NOTICE!! · 2019. 12. 17. · NOTICE!! These documents have been scanned! Do not place un-scanned...

NOTICE!!These documents have been scanned!

Do not place un-scanned documents beneath this notice!

Do not remove this notice from this file!

GPO Jacket No. 560-102 Print Order 61540

Rise Business Services, LLC Job=AZ15 5/10/2019

III nil III HIM IIIBox Number= AZ15031

III III III IIII III II H III III lllll II III 11 INIClaim Begin-End: AMC429557-AMC429557

1 Initial Receipt

AZ15031-4 AMC429540-AMC429995

AMC# DAT^fifcsED REMARKS

W ^ - 7

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i

NO WARRANTY IS MADE BY BLM FOR USE OF THE DATA FOR

PURPOSES NOT INTENDED BY BLM

of 1I» •United States Department of the Interior

Bureau of Land Management ReceiptLANDS/RECREATION & PLANNING

ONE N CENTRAL AVE PHOENIX, AZ 85004 -2203!

Phone: 602-417-9200No:

r nrm ՛ Jk_i_3152366

T ransaction #: 3244711 D ate o f Transaction: 10/20/2014 L _ P _ vBY:

CUSTOMER:JIMMY STEWART 9110 S TRAFALGAR DR KIRKLAND,AZ 86332-4004 US

L IN E# QTY D E SC R IPT IO N R E M A R K S

U NITPR IC E TO TA L

1 1.00

LOCATABLE MINERALS / MINING CLA1MS- NEW.UNADJUD, ONE OR MORE AUTH NOS / NEW MINING CLAIMS LOCATION FEE C A SES: AMC429557/S37.00

- n/a - 37.00

2 1.00LOCATABLE MINERALS / MINING CLAIMS- NEW,UNADJUD, ONE OR MORE AUTH NOS / NEW MINING CLAIM PROCESSING FEE C A SES: AMC429557/S20.00

- n/a - 20.00

ՂJ 1.00

LOCATABLE MINERALS / MINING CLAIMS- NEW,UNADJUD, ONE OR MORE AUTH NOS / NEW MINING CLAIMS MAINTENANCE FEE C A SES: AMC429557/S 155.00

- n/a - 155.00

T O T A L : $ 2 1 2 .0 0

PAYMENT INFORMATION1 AMOUNT: 212.00 POSTMARKED: N/A

TYPE: CHECK RECEIVED: 10/17/2014CHECK NO: 1149

NAME: STEWART. JIMMY 9110 S TRAFALGAR DR KIRKLAND AZ 86332-4004 US

REMARKS

This receipt was generated by the automated BLM Collections and Billing System and is a paper representation o f a portion o f the official electronic record contained therein.

10/20/14

NOTICE!!

These documents have been scanned!



GPO Jacket No. 560-102 Print Order 61540

Rise Business Services, LLC Job=AZ15 5/10/2019

Box Number= AZ15031

Claim Begin-End: AMC429557-AMC429557

2 Correspondence

AZ15031-4 AMC429540-AMC429995

AZ15031

AMC429557-AMC429557

BREAK

7014

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DGU.S. Postal Service tm y*CERTIFIED MAIL™ RECEIPT(Domestic Mail Only; No Insurance Coverage Provided)

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O F F I C I U - 4 J r S EPostage

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Return Receipt Fee (Endorsement Required)

Restricted Delivery Fee (Endorsement Required)

Total Postage 8>

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2615 Jl L I 5 pP na2: 2 8

t à 1 L 11 A I f A i v i i - O N / A

TRACEY LOHMANNSent To

7170 W CLARE ISLAND DR KIRKLAND, AZ 86332-5002

m~staie;zip+. 93X0/RM/AMC429557PS Form 3800,

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■ Print your name and address on the reverse so that we can return the card to you.

■ Attach this card to the back of the mallpiece, or on the front if space permits.

1. Article Addressed to:

TRACEY LOHMANN 7170 W CLARE ISLAND DR KIRKLAND, AZ 86332-5002 9310/PM/AMC429557

AgentAddressee

C. Date of Delivery

from item i? Yes If YES, enter deliveryaddress below: □ No

Z0I5 JUL 20 P U: 01

P H O E N I X , A R I Z O N A3. Service Type

□ Certified Mail® □ Priority Mail Express"□ Registered □ Return Receipt for Merchandise□ Insured Mall □ Collect on Delivery

4. Restricted Delivery? (Extra Fee) □ Yes

2. Article Number(Transfer from service label) 7G14 G15D ODDO 5453 DIDD

PS Form 3811, July 2013 Domestic Return Receipt

U nited First-Class Mail Postage & Fees Paid USPSPermit No. G-10

AZSS2 IB JUL M 5

• Sender: Please print your name, address, and ZIP+4® in this box*

UNITED STATESDEPARTMENT OF THE INTERIOR

Bureau of Land Management Arizona State Office

One N. Central Avenue, Suite 80G Phoenix, AZ 85004-4427

,Vllli|ii!ii,|iiìl,Ì,f,)Ì!i,l,ll,,lÌi,,iii,ii,' ,iiiÌÌli,,'*'ÌlÌÌ

»* • •United States Department of the interior

BUREAU OF LAND MANAGEMENT Arizona State Office

One North Central Avenue. Suite 800 Phoenix, Arizona 85004-4427

www.blm.gov/az/

JUL t 3 2015

In Reply Refer To:3800 (9310) RM AMC429557

CERTIFIED MAIL - RETURN RECEIPT REQUESTED No. 7014 0150 0000 5453 0900

NOTICE

TRACEY LOHMANN : This Notice Affects the Claims7170 W CLARE ISLAND DR : Shown in the Block Below.KIRKLAND, AZ 86332-5002 :

AMC429557 'NEW LORRIAN

Mining Claim Location Noticefsl - Amendmentis) Required

Pursuant to Title 43 Code of Federal Regulations (CFR) 3832.1, the Bureau of Land Management (BLM), Arizona State Office, received your notices of location for recording mining claims. In accordance with 43 CFR 3832.12, the claims listed above cannot be accepted as filed and must be amended as noted below.

Lode claims must be described by metes and bounds with a tie-in between a comer of the claim and a permanent monument (such as a section quarter-comer survey monument).

When amending a claim, you cannot take in any new ground. Amending the claim may result in a claim that contains significantly less acreage than was originally located. If you wish to retain the same acreage, you may want to relocate the claim(s) correctly, rather than amend the incorrectly located claim(s).

You must file an amendment for each claim listed above to correct the defects identified. There is a $10 BLM processing fee for each amendment. We must receive the amendments within 30 days of your receipt of this notice. If the amendments are not received within the 30 day timeframe the mining claims will be declared null and void.

http://www.blm.gov/az/

2

If additional information is required, please contact ReAnn Myers at 602-417-9413. Please include your AMC serial number(s) on all correspondence.

Sincerely,

Rebecca HeickActing Deputy State DirectorLands & Minerals Division

Enclosures

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- ARIZONA

Postage

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Total Postage ? c —

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Street, Apt. No.; or PO Box No.

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JIMMY STEWART 9110 S TRAFALGAR DR KIRKLAND, AZ 86332-4004 9310/RM/AMC429557

PS Form 3800,

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Complete Items 1,2, and 3. Also complete item 4 if Restricted Delivery is desired.Print your name and address on the reverse so that we can return the card to you.Attach this card to the back of the mailplece, or on the front if space permits.


JIMMY STEWART

9110 S TRAFALGAR DR KIRKLAND, AZ 86332-4004 9310/RM/AMC429557

COMPLETE THIS SECTION ON DELIVERY

□ Agent S Addressee

B: Received by (

/ ML*a - -C. Date of Delivery

f - / ----L'L .I! — 'Ip r Is delivery address different from ltem'1? L tU Yes

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/ÖI5 JUL 20 P U: 01

PHOENIX. A R I Z O N A3. Service Type

□ Certified Mall® □ Priority Mail Express”□ Registered □ Return Receipt for Merchandise□ Insured Mail □ Collect on Delivery

4. Restricted Delivery? (Extra Fee) □ Yes

2. Article Number(Transfer from service label) 7D14 DISCI Ö0DD 5453 0ÖÖ7

PS Form 3811, July 2013 Domestic Return Receipt

United States Postal Service First-Class Mall Postage & Fees Paid USPSPermit No. G-10

• Sender: Please print your name, address, and ZIP+4® in this box*



One N. Central Avenue, Suite 800 Phoenix, AZ 85004-4427

United States Department of the InteriorBUREAU OF LAND MANAGEMENT

Arizona State Office One North Central Avenue, Suite 800

Phoenix, Arizona 85004-4427 www.blm.gov/az/

JUL 1 3 2015



NOTICE

JIMMY STEWART : This Notice Affects the Claims9110 S TRAFALGAR DR : Shown in the Block Below.KIRKLAND, AZ 86332-4004 :

AMC429557 NEW LORRIAN

Mining Claim Location Notice(s) - Amendmentfs) Required

Pursuant to Title 43 Code of Federal Regulations (CFR) 3832.1, the Bureau of Land Management (BLM), Arizona State Office, received your notices of location for recording mining claims. In accordance with 43 CFR 3832.12, the claims listed above cannot be accepted as filed and must be amended as noted below.



