_____________________________, County of ___________________________, State

of ____________________, do hereby declare and publish as a legal notice to

all the world, that _____ have a valid right to the occupancy, possession

and enjoyment of the ______________________________________________________

_________________________________, located _________________________, 19___

for the discovery of mines and the development of lodes, and situate in

_________________________________ Mining District, ________________________

County, State of _________________________, described as follows, to-wit:

Mouth of tunnel situate _________________________________________________

_____________________________________________; from the mouth of the tunnel