Dor Form 82061-B - Property Tax Form - Mines (Other Than Copper) - 2014 Page 2

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MINES(OTHER THAN COPPER)
CONFIDENTIAL
Company Name___________________________________
For the Year Ended December 31, 2012
FILING INSTRUCTIONS ARE ENCLOSED
Please refer to filing instructions when completing this report.
If you need assistance
in completing this report, call the Property Tax Division, Centrally Valued Property Unit
at the following number - 602 716 - 6838.
Abbreviations used in this report include: UG =
Underground, OP = Open Pit, SMLT = Smelter, RFNY = Refinery, REV = Revenue, EXP = Expenses,
LBS = Pounds, OZS = Ounces, SXEW = Solvent Extraction Electrowinning, YR = Year.
MINING COMPANY PROPRIETARY DATA
Name of Property_____________________________________________________________________
Name of Owner________________________________________________________________________
Name of Operator/Lessee______________________________________________________________
Address of Operator/Lessee___________________________________________________________
Official Responsible for this Report_________________________________________________
Telephone Number_____________________________________________________________________
Contact Person Regarding Information in this Report__________________________________
Telephone Number_____________________________________________________________________
Type of Mine:
Underground, Open Pit, Leach, In-Situ__________________________________
Principal Saleable Product___________________________________________________________
Other Saleable By-Products___________________________________________________________
Date Production Started______________________________________________________________
Date Production Stopped_______________________
Permanent or Temporary_______________
Average weighted sales price per unit received for each product sold in calendar year
2012: ________________________________________________________________________________
DOR Form 82061-B (Rev. 11-12)
PAGE A2 OF A19

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