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NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or <br /> as supplemental information to this NOI. GPS measurements will be acceptable for this <br /> purpose: <br /> Lat: x: E 759601 (PLAP22-01 M) <br /> Long: Y: N 4145870 <br /> 6. LAND OWNERSHIP: <br /> Private Public Domain (BLM) ❑ National Forest(USFS) <br /> State 0 State Sovereign Lands ❑ Other(please describe) <br /> If prospecting is located on BLM or USFS land the remaining section must be <br /> completed,otherwise go to section II Maps&Drawings <br /> 7. PROSPECTING ON BUREAU OF LAND MANAGEMENT (BLM) LAND AND U.S. FOREST <br /> SERVICE (USFS) LAND <br /> The Division and the BLM/USFS have entered into cooperative agreements that eliminate <br /> the need for a prospector to post a financial warranty with each agency and allow them <br /> to coordinate the review of the NOI in order to minimize administrative processing time <br /> and effort <br /> A. CLAIMANT: <br /> Name <br /> Address <br /> City, State, Zip r <br /> Telephone ` <br /> Fax ` <br /> Form 2—Public File Page 3 of 14 <br />