You must file an amendment for each claim listed above to correct the defects identified. There is a $10 BLM processing fee for each amendment. We must receive the amendments within 30 days of your receipt of this notice. If the amendments are not received within the 30 day timeframe the mining claims will be declared null and void.

http://www.blm.gov/az/

. s

2


Sincerely,


Enclosures

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Certified Fee



Total Postage £

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2015 JUL

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Sent To

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FRED HELMECKE8220 W FRAMINGHAM RDKIRKLAND, AZ 86332-4048or PO Box No.

"ciiy,'stale) zfp+ g310/RM/AM C429557

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■ Print your name and address on the reverse so that we can return the card to you.

■ Attach this card to the back of the mailpiece, or on the front if space permits.


FRED HELMECKE 8220 W FRAMINGHAM RD KIRKLAND, AZ 86332-4048 9310/RM/AMC429557

COMPLETE THIS SECTION ON DELIVERY

United States>Postal Service

■ fiZ’BGBL .20 JLJL a±S

’O- -V.• Sender: Please print your name, address, and ZIP+4® in this box*

UNITED STATES DEPARTMENT OF THE INTERk


One N. Central Avenue, Suite 300 Phoenix, AZ 85004-4427

First-Class Mail Postage & Fees Paid USPSPermit No. G-10

......................................... .

United States Department of the InteriorBUREAU OF LAND MANAGEMENT

Arizona State Office One North Central Avenue. Suite 800

Phoenix, Arizona 85004-4427 www.blra.gov/az/

JUL 1 3 2015



NOTICE

FRED HELMECKE : This Notice Affects the Claims8220 W FRAMINGHAM RD : Shown in the Block BelowKIRKLAND, AZ 86332-4048 :

AMC429557 NEW LORRIAN

Mining Claim Location Noticeisi - Amendment's^ Required

Puisuant to Title 43 Code of Federal Regulations (CFR) 3832.1, the Bureau of Land Management (BLM), Arizona State Office, received your notices of location for recording mining claims. In accordance with 43 CFR 3832.12, the claims listed above cannot be accepted as filed and must be amended as noted below.



You must file an amendment for each claim listed above to correct the defects identified. There is a $ 10 BLM processing fee for each amendment. We must receive the amendments within 30 days of your receipt of this notice. If the amendments are not received within the 30 day timeframe the mining claims will be declared null and void.

http://www.blra.gov/az/

2


Sincerely,


Enclosures

NOTICE!!


Do not place un-scanned documents beneath this notice! Do not remove this notice from this file!

GPO Jacket No. 560-102 Print Order 61540 Rise Business Services, LLC Job=AZ15 5/10/2019Box Number= AZ15031


3 Transfers

AZ15031-4 AMC429540-AMC429995

AZ15031

AMC429557-AMC429557

BREAK

NODOCUMENTS

FOUND

NO DOCUMENTS FOUND NO DOCUMENTS FOUND

NOTICE!!




GPO Jacket No. 5 6 0 -1 0 2 P r in t O rd e r 6 1 5 4 0

Rise B usiness Services, LLC Job=AZ15 5 /1 0 /2 0 1 9

Box Number= AZ15031


4 Annual Filings

AZ15031-4 AMC429540-AMC429995

AZ15031

AMC429557-AMC429557

BREAK

1.1

4.

5.

6 .

7.

Form 3830-2 (January 2017)

U*PfED states DEPARTMENT OF THE INTERIOR

BUREAU OF LAND MANAGEMENTM A IN TEN A N C E FEE W A IVER C ER TIFIC ATIO N

SEE INSTRUCTIONS ON PAGE 2

2>7 a a 1 3l o 3

lĴ 9^ G V c l FORM APPROVEÌT1 ° ' } OMB NO. 1004-0114

Expires: January 31,2020

This small miner waiver is filed for the assessment year beginning on September 1, 2018 and ending on September 1, 2019The undersigned and all related parties owned ten or fewer mining claims, mill, or tunnel sites located and maintained on Federal lands in the United States of America on September l, 2018 .The undersigned have performed the.assessment work required by law for each mining claim listed prior to filing this waiver and understand that by filing this form, the undersigned must file an affidavit of assessment work with the Bureau of Land Management (BLM) by the December 30th following the filing of this waiver. The undersigned understand that if the assessment work obligation has not yet come due under 30 U.S.C. 28 (for those claims in their first assessment year only), a notice of intent to hold reciting this condition must be recorded by the December 30th following the filing of this waiver.The undersigned understand that mill and tunnel sites may also be listed on this waiver and be waived from payment of the maintenance fee, and that a notice of intent to hold for these sites is required to be filed with the BLM by the December 30th following the filing of this waiver.The undersigned understand and acknowledge that pursuant to 43 U.S.C. 1212 and 18 U.S.C. 1001. the filing or recording of a false, fictitious, or fraudulent document with the BLM may result in a fine ofup to $250,000, a prison term not to exceed five years, or both.The mining claims, mill or tunnel sites for which this waiver from payment o f the maintenance tees is requested are:

CLAIM OR SITE NAME BLM RECORDATION SERIAL NUMBER1. Friends Haven 382073 \ ^2. Has Been #1 378169

3. New Lorrian 429557

4. Little Bit 402392 m

5. 73 »g* S ------------------^ M c6.

----------------------------o ------ --------------m ^

7.±z cr>--------------------------X oo

8. rZ.9. — *0 n rriU-4 J I D10. O fvy -H-JZ. ^ n

The owner(s) (claimants) o f the above mining claims and sites are:

Willis Rhea Jr

(Owner’s Name - Please Print)

8255 W. Carnaby Ln

_ _ u>JJL aIca , JU , ________(Owner’s Signature)

Kirkland AZ 86332

(Owner’s Mailing Address) (City) (State) (Zip Code)

CLjr rvV" ”7 a t a _. n C« a * c m3?

14334 N. 78th Dr(Owner’s Mailing Address)

Zak Necker

(Owner's Name - Please Print)

18013 W. Port AU Prince

(Owner’s Mailing Address)

Peoria AZ 85381(City)

............. . _(State) (Zip Code)

TÜ«

POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENCE:

hereby:

L To sign my - a on any BLM document referencing the recordation o f any association

placer mining claims in my name.

intents and purposes as principal might or could do if personally pres .

All that said agent shall lawfully do or cause to be done under tha’ al|

attorney is expressly approved. 1 authorize my name ° be ° claims and ,association placer mining claims I am party to . I have a bona fide interest n

located the claims independently, for my own self-interest and m good faith.

, certify th a t these claims are in no way being located fo r the benefit of a ™ P ™ “ ^ oratt0n ' or another individual in order to gain additional acreage that they are not entitled

accordance with the law.

Current M ailing Address f\ -z-_ CD

y V7 JJ iSignature of listed claim ant: ^ - — U Q

. "1 ?n16 the Claimant Joel C hafitz , personally came b e fo re g e a r g befog

document and the he/she signed the above document m my presence. ^ ro

and for the County o f . ,/vC -A ^—

D ò \ !^My commission expires. V_------------ -------------

InState of ^rVCl&'T -̂ Zf_

o2E3 >

KjJ

u ‘m; 0~n~nO

a «itiooeTTeMo«*& Notary PuWc- Araon«

list kiaoa ~Capir** 03/‘

Signature of Notary PublicPlace Notary Seal/Stam p Above


. . . - - - —

hereby:

! . to sign my name on any BLM docum ent referencing ,he recordation of any association

placer mining claims in my name.

aAnt fu ll nower and authority to do all and every act and thing 2. Giving and granting to sa, a P to any of the foregoing as fu lly to all

- * * —A" tha t said a6ent =ha" laW,U'̂ V ^°a °tT T e T ? n a lT T b T o ir e L T tio n Vno tice of any and all

» y , - a ^ T .n r : r - ,

located the claims independently, for my own self-,merest an m go

, hpoinp located fo r the benefit of a company, corporation,

r r “ r Z : ^ ate no, e n „ „e d ,0 inaccordance w ith the law.

