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RANGE (write number and check direction) R East West <br />QUARTER SECTION (check one): fl NE NW SE SW <br />QUARTER/QUARTER SECTION (check one): NE __ _ NW SE SW <br />GENERAL DESCRIPTION: (the number of miles and direction to the nearest town and the approximate elevation): <br />11. LAND 03b 1' ERSHIP <br />G. CLAIMANT: <br />Name: Patriot Diamonds Inc/ Colorado Blue Diamonds Inc <br />Address: Suite 2, Mount Royal Village, 880 -16th Avenue SW, Calgary, AB T2R 1J9 Canada <br />Telephone: 403 - 294 -5713 <br />Fax Number: 403 - 262 -4860 <br />H. SITE /CLAIM INFORMATION: <br />NAME <br />2 (FORM 2 - Public filing) <br />NOTE: Supply longitude and latitude or UTM coordinates if lands have not been surveyed or as supplemental information to <br />this NOI. GPS measurements will be acceptable for this purpose: <br />Private I,� Public Domain (BL National Forest (USFS) <br />State ] C State Sovereign Lands Other (please describe): <br />SERIAL NUMBER LEGAL DESCRIPTION <br />rA <br />If prospecting is located on BLM or USFS land the remaining section must be completed, <br />otherwise go to section II Maps & Drawings <br />12. PROSPECTING ON BUREAU OF LAND MANAGEMENT (BLM) LAND AND U.S. FOREST SERVICE (USFS) <br />LAND <br />The Division and the BLM/USFS have entered into cooperative agreements that eliminate the need for a prospector to post a <br />financial warranty with each agency and allow them to coordinate the review of the NOI in order to minimize administrative <br />processing time and effort. <br />List names, serial numbers and provide legal description to nearest quarter- quarter section of all sites or claims (attach <br />additional page, if necessary). <br />