CLTA Mining Claim Certificate 18

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF LAND MANAGEMENT

CERTIFICATE OF TITLE ON MINING CLAIMS

Form Approved

Budget Bureau No. 42-R1203.1

Mineral Entry Serial Number

___ An individual

___ a corporation, hereby

certifies that an examination of the instruments shown by the indices in the office of the

Recorder of the County of ______________, State of __________________, discloses

that the title to the mining claim hereinafter described that was acquired by the locators of

said claim by the filing of said claim is at the date hereof vested in

Subject to:

(1) Paramount title of the United States of America.

(2) Any taxes or assessments that may be a lien.

(3) The inadequacy of any evidence of labor that may appear of record.

(4) Adverse rights which may exist by reason of any encroachment of other mining claims onto the claim hereinafter described or of any overlapping of the boundaries of said claim onto other claims.

The mining claim above referred to is that certain claim situated in the ______________

mining district, County of _______________, State of _____________________, more

particularly described as follows (see instructions):

This certificate is issued and accepted upon the understanding that the liability assumed hereby shall not exceed $100.

Seal

____________________________________________

(Individual or Firm Name)

____________________________________________

(Address)

By (Signature)

_________________________

(Date)

Instructions Attached

INSTRUCTIONS

1. Description of mining claims may be incorporated by reference to and attachment of a certified copy of certificate of location.

2. A certificate, when executed by a corporation, must:

(a) bear the corporate seal;

(b) indicate where corporation was organized; and,

(c) indicate authority to do business in the state in which the land is located.

For issuing guidelines on this form, see Guidelines