, , -2 U f /1̂Current Mailing Address SÇ133

c v - 0

. & 2016 th0 Claimant, Zak Necker, personally came before S a n d rb e in jd u lyOn November _ j2 _ 2016, the ua im a _________ ________ a „ , r ,,K0r f ï ï th e S io v e d W

Signature of listed claiman

.... ~® •*-§. . . _t ___.u^wo ^n rnm pn t m mv oresence. - . ..» d

sworn, uiu bicu-c, -docum ent and the he/she signed the above docum ent ,n my presence,

^ , State of A £ l > M .In and fo r the County o -------

My commission expires: — H 1 OO j 2Xj_J_

sfv iw

m

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ADRIAN HARRIS Notary Public

My. Commission Expires November 30,2017

Maricopa County

Signature of Notary PublicPlace Notary Seal/Stamp Above

l

POATV-docx 1 / 1X

Back to Message


*

, Tom Villone, referred to as claimant, in the County of Yavapai. State of Anzona. do ap omt Tracey lohmann as my true and lawful agent for any and all assoc,abon mm.ng “ lam party to. In principal’s name, and for principal’s use and benefit, sard agent rs authonz

hereby:

! . To sign my name on any BLM document referencing the recordation of any association placer

mining claims in my name.

intents and purposes as principal might or could do rf personally present.

All that said agent shall lawfully do or cause to be done under the authority o f this power of I t y is expressly approved. I authorize my name to be on the locatron nobce o f any and il I “ fion7acer L * g claims I am party to . , have a bona fide In te res t.these darms and I

located the claims independently, fo r my own self-interest and m good farth.

, certify that these daims are in no way being located for the benefit of a company corporation,

or another individual in order to gain additional acreage that they a renot entrtled to ^ ^

accordance with the law. r * A A ° . .

\ J 3“ oV. . . , Current Mailing Address

Signature of listed claimant:

On November 2016, the Claimant. Tom Villone, personally came before me and, being duly

document and the he/she signed the above document in my presence.

, State of j W \ 1 VT£C-----------In and for the County of _

My commission expires: _

^T-Jc-ou y i 1 *\ Tammy Imparia

Notary Public - Arizona , Yavapai County My Commission Expires

April 27, 2019

Signature o f Notary Pubi«?Place Notary Seal/Stamp Above

z r .INJ 0 3r ~

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u' U d0STAGEPR8E| 3C0?TT’ AZ AUQ 21,18.70123050000060083548


rÄ:UNITED STATES DEPARTMENT OF THE INTERIOR

BUREAU OF LAND MANAGEMENT

A FFID A V IT OF A N N U A L A S S E S S M E N T W O R K

I mco? 3FORM APPROVED ^OMB NO.: 1004-0114 ^ O ^ T O / O Expires: January 31, 2020

HI

WHEN RECORDED, MAIL DOCUMENT TO:

n a m e : Tracey Lohmann

a d d r e s s - ̂T0 W. Clare Island

c i t y , s t a t e , z i p : Kirkland, AZ 86332

H H 5 3 3 I

y v a i / 7 3

FOR COUNTY RECORDER’S USE

No. of Claims J_____________x SlO/claim

Total due BLM S ̂Q-OQ______TO .ALL W HOM IT MAY CONCERN:

1. The undersigned certifies that at least S I00 per claim was expended for development, labor and improvements, or equivalent value added, as the annual assessment work for the assessment year ending September 1, 2018 for the following contiguous unpatented mining claim(s), located in the County of Yavapai_________________ , in the State of Ar'zona____________________.

BLM Serial No. Name of ClaimTp Rg Sec Mer

Example: 13N 5E 14 MDMCounty Recordation Book and Page No.

Co. Recording Date

4 2 1 6 3 3 Alders Hideout 12.5N 2 W 1 9 S R B 4 9 3 8 - P 6 5 4 0 2 / 2 0 / 1 3

— 9?--------------

m gog 5̂^ KJ

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—» 0g ryj *£> £ ?

00

2. Type o f labor and improvem ents (specify w hat was done and give the total value for that labor and im provem ent to show at least $100 for each claim). I f a geological, geochem ical, or geophysical survey was performed, as per 30 U.S.C. 28-1, reference the title o f the report o f survey, give cost and date o f the survey and report, and indicate it was filed with the County Recorder:

Description of Work PerformedValue of Work

PerformedDate Work Was

PerformedTrail and road work, test holes, area clean up and trash removal $500.00 April - June 2018

VOf-* •—zjE j y -y cmm

■--------------------------- 31—oorn j VO—-o--------- ---------------- J

3.

><

y>fSÎO

Nam e and m ailing address o f each person who perform ed the labor and im provem ent: "Qr-uo r o

Nam e (please print) Current M ailing Address (please print) ^ jrThomas R. Villone_____1105 S 12th St, Cottonwood, AZ 8632§Q(N

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• m-C D

èw)

4. N am e and m ailing address o f each person who holds and claims the subject m ining claim(s) for the valuable minerals contained therein. Be sure to indicate i f there is a change o f address:

Nam e (please print) Current M ailing Address (please print)Shawn Moffett 310 North Terrace, Janesville, WX 53548

5. The undersigned testifies that on the date o f 0 2 ^ 2 0 _______________________ ̂ 2 0 ^ , all m onum entsrequired by law were erected upon the subject claim (s), and all notices required by law were posted on the subject claim(s) or copies thereof were in place, and at said date, each com er m onum ent bore or contained

(Continued on page 3) ( Form 3830-4, page 2)

m arkings sufficient to appropriately designate the com er o f the claim to which it pertains and the nam e o f the claim(s).

I hereby certify under penalty o f perjury under the laws o f the State o f A r i z o n a foregoing statements are true and correct:

( ? , \ J l O l a - A K - t ____(Signature o f person responsible for above statement)

D a ,, IP T

that the

Title 18 U.S.C. 1001 and 43 U.S.C. 1212 make 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.

Notary Block

SUBSCRIBED AND SWORN TO before me, this "Tf*# day of fh j-(U t£ T

By:__ ^ ________________________________________________________

20

(Signatureybf Affiant)

Title:____ ______________________

My Commission Expires: l 0 )

BEVSttYJEANSTEWh. Not» Pvbfc - State of Aifeona

YAVAPAI COUNTY My Commlulon Expires

August 10,2021

INSTRUCTIONS “o g -r c ~ -rO C*» -

1. This is an optional form that may be used to satisfy the requirements for the Bureau oQ^and fi&nagetngpt (BLM)under the provisions of 43 U.S.C. §1744 and 30 U.S.C. §28-28d and the regulations tHgeunde?(43 Cfyl| part 3835). Since local and State laws may vary, you should contact your local and State a p n c ie ^ h e re 'fh e claims are located to ensure all applicable laws and requirements are satisfied. 2^ 4 <

2. The claimant(s) must fill in the date in paragraph 1 for the applicable assessment year jagd the^fcunfySd statewhere the claims are located. o (sp

3. All claim names, BLM serial numbers, legal descriptions, and original county recordir^infoqBationJnust belisted for the claims pertaining to this assessment notice. OO ™

4. The claimant(s) must complete paragraph 2 listing all labor or improvements which was performed on or did benefit the subject mining claims. The value and date of the labor or improvements must also be listed. The total amount of labor or improvements can be listed, but the total expenditure must equal at least $100 for each claim.

5. The names and current mailing addresses of the person(s) performing the labor shall be listed in paragraph 3.6. The name and current mailing address of each owner (claimant) of the claims shall be listed in paragraph 4. The

mailing address shall be the owner’s address and not the address o f an agent or anyone representing the claimant. Be sure to note if there has been a change o f address.

7. Paragraph 5 shall be completed to show the date it was verified that all monuments required by law were properly erected, all notices were posted, and that comers were appropriately designated for all claims listed.

8. An exact legible reproduction or duplicate (other than microfilm or other electronic media) of this affidavit or another type of affidavit o f assessment work that you file or will file in the county where each claim is located, must be filed with the BLM on or before December 30 of the calendar year in which the assessment year ends.For mill or tunnel sites, a separate notice of intent to hold must be filed with the BLM on or before December 30. Requirements for filing a notice of intent to hold can be found at 43 CFR 3835.33.

9. A processing fee of $ 10 for each claim listed must be remitted to the BLM along with this or any other affidavit of assessment work.

