Montana Form Mine-Cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits - 2006
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5MontAnA
MINE-CERT
Rev. 2-06
Application and Affidavit for Certification.
and Approval of Mineral and Coal Exploration Incentive Credits
5-32-504, MCA
Instructions attached
Application for the year ended December 3, _________
Due date: To be timely, this application form must be submitted no later than 60 days after the close of the calendar year.
Name of applicant ___________________________________________________________________________________
Address of applicant _________________________________________________________________________________
Project name (if any) _________________________________________________________________________________
Project area (for general reference purposes) ______________________________________________________________
Part A
Eligible Costs
Enter the total amount of exploration incentive credit costs from Line 9, Part D, of this application...$___________________
Specific activities for which costs may be taken: You can request an exploration incentive credit for the eligible costs for each
of the following mineral exploration activities that are performed for the purpose of determining the existence, location, extent
or quality of a locatable or leasable mineral or coal deposit regardless of whether the land is state owned land.
Surveying by geophysical or geochemical methods
Drilling exploration holes
Conducting underground exploration
Surface trenching and bulk sampling
Performing other exploratory work, including aerial photographing, geological and geophysical
logging, sample analyzing and metallurgical testing
Part B
Property Information
If a deposit has been established to exist, enter the location of the prospect/mineral property for which credit will be applied.
Include all meridians, townships, ranges and sections.
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Enter the claim names and/or the ADU/Serial numbers for the prospect/mineral property and the date that the mineral rights to
these locations were acquired.
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