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-4 - <br />ADDITIONAL INFORMATION <br />This space can be referenced for further information of any of the itemsin this form. <br />To the best of my knowledge, all the information presented in this application is true <br />and correct. <br />Penn Mounta n Mini g I <br />Dater I~t~ ~0, ~y ey: ~ ~ ~ ~~~ <br />President and Mine M r.' <br />to <br />(Signature by individual legally authorized to <br />bind the operator to this application) <br />(Rev. 4/84) <br />Doc. No. 5547 <br /> <br />