APPENDIX #1 Form 3400–6 UNITED STATES " FORM APPROVED (October 1968) DEPARTMENT OF THE INTERIOR " BUDGET BUREAU NO. 42–R1373.1 BUREAU OF LAND MANAGEMENT "_____________________________ " " Date "_____________________________ APPLICATION FOR SURVEY OF MINING CLAIM " " SEE INSTRUCTIONS ON REVERSE _____________________________________________"_____________________________ " 1. Name of Applicant " Address (include zip code) (first, middle initial, last)" " ____________________________________"______________________________________ Hereby makes application for an official mineral survey of the mining claims named and identified in this application ___________________________________________________________________________ 2. Give group name (if any) ___________________________________________________________________________ 3. NAME OF CLAIM(S) ___________________________________________________________________________ " " DATE "_________________________________________ " " " " NAME OF LOCATION " LOCATED " RECORDED " AMENDED " AMENDED " " " " RECORDING _________________________________"_________"__________"_________"__________ " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " _________________________________"_________"__________"_________"__________ 4. LOCATION OF CLAIM(S) ___________________________________________________________________________ " " " Section " Township " Range " Meridian " " " ________"__________"_______"_______________________________________________ " " County " State " National Forest " " ___________________"_______"_______________________________________________ 5a. Is each claim based on a valid location and fully described in the certified copy of the record of each location certificate filed with this __ __ application? "__" Yes "__" No b. Is each location distinctly marked by monuments on the ground and can __ __ its boundaries be traced readily? "__" Yes "__" No ___________________________________________________________________________ APPENDIX #1 APPENDIX #2 Form 3860–6 UNITED STATES " Place (October 1976) DEPARTMENT OF THE INTERIOR "_________________________ (formerly 3400–7) BUREAU OF LAND MANAGEMENT " " Date ORDER FOR MINERAL SURVEY "_________________________ To Mineral Surveyor: __ " Sir: Application has been filed in this Office by , dated , 19 . for an official survey of the mining claim consisting of locations named, located, and recorded as follows: ___________________________________________________________________________ Group name, if any ___________________________________________________________________________ " DATE " "____________________________________" NAME OF LOCATION " " " " AMENDED " LOCATED " RECORDED " AMENDED " RECORDING ______________________"___________"____________"___________"_______________ " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " ______________________"___________"____________"___________"_______________ Mining District " County " State " " ______________________"________________________"___________________________ Section " Township " Range " " ______________________"________________________"___________________________ Meridian " National Forest " __________________________________"________________________________________ The claim is fully described in the certified copy of the location certificate filed by the applicant for the survey, copy of which is enclosed herewith. You are hereby directed to make the survey of said claim in strict conformity with existing laws, official regulations, and instructions thereunder, and make proper return of the survey to this Office. This survey will be designated as Mineral Survey Number Very truly yours, __________________________________________ (Authorized Signature) __________________________________________ (Title) APPENDIX #2 APPENDIX #3 No. 345. NOTICE OF LODE LOCATION.-- Bradford Publishing Co., 1824–46 Stout Street, Denver, Colorado _ STATE OF________________________" " " SS. " COUNTY OF ______________________" Know All Men by These Presents, That ______________, the undersigned, ha____ this___________ day of________________, 19___, located and claimed, and by these presents do _____locate and claim by right of discovery and location, in compliance with the Mining Acts of Congress, approved May 10, 1872, and all subsequent Acts, and with local customs, laws and regulations, ____________________ linear feet and horizontal measurement on the ____________________________________________ lode, vein, ledge or deposit, along the vein thereof, with all its dips, angles and variations as allowed by law together with ________________ feet on the ________________ side and ________________ feet on the ________________ side of the middle of said vein at the surface, so far as can be determined from present developments; and all veins, lodes, ledges, or deposits and surface ground within the lines of said claim ________________ feet running ________________ from center of discovery ________________ and ________________ feet running ________________ from center of discovery ________________, said discovery ________________ being situated upon said lode, vein, ledge or deposit, and within the lines of said claim in _______________________________________ Mining District, County of ________________ and State of ________________ Discovered and located ________________________________, 19___ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ APPENDIX #3 APPENDIX #4 Form. 3400–11 UNITED STATES " Mineral Survey number (September 1967) DEPARTMENT OF THE INTERIOR " (formerly 4–683) BUREAU OF LAND MANAGEMENT "_________________________ " State " FIELD NOTES "_________________________ " Land District " _________________________________________________"_________________________ Of the Survey of the Mining Claim of (name and address of Claimant) ___________________________________________________________________________ Known as the (name of group, if any) ___________________________________________________________________________ CONSISTING OF LOCATIONS NAMED AND LOCATED AS FOLLOWS ___________________________________________________________________________ NAME OF LOCATION " DATE "__________________________ " LOCATED " AMENDED ________________________________________________"_____________"____________ " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " " ________________________________________________"_____________"____________ Mining district " County " _____________________________________"_____________________________________ Section " Township "Range "Meridian " Survey under order dated " " " " ____________"____________"___________"__________"__________________________ Survey commenced "Survey completed " Name of Mineral Surveyor " " __________________"__________________"_____________________________________ APPENDIX #4 APPENDIX #5 Form 3860–7 UNITED STATES (November 1976) DEPARTMENT OF THE INTERIOR (formerly 3400–8) BUREAU OF LAND MANAGEMENT CERTIFICATE OF SURVEYOR ___________________________________________________________________________ Name of Mineral Surveyor " Date " ____________________________________________________"______________________ I Hereby Certify That in pursuance of an order received from the , at dated ,19 , I have carefully executed the survey of the claim of known as the (lode, placer, or mill site) situated in , Township , Range , Meridian, in the State of . This survey, designated as number , has been executed by me and under my direction and has been made in strict conformity with said order, the Manual of Instructions for the Survey of Public Lands of the United States, and in specific manner described in the foregoing field notes. I Further Certify That the labor expended and improvements made upon and for the benefit of the (lode or placer) location(s) embraced in the said mining claim by claimant(s) or grantors are fully stated in my report. The character, extent, location, and itemized value are specified in full detail. No portion of, or interest in, said labor and improvements so credited to this claim has been included in the estimate of expenditures upon any other claim. ____________________________________ _____________________________________ (Location) (Signature of Mineral Surveyor) ___________________________________________________________________________ CERTIFICATE OF APPROVAL " Office " "_________________________ " Location " "_________________________ " Date " "_________________________ The foregoing field notes of mineral survey number , in __ __ , "__" surveyed"__" unsurveyed Township , Range , Meridian, in the State of , executed by , Mineral Surveyor, under order dated , 19 , having been critically examined and the necessary corrections made prior to their certification by the surveyor, the field notes and the survey therein described are hereby approved. ____________________________________ _____________________________________ (Authorized Signature) (Title) CERTIFICATE OF TRANSCRIPT I Hereby Certify That the foregoing transcript of field notes of the above-described mineral survey number is a true copy of the original field notes. ____________________________________ _____________________________________ (Authorized Signature) (Title) ___________________________________________________________________________ Title 18, U.S.C. section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any false, fictitious, or fraudulent statements or representations as to any matter within its jurisdiction. ___________________________________________________________________________ APPENDIX #5 APPENDIX #6 Form 3860–8 UNITED STATES " Serial Number (February 1977) DEPARTMENT OF THE INTERIOR " BUREAU OF LAND MANAGEMENT " "_______________________ CERTIFICATE OF EXPENDITURES, IMPROVEMENTS, " Date AND MINERAL SURVEY " ___________________________________________________"_______________________ Name of Claimant " Mineral Survey Number " " ___________________________________________________"_______________________ " I Hereby Certify That the " I Further Certify That the " record of the above-described " record reveals not less than $500 " mineral survey furnishes such an " worth of labor has been expended for " accurate description of all claims " improvements upon or for the benefit " embraced within the survey that it " of each of the lode claims embraced " will, if incorporated into a patent, " within the survey and that the " serve fully to identify the premises " improvements were made by the " and that references are made in the " claimant or his grantors. " survey to natural objects or " " permanent monuments so that the " " location of the claims will be " " perpetuated and fixed. " " _____________________________________"_____________________________________ Date " Authorized Signature " " " ________________"__________________________________________________________ (See reverse) APPENDIX #6 APPENDIX #7 Form 3400–5 UNITED STATES " Place (December 1966) DEPARTMENT OF THE INTERIOR "_____________________________ (formerly 4–286a) BUREAU OF LAND MANAGEMENT " " Date "_____________________________ " " INSTRUCTIONS " " The Director, Bureau of Land " Management, and the manager APPROVAL OF MINERAL SURVEY " of the appropriate land (or " land and survey) office must " be notified of the approval " of each mineral survey, " using this form. _____________________________________________"_____________________________ _____________________________________ _____________________________________ Sir: The following described mineral survey was approved on , 19 : ___________________________________________________________________________ SURVEY NUMBER " NAME OF CLAIM " ACRES ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ " " ______________"_________________________________________________"__________ This survey is actually in conflict with the following approved mineral survey(s) listed by name and number, as marked, defined, and established on the ground ___________________________________________________________________________ Applicant for survey (name and address) ___________________________________________________________________________ Survey made by , Mineral Surveyor. ___________________________________________________________________________ The following legal subdivisions are covered in whole or in part by this survey, if situated on surveyed lands ___________________________________________________________________________ The survey is shown on the diagram below, sketched as actually marked, defined, and established on the ground with respect to the lines of the public land surveys; data relating to courses and distances have been omitted. ___________________________________________________________________________ NOTE -- This sketch will be made in each case where upon surveyed land, whether or not there are any conflicting approved mineral surveys. Conflicting mineral surveys, however, will not be shown upon the sketch. ___________________________________________________________________________ Section , Township , Range Section , Township , Range _____________________________________ ____________________________________ (Title) ___________________________________________________________________________ APPENDIX #7 APPENDIX #8 No. 162. LOCATION CERTIFICATE--Lode Claim.