294 Appendix A. 



THE FIRST SCHEDULE. 



FORMS. 



Regulation 3. FoKM No. 1. 



AppIicat'ioH for Vrospccting Licence. 



Bkitish (tUIANA. 



The Mining Regulalions, 1905. 



To the Commissioner of Lands and Mines, Georgetown \or to the 

 Warden, No. District]. 



1 \or we] hereby make application for n Licence to prospect for Gold [or 

 Precious Stones] within the Colonj- and to locate Claims therein. 



Name, style, or firm (if any). 



Address. 



Kegis-tered Address. 



Dated this day of ,11) . 



(Signed) 



IJpguUilinn \. FoKM No. 2. 



Vroitpcet'inii Licence. 



JUtrnsH (4riANA. 



The [Mining Regulations, I'JO;). 



No. 



A Licence is hereby granted to 

 of to prospect for Gold or Precious Stones 



within the Colony, and to locate claims therein. 



This Jiiceuce shall remain in fone for the purpose of prospecting until 

 tlie day of 



Dated this day of , 19 



(Signed) 



CoiiDnissioner of Lands and Mincn \_or Ifardc/i^. 



Kegulalicne. l'''>i"i No. 3. 



AKthoritji from Licence Lloldrr to I'r<iy/i<cf. 

 British Gitiana. 



The Mining Regulations, 190;'). 



of 

 is hereby authorised to prospect for me within the colony and to locate 

 claims therein on my behalf, under and subject to Prospecting Licence No. 



This authority expires on the day of , 19 . 



Dated this day of , 19 . 



(Signed) 



Approved. 



(Signed) 

 Conimisaioner of L.ands and Mines \_or Warden']. , 



