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Agreement to Conduct Permitting by Electronic Means <br />5. Affiant will inform the Division of Reclamation Mining and Safety within thirty <br />(30) days in the event that his/her authorization to execute ePermitting Documents <br />on the Company's behalf is terminated. <br />Further, Affiant sayeth not. <br />491—'t r Z A? �C pT r <br />Affiant's name <br />Notarized Affidavit of Signature <br />STATE OF: <br />COUNTY OF: ) ss. <br />The foregoing instrument was acknowledged <br />before me this day of by <br />(date) (month) (year) <br />as <br />ale 0-�� /? gU.� 01 secr&167-cl _ <br />(Name of permittee representative) (title) <br />(seal) <br />My Commission expires: <br />Page 5 of <br />NOTARY PUBLIC <br />