jm no. tb1173170 16 9 2 note
TRANSCRIPT
-. —, ..... .....,. i* •mil Mill l52B14SW0073 17 HUTCHINSON
TOWNSHIP: HUTCHINSON
WORK PERFORMED FOR-r UK. Mitch Wicheruk
RECORDED HOLDER: SAME AS ABOVE H
* OTHER f J
010
REPORT NO: 17
JM NO.TB1173170
TB11731704
Tb1173170
TB1173170
HOLE NO. FOOTAGE50
17
51
48
16 9 2
Sept 16 92
Sept 18 92
Sept 18 92
NOTE
d
d
NOTES;Report of Work # 9340 00010
© Ministry of Mimstere du Diamond Journal de Complete this form and Northern Development Developpement du Nord Dri , |ina forsqe 3U related sketch in duplicate. Fill in on every page and Mines et des Mines unning iui-vjc au r
Ontario i oa diamant Remplir en deux exemplalres la Remplir ces cases a y presente formule et le croquis annex6 chaque page
;*flg Company Collar Elevation Bearing of hole from true Total Footage Dip of Hole at ' •~o*eagnie de forage Elevation du collier North/Position du forage Avancement total du Inclinaison du forage au
^^ par rapport au nord vrai forage_ 'Terr* p^j sics 360 * O 0 .6 coiiar/coinw "" 1 0 *-a* Hole Started ' Date Completed Date Logged Logged by ' Da* de commencement du forage Date d'achevement Date description au Inscrit parf t - l J - ' 1 - iOU-nal 1 -*" f ^t 1 FUPii^p~L /j/'? "Z. O^/7 '
"PWration Co.. Owner or Optionee Cc^pagnie d'exploration, proprietaire ou titulaire d'option
Fsctage/AvancementFfOm/De To/A
0
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7- s
13^6
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rt* f :t u*U..,cCA^
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f/uf.^OdW.-.tC^oO^
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wa^wOa\c* w ,'c.
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Description (Colour, grain size, texture, minerals, alteration, etc.) Description (Couleur, granulometric, texture, mineraux, transformation, etc.)
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J^ -1 . i ~f ~ ' ' ——————— ———
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So- Q ^ ~'-
Address/Location where core stored Adresse/endroit oil la carotte est stoc
J:-*, tt '"'-f
^ ''^.J'^jJ^lt ; '--V
Pun* FMIurf AnptVAngMom
ConsoKwwi Fcougi t ' Lonqmur Your SamW No.
N* d'tenantlllon du prcsoecwur
V^S
4^3^
M^ V5-
kee
'-
Hole No. k Forage n" , .s
r H ole..?Page No. Page n 0
^
Map Reference No. Claim No. N 0 de reference sur la carte N" de concession miniere
Location (Twp. Lot, Con. or Lat. and Long.) Emplacement (canton, lot, concession, ou latitude et longitude)
Property Name Nom de la propriety
Samoie Footaoe/Nrveau ae pt-
From/Da
^
J?. (o
rfo. o
To/A
/.S
M 0. 0
y?.o
SamoM Length
I'fcuntiiion
/. z
z,V
Assays t /Analyses mineralurgiaues
Ae* f f If
o^!3\
8(0
Z 1-
wi;*(03;9i) ,por features such as foliation, bedding, scnistosity, me-.,,- - v- -ne long axis of the core. f Additional credit available. See Assessment Work Reguietson. •Examples de caracteristiques : foliation schistosity, st'3' ; :. ,, - . ,"-c.; e est —-esure par raooort a I'axe lonaitudinal de la c;: * Des credits suoolementaires sont offerts Consumer le* rec : 9Tients reiatifs aux travaux d'evaiuatio"
l*—
tt
\v l
01
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x
x*'"'*\ Ministry of Mimstere du Diamond Journal de Complete this form andiwyj Noimem uuvttiopiiibNL ueveioppeineni uu NO,U Drj|| ina forage 3U related sketch in duplicate. Fill in on every page Hole No. VW and Mines et des Mines ivimmy s -- . Forage n 0 QnJaTio LQQ diamant Remplir en deux exempiaires la Remplir ces cases a K
" presente formule et le croquis annex6 chaque page r ~{ le. "~
Doling Company Collar Elevation Compagme de forage Elevation du collier
"i^'Tre^. P^i'ZffS
Data Hole Started ' Date Completed Date Logged 0*1* de commencement du forage Date d'achevement Date description au
i f if journal
^XBioration'Co., Owner or Optionee Date Submitted Compagme d'exploration, proprietaire ou titulaire d'option Date de depdt
rf. fiJ^Atrt t
Footage/AvancementProm/De' o
^o
To/A
^.o
1 ' ? ' -Q
Rock Type Type de roche
flfafic Ooft**k
(J? k**)
rf! C- (Jo/fa '
(M.**)
Bearing of hole from true Total Footage Dip of Hole at e North/Position du forage Avancement total du Inclinaison du forage au par rapport au nord vrai forage
f SO * t ' T Collar/colliw "~V^Logged by ' Inscrit par
J* 6~ - C. lo, S le.
