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I the undersigned being the NOI holder or the person authorized to sign on behalf of the NOI <br /> holder, declare that the information given in this NOI form is true and correct. <br /> SIGNATURES MUST BE IN BLUE INK <br /> Signed and dated this 1 day of September 2017 <br /> (date) (month) ( ear) <br /> Signature of NOI holder or person authorized to sign. <br /> Name (typed or printed): Jeff Schimel & Jim Reed <br /> Title/Position: Claimants <br /> M:\min\share\vsforms\07-07-01 vsforms\Prospecting forms\NOI Prospecting App.07/24/07 <br /> Form 2—Public File Page 14 of 14 <br />