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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 />m S 112%e=D1 <br />Notarized Affidavit of Signature <br />STATE OF: CD\ ) <br />COUNTY OF: ) ss. <br />The foregoing instrument was acknowledged <br />before me this '� D day of <br />(date) <br />as L <br />(Name of permittee' 4 resentative) (title) <br />FASHLEY TOBIAS <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID 20174029217 <br />MYCOMMISSION EXPIRES JULY 12, 2021 <br />(seal) <br />My Commission expires: <br />),D1-1 by <br />(month) (year) <br />of 5 Q W D I es aj e, , _- <br />(permittee) <br />Page 5 of 6 <br />NOTARY PLIBLIC <br />