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Schedule A. Notice of Amalgamation to he signed in Duplicate, and one Copy Returned signed by the Registrar. To the Mining Register at 18 . We hereby give notice that we desire to have our claims amalgamated, situated at the particulars of which claims are given below.

Registered Date (Signature) Registrar: Schedule B. Notice of Neglect, Absence, or Omission. To Mr. A. 8., shareholder in the Claim, situated at . I hereby give you notice that your hired servant, C. D., working in the above claim, has been guilty of [here state particulars of neglect, absence, or omission] contrary to the provisions of the Gold Field Regulations, and if such neglect, absence, or omission be continued for [twenty-four hours, or seven days] from the date of the service of this notice upon you, I shall then apply to the Warden for permission to work the same. Dated at this day of 187 . E. F. Mutee's Right No. Endorsement on the Bach of Copy. A copy of this notice was served on A.B. personally [or by leaving the same at his last known place of residence] at on the day of 18 E. F. Schedule C. Application to Form a Water-race. To the Warden at 187 . hereby give notice that desire to construct a water-race for mining purposes, commencing at a point , and terminating . The length of such race is or thereabouts, and its intended course is . The mean breadth and depth of such race is ;it is capable of carrying sluice-heads of water, and it is proposed to appropriate sluiceheads. Signature of Applicant — No. of Miner's Right — Any person having any objection to this application must lodge the same, in writing, at the Warden's Office, at , within fourteen days from date hereof. Date: Warden. Schedule D. Application for a Residence Site. To the Warden at I hereby give notice that I desire to occupy for Residence feet by feet of land, situated at and I have this day marked said land with in conformity to the Gold Field Regulations. Signature of Applicant ") And No. of Miner's Right ) Any person having any objection to this application must lodge the same in writing at the Warden's Office, at , within fourteen days from the date thereof. Date Warden.

Locality. Registered No. and Name of the respective Claims to be amalgamated. Class of Claims. Names of Owners of the Claims to be amalgamated. Share of each Owner of the Amalgamated Claim. Signature of each Owner in Amalgamated Claim.