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I the undersigned beine the NO holder or the person authorized to sign on behalf of the N01 <br /> holder declare that the information given in this N01 form is true and correct <br /> SIGNATURES MUST BE IN BLUE INK <br /> Signed and dated this day of A 202� <br /> (date) month) ear) <br /> Signature of NOI holder or person authorized to sign: <br /> Name (typed or printed): <br /> Title/Position: <br /> Z?< .zL-4TD.4, <br /> M:\m i n\oss\s lb\Mineral sForms\Pros pec[Form Z <br /> 30 Aug 2017 <br /> w <br /> j <br /> e 5: <br /> F <br /> qq Y <br /> �II <br /> 3 P'g9C 14 of lei <br /> +rcnugj3.xs <br /> t <br />