WHEN RECORDED RETURN TO:
Mailing Address of Claimant

	

NOTICE AND CERTIFICATE OF LOCATION
	Lode Mining Claim in Washington

NOTICE IS HEREBY GIVEN THAT_______________________, whose mailing address is ____________________________ , City, State, Zip Code, pursuant to and in compliance with the mining laws of the United States and the State of Washington, has located a Lode Mining Claim on public domain lands in the County of Pend Oreille, State of Washington, in an unorganized mining district.  The undersigned citizen of the United States hereby certifies and declares as follows, to wit:

1.	The name of the locator is: ____________________________

2.	The name of the claim is:					

3.	The date of discovery, location and posting the notice of location is:  Date _________________

4.	The claim is situated all or in part approximately within the following quarter-section(s), section(s), township(s), and range(s) of the Willamette Meridian, Pend Oreille County, Washington:

5.	The undersigned locator claims 1,500 feet in length along the course of the vein or lode,                 feet in a                   direction and               feet in a                  direction from the point of discovery and the monument of location upon which the Notice of Location is posted, together with 300 feet in width on each side of the center of the vein or lode from the point of discovery.

6.	The general course of the lode or vein, as near as can be determined, is                                                   .

7.	The description of the claim located by reference to some natural object or permanent monument as will identify the claim is as follows, to wit:  The monument of location is situated approximately                       feet in a                               direction from a readily identifiable landmark, being                                                                                                                       .

LOCATOR:

Mining Company
501 N Mining Blvd.
Spokane, Washington 99202

By:								Witness:

                        				     	          _________________________________________
Agent for Locator							Agent for Locator