( Forni 383(W , page 3}(Continued on page 4)

\

When Recorded, MAIL TO:

Tracey Lohmann 7170 W. Clare Island Kirkland, AZ 86332

2018-0046203 pdl09/06/2018 01:54:56 Paqe: 1 of 4Leslie PI. HoffmanOFFICIAL RECORDS OF YAVAPAI COUNTY $15 00TRACEY LOHNPNN

Affidavit of Assessement Work - Maintoncc Foe Waiver-

Alders W vice

T) 03z t—o 5 ”Tm ooz><

m"O

> oDOV r ‘m■.'13 CDo foz * * *1>> XTc o

FP4 DOC483S2395


UNITED S i l f eDEPARTMENT OF THE INTERIOR


AFFIDAVIT OF ANNUAL ASSESSMENT WORK

H drm a p p r o v e dOMB NO.: 1004-0114 Expires: January 31, 2020

W HEN RECORDED, MAIL DOCUMENT TO:


a d d r e s s - 7 1 7 0 W. Clare Island

c it y , s t a t e , z ip : Kirkland, AZ 86332FO R COUNTY RECORDER’S USE

No. of Claims 4______________

x $ 10/claim

Total due BLM S 40 00TO ALL W HOM IT MAY CONCERN:

1. The undersigned certifies that at least $100 per claim was expended for development, labor and improvem ents, or equivalent value added, as the annual assessment work for the assessment year ending Septem ber 1, 2018 for the following contiguous unpatented m ining claim(s), located in the County o f YavaPai___________________ , in the State o f Arizona______________________ .



Co. Recording Date

435078 Just A Trace 13N 4W 25 SR 2015-0053520 11/09/15411274 Little Bucket 13N 4W 24 SR B4835-PgU 09/26/11416357 Los Padres 13N 4W 25 SR B4888-P65 06/20/12445331 Little Trace 13N 4W 26 SR B4856-P400 08/05/17

3 ;- 2s» r—----------------- ©— *m c tZ C

-O Tr-3 -4̂ 3

^ r- c

f'vl 1'T <

* ■—* 1—Ì? -p' V SJ ™

(Continued on page 2)

2. Type o f labor and improvements (specify w hat was done and give the total value for that labor and im provem ent to show at least $100 for each claim). I f a geological, geochem ical, or geophysical survey was performed, as per 30 U.S.C. 28-1, reference the title o f the report o f survey, give cost and date o f the survey and report, and indicate it was filed with the County Recorder:

Description of Work PerformedVaine of Work


PerformedTrail and road work, test holes, area clean-up a id trash removal $1000.00 Feb-June 2018

03F-J .--ZC Sm

___________________ Z(7 i-----5^— -----------m___ ro_____-n

>< t o o

N am e and m ailing address o f each person who perform ed the labor and im provem ents^ ”0O !S>

Nam e (please print)Tracey LohmannJimmy Stewart

Current M ailing Address (please print) > s=7170 W. Clare Island, Kirkland, AZ 86339

Leland AndersonJoel Chafitz

9110 S. Trafalgar DR, Kirkland, AZ 86332

-833-Middlebrook, Prescott, AZ 86303 14334 N. 78th DR Peoria, AZ 85381

ererb vs -V'¿ T « t o ételL-

N am e and m ailing address o f each person who holds and claims the subject m ining claim(s) for the valuable m inerals contained therein. Be sure to indicate if there is a change o f address:

Nam e (please print) Current M ailing Address (please print) ^ tjs-Leland Anderson__________ ——833-Middlebrook, Prescott, AZ 86303 ° ^ "Leland Anderson JrTracey LohmannJimmy StewartJoel ChafitzLarry Anderson Ron Barr

N. Victor RD, Prescott Valley, AZ 863147170 W. Clare Island, Kirkland, AZ 863329110 S. Trafalgar DR, Kirkland, AZ 86332 14334 N. 78th DR, Peoria, AZ 85381 7960 S. Mayo DR, Kirkland, AZ 86332 PO Box 235, Kirkland, AZ 86332

5. The undersigned testifies that on the date o f H ^ 0 9 _______________________ _ 2 0 11 , all m onum entsrequired by law w ere erected upon the subject claim(s), and all notices required by law were posted on the subject claim(s) or copies thereof were in place, and at said date, each com er monument bore or contained

( Form 3830-4, page 2)(Continued on page 3)


I hereby certify under penalty o f peijury under the laws o f the State o f A f iZ O n S foregoing statementsâre true and correct:

that the

Date:(Signature of person responsible for above statement)

Title 18 U.S.C. 1001 and 43 U.S.C. 1212 make it a crime for any person knowingly and willfully to make to any department or agency o f the United States any false, fictitious or fraudulent statements or representations as to any matter within its jurisdiction.

Notary Block

SUBSCRIBED AND SWORN TO before me, this day of

By: ' (1>? .t (Signa‘: ' * ^ ■'

> 20

Title

^(Signature of pliant)

n —

My Commission Expires:

Kdttb Maritm AwWua - Attuo»

ïmfdCwuQ m, r iM Tih ~—*

1.

2.3.

4.

5.6.

7.

8 .

9.

IN ST R U C T IO N S ~Dr ro

03

This is an optional form that may be used to satisfy the requirements for the Bureau o f S n d M âgefriqS (BLM) under the provisions of 43 U.S.C. §1744 and 30 U.S.C. §28-28d and the regulations theieundef^43 C & p a r t 3835). Since local and State laws may vary, you should contact your local and State agjpcies ^ e re f |£ g la i rn s are located to ensure all applicable laws and requirements are satisfied. TO —, " ’•¡-7)The claimant(s) must fill in the date in paragraph 1 for the applicable assessment year ahd the county aifc?state where the claims are located. ^ *19 -nAll claim names, BLM serial numbers, legal descriptions, and original county recordinîhfontfStion rriust be listed for the claims pertaining to this assessment notice. 'The claimant(s) must complete paragraph 2 listing all labor or improvements which was performed on or did benefit the subject mining claims. The value and date of the labor or improvements must also be listed. The total amount of labor or improvements can be listed, but the total expenditure must equal at least $ 100 for each claim. The names and current mailing addresses o f the person(s) performing the labor shall be listed in paragraph 3.The name and current mailing address of each owner (claimant) of the claims shall be listed in paragraph 4. The mailing address shall be the owner s address and not the address o f an agent or anyone representing the claimant. Be sure to note if there has been a change o f address.Paragraph 5 shall be completed to show the date it was verified that all monuments required by law were properly erected, all notices were posted, and that comers were appropriately designated for all claims listed.An exact legible reproduction or duplicate (other than microfilm or other electronic media) of this affidavit or another type of affidavit o f assessment work that you file or will file in the county where each claim is located, must be filed with the BLM on or before December 30 of the calendar year in which the assessment year ends.For mill or tunnel sites, a separate notice o f intent to hold must be filed with the BLM on or before December 30.Requirements for filing a notice of intent to hold can be found at 43 CFR 3835.33.A processing fee of $10 for each claim listed must be remitted to the BLM along with this or any other affidavit of assessment work.


»Form 3830-4

(January 2017)UNITED S Ü f f i s

DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT


H^ORM APPROVED OMB NO.: 1004-0114 Expires: January 31, 2020



a d d r e s s : 7170 W. Clare Island

city, state, zip.- Kirkland, AZ 86332FOR COUNTY RECORDER’S USE

No. of Claims 4_______

xSlO/claim

Total due BLM S 4 0 -°°TO ALL WHOM IT MAY CONCERN:

1. The undersigned certifies that at least $100 per claim was expended for development, labor and improvements, or equivalent value added, as the annual assessment work for the assessm ent year ending September 1, 2018 . for the following contiguous unpatented m ining claim (s), located in the County o f YavaPai___________________ , in the State o f Arizona



Co. Recording Date

382073 Friends Haven 13N 4W 25 SR B4498-P957 04/18/07378169 Has Been #1 13N 3W 29 SR B4474-P733 01/23/07429557 New Lorrian 8N 2W 17 SR 2014-0046577 10/13/14402392 Little Bit 12.5N 3W 30 SR B4769-P42 10/06/10

'0 s:r S (—■>— ----------

m 07—7— m _ "O - J PU> 0

c->û _

S TJ--------•m0 0

ë ^ > *=■ -W—1 * «


2. Type o f labor and im provem ents (specify w hat was done and give the total value for that labor and im provem ent to show at least $100 for each claim). I f a geological, geochemical, or geophysical survey was performed, as per 30 U.S.C. 28-1, reference the title o f the report o f survey, give cost and date o f the survey and report, and indicate it was filed with the County Recorder:



PerformedTrail and road work, test holes, area clean-up end trash removal $1000.00 FebjJune 2018

-o g ;—---- ---------——s ---

o -S5— ---------------C/5 _------ ------—..—pxj--___________ -Z-

fn--- : sj--------- --~o rn-n o5•Z2

--------V - S

3. N am e and m ailing address o f each person who perform ed the labor and im p ro v e m e n t-3> ^

Nam e (please print) Tracey Lohmann

Jimmy StewartLeland AndersonJoel Chafitz

Address (please print)7170 W. Clare Island, Kirkland, AZ 863329110 S. Trafalgar DR, Kirkland, AZ 86332 ^£33- Middlebrook, Prescott, AZ 86303 14334 N. 78th DR Peoria, AZ 85381

4. N am e and m ailing address o f each person who holds and claims the subject mining claim(s) for the valuable minerals contained therein. Be sure to indicate i f there is a change o f address:

