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2 That I did on the
day of
, 19
, duly stake out in accordance with the requirements of these Regulations, a coal mining location, described as follows:
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5 To the best of my information and belief, the location applied for is not already included in an existing coal lease and is not being used by any person as a source of coal, except as follows: (If none, so state) and I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act.
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Fee and Royalty (if applicable) calculated as follows:
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Applicable fee and royalty (if any) are calculated as follows: —
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I
of (Address)(Occupation of applicant) hereby apply for a licence on my behalf or on behalf of
to explore for coal on the following lands described as (indicate in ☐ by (x) which quarter(s) applied for)
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Fee and Deposit calculated as follows:
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