Submitted by (Signature) . -, m Depose par (signature) J RJPi
4 fa fi AfI/IAT^
\ l FUPi
Description (Colour, grain size, texture, minerals, alteration, etc.) Description (Couleur, granulometric, texture, mmeraux, transformation, etc.)
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Address/Location where core stored Adresse/endroit ou la carotte est stockee
Olmi Fnwt AngM'JAngMdM carattnHoMi
POMS
Cora StNonwi
m PMOB dts araoNYour Sa/noie No. N 0 d'ftcnanlillon du pneoectaur
LfKo
H T- li
V752-
Page No. Page n 0
1
Map Reference No. Claim No. N" de reference sur la carte N" de concession miniere
Location (Twp. Lot, Con. or Lat. and Long.) Emplacement (canton, lot, concession, ou latitude et longitude)
Property Name Nom de la propriete
Samoie Footaae/Niveau He pre-
From/Os
^..o//'^/S.o
To/A
l f. 4
/f, G
/C. G
Sample Length Longueur de I'icftanlillon
^
9-0
/.o.
Assays t/Analyses mineralurgiques
fi* ffi,
1*
Sf
/*
014.4(03/91) *F0r features sucn as foliation, bedding, schistosity, measured from the long axis of the core.'Examples de caracteristiques : foliation, schistosity, stratification. L'angle est mesure oar rapport a I'axe longitudinal de la carotte.
t Aaditional credit available. See Assessment Work Regulation.t Des c'?:its suDCfementaires sont offens. Consulter les reglements re'atifs aux travaux d'evaluation.
@ Min;stry of Minister* du Diamond Journal de Complete this form and Northern Development Developpement du Nord nrillinn foraqe 3U related sketch in duplicate. Fill in on every page and Mines et des Mines uiiiimg "3*-
Ontario Loa diamant Rempllr en deux exemplaires la Remphr ces cases a y presente formule et le croquis annex6 chaque page
Drilling Company --..-. .-i-— .-. - Compagnie de forage
"Terra /yLff/csDate Hole Started ' X Dat* de commencement du forage
^ **?/?^/?. m i
Collar Elevation Elevation du collier
Date Completed Date Logged Date d'achevement Date d'inscription au
journal
Sett 18 nil. s^x^/nExoioratiort Co., Owner ot Optionee - ' ' Date Submitted Comoagme d'exploration, proprietaire ou titulaire d'option Date de depot
/7I . (^Jt'^L^r^ts.
Pooiage/Avancement^rom/De 1
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Rock Type Type de roche
Alkr* 4i u *i rant
/Yl a / -'c Lw laa M /c
(T^ooo?)/?w -fi 'c L/6 (Ca H /c
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Bearing of hole from true Total Footage Dip of Hole at " North/Position du forage Avancement total du Inclinaison du forage au par rapport au nord vrai forage
I8&* jT/,0 ccnar/col^l V5 'Logged by * Inscnt par ,
-c f ri 1 Fupi 'J . (s-. C/cty/cSubmitted by (Signature) El m \ Depose par (signature) —————— 11 —— : ————
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Description (Colour, grain size, texture minerals, alteration, etc.) Description (Couleur, granulometric, texture, mineraux, transformation, etc.)
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, J f J0*1 ri 4f/s - —
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Carba^A'te dLl-kr^,
-{-/'Mi~ a s**,'** eat rv^cfirrt')————— EL^ —— s: —————————
Quarry f.z* * 5 /*t/^,-^ ' ' ' 1.•^"f-Q i" f rt e* If f i C. .
