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12/4/2017 Annual Report ePermitting Signup - Google Forms <br />https://docs.google.com/forms/d/1lrxOW3YTBhUqGtqfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNhfGWv8L0PrEsdfzVpZWd6CISbtqr_…1/4 <br />22 responses <br />Accepting responsesSUMMARYINDIVIDUAL <br />of 22 <br />Responses cannot be edited <br />Annual Repor t ePermitting Signup <br />* Required <br />Please complete this form to create an ePermitting account for <br />submittal of annual reports and fees. You will receive an email with <br />your login information within one business day. <br />Nemwont Mining Corporation Cripple Creek & Victor Gold Mine <br />21 <br />Name of Permittee or NOI Holder: * <br />Annual Report ePermitting SignupQUESTIONS RESPONSES 22