32D04SW9783 53 GAUTHIER

010

DIAMOND DRILLING
TWP/AREA GAUTHIER REPORT NO. 53 MOOSE CRESSING FARM/R. HILL WORK PERFORMED FOR:

RECORDED HOLDER: SAME AS ABOVE [X ] : OTHER[ CLAIM NO.

HOLE NO.

FOOTAGE

DATE

NOTE

L30263 L30263

92-G1 92-G-2

136 ft. 119 ft.

Sept. 10/92 Nov. 5.92

(l))

NOTES: (D W9380.00330

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* ^"^ Ministry of Northern Development

Report of Work Conducted After Recording Claim

Mining Act

Transaction Number

Ontario

Personal Information collected on this form Is obtained under the authority of the Mining Act. This information will be used for correspondence. Questions about this collection should be directed to the Provincial Manager, Mining Lands, Ministry of Northern Development and Mines, Fourth Floor, 159 Cedar Street, Sudbury, Ontario, P3E 6A5, telephone (705) 670-7264.

Instructions: - Please type or print and submit in duplicate. -Refer' " "' ' Recoi - A sep - Techr
- A Ske 330845*9783 53 GAUTHIER

ONTARIO GEOLOGICAL SURVEY GIS-ASSESSMENT FI - ASSESSMENT FILES , issment work or consult tl Minin the

DEC 2 i 1993
900

ar y this

Recorded Holder(s) Address

R.

Telephone No.
L-0

Mining Division Dates Work Performed From:

fSo

M or Q Plan No.

71

To:
Type
i ^jNJK5 1}|^M0AJD J^ltU/A/4

/k

Work Performed (Check One Work Group Only)

Work Group Geotechnical Survey

V Including Drilling
Rehabilitation Other Authorized Work Assays Assignment from Reserve

Physical Work,

Total Assessment Work Claimed on the Attached Statement of Costs Note: The Minister may reject for assessment work credit all or part of the assessment work submitted if the recorded holder cannot verify expenditures claimed in the statement of costs within 30 days of a request for verification. Persons and Survey Company Who Performed the Work (Give Name and Address of Author of Report)
Name Address

( as

(attach a schedule If necessary)

Certification of Beneficial Interest * See Note No. 1 on reverse side

1 certify that at the time the work was performed, the claims covered in this work report were recorded in the current holder's name or held under a beneficial interest by the current recorded holder. Date

* /M

Recorded, Holder or Agent (Signature)

'

Certification of Work Report

l certify that l have a personal knowledge of the facts set forth In this Work report, having performed the work or witnessed same during and/or after its completion and annexed report is true. Name and Address of Person Certifying Telepone No. Date Certified B

A3

For Office Use Only

Total Value Cr. Recorded Date Recorded Deemed Approval Date

^-

bc.

43

^"7 C

Date Approved

n'IVISIOi
M DEC 6 Pl'l 3 n 1=7.

Date Notice for Amendments Sent

0241 (03/91)

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1. 2. 3. D Credits are to be cut back starting with the claim listed last, working backwards. 0 Credits are to be cut back equally over all claims contained in this report of work. D Credits are to be cut back as prlorized on the attached appendix. In the event that you have not specified your choice of priority, option one will be implemented.
Note 1:

gel 3 |sP

Credits you are claiming in this report may be cut back. In order to minimize the adverse effects of such deletions, please indicate from which claims you wish to priorize the deletion of credits. Please mark (s) one of the following:

Examples of beneficial Interest are unrecorded transfers, option agreements, memorandum of agreements, etc., with respect to the mining claims. Note 2: If work has been performed on patented or leased land, please complete the following:
l certify that the recorded holder had a beneficial interest in the patented or leased land at the time the work was performed. Signature 'A

\/

Ministry of

Northern Development
Ontario and Mines

Statement of Costs for Assessment Credit litat des coOts aux fins du credit d'evaluation
Mining Act/Loi sur les mines

Transaction No./N 0 de transaction

Ilistere du Seveloppement du Nord et des mines

Personal information collected on this form Is obtained under the authority of the Mining Act. This Information will be used to maintain a record and ongoing status of the mining claim(s). Questions about this collection should be directed to the Provincial Manager, Minings Lands, Ministry of Northern Development and Mines, 4th Floor, 159 Cedar Street, Sudbury, Ontario P3E 6A5, telephone (705) 670-7264.