-- Bradford Publishing Co., 1824–46 Stout Street, Denver, Colorado Know All Men by These Presents, That ____________________________________________ ___________________________________________________________________________ ha____ located the ______________________________________ lode mining claim, and by this certificate, and by right of discovery and location, claim_____ ___________________________________ feet, linear and horizontal measurement along the vein thereof, with all its dips, angles and variations as allowed by law ____________________________ feet on said vein running _____________ _____________ from the center of the discovery ____________________________ and feet running ___________________________________ from the center of the discovery ____________________________ , together with ____________________ ______________ feet on each side of the middle of said vein at the surface, and all veins, lodes, ledges, deposits and surface ground within the lines of said claim, situate in _________________________________ Mining District, County of _________________________, and State of _________________________ and described by metes and bounds as follows, to wit: Beginning at Corner No. 1 _________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Said lode was discovered on the _______ day of _______________, 19____ and located on the ______________ day of __________________________, 19____ Dated this _______________ day of ____________________________, 19____ ________________________________[SEAL] ________________________________[SEAL] ________________________________[SEAL] ________________________________[SEAL] ________________________________[SEAL] ________________________________[SEAL] ___________________________________________________________________________ APPENDIX #8 APPENDIX #9 No. 114. ADDITIONAL AND AMENDED LOCATION CERTIFICATE. --Bradford-Robinson Ptg. Co., Mfrs. Robinson’s Legal Blanks, 1824–46 Stout St., Denver, Colorado STATE OF COLORADO, } } } SS. Know All Men By These Presents, County of _______________} That ______________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ the undersigned, ha___ this _____________ day of ___________________, 19___ amended, located and claimed and by these presents do _____ amend, locate and claim, by right of the original discovery and this Additional and Amended Location Certificate, in compliance with the Mining Acts of Congress, approved May 10, 1872, and all subsequent acts, and with Sections 169 and 182, Chapter 110, 1935 Colorado Statutes Annotated, and with local customs, laws and regulations _____________________________________________ ____________________________________ linear feet and horizontal measurement on the ________________________________________________________ lode, vein, ledge or deposit, along the vein thereof, with all its dips, angles and variations, as allowed by law, together with ______________________________ feet on the __________________________ side, and __________________________ feet on the __________________________ side of the middle of said vein at the surface, so far as can be determined from present developments, and all veins, lodes, ledges or deposits and surface ground within the lines of said claim __________________________ feet running ________________________ from center of discovery ________________ and ________________ feet running __________________________ from center of discovery _______________________ said discovery _____________________________ being situated upon said lode, vein, ledge or deposit, and within, the lines of said claim, in ___________ ____________Mining District, County of _______________________ and State of Colorado, described by metes and bounds as follows, to-wit: Beginning in Corner No. 1 This being the same lode originally located on the _________________ day of ______________________ 19____, and recorded on the _________________ day of ______________________ 19____, in Book ________ Page ________ in the office of the Recorder of ____________________ County. This further Additional and Amended Certificate of Location is made without waiver of any previously acquired rights, but for the purpose of correcting any errors in the original location, description or record, and of taking in and acquiring all forfeited or abandoned overlapping ground, and of taking in any part of any overlapping claim which has been abandoned, and of securing all the benefits of said Sections 169 and 182, Chapter 110, 1935 Colorado Statutes Annotated. Said lode was discovered the ________ " ___________________INTEREST. [SEAL] " day of _________________ A. D. 19____ " ___________________INTEREST. [SEAL] " ATTEST: " ___________________INTEREST. [SEAL] " _____________________________________ " ___________________INTEREST. [SEAL] " Date of Additional and Amended Cer- " ___________________INTEREST. [SEAL] " tificate _______________ A. D. 19____ " ___________________INTEREST. [SEAL] APPENDIX #9 APPENDIX #10 _________________________ " " " FOR RECORDER’S USE ONLY " " " Recorded at the request of: NOTICE " " " " ________________________________ " " " " When recorded please mail to: " " OF " " Name ___________________________ " " " " " " Street _________________________ " " LOCATION " " " " City ___________________________ " " " " " " State __________________________ LODE " " " " "_________________________" TO WHOM IT MAY CONCERN: Please take notice that: 1. The name of this claim is the _____________________ Lode Mining Claim. Said claim is situated in the vicinity of _______________________ or in the ________________________________________________ Mining District, County of San Bernardino, State of California. The date of this location is the __________ day of _________________, 19___ 2. The undersigned locators are citizens of the United States, or have declared their intention to become such. 3. The said locator___ do____ hereby locate and claim ___________________ (Not to exceed 1500) linear feet of this vein or lode, together with surface ground extending ___________________ feet in width on each side of the middle of said vein (Not to exceed 300) or lode and more particularly described as follows: Commencing at the monument where this notice is posted, which monument is at the point of discovery on said vein or lode and on the center line of this location _________ hereby claim ______________ feet extending in a (I or We) ______________ direction along the course of said vein from the discovery monument and _______________ feet in a _______________ direction from the discovery monument, along the course of said vein. The general course of said vein is in a _________erly and ___________erly direction. The discovery monument is situated about ________________________________ ___________________________________________________________________________ (Distance from natural object or permanent monument and give direction) ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 4. All dips, variations, spurs, angles and all veins, ledges, or deposits within the lines of this claim, together with all water and timber and any other rights appurtenant, allowed by the laws of this State or of the United States are hereby claimed. LOCATORS ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ STATEMENT OF THE MARKING OF THE BOUNDARIES AND OF PERFORMANCE OF DISCOVERY WORK NOTICE IS HEREBY GIVEN by the undersigned locator--that in accordance with the provisions of the Mining Law:-- 1. There has been erected at the discovery point, at each corner and at the center of each end line of said claim ___________________________________________________________________________ ___________________________________________________________________________ 2. The Locator has performed the following discovery work: ________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ DATED _____________________, 19___ LOCATORS ______________________________________ ______________________________________ ______________________________________ PA 1561–-4M–3–62 ______________________________________ APPENDIX #10 APPENDIX #11 No. 296. LOCATION CERTIFICATE.--Tunnel.--Bradford Publishing Co., 1824–46 Stout Street, Denver, Colorado--3–72 ___________________________________________________________________________ STATE OF ________________________} } } SS. } County of _______________________} TO ALL WHOM THESE PRESENTS MAY CONCERN: Know ye, that _____________________ ___________________________________________________________________________ ______________________________________ citizen_____of the United States, of _____________________________, County of ___________________________, State of ____________________, do hereby declare and publish as a legal notice to all the world, that _____ have a valid right to the occupancy, possession and enjoyment of the ______________________________________________________ _________________________________, located _________________________, 19___ for the discovery of mines and the development of lodes, and situate in _________________________________ Mining District, ________________________ County, State of _________________________, described as follows, to-wit: Mouth of tunnel situate _________________________________________________ _____________________________________________; from the mouth of the tunnel ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Size of tunnel ________________ feet wide by ______________ feet high in the clear. Course of tunnel from its mouth, __________________________ 3,000 feet to the ________________ end of said tunnel, at which end is set a substantial ______________________________ being the end _____________________________, and between the tunnel mouth and the end _______________________ the center line of the tunnel is marked at _________ feet, __________ feet, _________ feet, _________ feet, _________ feet, _________ feet, _________ feet from the mouth by marked stakes or blazed and marked trees. From the end ___________________________________________________________________________ bears _____________________________________________________________________ bears _____________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ from said end ______________, set a stake _________________________________ ___________________________________________________________________________ from said end ______________, set a stake _________________________________ ___________________________________________________________________________ from mouth of tunnel set a stake __________________________________________ ___________________________________________________________________________ from mouth of tunnel set a stake __________________________________________ ___________________________________________________________________________ which last four mentioned stakes _____________________ the exterior corners of the claim of said tunnel site. And ___________________ claim for line of tunnel 1,500 feet on each side of the center of the bore or course of the tunnel, and the right to all lodes which may be discovered in the due prosecution of said tunnel within 1,500 feet on each side of the center of said line. _______________________ also claim a square tract of land 125 feet on each side of the mouth of tunnel and extending 250 feet immediately below the mouth of the tunnel, as staked upon the ground, for dumping purposes. Together with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining, and all rights granted to the locator ___________________ as tunnel rights under the terms of Section 2323 of the Revised Statutes of the United States. WITNESS __________ hand___ and seal___ this _________________________ day of ______________________, 19___ _____________________________________[SEAL] _____________________________________[SEAL] _____________________________________[SEAL] _____________________________________[SEAL] ___________________________________________________________________________ APPENDIX #11 APPENDIX #12 STATE OF ________________________} } SS. County of _______________________} Before me, the subscriber, a notary public in and for said County, personally appeared _______________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ to me personally known to be the same person_____described in and who executed the within declaration of occupation, and acknowledged that ______ h_____ signed, sealed and published the same as ______h_____ free and voluntary act and deed for the uses and purposes therein set forth. WITNESS my hand and seal, this _____________ day of _____________________, 19____ My commission expires _____________________________________________, 19____ _____________________________________________________ Notary Public. ___________________________________________________________________________ STATE OF ________________________} } SS. County of _______________________} ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ of the Count ______ of ___________________________________________ State of ______________________, being first duly sworn according to law, depose and say_______: That_____h_____ citizen___ of the United States over the age of twenty-one years; that _____ h_____ owner_____ by pre-emption, location and occupation of the foregoing tunnel site, the said tunnel being prosecuted for the development of lodes belonging to said affiant_______, also for the discovery of other lodes; affiant___ further say ______ that ____ h_______ ha___ expended in actual work and improvements on said tunnel not less than __________________________________________________________________ Dollars, and that said tunnel has already been run the distance of _________________ ___________ feet, and that it is bona fide ___ h______ intention to prosecute work on said tunnel, so located and described, with reasonable diligence for the purposes therein set forth. ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ SUBSCRIBED and sworn to before me this ________________________________ day of ____________________________, 19____ My commission expires ______________________________________________, 19___ ____________________________________________ Notary Public. _______________________________________ LOCATION CERTIFICATE OF TUNNEL AND TUNNEL SITE _______________________________________ Tunnel and Tunnel Site of _____________ _______________________________________ in _____________________________ Mining District, _____________________ County, State of ______________________________ _______________________________________ STATE OF ________________________} } SS. County of _______________________} I hereby certify that this Location Certificate was filed for record in my office at _____________ o’clock ____M., _________________________________ 19___ and is duly recorded in book __________ at page _______________________________ _______________________________________ Recorder. By ____________________________________ Deputy. _______________________________________ Fees, $________________________________ _______________________________________ --------------------------------------- BRADFORD PUBLISHING COMPANY CO., DENVER APPENDIX #12 APPENDIX #13 Recorded at________o’clock______M.,_________________ Reception No._____________________________ Recorder. -------------------------------------------------------------- Know All Men By These Presents: That,______________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ the undersigned citizens of the United States, residents of the County of_______________, State of________________________, having complied with the provisions of Chapter 6, Title XXXII, of the Revised Statutes of the United States, and with the local customs, laws and regulations, claim by right of discovery and location, The ___________________________________ placer claim, situate, lying and being in______________________ Mining District, County of_______________________, and State of ____________________, described by metes and bounds as follows, to wit: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ ______________________________ area ____________________ acres, said claim was located on the_______ day of__________, 19_____. Date of certificate________________________, 19_____. Attest: ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ No. 161. PLACER LOCATION CERTIFICATE.--Bradford Publishing Co., 1824–46 Stout Street, Denver, Colorado (573–5011)-–5–77 APPENDIX #13 APPENDIX #14 No. 270. LOCATION CERTIFICATE--Mill Site.--Bradford Publishing Co., 1824–46 Stout Street, Denver, Colorado (573–5011)-–6–77 ------------------------------------------------------------------- LOCATION CERTIFICATE OF MILL SITE STATE OF_________________ } } SS. County of_________________ } To All Whom These Presents May Concern: Know ye that ____________________________________________________ ___________________________________________________________________ of ________________________________________________________________ ___________________________________________________________________ do______hereby declare and publish as a legal notice to all the world that_______have a valid right to the occupation, possession and enjoyment of all and singular that tract or parcel of land not exceeding five acres, situate, lying and being in_____________________________________________Mining District, in the County of_________________, in the State of__________________, bounded and described as follows, to wit: The______________________Mill Site,beginning at Cor. No. 1_______ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ together with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining. Witness______hand_____and seal______, this__________day of________, 19____. _______________________________[SEAL] _______________________________[SEAL] _______________________________[SEAL] _______________________________[SEAL] _______________________________[SEAL] _______________________________[SEAL] _______________________________[SEAL] _______________________________[SEAL] ------------------------------------------------------------------ APPENDIX #14 |