Mining Claim Form – Fill Out and Use This PDF

The forms in this circular may be reproduced for filing with the Bureau of Land Management and the County Recorders’ office. There are no officially designated forms, but the forms provided meet the statutes and the requirements of these agencies. These forms may also be downloaded from the Department website, www.mines.az.gov/claimforms.pdf in PDF format.

Find the Bureau of Land Management’s Maintenance Fee Waiver Certification form 3830-2 at: www.blm.gov/pgdata/etc/medialib/blm/az/pdfs.Par.44542.File.dat/3830-2_MaintFee.pdf

The following is a brief summary of the filing process for Federal mining claims:

Mineral rights can be obtained on State or Federal lands that are open to mineral entry. Mining claims, leases, and mineral material sales apply to Federal Lands. Prospecting permits, leases, and material sales apply to State Trust Land. The process is complex, but can be accomplished by the average citizen.

Mining claims cannot be used as a residence or home site. Under the current moratorium on patenting claims, no title to the land can be obtained.

The initial claim recording expenditure for a federal mining claim is about $10 at the county recorder’s office and is $189 total fees at the Bureau of Land Management.

The steps in acquiring mineral rights are generally as follows:

l. Find an area of interest and determine its legal description (i.e. Township, Range, Section, etc.)

2.Determine surface and subsurface ownership status as explained in ADMMR Special Report SR23, Manual for Determination of Status and Ownership, Arizona Mineral and Water Rights

3.Acquire and maintain mineral rights as described in ADMMR Special Report SR12, Laws and Regulations Governing Mineral Rights in Arizona.

The above publications may be ordered from ADMMR or perused at the Department's office and at select Arizona libraries.

I:\Pubs\lawreg\Forms MCF Series\Cir115ClaimFormsCover.doc 7/27/2009

Form MCF100

Revised July 2005

This form is available from the Arizona Department of Mines & Mineral Resources and may be reproduced.

Scale : 1" = 2000 feet

1.The above map depicts the __________________________ mining claim, which is located in Section (s)

___________ , Township _______ _______ , Range ______ ______ , Gila and Salt River Base and Meridian,

______________________ County, Arizona.

2. The type of corner and location monuments used are as follows: _________________________________

______________________________________________________________________________________.

3. The bearings and distances in degrees and feet between claim corners are as depicted on the map.

Form MCF100a

Revised July 2005

This form is available from the Arizona Department of Mines & Mineral Resources and may be reproduced.

When Recorded Return Document to:

______________________________

______________________________

______________________________

_____________________________________________

Check here is this is a change of address.

Telephone: ___________________________

E-mail address: ________________________

____________________________________________________________________________________

State ____Zip ____________ being duly sworn, depose and say that I am a citizen of the United States, more than

eighteen years of age, and that all of the facts set forth in this affidavit, subject to the provisions and penalties of 18 U.S.C. 1001 pertaining to the filing of false, fictitious, or fraudulent statements with the United States, are true and correct according to the best of my knowledge, information and belief.

4. Owner’s name and address (If not shown in Items 1-3 above). _______________________________________

___________________________________________________________________________________________

5.That I am personally acquainted with the mining claim(s). The work and improvements were made by and at the expense of the owner(s) of said claim(s). Said contiguous group of claims, listed on this document, are situated in the

____________________ (optional) Mining District; ___________________________ County, Arizona.

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3

4

5

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Form: MCF108

Revised Jan. 2006

Page 1 of 2

AFFIDAVIT OF PERFORMANCE OF ANNUAL WORK – page 2

BLM

Date

Stamp

7

8

9

10

6.That between the dates starting at 12 o’clock noon on September 1, 20 ____ and ending at 12 o’clock noon on September 1, 20 ____ at least $ ______________dollars worth of work and improvements were done and performed upon said claim(s) or upon one or more of a contiguous group of claims for the benefit of all, wholly or partly outside of a contiguous group of claims for the benefit of all, not including the location work.

7.That the following persons were employed to perform the work and improvements described herein: ___________

_____________________________________________________________________________________________

8.That the work and improvements performed were: ___________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

9.Dated:____________ Signature: _________________________________________________________________

SUBSCRIBED AND SWORN TO before me, a Notary Public, this ___________ day of ___________ 20________

By: _________________________________________________________

Notary Public _________________________________________________

My Commission Expires ________________________________________

This form is available from the Arizona Department of Mines & Mineral Resources and may be reproduced.

___________________________________________________________________________________

I (We) intend to hold the claims(s) and/or site(s) listed below for the calendar year 20___, and I (We) have filed or will file a Notice of Intent to Hold in the county where the claim (s) is located.

Reason for filing a Notice of Intent to Hold instead of an assessment work filing (check one): Maintenance fee was paid to maintain claim(s) during this assessment year.

Mill or tunnel sites.

Claim(s) was located during the current assessment year.

BLM has deferred assessment work (attach copy of decision granting deferment, or pending petition for deferment including date petition was filed.)

Form: MCF110

Revised Jan.2006

Page 1 of 2

NOTICE OF INTENTION TO HOLD MINING CLAIMS/SITES page 2

BLM

Date

Stamp

1.State of Arizona, County of ________________________________________

2.I (Name) _______________________________________________________

3.Reside at (Address) ________________________________________________________________________

City _____________________ County __________ State ______Zip ____________ being duly sworn, depose and

say that I am a citizen of the United States, more than eighteen years of age, that all of the facts set forth in this notice, subject to the provisions and penalties of 18 U.S.C. 1001 pertaining to the filing of false, fictitious, or fraudulent statements with the United States, are true and correct according to the best of my knowledge, information and belief.

4. Owner’s name and address (If not shown in Items 1-3 above). _______________________________________

___________________________________________________________________________________________

5. Dated:____________ Signature: _______________________________________________________________

Form: MCF110

Revised Jan. 2006

Page 2 of 2

This form is available from the Arizona Department of Mines & Mineral Resources and may be reproduced.

___________________________________________________________________________________

Form MCF114

Revised June 2005

This form is available from the Arizona Department of Mines & Mineral Resources and may be reproduced.