Nam e (please print) Willis Rhea JrDennis Fasula Tracey Lohmann Jimmy Stewart Joel Chafitz Zak Necker Fred Helmecke Thomas R. Villone

Current M ailing Address (please print)8255 W. Carnaby LN, Kirkland, AZ 863328805 S. Donegal DR, Kirkland, AZ 86332 7170 W. Clare Island, Kirkland, AZ 86332 9110 S. Trafalgar DR, Kirkland, AZ 86332 14334 N. 78th DR, Peoria, AZ 85381 18013 W. Port Au Prince, Surprise, AZ 85388 8220 W. Framingham, Kirkland, AZ 86332 1105 S. 12th St, Cottonwood, AZ 86326 (V iao)

5. The undersigned testifies that on the date o f 20 °]_, all monumentsrequired by law were erected upon the subject claim(s), and all notices required by law were posted on thesubject claim(s) or copies thereof were m place, and at said date, each com er m onum ent bore or contained



I hereby certify under penalty o f perjury under the laws o f the State o f A r i z o n a foregoing statements are true and efifrect:

------------- -------------------— _________________________________ Date: Q ' l i P ________(Signature of person'responsitife for above statement)

that the


Notary BlockSUBSCRIBED AND SWORN TO before me, this L&f~ day of

My Commission Expires: * ) - 7 ~ n?¿2 ¿2 7 -

20

\ -- ^ ^ , :I E dith Maritym A adersoa1 l^ lN i ta o h i ik - iU ia u 4 v X & Jw YftVMMU C 'otuuj

INSTRUCTIO NS *o 3 i2HZ ~ - r

1. This is an optional form that may be used to satisfy the requirements for the Bureau offiand Management (BLM)under the provisions of 43 U.S.C. §1744 and 30 U.S.C. §28-28d and the regulations fe e u n d e r (43 part 3835). Since local and State laws may vary, you should contact your local and State £tgencie^here4fE claims are located to ensure all applicable laws and requirements are satisfied. ^ <

2. The claimant(s) must fill in the date in paragraph 1 for the applicable assessment yearpujd the9ounty;§i?d statewhere the claims are located. o hp _

3. All claim names, BLM serial numbers, legal descriptions, and original county recordiijmfoifflatiohmust belisted for the claims pertaining to this assessment notice. —1 ~~

4. The claimant(s) must complete paragraph 2 listing all labor or improvements which was performed on or didenefit the subject mining claims. The value and date of the labor or improvements must also be listed. The total

amount of labor or improvements can be listed, but the total expenditure must equal at least $ 100 for each claim5. The names and current mailing addresses of the person(s) performing the labor shall be listed in paragraph 3.6. The name and current mailing address of each owner (claimant) of the claims shall be listed in paragraph 4. The

mailing address shall be the owner’s address and not the address of an agent or anyone representing the claimant. Be sure to note if there has been a change of address.


8. An exact legible reproduction or duplicate (other than microfilm or other electronic media) of this affidavit or another type of affidavit of assessment work that you file or will file in the county where each claim is located must be filed with the BLM on or before December 30 of the calendar year in which the assessment year ends ’ fo r mill or tunnel sites, a separate notice of intent to hold must be filed with the BLM on or before December 30. Requirements for filing a notice of intent to hold can be found at 43 CFR 3835.33.

9. A processing fee of S10 for each claim listed must be remitted to the BLM along with this or any other affidavit ot assessment work.

(Continued on page 4)( Form 3830-4, page 3)

When Recorded MAIL TO:


2018-0046204 ADL09/06/2018 01:54:5^ Page: 1 of 4Leslie M. HoffmanÎrÎœy1^ 0"05 0F YftVftPflI C0UNTY $15-00

J

Affidavit of Assessement Work ■— Maintenee-f ee Waiver

f W o d - b ¿A c ,~oreomz> ;3>

n-joz

oom-ors3O

U

CO

■ • >mJ O

FP4 DOC483S2396

When Recorded, MAIL TO:

Tracey Lohmann 7170 W. Clare Island Kirkland, A2 86332

2018-0046205 ADL09/06/2018 01:54:56 Page:Leslie tl. HoffmanOFFICIAL RECORDS OF YAVAPAI COUNTYTRACEY LOHnflfJN

1 of 4 $15.00

Affidavit o f Assessement Work — Maintence Fee-W aiver-------

J iu v V A-

FP4 DOC483S2397


701fl CfciflO D001 s2É'EÍ>,:71é § F V fJ'

Receipt Page 1 o f 2

United States Department o f the Interior Bureau o f Land Management

DIV OF LA N D S, MINRLS & ENERGY ONE N CENTRAL AV E

Receipt

PHOENIX, AZ 85004 -4427 Phone: 602-417-9200

No: 4267577

T ransaction #: 4383297D ate o f T ransaction: 09/21/2018______________________

c u s t o m e r !

llTRACEY LOHM ANN 7170 W CLARE ISLAND DR KIRKLAND,AZ 86332-5002 US

LINE#

QTY DESCRIPTION REMARKS UNITPRICE TOTAL

1 1.00

LOCATABLE MINERALS / MINING CLAIMSNOT NEW -UNADJUD,O NE AUTH NO. ONLY / M INING CLAIM M ONEY RECEIVED CASES: A M C 421633/$90.00

POL 2018/9 - n/a - 90.00

TOTAL: $90.00

PAYM ENT INFORMATION

1 AMOUNT: 10.00 POSTMARKED: N/A

TYPE: CHECK RECEIVED: 09/20/2018

CHECK NO: 1527

NAME: LOHMANN, TRACEY 7170 W CLARE ISLAND DR KIRKLAND AZ 86332-5002 US



CHECK NO: 1528




CHECK NO: 1529


lv H - r % c * / / i1 r v » r \ r » r M ^ n o r \0 ^ /î r1r\-t n o t / r> m V > 1 r i / r7 r \ r r \ /=*-r 0 / 0 1 n m Q

Form 3830-2(January 2017)

yM STATESDEPARTMENT JF THE INTERIOR BUREAU OF LAND MANAGEMENT

MAINTENANCE FEE WAIVER CERTIFICATI

SEE INSTRUCTIONS ON PAGE 2 ^

j

a c t 8

FORM APPROVEDOMB NO. 1004-0114

Expires: January 31, 2020

4.

1 lands in the United StatesThis small miner waiver is filed for the assessment year beginning on September 1, 2P*o" and ending on September 1, 2QT*f^The undersigned and all related parties owned ten or fewer mining claims , mill, or tunnel sites located and maintained on Federal la o f America on September 1, 2017 .The undersigned have performed the assessment work required by law for each mining claim listed prior to filing this waiver and understand that by filing this form, the undersigned must file an affidavit of assessment work with the Bureau o f Land Management (BLM) by the December 30th following the filing of this waiver. The undersigned understand that if the assessment work obligation has not yet come due under 30 U.S.C. 28 (for those claims in their first assessment year only), a notice o f intent to hold reciting this condition must be recorded by the December 30th following the filing of this waiver.The undersigned understand that mill and tunnel sites may also be listed on this waiver and be waived from payment of the maintenance fee, and that a notice of intent to hold for these sites is required to be filed with the BLM by the December 30th following the filing of this waiver.The undersigned understand and acknowledge that pursuant to 43 U.S.C. 1212 and 18 U.S.C. 1001, the filing or recording of a false, fictitious, or fraudulent document with the BLM may result in a fine of up to $250,000, a prison term not to exceed five years, or both.The mining claims, mill or tunnel sites for which this waiver from payment o f the maintenance fees is requested are:

CLAIM OR SITE NAME BLM RECORDATION SERIAL NUMBER/* New Lorrian ' . 429557

2.3.

4.

5.

6.

7.

8.

9.

IO.

