Montana Form Mine-Cert - Application And Affidavit For Certification And Approval Of Mineral And Coal Exploration Incentive Credits - 2010
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MontAnA
MINE-CERT
Rev 08 10
2010 Application and Affidavit for Certification
and Approval of Mineral and Coal Exploration Incentive Credits
15-32-504, MCA
Application for the year ending December 31, ________
This application form must be submitted no later than 60 days after the close of the calendar year.
Name of applicant _________________________________________________________________________________
Address of applicant _______________________________________________________________________________
Project name (if any) _______________________________________________________________________________
Project area (for general reference purposes) ____________________________________________________________
Part A
Eligible Costs
Enter the total amount of exploration incentive credit costs from Part D, Line 9, of this application ..... $ _______________
Specific activities for which costs may be taken: You can request an exploration incentive credit for the eligible costs
for each of the following mineral and coal exploration activities that are performed for the purpose of determining the
existence, location, extent or quality of a locatable or leasable mineral or coal deposit regardless of whether the land is
state owned.
Surveying by geophysical or geochemical methods
Drilling exploration holes
Conducting underground exploration
Surface trenching and bulk sampling
Performing other exploratory work, including aerial photographing, geological and geophysical
logging, sample analyzing and metallurgical testing
Part B
Property Information
If a deposit has been established to exist, enter the location of the prospect/mineral property for which you will apply for a
mineral and coal exploration tax credit. Include all meridians, townships, ranges and sections.
________________________________________________________________________________________________
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Enter the claim names and/or the ADU/Serial numbers for the prospect/mineral property and the date that the mineral
rights to these locations were acquired.
________________________________________________________________________________________________
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*20040201*
2004
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