____________________________________ _____________________________________ (Authorized Signature) (Title) CERTIFICATE OF TRANSCRIPT I HEREBY CERTIFY That the foregoing transcript of field notes of the above-described mineral survey number is a true copy of the original field notes. ____________________________________ _____________________________________ (Authorized Signature) (Title) ___________________________________________________________________________ Title 18, U.S.C. section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any false, fictitious, or fraudulent statements or representations as to any matter within its jurisdiction. ___________________________________________________________________________ APPENDIX #5 ------------------------------------------------------------------------ [Illustration: APPENDIX #6] Form 3860–8 UNITED STATES | Serial Number (February 1977) DEPARTMENT OF THE INTERIOR | BUREAU OF LAND MANAGEMENT | |_______________________ CERTIFICATE OF EXPENDITURES, IMPROVEMENTS, | Date AND MINERAL SURVEY | ___________________________________________________|_______________________ Name of Claimant | Mineral Survey Number | | ___________________________________________________|_______________________ | I HEREBY CERTIFY That the | I FURTHER CERTIFY That the | record of the above-described | record reveals not less than $500 | mineral survey furnishes such an | worth of labor has been expended for | accurate description of all claims | improvements upon or for the benefit | embraced within the survey that it | of each of the lode claims embraced | will, if incorporated into a patent, | within the survey and that the | serve fully to identify the premises | improvements were made by the | and that references are made in the | claimant or his grantors. | survey to natural objects or | | permanent monuments so that the | | location of the claims will be |