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Targeted Mineral Explora�on Incen�ve – Applica�on Form

Saskatchewan Geological Survey


610-1945 Hamilton Street
Application is hereby made under the provisions of The Targeted
Regina, SK S4P 2C7
Mineral Exploration Incentive Regulations (TMEI Regulations). Phone: 306 798-4212 I Email: tmei@gov.sk.ca

PART 1 – Applicant Informa�on

Applicant (company or person)


Contact Person and Title
Mailing Address
Email
Phone

PART 2 – Project Informa�on

Project Name Expected # of Claims


Work Start Date Expected # of Drill Holes
Work End Date Es�mated Direct Drill Costs
Es�mated Total Drill
Primary Commodity Targeted
Program Expenditures

PART 3 – Schedule of Disposi�ons

NOTE: A signature of Authoriza�on is required by the holder of a claim if a “designate”—as per Sec�on 5 of The Targeted
Mineral Exploration Incentive Regulations—is applying for the TMEI funding.

Claim Number Claim Holder Percent Held Signature of Authoriza�on

PART 4 - Declara�on

I, , hereby declare the details of this applica�on to be accurate and true.

Signature: Date:

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