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NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or <br /> as supplemental information to this NOI. GPS measurements will be acceptable for this <br /> purpose: <br /> Lat: 39 16'14.55"N X: <br /> Long: 106 08'54.30"W Y: <br /> 6. LAND OWNERSHIP: <br /> FPrivate ❑ Public Domain (BLM) National Forest (USFS) <br /> 17 State State Sovereign Lands Other (please describe) <br /> If prospecting is located on BLM or USFS land the remaining section must be <br /> completed, otherwise go to section II Maps&Drawings <br /> 7. PROSPECTING ON BUREAU OF LAND MANAGEMENT (BLM) LAND AND U.S. FOREST <br /> SERVICE (USFS) LAND <br /> The Division and the BLM/USFS have entered into cooperative agreements that eliminate <br /> the need for a prospector to post a financial warranty with each agency and allow them <br /> to coordinate the review of the NOI in order to minimize administrative processing time <br /> and effort. <br /> A. CLAIMANT: <br /> Name <br /> Address <br /> City, State, Zip r l <br /> Telephone ` J <br /> Fax <br /> Form I—DRM.S Use and Confidential File Page 3 of 14 <br />