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AFFIDAVIT OF ANNUAL ASSESSMENT LABOR
GROUP OF PLACER MINING CLAIMS
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STATE OF WYOMING :
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COUNTY OF LINCOLN :
The undersigned, being duly sworn, states:
1. At least $ 200.00 worth of labor or improvements was performed
or made during the annual assessment year beginning at noon on September
1, 2004 and ending at noon on September 1, 2005 upon or for the benefit
of the following listed placer mining claimS:--
Recorded in BLM
Name of claims(s) book/page(s) Serial No(s)
Peacock Claim #2 564/149 14/197 WMC260693
Peacock Claim #3 564/150 14/198 WMC260694
2. The labor or improvements consisted of: Mining, which consisted
of removing the valuable minerals in the form of rocks of different
sizes, scattered throughout both claims, in new or old washes or along
hill sides.
arid was done at the following locations: Peacock Claim #2 and
Peacock Claim #3
3. The person(s) who performed the labor or, improvements are
identified as follows: Heather Hulse, Mike Hulse, Jesse Allred,
C. Mark Allred, Darlene A. Allred, Doreen Allred.
4. Said labor or improvements were made at the request and for
the benefit of C. Mark Allred, and Darlene A. Allred owners of
Peacock #2 and #3 placer Claims.
Signature ofA~fiants
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Dated:
and sworn to before me this
RECEIVED 12/20/2005 at 11: 18 AM
RECEIVING # 914578
BOOK: 607 PAGE: 831
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
A.D. 2005
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Notary Public
My commission expires
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CATHEflINE M. WALTERS· NOTARY PUBLIC
County 0' er.~n;~ Slate of
Lincoln ~Jt?; Wyonli'}!1
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