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I,the undersi_gned,being the NOI holder or the person authorized to sign on behalf of the NOI holder, <br /> 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 L 41.� day of Oct _ o Z 3 <br /> (date) (month) (ye <br /> Signature of NOI holder or person authorized to sign: <br /> Name(typed or printed): jc-J:)tt ?o�+ o Y r <br /> Title/Position: 2w-, e`-{ nn a ✓' <br /> M:\min\oss\slb\MineralsForms\ProspectForm2 <br /> 30 Aug 2017 <br /> Form 2-Public File Page 21 of 21 <br />