^ dolauf&t^f, l^rot^t CA r b a *OL -fa
/''rr/Ve,r f ' ——— f ———————————— ; ————————————————
^6^ 7^^ f *-t- . -r /O e*J TV ,0 Uj&^Jc-
k'oistj l f * fQ*\ -^LC-V s* ^ "2^.3
't* **d /is. ct c.0 tt 1 1. *- ii X i^2 r f. of/
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f, Afc-Lfn C-Or bonctV-t'z. 1?^ w'narJ . ———— -^ ——— I ———————————————— i^-ie ——— —————————————————
.vi &0//C1 V^ C/4 f A5" ^/^ S ei^vv
r r' M *4* sfi-*arr't*iA*. c* s* f i* -fSf, C&r'bar.Cfr? tst\*o/ /eiccatei+p
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r-r '# -e.j4- ^ eOf''c* i**. ^ /-*?^s
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F*\eil4 ^•/•rot*G s a r •^ett.a.'yta a y. as. ——— F — /.(-t —— — — ——————— t^. ———————————
*rXyr^^ ? 6S*r "/Z. U2/S! X TT^
0^04,83/91) *For features such as foliation, bedding, scnistosny, measured from the long axis of tne core. •Exemples de caracteristiques : foliation schistosity, stratification. L'angle est mesure oar -anoort a I'axe lonaitudinpi ci? la c* -r*"?
Address/Location where core stored Adresse/endroit oil la carotts est stockee
..' . Vv, ..l ^ ^-••-
•'- V: |, -1 ,.,.
Plwv FNIUT* AngUVM9U (M cmcMonouM
Cora SotomA FooU9t T/LWNWMpMOioMeanaH
MMnM
Your Samae No. N* d'fcnantillon duprosoecieur
Wk
^1-
77 V3
y^y?
Hole No. k Forage n"
7Page f;o. Page n 0
1
Map Reference No. Claim No. N" de reference sur la carte N0 de concession miniere
1 l 1 2 | ?-oLocation (Twp. Lot, Con. or Lat. and Long.) Emplacement (canton, lot, concession, ou latitude et longitude)
H^-VcUvii Tujp.
Property Name Nom de la propriete . i .vW^U'.s. u. -54^-Veji. C L<*-^^vs
Sample Footage/Nweau de ore- evement de I'ecnantillon i en oiedsl
From/De
0
J- 5
it. a
i /.l
\
T(VA
3. r
?. y
x* .r
13.0
Sample Length Longueur de I'ecnantillon
j. r
3.7
*r
AJ"
Assays f/Analyses mineralurgiaues
#u Pf is
39-
^ 5
/5f
/yy
i
T Adaitionai credit available. See Assassment Work Regulation.t DQ S Cro ,|.t r. lo . - . c . . r c, 1 or oc ron o^o q 5 c
Diamond Journal de Complete this form andt^y/l Nuillum Uttveiupnittiu Ueveloppoinenl du Nuid Dri || ina forage 3U related sketch in duplicate. Fill in on every page Hole No. Vyy and Mines et des Mines urilimg i vi aye au K A W Forage n" Ontario LOQ diamant ' Remplir en deux exemplaires la Remplir ces cases a ^
y presente formula et le croquis annex* chaque page r 3
Silling Company Collar Elevation Compagnie de forage Elevation du collier
Stte Hole Started Date Completed Date Logged 9il* de commencement du forage Date d'achevement Date description au
journal
Swioration Co., Owner or Optionee Date Submitted Compagnie d'exploration, propnetaire ou titulaire d'option Date de depot
^ootage/AvancementProm/De To/A
•go .0
Rock Type Type de roche
/7/Jf/fc. L/j/^rt/c,
/ ^ i \ r f 0 t*^ J
Beanng of hole from true Total Footage Dip of Hole at " North/Position du forage Avancement total du Inclinaison du forage au par rapport au nord vrai forage
Collar/collierLogged by ' Inscrit par
A
Submitted by (Signature) . -. Depose par (sitrtiature*' R''p|
A i j(~Yl ^AJ
Ft./PI
Description (Colour, grain size, texture, minerals, alteration, etc.) Description (Couleur, granulometric, texture, mineraux, transformation, etc.)
r'l'fit.'rb mec/i'ijM*. aror^fal, 1 6. ne o v.fi tn-a ^ /•/a/* ftr.So 0 -/V*e.-/**/-,^^ ^ A
S 'rtft? z?*,/*/ V ef /
'
"
Address/Location where core stored Adresse/endroit ou la carotte est stockee
PUnvHuura
cmcunmuM MM
ConSoflCNntfi FOOUQI t/UnqMtf •n (Ma on ciraou
Your Sample No.
