Issued September 2015

Operations Reports — Expenditure on Mining Tenement (Form 5)

Requirements to Lodge a Form 5 Report

Regulations 16, 22, 23E and 32 of the Mining Regulations 1981 provide that:

• Form 5 Operation Reports shall be filed at the Department within 60 days after each anniversary of the

commencement of term of the tenement; or

• within any period of extension as approved under Section 162B of the Mining Act 1978.

If a Form 5 is not lodged within the required period notice of intention to forfeit proceedings will be

initiated on the basis of non-compliance with the reporting and/or expenditure conditions.

Also make sure that the appropriate Attachment is completed:

• Attachment 1 is to be completed only if exploration or mining activities have taken place on the

tenement during the relevant period.

• Attachment 2 is to be completed only if prospecting or small scale mining has taken place on the

tenement during the relevant period.

Incomplete or incorrect Form 5’s will not be processed or entered in the tenement register until the

form complies with requirements.

NOTE: TENEMENT EXPENDITURE AND THE GOODS AND SERVICES TAX (GST) - It is required that expenditure on mining tenements be recorded and reported on an annual basis. The GST component of expenditure in connection with mining tenements should be included in the calculation of annual expenditure

reported on the Form 5 Operations Report.

Information required on a Form 5

When completing a Form 5 Report, the following details are required to be included:

• whether the report is an annual report, final report or surrender report (this also includes partial

surrenders) for the tenement;

• the period covered by the report (i.e. from the anniversary commencement date to anniversary

conclusion date or surrender date);

• the type of tenement (i.e. mining lease, prospecting licence, exploration licence, retention licence) and

the tenement number;

brief details of any operations carried out during the period of the report (various

suggested headings are on the front page of the Form 5);

the expenditure amount claimed for each type of operation together with the total amount

expended on the tenement;

the cost and detailed description for each activity claimed under Part A "Mineral

Exploration Activities" or Part B "Mining Activities (Development and production) in

Attachment 1;

details of any related annual mineral exploration report; and

mineral commodity details.

Incomplete or incorrect Form 5's will not be processed or entered in the tenementregister until the form complies with requirements.

Requirement to attach MhTeral Exploration Reports

Detailed technical reports (mineral-exploration reports) are also required to be lodged in

accordance with Section 115A mining tenements when certain .qeoscient f c activities areundertaken in the search for minerals, these being:

• programs involving one or more of the geological sciences (includes geological review,interpretation and target generation);

• drilling programs; or

• activities involving the collection and assay of soil, rock, groundwater and mineral samples.

As a rule, a report is required where 'Mineral-Exploration Activities' have been claimed on theForm 5.

Any such reports shall include the following:

methods of exploration;

a completed record of all geological, geophysical, geochemical and other technical

investigations carried out by or on behalf of the tenement holder;

a complete record of all drill holes and excavations;

details of the nature of material tested and all assay results;

a summary of reserves in a form as recommended by the AUSIMM, AIG and AMIC;

statement of expenditure;

details of any amount claimed in lieu of wages; and

a report title, name of joint holder responsible for operations on the tenement where

applicable, tenement information, date and complete table of contents.

Note: All maps and sections shall be related to the Australian Map Grid (MGA) or to known

surveyed points.

Further details of the requirements, and standards, and group reporting details requiredfor mineral exploration reports can be found of the pamphlet "Guidelines for Mineral

Exploration Reports on Mining Tenements".

If a mineral exploration report is required, it is to be attached to the Form 5 Report and should

be listed on the second page of the form (see Section 115A and the instructions attached to theForm 5.)

A combined mineral-exploration report may be submitted separately from the Form 5 where the

due date (as agreed to by the Director of Geological Survey of WA) differs from the anniversary

date. In this case, the Form 5 should make reference to the mineral-exploration report

containing details of the activities claimed.

When the minimum required annual expenditure will not be met for a particular year, an

application for exemption (Form 18) must be completed by the tenement holder or anauthorised a qent. (See relevant Guidelines)

IIHow to complete an Expenditure

Report for Prospecting and/or Small

Scale Mining Activities (Page 1) IIII

Insert tenement type II& number II

/ÿ iÿ, A"It"T A C H.Ile| EN"£ 2 [SUMMARY OF PR{)SPECTING ANDÿ./YR SMAiJ. ÿ'ÿE M iN ! N(; ACTIVITI Fÿ-ÿ."

!I"=lnrh.i in ÿ=/ÿLÿ:= ÿqir. =unÿalruq ÿ II

Iÿ. -- " ÿ : !1 Make sure you

Tÿ-mEm TYI*: I r I T ..... ÿ,.. I= ÿ II clearly identify the! I ............ ÿ "ÿ'71ÿ I beginning & end ot

From. 1" - " T -ÿ 7 -- ÿ ÿ" II the period covered.eÿ..l.ÿ ÿ=.a= ' , ÿ ,. ÿ , -+ = .... - I II by the report

A, Gmmr=l PrÿDeci[hlut AcU['vltleK IImini mÿ.m.,; il i+ I

This section is to be

Fuel, mlÿ etcJ

I)ÿhipmÿnt;

Nn. rÿi ,tÿyÿ wnrkÿ

COi'mlrtldiml hnnlÿrlulb;

Pill and ÿq/IFmÿm kin

¥1pld ÿpldlle= ltu,ÿ] mÿu=nniblr--,, ÿ1ÿ),

,ÿ,llLPmltÿIJalil.&.mÿlmmAS#soÿ::

_ _ill $ i'

I .,i !

