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Agreement to Conduct Permitting by Electronic Mearns <br />5. Affiant will inform the Division of Reclamation Mining and Safety within thirty <br />(30) days in the event that hisiher authorization to execute ePermitting Documents <br />on the Company's behalf is terminated. <br />Further, Affiant sayeth not. <br />Affiant's name <br />Signature <br />Notarized Affidavit ofSienature <br />STATE OF: <br />COUNTY OF: 1 ss. <br />The foregoing instrument was acknowledged <br />before me this day of by <br />(date) (month) (year) <br />as <br />(Name of permittee representative) (title) <br />of <br />(seal) <br />My Commission expires: <br />(permittee) <br />Page 5 of 6 <br />NOTARY PUBLIC <br />