du pmoectwr
Paae No. Page n"
, 2-Map Reference No. Claim No. N0 de reference sur la carte N0 de concession mimere
Location (Twp. Lot, Con. or Lat. and Long.) Emplacement (canton, lot, concession, ou latitude et longitude)
Property Name Nom de la propriety
Sample Fooiaoe/Niveau ae pnV
From/D* To/A
Sample Length Longueur oe I'scnanlillon
Assays f/Analyses mineralurgiques
0201 (03/91) *For features such as foliation, bedding, schistosity, meas . . rcm the long axis of the core. t Additional credit available. See Assessment WorK Regulation. •Exemoies de caracteristiques : foliation, schistosity strat - - L'angie es: Tiesur6 aar rapDOrt a I'axe longitudinal de la ea"'---; t Des credits suooiemontairos sent o'ferts. Cinrj 1**"- '*?? 'o-.a^onts relatifs aux '-avaux d'evaiuavon
Diamond Journal de Complete this form andW J Noun*,, ueveiouinem ue^tH.wm uu NU.U Q n |j forage 3U related sketch in duplicate. Fill in on every page Hole No.. \JLS and Mines et des Mines wimmg a i- . Forage n" Ontario LOQ diamant Rempllr en deux exemplalres la Remplir ces cases a ^ .
a presente formule et le croquis annexe chaque page r HDrilling Company Collar Elevation Corripagnie de forage Elevation du collier
'Teffa pL,*rclDat* Hole Staned ' J - Date Completed Date Logged Dal* de commencement du forage Date d'achevement Date description au
S3 -J journal
Exploration Co., Owner or Optionee Date Submitted Compagnie d'exploration, proprietaire ou titulaire d'option Date de depot
Footage/AvancementProm/De
0
t ,
2 3 .S
y/, s
To/A
30, 5
y/. z
Y*, e
Rock Type Type de roche
/M .f . i L f - //!a f r c (so l^o ^ , c
(^.j)
A 5 7^ ^^^
/y/oT.'c. Ua/CQ H -' c
/'y ^S /X^/ ^/^ 7"fi^ ' ' f "tf* **^ ^
Bearing of note irom true Total Footage Dip of Hole at ' North/Position du foraoe Avancement total du Inclinaison du forage au par rapport au nora vrai forage
"3 t ^ ^J A f*J^ ft OfcO /^ Collar/collier T^
Logged by " Inscrit par . \
v | .Vjr'M^-1^ eSubmitted by (Signature) e, ,D. Depose par (signature) a'pl --. ..
V K V Ft./Pi
Description (Colour, grain size, texture.'minerals, alteration, etc.) Description (Couleur, granulometric, texture, mineraux, transformation, etc.)
/h -e.61/ 't*, t — t, f'zd'vi e0f, /tJ
/ y / / f~^c.c* fGn -e s e-4 S~Vo f a ~^ o( f /-(f ^ &ZT,
XA r 7-1^^ 0r~ Jr6na.,Tt. y ' Zs ' J" t-S-'rSr ,f ' u
t/ -5 - T--** - 3d^, o -t^ v-v lts-4s ^
8. ^ - \o - o ^ c. y* O -e.^ w W-i"?
11- S- 2 f. 5 'o *xa ue-'^/^Tj-O ^ -, — ^. i
^ ^ c, Kva/^^
^i-^e.&roilri'e.d.. da /" b a ^i ij/ /^ 57 /,/e r&zr ^^ af 'J . ' s
•6) ff'a, -//'a ^
{^3 rf */ ?' *3 rf^^S '
Address/Location where core stored Adresse/endroit ou la carotte est stockee
•j. '. ' , ,.- /,1 ' ^ :. -^.^
PUnar fMUre AngH'/AnsHDM cvKrtnniQUM
CoraSotonwi Footig* t ' \anfm* •n puds OMcmoM
Your Samon No. N* d'echantillon au prospecteur
y? 5-3v^r^/
Page No. Page n 4
i
Map Reference No. Claim No. N e de reference sur la carte N 0 de concession miniere
Location (Twp. Lot, Con. or Lat. and Long.) Emplacement (canton, lot, concession, ou latitude et longitude)
\-\ IA "Vc-Lv. t**o-v TC— P .
Property Name Nom de la propriete
Sample Footage/Niveau oe pre-
From/Da
(0-Y- 5
To/A
2. S7-0
Simple Length Longueur oe I'ecnamillon
2.-?
^.r
.
Assays t /Analyses mmeralurgiques
^0
y z.