The o.wner(s) (claimants) of the above mining claims and sites are:

I c ' Fred Helmecke y(Owner’s Name - Please Print) (Owner’s Signature)

8220 W. Framingham(Owner’s Mailing Address)

Kirkland(City)

AZ______ 86332(State) (Zip Code)

(s> ^Tracey Lohmann

(Owner’s Name - Please Print)

s(Owner’s Signature)

7170 W. Clare Island Kirkland AZ 86332(Owner’s Mailing Address) (City) (State) (Zip Code)

(Owner’s Name - Please Print) (Owner’s Signature)—

(Owner’s Mailing Address) (City) (State) (Zip Code)


MC NATIONWIDE CLAIMANT LISTING September 21, 2017

u m STATES DEPARTMENT OF THE in t é ë U rBUREAU OF LAND MANAGEMENT

AZ NationalTotalCust CLAIMAI'

HELMECKE FRED 8220 W FRAMINGHAM RD KIRKLAND, AZ 86332-4048 1 1LOHMANN TRACEY 7170 W CLARE ISLAND DR KIRKLAND, AZ 86332-5002 6 6STEWART JIMMY911 OS TRAFALGAR DRKIRKLAND, AZ 86332-4004 7 7

Page 1





FORM APPROVEDOMB NO.: 1004-0114Expires: January 31, 2020



a d d r e s s - 7170 W. Clare Island

c m 7, s t a t e , z ip : Kirkland, AZ 86332

v . ^ 3 3 H & s s n

H n l 5 £ 7 ^ 0 7 3

L j t j t - S ' L A

4 1 6 ^ ^ 7

FOR COUNTY RECORDER’S USE

No. of Claims J _____________

x $ 10/claim

Total due BLM $ 1°-00TO ALL WHOM IT MAY CONCERN:

1. The undersigned certifies that at least $100 per claim was expended for developm ent, labor and im provem ents, or equivalent value added, as the annual assessm ent w ork for the assessm ent year ending Septem ber 1, 2017 for the follow ing contiguous unpatented m ining claim (s), located in the County o f Yavapai___________________ in the State o f Arizona



Co. Recording Date

374725 Use To Be 11N 4W 23 SR B 4446 - P 220 10/18/06

crj

f ^

T—; ;

______l v 1 f ‘ j


7> > / / 7 ' r 7cr.

M “I

/V 7

, f l

f AUG 0 9 20I7

2. Type o f labor and improvements (specify what was done and give the total value for that labor and improvement to show at least $100 for each claim). If a geological, geochem ical, or geophysical survey was performed, as per 30 U .S .C . 28-1, reference the title o f the report o f survey, give cost and date o f the survey and report, and indicate it was filed with the Comity Recorder:

Description of Work PerformedValue o f Work


PerformedTrail and road work, test holes, area clean up and trash removal $500.00 Jan - May 2017

3. N am e and mailing address o f each person who performed the labor and improvements:

Name (please print) Current Mailing Address (please print)Ron Barr________________ P.O. Box 235 Kirklanaj AZ 86332Nanette Eigen P.O. Box 235 Kirkland, AZ 86332

4.

5.

N am e and mailing address o f each person who holds and claims the subject mining claim(s) for the valuableminerals contained therein. Be sure to indicate i f there is a change o f address:

Name (please print)Ron Barr

Current Mailing Address (please print)P.O. Box 235 Kirkland, AZ 86332

Nanette Eigen P.O. Box 235 Kirkland, AZ 86332

---F=3---- —--------err>--- ---- C —p -; T̂“1~cr: . ;t‘;

: I 21-- ‘

— XI.UJ

The undersigned testifies that on the date o f 1 0 ^ 8 _______________ ________ } '2 0 ^ ® o a ll monumentsrequired by law were erected upon the subject claim (s), and all notices required by law were posted on the subject claim(s) or copies thereof were in place, and at said date, each com er monument bore or contained


I hereby certify under penalty o f petjury under the laws o f the State o f Arizona_____________ that theforegoing statements are true and correct:

________ ___________________________________________________ Date: ¿2S ' / * 7(Signature o f person responsible for above statement)

markings sufficient to appropriately designate the comer o f the claim to which it pertains and the name o f theclaim(s).

Title 18 U.S.C. 1001 and 43 U.S.C. 1212 make it a crime for any person knowingly and willfully to make to any department or agency o f the United States any false, fictitious or fraudulent statements or representations as to any matter within its jurisdiction.

Notary Block

1. This is an optional form that may be used to satisfy the requirements for the Bureau o f Land Management (BLM) under the provisions o f 43 U.S.C. §1744 and 30 U.S.C. §28-28d and the regulations thereunder (43 CFR part 3835). Since local and State laws may vary, you should contact your local and State agencies where the claims are located to ensure all applicable laws and requirements are satisfied.

2. The claimant(s) must fill in the date in paragraph 1 for the applicable assessment year and the county and state where the claims are located.

3. All claim names, BLM serial numbers, legal descriptions, and original county recording information must be listed for the claims pertaining to this assessment notice.

4. The claimant(s) must complete paragraph 2 listing all labor or improvements which was performed on or did benefit the subject mining claims. The value and date o f the labor or improvements must also be listed. The total amount o f labor or improvements can be listed, but the total expenditure must equal at least $100 for each claim.

5. The names and current mailing addresses o f the person(s) performing the labor shall be listed in paragraph 3.6. The name and current mailing address o f each owner (claimant) o f the claims shall be listed in paragraph 4. The



8. An exact legible reproduction or duplicate (other than microfilm or other electronic media) o f tl\is,affidavit or another type o f affidavit o f assessment work that you file or will file in the county where each cfaijn isiocated, must be filed with the BLM on or before December 30 o f the calendar year in which the ¿¡sessment year ends.For mill or tunnel sites, a separate notice o f intent to hold must be filed with the BLM on nr before December 30. Requirements for filing a notice o f intent to hold can be found at 43 CFR 3835.33. c ' 1 -

9. A processing fee o f $ 10 for each claim listed must be remitted to the BLM along with thisLpr any other affidavito f assessment work. '0

u je'v.... . .'|M- r o

o(Continued on page 4) ( Form 3830-4, page 3)





FORM APPROVEDOMB NO.: 1004-0114Expires: January 31,2020

W HEN RECORDED, MAHL, DOCUMENT TO:


a d d r e s s : 7170 W. Clare Island

c i t y , s t a t e , z ip : Kirkland, AZ 86332FOR COUNTY RECORDER’S USE

No. o f Claims \ ________

x$10/claim

Total due BLM $ 1 0 -00TO ALL WHOM IT MAY CONCERN:

1. The undersigned certifies that at least $100 per claim was expended for development, labor and improvements, or equivalent value added, as the annual assessment work for the assessment year ending September 1, 2017 for the follow ing contiguous unpatented mining claim (s), located in the County o f Yavapai___________________ , in the State o f Arizona________________



Co. Recording Date4 2 9 5 5 7 N e w L o r r i a n 8 N 2 W 1 7 S R 2 0 1 4 - 0 0 4 6 5 7 7 1 0 / 1 3 /1 4

--- :--------■ c z dc 1------------------------ J- ; :■r C73------------------------- --------------- t-------- r r ' ■F U UC~i t * 1------------------------- ------------- i&d---->- I j


2. Type o f labor and improvements (specify what was done and give the total value for that labor and improvement to show at least $100 for each claim). I f a geological, geochemical, or geophysical survey was performed, as per 30 U.S.C. 28-1, reference the title o f the report o f survey, give cost and date o f the survey and report, and indicate it was filed with the County Recorder:



PerformedTrail and road work, test holes, area clean up and trash removal $600.00 Jan - April 2017

3. N am e and m ailing address o f each person who performed the labor and improvements:

Name (please print) Current Mailing Address (please print)Tracey Lohmann__________ 7170 W. Clare Island, Kirkland, AZ 86332Jimmy Stewart____________ 9110 S. Trafalgar DR, Kirkland, AZ 86332Fred Helmecke_________ 8220 W. Framingham, Kirkland, AZ 86332

4. N am e and m ailing address o f each person who holds and claims the subject mining claim (s) for the valuable minerals contained therein. Be sure to indicate i f there is a change o f address:

Name (please print) Current Mailing Address (please print)Tracey Lohmann 7170 W. Clare Island, Kirkland, AZ 86332Jimmy Stewart__________ 9110 S. Trafalgar DR, Kirkland, AZ 86332Fred Helmecke_________ 8220 W. Framingham, Kirkland, AZ 86332

r-o— ._____c=>r ' —'r- - 3»-

cr>—h~r r

5. The undersigned testifies that on the date o f ^ 0 ^ 3 ______________________ j : 2 0 1 ^ all-m onum entsrequired by law were erected upon the subject claim (s), and all notices required by law wfere posted on the subject claim(s) or copies thereof were in place, and at said date, each com er monument bore or contained


markings sufficient to appropriately designate the comer o f the claim to which it pertains and the name of theclaim(s).

I hereby certify under penalty o f peijury under the laws o f the State o f A r iz o n a foregoing statement&vare hue and correct:

(Signature of person responsible for above statement)Date: ^ ~ I ^ l"7

that the


Notary Block

1. This is an optional form that may be used to satisfy the requirements for the Bureau of Land Management (BLM) under the provisions o f 43 U.S.C. §1744 and 30 U.S.C. §28-28d and the regulations thereunder (43 CFRpart 3835). Since local and State laws may vary, you should contact your local and State agencies where the claims are located to ensure all applicable laws and requirements are satisfied.



4. The claimant(s) must complete paragraph 2 listing all labor or improvements which was performed on or did benefit the subject mining claims. The value and date o f the labor or improvements must also be listed. The total amount of labor or improvements can be listed, but the total expenditure must equal at least $100 for each claim.