SLIIBTU'L&L {A I,

Fuÿ elLÿ etc.1

Fleld luPldla (feoÿ rrumum=lhlÿ+ el-cO:

TennB of ÿJ'rÿdlrt mined ÿ- IrÿleÿJ+

Abarlelÿtl IllUme Suÿ,+vÿ.ÿ

ADIInnl T,Pnmnÿnd Reml anti lt,llilÿ

drag ' 't= 'l'ttÿe:

SU!IT +ffrAL (C)

SLiB1FOTAL <O)

SU'RT(],TAL (£I'

completed if prospectingactivity was undertakenon the tenement duringthe relevant period & theamounts expended on

each type of activity. Besure to enter the subtotal

after completion.

$

$

|

iS

I,

I,I,

This section is to becompleted if Small ScaleMining activity wasundertaken on thetenement during therelevant period & theamounts expended on

each type of activity. Besure to enter the subtotal

after completion.

5

I; I

,!This section is to becompleted if you areclaiming any expenditureagainst these headings.

Be sure to enter the

subtotal after completion°

!

rill' +i ÿi il Ii +,ÿ l !=Pi+ li li ÿlid ili liiiiliÿ fm hl il +l! .liE-.+, i'ÿtÿ

Add up subtotals & makeII sure this total is copied toII the 'TOTAL EXPENDITURE'II box on the frontpage of thelI form 5

JJJ1

[-,oumlnrÿ pumndrqP,,, =ampl]nÿ, doil:yÿnlÿ, dr-y-bluÿlmÿ

How to complete an Expenditure

Report for Prospecting and/or Small

Scale Mining Activities (Page 2) IJCOMPLETE ATTACHMENT 2 BEFORE YOU COMPLETE THE FORM 5

Frrrr, ÿ

It is important to note if it is a finalreport or an annual report

.h-rEJÿ' AUÿTKALUt

iÿ. -='I. ÿi, "i1111, K3 Irÿ111 ",Aÿ, / /

'ÿr' ] ÿ :L\ !:iF" 'ÿ'"ÿ "ÿ-ÿ /

,#,smmflÿ

Tcmmeÿ T)peÿ

L__] Fÿ, I ] 'JI Insert tenement type& number

Ii=ÿb==dÿtn ml==,-'ÿJÿ,n

,liÿIx.rtÿa IP.rloÿ From, I / t ÿ !

MIÿi'ERAL-I;:ÿPt.ORATi[ON ANBiOR MINING ACTIVITIES

A- M!NEIK/tl,-IÿPIJ)iATIDÿ At."lrlVITIFÿ,

Lm"

i:1 bll:lÿl I:ÿ,=lTadmm=Akal:i']mma =!

;':d,.tcrr= ul'

hÿ pÿrMÿ

IL btlNIN(ÿ &(.l'l¥1-rlF_ÿ $

c, ÿOÿXL RI This section is not required to be II

cÿ-o^,ÿ,ÿ.ÿ ÿ completed for 'Prospecting and/or

Small Scale Mining Activities'D, A]',Iÿ'NILI&I'. TENEB

I

oR

PROSPEC33NG AN3)/OR SMALL SCALE MLNING ACTIV]TIES

Make sure you

clearly identify thebeginning & end otthe period coveredby the report

TÿI'AL EXPENDIFURE: I $ ÿ.

,'A 4rj, E ON ATTACIIMÿEh'I" 2ÿ ÿ

• nd.,'m Mlnlnl= ^rllÿÿ .ÿ Aklm"hrmml ÿ ÿled ÿl.mrmÿ ,,dr Pr'ml,,,dÿl ÿn/I.tm- ÿ ÿ MInIÿI \

'ÿ. ÿ.ÿ2 ÿm'='+,tÿ 'dIll'In ÿI + m p<+'n'm n n th ÿ" Im'tmml rrt n k*' Imm''dLmÿ LIw In tm'mr'ÿmÿ' ÿ m

Make sure this total iscopied from the'TOTAL EXPENDITURE'

box on theATTACHMENT 2

How to complete an Expenditure

Report for Prospecting and/or Small

Scale Mining Activities (Page 3)

| i.I! wu.mirÿ= irll

6d, Jrt ÿ ,ÿ

_r

Insert the full name & address of If$

the tenement holder(s)[I

Tul liP,ÿ ÿrH:i.klnctt ÿf

=rlnÿj=n, lmltlÿ

d r,L-l,ÿr r.Tmÿ J-il II This only needs to be completed

if the operator(s) of the tenement- is different from the holder(s)

mÿ,l.

