Form Mine-Cert - Application And Affi Davit For Certifi Cation And Approval Of Mineral And Coal Exploration Incentive Credits Page 3

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Applicant Name__________________________________

Part IV. Breakdown of Exploration Costs Incurred to Bring the Mine into Production

The amount of Mineral and Coal Exploration Incentive Credit allowed is based on the costs incurred for activities in

direct support of exploration activity conducted at a speciﬁ c exploration site for the purpose of determining the existence,

location, extent, or quality of a mineral or coal deposit. We require a breakdown of the eligible costs associated with this

credit. Eligible costs are the costs incurred during the year for the ﬁ ve mineral and coal exploration activities listed in

Part I on page 1 of this application. The activities must relate to the legal description deﬁ ned in Part III, line 9. Please see

the instructions for details about the eligibility of these costs. Enter the summary of the costs that you have calculated for

each category below.

1. Personnel Costs ................................................................................................................$ _________________

2. Transportation Costs .........................................................................................................$ _________________

3. Fuel Costs .........................................................................................................................$ _________________

4. Field Camp Costs ..............................................................................................................$ _________________

5. Communication Costs .......................................................................................................$ _________________

6. Geochemical and Geophysical Costs ................................................................................$ _________________

7. Contractual Costs ..............................................................................................................$ _________________

8. Miscellaneous/General Business Operating Costs ...........................................................$ _________________

9. Add the amounts on lines 1 through 8 above and enter the result.

These are your total Exploration Incentive Credit Costs. ...........................................$ _________________

Enter this amount in Part I on page 1 of this application.

Please attach a detailed ledger supporting your totals. Include in your ledger which of the ﬁ ve mineral and coal exploration

activities apply to each detailed cost. You should save all of your receipts and/or cancelled checks because these ledgers

are subject to audit.

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