,
0204(03/91) .F0r features such as foliation, bedding, schistosity, measured from the long axis of the core. f Additional credit available. See Assessment Work Regulation. *Exemnles de caractenstiouos ' foliation, schistosity, stratification. L'anal0 9** rroc"rn r*ar rsnrvr* 4 I'^va lon-i'i.r*;-.^ -i o i-, --.r-'*- * no* ~-A-J .- -.. — i AmQ ^^:,, r ^.* ~ u~^~ /~--.,,..-, ... .i-.. — .,.- . .,^.-.,, , ,.., .......... j-i..-...-. - .
Ministry ofNorthern Developmentand Mines
)ntario
Report of Work Co After Recording CI
Mining Act ' 52B14SW0073 17 HUTCHINSON 900srsonai information collected on this form is obtained under the authority of the Mining Act. This information will be used for correspondence. Questions about is collection should be directed to the Provincial Manager, Mining Lands, Ministry of Northern Development and Mines, Fourth Floor, 159 Cedar Street, idbury, Ontario, P3E 6A5, telephone (705) 670-7264. -.i-. ' ' ' v V-Ki'istructions: - Please type or print and submit in duplicate.
- Refer to the Mining Act and Regulations for requirements of filing assessment work or consult the Mining Recorder. - - ( • ••'"••^'\. — / ^ *? *? o t/ ' ' s
- A separate copy of this form must be completed for each Work Group. ; 'X ,,' V v ' ® ® G f ® ,~- Technical reports and maps must accompany this form in duplicate. ^ \,"/, - ' '^ ^i,
- A sketch, showing the claims the work is assigned to, must accompany this form, l '.O '.-
acorded Holder(s) Client
ddress
fro* 2 *11 0*f.Telephone No.
T leoTownship/Area
V-\*TC.iv\vvSo W
lining Division
\W
M or G Plan No.
Dates Work Performed
From: - - 1 Hi S? J
ork Performed (Check One Work Group Only)Work Group
Geotechnical Survey
Physical Work, Including Drilling
Rehabilitation
Other Authorized Work
Assays
Assignment from Reserve
Type
" rorJTARin-GEOLOniCAfSUKVtY j'- 1 GtS - /^"PS^FNT- r^-ES 1
' A ^^^ * -'S *{S fc V " ';* " - •"- '" ,- - . . m
C.) \ t* \A^- O V^ ^ ^-^ ^ ) \ \ ( i^\ 0* r 1 i
0 -- : l ;- ^ ^mw^ j1 . ' ' " ;" ~ - ' "' l " '- p'ici'A^rx/rTri 7
1 H . i- a si~-. 'e .!*'" fc 1 3 --' f"v '"f '! | iTWT~^7aW. .™-^.1!W..Jr5B-J" .^TWO*C,^.^^tW,7,-,: -T
; . , ' i . -
otal Assessment Work Claimed on the Attached Statement of Costs y 7ote: The Minister may reject for assessment work credit all or part of the assessment work submitted if the recorded
holder cannot verify expenditures claimed in the statement of costs within 30 days of a request for verification.
arsons and Survey Company Who Performed the Work (Give Name and Address of Author of Report)Name Address
tach a schedule If necessary)
silification of Beneficial Interest * See Note No. 1 on reverse sidecertify that at the time the work was performed, the claims covered in this work eport were recorded in the current holder's name or held under a beneficial interest )y the current recorded holder.
Recorded Holder orAgent (Signature)
?rtification of Work Report, certify that l have a personal knowledge of the facts set forth in this Work report, having performed the work or witnessed same during and/or after its completion and annexed report is true. .ame and Address of Person Certifying
Dati S '
ir Office Use OnlyTotal Value Cr. Recordedy' Date Recorded
•*-s A *v *^fc t f JDeemed Approval Date
Mining Recorder \ ~" *
Date Approved
Kb . ^. /9 93Date Notice for Amendments Sent '
Received Stamp
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Credits you are claiming in this report may be cut back. In order to minimize the adverse effects of such deletions, please indicate from which claims you wish to priorize the deletion of credits. Please mark (^) one of the following:
1. D Credits are to be cut back starting with the claim listed last, working backwards. . , .2. D Credits are to be cut back equally over all claims contained in this report of work.3. D Credits are to be cut back as priorized on the attached appendix.
In the event that you have not specified your choice of priority, option one will be implemented.
Note 1: Examples of beneficial Interest are unrecorded transfers, option agreements, memorandum of agreements, etc., with respec, to the mining claims.
Note 2: If work has been performed on patented or leased land, please complete the following:
l certify that the recorded holder had a beneficial interest in the patented or leased land at the time the work was performed.