Les renseignements personnels contenus dans la presente formule sont recueillis en vertu de la Lol sur les mines et serviront a tenir a jour un registre des concessions minieres. Adresser toute quesiton sur la collece de ces renseignements au chef provincial des terrains miniers, ministere du Developpement du Nord et des Mines, 159, rue Cedar, 4e etage, Sudbury (Ontario) P3E 6A5, telephone (705) 670-7264.

1. Direct Costs/CoQts directs

Type Wages Salalres
Description

2. Indirect Costs/CoOts Indlrects

Amount Montant
Totals Total global

Labour Main-d'oeuvre Field Supervision Supervision sur le terrain

y/jTo
J/W

* * Note: When claiming Rehabilitation work Indirect costs are not allowable as assessment work. Pour le remboursement des travaux de rehabilitation, les couts. indirects ne sont pas admissibles en (ant que travaux devaluation. Type Transportation Transport
Type Description Amount Montant Totals Total global

4ss*

Contractor's and Consultant's Fees Drolls de ('entrepreneur t de ('expertconsell Supplies Used Fournltures utlllsees

Type

Type

GIC& (bf d*v*\\i

f f***fil)

/57"

1*7"
Equipment Rental Location de materiel Type SofJtt, &2-1*- 4ZSTrO"*

Food and Lodging Nourrlture et h6bergement Mobilization and Demobilization Mobilisation et demobilisation

r^ofC .

1 3*.81

Sub Total of Indirect Costs Total partial des couts Indlrects

w
l** *
73 W

Z^bo^
Total Direct Costs Total des coOts directs

Amount Allowable (not greater than 20H ol Direct Costs) Montant admissible (n'excedant pas 20 W des couts directs) Total Value of Assessment Credit (Total of Direct and Allowable
Indirect eoatil

7Z07"

Valeur totale du credit devaluation

(Total du coflti direct*

t Indirect! idmlulbles

Note: The recorded holder will be required to verify expenditures claimed in this statement of costs within 30 days of a request for verification. If verification Is not made, the Minister may reject for assessment work all or part of the assessment work submitted.

Note : Le titulaire enregistre sera tenu de verifier les depenses demandees dans le present etat des coQts dans les 30 jours suivant une demande a cet effet. Si la verification n'est pas effectuee, le ministre peut rejeter tout ou une partie des travaux devaluation presented.

Filing Discounts 1. Work filed within two years of completion is claimed a\nOOVo)ot the above Total Value of Assessment Credit. ^s*^ 2. Work filed three, four or five years after completion is claimed at SOW of the above Total Value of Assessment Credit. See calculations below:
Total Value of Assessment Credit x 0.50 Total Assessment Claimed

Remises pour depot

1. Les travaux deposes dans les deux ans suivant leur achievement sont rembourses a 100 07o de la valour totale susmentionnee du credit devaluation. 2. Les travaux deposes trois, quatre ou cinq ans apres leur achievement sont rembourses a 50 "/o de la valour totale du credit devaluation susmentionne. Voir les calculs ci-dessous.
Valeur totale du credit devaluation Evaluation totale demandee

x 0,50 -

Certification Verifying Statement of Costs

l hereby certify: that the amounts shown are as accurate as possible and these costs were incurred while conducting assessment work on the lands shown on the accompanying Report of Work form.

Attestation de l'etat des coOts

J'atteste par la presente : que les montants indiques sont le plus exact possible et que ces depenses ont et6 engagees pour effectuer les travaux d'evaluation sur les terrains indiques dans la formule de rapport de travail ci-joint. Et qu'a titre de
(titulaire enregistre, representant, poste occupe dans la compagnle)

that as ___^.

l Holder; Ageny Position In Company)

f .

l am authorized

je suis autoris6

to make this certification

a faire cette attestation.

Signature /' J ;. Date

Wfe^0212 (04/91)

j^ c 3/13

Nota : Dans cette formule, lorsqu'il designe des personnes, le masculin est utilise au sens neutre.