AND ADDRESSES OF AFFECTED LANDOWNERS (See page 3 for information on requirements to complete this page) Landowner notifications required. Section A, Approved Form 24 should be used for these notifications. Number and Type Land Owner names Address NT Portion or Section Number Witnessed by: Declaration : I declare the information contained in the table above to be correct, as at / / _____________________ SIGNATURE: __________________________ SIGNATURE: NAME: _____________________________ NAME: __________________________________
AND ADDRESSES OF AFFECTED LANDOWNERS (See page 3 for information on requirements to complete this page) Landowner notifications required. Section A, Approved Form 24 should be used for these notifications. Number and Type NT Portion or Section Number Land Owner names Address Declaration : I declare the information contained in the table above to be correct, as at / / SIGNATURE: __________________________ NAME: __________________________________ Witnessed by: SIGNATURE: _____________________ NAME: _____________________________
af1-exploration-licence-ma-application.docx