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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 />51) .t n Y'1 �D0 n,�1C-FT <br />Affant's name <br />ignatu t <br />Notarized_ Affidavit of Signature <br />STATE OF: ) <br />COUNTY OF: ) <br />braV,A <br />The foregoing instrument was acknowledged <br />before me this day of <br />(date) <br />ss. <br />5tA-Z-aV)v)e--1 <br />J_ as <br />(Name of permittee representative) (title) <br />r. <br />7H IN <br />NO Plr) <br />STATE CO! <br />NOTARY 2% <br />WC JSSION S$ <br />s <br />(seal) <br />My Commission,expires: <br />0 <br />of <br />(permittee) <br />Page 5 of 6 <br />by <br />(month) (year) <br />NOTARY PUBLIC <br />CATHERINE S. ACORD <br />NOTARY PUSI.IC <br />NOTARY ORADO <br />ID 200044b24d0es <br />MY <br />ICQIV�IISSIOH !?(FIRES SEPTEI� 10.20 <br />