Signature Date
intario
Ministry ofNorthern Developmentand Mines
Mi' 'TO du06 ppement du Nordet des mines
Statement of Costs for Assessment CreditBat des couts aux fins du credit d'evaluation
Mining Act/Loi sur les mines
Transaction No./N" de transaction
^00 c
l information collected on this form is obtained under the authority the Mining Act. This information will be used to maintain a record and going status of the mining claim(s). Questions about this collection should directed to the Provincial Manager, Minings Lands, Ministry of Northern
ivelopment and Mines, 4th Floor, 159 Cedar Street, Sudbury, Ontario )E 6A5, telephone (705) 670-7264.
Les renselgnements personnels contenus dans la presents formule sont recueillis en vertu de la Lol sur tes mines et serviront k tenir a. jour un registre des concessions minieres. Adresser toute quesiton sur la collece de ces renseignements au chef provincial des terrains miniers, ministers du Developpement du Nord et des Mines, 159, rue Cedar, 4e etage, Sudbury (Ontario) P3E 6A5, telephone (705) 670-7264.
Direct Costs/CoOts directs
Type
/ages alaite*
ontractor's id Consultant'* se* roll* de antrepreneur ; de I'expert- onsell
applies Used ournlturesiillstes,
quipment antal ^cation de .ateriel
Description
Labour Main-d'oeuvreField Supervision Supervision sur le terrain
TypeOt'tvHO*. J ' /J-/ ffi'**
50/1 //t'* 9
^ ojj/^y+ftfap?TypeT */ t/ "
t
Type
Amount Montan!
LJIK '
JQO. "
Ll2.Q-
Total Direct Costs Total des couts directs
Totals Total global
Vte
Y: •••'
ffrlr
2. Indirect Costs/Gouts indirects* * Note: When claiming Rehabilitation work Indirect costs are not
allowable as assessment work.Pour le remboursement des travaux de rehabilitation, les couts indirects ne sont pas admissibles en (ant que Iravaux devaluation.
Type
Transportation Transport
Food and Lodging Nourrlture et' hebergementMobilization and Demobilization Mobilisation et demobilisation
Description
Type
Amount Montan!
Sub Total of Indirect Costs Total partiel des coOts fndlrects
Amount Allowable (not greater than 204fc of Direct Costs) Montan! admissible (n'excedant pa* 20 H de* couta directs)Total Value of Assessment Credit Valeur totale du credit [Total of Direct and Allowable devaluation Indirect coital (Total du coflts direct!
Totals Total global
O
V7* '1•t Indirect! tdmlMlble*
te: The recorded holder will be required to verify expenditures claimed in this statement of costs within 30 days of a request for verification. If verification is not made, the Minister may reject for assessment work all or part of the assessment work submitted.
Note : Le titulaire enregistrd sera tenu de verifier les depenses demandees dans le present etat des couts dans les 30 jours suivant une demande a cet effet. Si la verification n'est pas effective, le ministre peut rejeter tout ou une partie des travaux d'evaluation preserves.
ing Discounts
Work filed within two years of completion is claimed at 100"Vfo of the above Total Value of Assessment Credit.
Remises pour dep6t
1. Les travaux deposes dans les deux ans suivant leur achievement sont rembourses a100 *M) de la valeur totale susmentionnee du credit d'evaluaiion.
Work filed three, four or five years after completion is claimed at 500A) of the above Total Value of Assessment Credit. See calculations below:
a! Value of Assessment Credit Total Assessment Claimed
x 0.50 -
2. Les travaux deposes trois, quatre ou cinq ans apres leur achievement sont rembourses a 50 "M) de la valeur totale du credit devaluation susmentionne. Voir les calculs ci-dessous.
Valeur totale du credit devaluation
x 0,50 -
Evaluation totale demanded
,'rtification Verifying Statement of Costs
ereby certify:,t the amounts shown are as accurate as possible and these costs re incurred while conducting assessment work on the lands shown the accompanying Report of Work form.
it as(Recorded Holder, Agent, Position in Company)
make this certification
Attestation de I'itat des coOts
J'atteste par la presente :que les montants indiques sont le plus exact possible et que ces depenses ont ete engagees pour effectuer les travaux devaluation sur les terrains indiques dans la formule de rapport de travail ci-joint.
l am authorized Et qu'a titre de je suis autoris6(lilulaire enregislre, representant, posts occupe dans la compagnie)
a faire cette attestation.
Signature. Jl
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