5. The names and current mailing addresses o f the person(s) performing the labor shall be listed in paragraph 3.6. The name and current mailing address o f each owner (claimant) of the claims shall be listed in paragraph 4. The

mailing address shall be the owner’s address and not the address of an agent or anyone representing the claimant. Be sure to note i f there has been a change o f address.


8. An exact legible reproduction or duplicate (other than microfilm or other electronic media) o f ffis affidavit or another type o f affidavit o f assessment work that you file or will file in the county where each cfeim is located, must be filed with the BLM on or before December 30 o f the calendar year in which thiasses^ment yearends.For mill or tunnel sites, a separate notice of intent to hold must be filed with the BLM ofi or before December 30. Requirements for filing a notice of intent to hold can be found at 43 CFR 3835.33. ' L L'J

9. A processing fee o f $ 10 for each claim listed must be remitted to the BLM along with tips or any other affidavito f assessment work. jTj ^ : o

W UJ _J


FORM APPROVEDOMBNO.: 1004-0114Expires: January 31,2020







a d d r e s s - VV, Clare Island

c i t y , s t a t e , z i p : Kirkland, AZ 86332FOR COUNTY RECORDER’S USE

No. o f Claims ®_______

x $10/claim

Total due BLM $ 50-00TO ALL WHOM IT MAY CONCERN:

1. The undersigned certifies that at least $ 100 per claim was expended for development, labor and improvements, or equivalent value added, as the annual assessment work for the assessment year ending September 1, 2017 for the follow ing contiguous unpatented mining claim (s), located in the County o f Yavapai___________________ , in the State o f Arizona____________


Example: 13N 5 E 14 MDMCounty Recordation Book and Page No.

Co, Recording Date

382073 Friends Haven 13N 4W 25 SR B4498 - P 957 04/18/07378169 Has Been #1 13N 3W 29 SR B4474 - P 733 01/23/07402392 Little Bit 12.5N 3W 30 SR B 4769 - P 42 10/06/10416357 Los Padres 13N 4W 25 SR B 4888 - P 65 06/20/12435078 Just A Trace 13N 4W 25 SR 2015-0053520 11/09/15

-■ r-o/__Cpr ; jO**

—------------i----- GFS-->- 1 -

j

Ë: -Q------------- ----------- ■:äo UJ


2. Type o f labor and improvements (specify what was done and give the total value for that labor and improvement to show at least $100 for each claim). I f a geological, geochemical, or geophysical survey was performed, as per 30 U .S.C. 28.-1, reference the title o f the report o f survey, give cost and date o f the survey and report, and indicate it was filed with the County Recorder:



PerformedTrail and road work, test holes, area clean up and trash removal $1000.00 Jan - June 2017

3. Nam e and m ailing address o f each person who performed the labor and improvements:

Name (please print) Current Mailing Address (please print)Tracey Lohmann 7170 W. Clare Island, Kirkland, AZ 86332Jimmy Stewart 9110 S. Trafalgar DR, Kirkland, AZ 86332Leland Anderson 833 Middlebrook, Prescott, AZ, 86303Larry Anderson________ 7960 S. Mayo DR, Kirkland, AZ 86332

4. Name and m ailing address o f each person who holds and claims the subject m ining claim(s) for the valuable minerals contained therein. B e sure to indicate i f there is a change o f address:

Name (please print) Current Mailing Address (please print)Tracey Lohmann 7170 W. Clare Island, Kirkland, AZ 86332Jimmy Stewart 9110 S. Trafalgar DR, Kirkland, AZ 86332Larry Anderson 7960 S. Mayo DR, Kirkland, AZ 86332Leland Anderson 833 Middlebrook, Prescott, AZ 86303Dennis Fasula 8805 S. Donegal DR, Kirkland, AZ 86332Willis Rhea JR 8255 W: Carnaby LN, Kirkland, AZ 86332Zak Necker 18013 W. Port Au Prince, Surpriser AZ §5388Joel Chafitz 14334 N. 78th DR, Peoria, AZ 85381 ^Tom Villone P.O. Box 12391, Prescott, AZ 86304 S ”

5. The undersigned testifies that on the date o f ̂^ 0 9 ________________________, 2D£^_, "all monumentsrequired by law were erected upon the subject claim(s), and all notices required by lp v werU posted Ion the subject claim (s) or copies thereof were in place, and at said date, each comer monument bqre or contained



I hereby certify under penalty of peijury under the laws of the State of Arizona foregoing statements are t̂pie and correct:

that the

(Signature o f person responsible for above statement)Date: )(?-


Notary BlockSUBSCRIBED AND SWORN TO before me, this /¿£ day of

(¡H r;

Title:

My Commission Expires: 7- 9 -NMuyPiMe .Ma ■■ _Yy P MCii«J «rCMNlMt

1

INSTRUCTIONS

1. This is an optional form that may be used to satisfy the requirements for the Bureau of Land Management (BLM) under the provisions o f 43 U.S.C. § 1744 and 30 U.S.C. §28-28d and the regulations thereunder (43 CFR part 3835). Since local and State laws may vary, you should contact your local and State agencies where the claims are located to ensure all applicable laws and requirements are satisfied.



4. The claimant(s) must complete paragraph 2 listing all labor or improvements which was performed on or did benefit the subject mining claims. The value and date o f the labor or improvements must also be listed. The total amount of labor or improvements can be listed, but the total expenditure must equal at least $100 for each claim.

5. The names and current mailing addresses o f the person(s) performing the labor shall be listed in paragraph 3.6. The name and current mailing address o f each owner (claimant) o f the claims shall be listed in paragraph 4. The

mailing address shall be the owner s address and not the address o f an agent or anyone representing the claimant. Be sure to note if there has been a change o f address.

7. Paragraph 5 shall be completed to show the date it was verified that all monuments required by law were properly erected, all notices were posted, and that comers were appropriately designated for all claims listed. -

8. An exact legible reproduction or duplicate (other than microfilm or other electronic m ediafoftK l’affidavit or another type o f affidavit o f assessment work that you file or will file in the county where ̂ ach cgim is located, must be filed with the BLM on or before December 30 o f the calendar year in which the assessment yeafends.For mill or tunnel sites, a separate notice of intent to hold must be filed with the BLM on*>r before December 30. Requirements for filing a notice o f intent to hold can be found at 43 CFR 3835.33. v - ^ ~

9. A processing fee o f $ 10 for each claim listed must be remitted to the BLM along with this n r anwpther affidavit o f assessment work. t-.

S w - ~c r









a ddress: 7170 W. Clare Island


No. o f Claims J_______________

x$10/claim

Total due BLM $ 10-00TO ALL WHOM IT MAY CONCERN:

1. The undersigned certifies that at least $100 per claim was expended for development, labor and improvements, or equivalent value added, as the annual assessm ent work for the assessment year ending September 1, 2017 for the following contiguous unpatented mining claim (s), located in the County o f Yavapai____________________ , in the State o f Ar'zoria______________________ .



Co. Recording Date

421633 Alders Hideout 12.5N 2W 19 SR B 4903 - P 325 02/02/13

r-ocm -

1 ^i

3. j r ■ -A

g *0 ; ;

OJ


2. Type o f labor and improvements (specify what was done and give the total value for that labor and improvement to show at least $100 for each claim). I f a geological, geochemical, or geophysical survey was performed, as per 30 U.S.C. 28-1, reference the title o f the report o f survey, give cost and date o f the survey and report, and indicate it was filed with the County Recorder:




3. Nam e and mailing address o f each person who performed the labor and improvements:

Name (please print) Current Mailing Address (please print)Thomas R. Villone_________ P.O. Box 12391, Prescott, AZ 86304

4. Nam e and mailing address o f each person who holds and claims the subject mining claim(s) for the valuable minerals contained therein. Be sure to indicate i f there is a change o f address:

Name (please print)Shawn Moffett

Current Mailing Address (please print)310 North Terrace, Janesville, Wl. 53548f \ o \ e - O t u

r*-o .J

-------- r ~r- : rs*.

L j ...■ ■i ' .

— n --------- --— —

¡T-------o ------- n —-------- :--------—______________________ _____ C. ; i . f

2-’ —co------- i----------

5. The undersigned testifies that on the date o f 0 2 / 0 2 ________________________ ? 20^ au monumentsrequired by law were erected upon the subject claim (s), and all notices required by law were posted on the subject claim (s) or copies thereof were in place, and at said date, each com er monument bore or contained


I hereby certify under penalty o f perjury under the laws o f the State o f A r iz o n a _____________ that theforegoing statements are hue and corrert:

57̂ k \£XA 7 c , i ; , w oV-tAjP v Date:(Signature o f person responsibleior above statement) '

markings sufficient to appropriately designate the comer o f the claim to which it pertains and the name o f theclaim(s).


