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I,the undersigned,being the NOI holder or the person authorized to sign on behalf of the NOI <br /> holder, declare that the information given in this NOI form is true and correct <br /> SIGNATURES MUST BE IN BLUE INK <br /> Signed and dated this th day of 2 b23 <br /> (date) (month) (year) <br /> Signature of NOI holder or person authorized to sign: C"PO , O. &4- <br /> Name (typed or printed): CNAR LES 0• SPIELM AN <br /> Title/Position: <br /> M:\min\share\vsforms\07-07-01 vsforms\Prospecting forms\NOI Prospecting App,07/24/07 <br /> Form 2—Public File Page 14 of 14 <br />