District, _____________________ County, State of ______________________________ _______________________________________ STATE OF ________________________} } SS. County of _______________________} I hereby certify that this Location Certificate was filed for record in my office at _____________ o’clock ____M., _________________________________ 19___ and is duly recorded in book __________ at page _______________________________ _______________________________________ Recorder. By ____________________________________ Deputy. _______________________________________ Fees, $________________________________ _______________________________________ --------------------------------------- BRADFORD PUBLISHING COMPANY CO., DENVER APPENDIX #12 ------------------------------------------------------------------------ [Illustration: APPENDIX #13] Recorded at________o’clock______M.,_________________ Reception No._____________________________ Recorder. -------------------------------------------------------------- KNOW ALL MEN BY THESE PRESENTS: That,______________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ the undersigned citizens of the United States, residents of the County of_______________, State of________________________, having complied with the provisions of Chapter 6, Title XXXII, of the Revised Statutes of the United States, and with the local customs, laws and regulations, claim by right of discovery and location, The ___________________________________ placer claim, situate, lying and being in______________________ Mining District, County of_______________________, and State of ____________________, described by metes and bounds as follows, to wit: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ ______________________________ area ____________________ acres, said claim was located on the_______ day of__________, 19_____. Date of certificate________________________, 19_____.