Notary BlockSUBSCRIBED AND SWORN TO before me, this ol 7 # day of. S T By:

(¿idhaîujéofAffiant)

.20 (* 7

Title: ^-fj

My Commission Expires:. © BEVERLY JEAN STEWART1Near)- of A ir r ■YAVAPAI COUNTYMy Commission Expires July 8,2017 j

INSTRUCTIONS




4. The claimant(s) must complete paragraph 2 listing all labor or improvements which was performed on or did benefit the subject mining claims. The value and date o f the labor or improvements must also be listed. The total amount o f labor or improvements can be listed, but the total expenditure must equal at least $100 for each claim.

5. The names and current mailing addresses o f the person(s) performing the labor shall be listed in paragraph 3.6. The name and current mailing address o f each owner (claimant) of the claims shall be listed in paragraph 4. The



8. An exact legible reproduction or duplicate (other than microfilm or other electronic media) of this affidavit or another type o f affidavit o f assessment work that you file or will file in the county where each Shim is located, must be filed with the BLM on or before December 30 o f the calendar year in which thy assessment year ends.For mill or tunnel sites, a separate notice o f intent to hold must be filed with the BLM qn or bsiore December 30. Requirements for filing a notice of intent to hold can be found at 43 CFR 3835.33. >' i 'ri

9. A processing fee of $ 10 for each claim listed must be remitted to the BLM along with this or afiy other-affidavito f assessment work. *n ; rri

U . wc Ul _

C O ■ ________________( Form 3830-4, page 3)(Continued on page 4)








a d d r e s s - 7170 W. Clare Island


No. o f Claims J_______________

x $10/claim

Total due BLM $ 10 00TO ALL WHOM IT MAY CONCERN:

♦1. The undersigned certifies that at least $100 per claim was expended for development, labor and

improvements, or equivalent value added, as the annual assessment work for the assessment year ending September 1, 2017 for the follow ing contiguous unpatented mining claim (s), located in the County o f Yavapai___________________ , in the State o f Arizona______________________ .

BLM Serial No. Nam e of ClaimTp Rg Sec Mer


Co. Recording Date

417355 Blue Dog Two 12.5N 2W 19 SR B 4903 - P 325 09/04/12

__ e=> ---------------- r -------- —

P 3*-~ - cr

Î1 XT

'

^ 'U ' rncr uj

C O(Continued on page 2)

2. Type o f labor and improvements (specify what was done and give the total value for that labor and improvement to show at least $100 for each claim). If a geological, geochemical, or geophysical survey was performed, as per 30 U .S.C. 28-1, reference the title o f the report o f survey, give cost and date o f the survey and report, and indicate it was filed with the County Recorder:




3. Name and m ailing address o f each person who performed the labor and improvements:

Name (please print) Current Mailing Address (please print)Tomas R. Villone__________ P.O. Box 12391, Prescott, AZ 86304

4. Nam e and m ailing address o f each person who holds and claims the subject mining claim(s) for the valuable minerals contained therein. B e sure to indicate i f there is a change o f address:

Name (please print)Shawn MoffettThomas R. Villone Michael ShipleyCarole JollyMark Polydoros

Current Mailing Address (please print) (Tote.'-310 North Terrace, Janesville, W j 53548P.O.Box 12391, Prescott, AZ 86304__________8657 W. Rowel RD, Peoria, AZ 85383 P.O. Box 2284, Prescott, AZ 86302

•4053.1 Rocky Hill OR; Dewoy, AZ 86327- U-Se- ? 6 f e o y . f \ T -

A 4 J c n decoR-cL r T

~rrr

5. The undersigned testifies that on the date o f 0 9 / 0 4‘5 ■'A -

___________________ , 20 1 z ,-rall monumentsrequired by law were erected upon the subject claim (s), and all notices required by |aw were posted on the subject claim (s) or copies thereof were in place, and at said date, each com er monument Imre or contained

CD


I hereby certify under penalty o f peijury under the laws o f the State o f A r iz o n a _____________ that theforegoing statements are hue and correct:

r _____________ Date: (n —(Signature o f person responsible for above statement)



Notary Block

SUBSCRIBED AND SWORN TO before me, this S\LTi4 day ofBy: -----f~~

(Si^iati^ph of Affiant)

Title:.

My Commission Expires: 4 -

¿ T u /Q ( f________ 20 / y

---- WWW COUNTY.M r t, *017

INSTRUCTIONS




4. The claimant(s) must complete paragraph 2 listing all labor or improvements which was performed on or did benefit the subject mining claims. The value and date o f the labor or improvements must also be listed. The total amount o f labor or improvements can be listed, but the total expenditure must equal at least $100 for each claim!

5. The names and current mailing addresses of the person(s) performing the labor shall be listed in paragraph 3.6. The name and current mailing address o f each owner (claimant) o f the claims shall be listed in paragraph 4. The

mailing address shall be the owner’s address and not the address o f an agent or anyone representing the claimant. Be sure to note if there has been a change of address.

7. Paragraph 5 shall be completed to show the date it was verified that all monuments required by law were properly erected, all notices were posted, and that comers were appropriately designated for all claims lifted. ■

8. An exact legible reproduction or duplicate (other than microfilm or other electronic media) o f tl§§ affidavit or another type o f affidavit o f assessment work that you file or will file in the county wherei-each claim is located, must be filed with the BLM on or before December 30 o f the calendar year in which the assessment yeafinds.For mill or tunnel sites, a separate notice of intent to hold must be filed with the BLM oir or before December 30. Requirements for filing a notice o f intent to hold can be found at 43 CFR 3835.33. > ~

9. A processing fee o f $ 10 for each claim listed must be remitted to the BLM along with this or ari0 other affidavit o f assessment work.

_o ;


Rëceipt Page 1 o f 2

United States Department of the Interior Bureau of Land Management

DIV OF LA N D S, MINRLS & ENERGY ONE N CENTRAL AV E

Receipt

PHOENIX, A Z 85004 -4427 Phone: 602-417-9200

No: 3924552

T ransaction #: 4034078D ate o f Transaction: 08/07/2017_______________________

CUSTOMER:

llTRACEY LOHM ANN 7170 W CLARE ISLAND DR KIRKLAND,AZ 86332-5002 US___________________

LINE# QTY DESCRIPTION REMARKS

UNITPRICE TOTAL

1 1.00

LOCATABLE M INERALS / MINING CLAIM SNOT NEW -UNADJUD,O NE AUTH NO. O NLY / MINING CLAIM M ONEY RECEIVED CASES: A M C 374725/$90.00

POL 2017/9 W AV - n/a - 90.00

TOTAL: $90.00

PAYM ENT INFORMATION

1 AMOUNT: 50.00 POSTMARKED: 08/02/2017


CHECK NO: 1644

NAM E: LOHM ANN, TRACEY L 7170 W CLARE ISLAND D R KIRKLAND AZ 86332-5002 U S

2 AMOUNT: 10.00 POSTMARKED: 08/02/2017TYPE: CHECK RECEIVED: 08/04/2017

CHECK NO: 1645




CHECK NO: 1646


Il II

Receipt Page 2 o f 2



CHECK NO: 1647

NAME: LOHM ANN, TRACEY L 7170 W CLARE ISLAND DR KIRKLAND AZ 86332-5002 US



CHECK NO: 1648

NAME: LOHM ANN, TRACEY L 7170 W CLARE ISLAND DR KIRKLAND AZ 86332-5002 US

REM ARK S.

This receipt was generated by the automated BLM Collections and Billing System and is a paper representation of a portion of the official electronic record contained therein.

I.2

3.

4.

5.

6.

7.

Forni 3830-2 (October 2013)

^TNITED STATESDEPARTMENT OF THE INTERIOR

BUREAU OF LAND MANAGEMENTp 3 7 2

MAINTENANCE FEE WAIVER CERTIFICATION

SEE INSTRUCTIONS ON PAGE 2

A4 —

4 2 4 5 5 7

FORM APPROVEDOMB NO. 1004-0114

Expires: October 31. 2016

This small miner waiver is filed for the assessment year beginning on September 1, 201§/U> and ending on September 1. 20 I f f r f J The undersigned and all related parties owned ten or fewer mining claims , mill, or tunnel sites located and maintained on Federal lancisin the United States o f America on September 1, 2016 .The undersigned have performed the assessment work required by law for each mining claim listed prior to filing this waiver and understand that by filing this form, the undersigned must file an affidavit of assessment work with the Bureau of Land Management (BLM) by the December 30th following the filing o f this waiver. The undersigned understand that if the assessment work obligation has not yet come due under 30 U.S.C. 28 (for those claims in their first assessment year only), a notice o f intent to hold reciting this condition must be reco

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