood and Lodging Costs .60

pO o

Total Value of Assessment Work

Calculations of Filing Discounts:l 77 Q tJL * * O A

-A

1. Work filed within two years of performance is claimed at 100"**) of the above Total Value of Assessment Work.2. If work is filed after two years and up to five years after performance, it can only be claimed at SO'W) of the Total

Value of Assessment Work. If this situation applies to your claims, use the calculation below:TOTAL VALUE OF ASSESSMENT WORK x 0.50 = Total $ value of worked claimed.

Note:- Work older than 5 years is not eligible for credit.- A recorded holder may be required to verify expenditures claimed in this statement of costs within 45 days of a request for verification and/or correction/clarification. If verification and/or correction/clarification is not made, the Minister may reject all or part of the assessment work submitted. ? !

Certification verifying costs:

l, l- &Q M ftrf 6 fc O W n ftf) ft 11*1, do hereby certify, that the amounts shown are as accurate as may(please print full name) ' J l ,

reasonably be determined and the costs were incurred while conducting assessment work on the lands indicated on

the accompanying'

to make this certifii

0212(02/96)

ir W f f *L *— ™" "'i""ir - ^--fif— -r-.-T^--" * - ——^——^ ed holder, agent, or state company position wtth signing authority)

l am authorized

PORCUPINE MINING DIVJSION

Signature Date

OntarioWi.-iistry ofNorthern Developmentand Mines -

Schedule fOr Declaration Of

Assessment Work on Mining Land ///Trar.saciion Number toffies use)

1773 lMining Clelm Number. Or ifwork was done on other eligible mining land, show in this column the location number indicated on the claim map.

\JlllA2A—jj^-^-~ir^^fS^-^

\LL^A^--

Number of Claim Unit*. For other mining land, list hectares.

;

V

Column Totals

Value of work performed on this claim or other mining land

O

\s

/566s.

Value of work applied to this claim

2^0 J

' 7/.

,, J

&ANki-•^

/4^G*.

Value of work aMlgned to other mining claims

...,,

9 f -~4fc-

l

iBs&too

Bank. Value of work to be distributed at a future date

jpWIf- JUL 17 199? C

XN— T'f^ofiCUPiNE MINING owisior-

ytj*0290(02^6)

Ministry ofNorthern Developmentand Mines

Ministere du Developpement du Nord et des Mines Ontario

October 27, 1997

LEONARD EDWARD HILL122 HELEN AVENUEP.O. BOX 1022SOUTH PORCUPINE, OntarioPON-1HO

Geoscience Assessment Office 933 Ramsey Lake Road 6th Floor Sudbury, Ontario P3E 6B5

Telephone: (888)415-9846 Fax: (705) 670-5863

Dear Sir or Madam:

Subject: Transaction Number(s):

Submission Number: 2 .17731

StatusW9760.00383 Deemed Approval

We have reviewed your Assessment Work submission with the above noted Transaction Number(s). The attached summary page(s) indicate the results of the review. WE RECOMMEND YOU READ THIS SUMMARY FOR THE DETAILS PERTAINING TO YOUR ASSESSMENT WORK.

If the status for a transaction is a 45 Day Notice, the summary will outline the reasons for the notice, and any steps you can take to remedy deficiencies. The 90-day deemed approval provision, subsection 6(7) of the Assessment Work Regulation, will no longer be in effect for assessment work which has received a 45 Day Notice.

Please note any revisions must be submitted in DUPLICATE to the Geoscience Assessment Office, by the response date on the summary.

If you have any questions regarding this correspondence, please contact Bruce Gates by e-mail at . ndm.gov. on. ea or by telephone at (705) 670-5856.

Yours sincerely,

ORIGINAL SIGNED BYBlair KiteSupervisor, Geoscience Assessment OfficeMining Lands Section

Correspondence ID: 11 506

Copy for: Assessment Library

Work Report Assessment Results

Submission Number: 2 .17731

Date Correspondence Sent: October 27,1997 AssessorBruce Gates

Transaction NumberW9760.00383

Section:16 Drilling PDRILL

First Claim Number1154611

Township(s) l Area(s)

MANN

StatusDeemed Approval

Approval Date

October 15,1997

Correspondence to:Resident Geologist South Porcupine, ON

Assessment Files Library Sudbury, ON

Recorded Holder(s) and/or Agent(s):LEONARD EDWARD HILL SOUTH PORCUPINE, Ontario

Page: 1Correspondence ID: 11506

003

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