M:l,,-r=l-mÿlm'ÿm IrttpaH (Iror ÿ!miLIw 5mm[,!ÿl

-I ----'ÿFrÿlJhl f!ÿ,l! I'lÿ'rRhlil t'ÿ_'ÿtivtÿt'4" fLÿ le.llt:.nmnl !lÿlUp i ,<

I

Oÿmbinÿd Rp'ÿinE dzÿ far &roÿ: t t

I

This only needs to becompleted if you arerequired to attachdetailed Mineralexploration Reports asrequired by Section 115Aof the Mining Act 1978)ORif the tenement is part of acombined reportingproject

r ÿ=lllll'y II!!il lh,ÿ inr-rmÿ ÿ.ÿ ÿ_ÿ_ÿ I ÿ=d ÿ pJ in A!ÿbmenl t "ÿ'i.!3miu3" ill" Mllÿr'al,l.ÿtÿlaraiim. iiÿ,ÿe

.IÿI__ nil ,ÿlivilJrÿ" ur Attÿmÿm 2 "$1ÿnmiu'y a[ ÿrÿ.ÿpet-vÿg iÿ&ÿ¢ l!irlil]1.3--ÿ1ÿ ÿ]lnÿ #u.'livlikl"

canmÿlÿ m role ÿuuemenl of ilÿ ÿriliÿat curled ¢ÿt ind ink= eXlÿ--ÿ .,ÿ lhh fitÿml ÿlÿlt!=-1 dur=B

I1ÿ:1

i,,-,ÿlli, dÿ:i

l,ÿrÿ,ÿ 4rid

for pILÿ ,'raÿ I

IlNF_RAI. (3tIMHODITV ÿJGBT (IN I"E.NEÿ,iI'ÿT"- O.uht

I__ _ [rcÿ L'ÿm

I ZIno'ÿlbÿr

J lease ensure that

you sign & date thereport beforelodgement

for/mining & the• amount you have

L$ : ] ...................... spentexploring................................ for/mining each

mineral

Pi44el,i!,'l'T&lÿ!ÿltÿi'l I -- 51IMMÿ. li!! &lÿ,41(:l,IMlÿ'r I ÿ Rr=pttlM/ily ,O!

Pl LtlI/ÿERA.IIÿRit'LION ÿ PIIÿL'ÿLÿC/ÿlllÿl IÿM.I,U.

AL%l[JÿIR MLMINÿ A ÿ':HÿtT1FO] kÿ 7A i-I'; M]Nÿ'KI" &C'I'WI'T'Iÿ.5

IAI "Flit illii_llrr,¢lll luli ÿ ÿ llri: Pÿ F-niill • iiii'rrlll]i, d ilii li=l,,llltq,,t_l!l'lliÿ "ÿl,1 llÿ

ltÿ ÿr d =ÿ,.ÿ =='ÿiÿflÿ, r=r Amÿhrrÿm I pÿl m.lÿ tidrlr bli Itÿ pro r,:ÿ ÿ-el ÿ i

lq4t

11!it4"li

i

di: Funa 3 ÿ ir, y prom ua ÿn a111 iÿm'd'wI I'ÿ

IIHow to complete an Expenditure

Report for Mineral Exploration

and/or Mining Activity (Page 1) III AII'ACILMEÿNT I

SUMMARY OF MINERAl+ EX.ÿLORATION ANL)IOR MINING ACTIVITIEÿr ÿ'd...-'nÿ.'Im I] ÿ ÿIbh llebx'ÿt.l.ml

Fenÿrl-i

Insert tenement type& number

l}ÿMÿA<dÿitiÿ ,ÿJopmenl md I'rÿuÿLÿl

,ÿ Ir

jÿ.nMlieeÿEsÿgrlilnn ,ÿ.ÿl,d iÿ.4 Make sure you

clearly identify thebeginning & end ofthe period coveredby the report

Once you have completed this form& indicated your amounts ofexpenditure under each relevant

heading, transfer these amounts to

the corresponding areas on the

front page of the report (i.e. theamount shown under A. to A. on

the front page of the Form 5Report.

,A ur,ÿ4'l.liJnAL !lu'Itii.= ÿurt1¢ÿ

E, AdmEnhlratf,+ÿi iliLmll O',',fÿ

[, Laid Aÿ'cÿnÿre 'r'lÿ.Lf Make sure this total is the sameas that shown in "TOTALEXPENDITURE" on the front

page of the Form 5 Report

P

__ . /-ii

IIHow to complete an Expenditure

Report for Mineral Exploration

and/or Mining Activity (Page 2)

22.b-I k 8N A£ÿTRÿL]/ÿ

OlÿJÿt TIONS REPORT- EKrlÿDII1]R£ ON ]ÿgNIÿ'G TIEÿIE:MENTIt is important tonote if it is a finalreport or an annual

report

FIIlR/];

II{Et.I= !--L1..,1:== md

B'rÿm:= t,i

MINLÿRAL.F-ÿPIÿRATÿnN ANDff)R MINING ACT[V]Tÿ

,'L M])IEit)ÿE3LPLOÿIÿTtON ACTIVI111ÿ]

MIHINÿ &CTIVIT[]ÿ

C, ABORIGLNAL lnÿp,.ITKGK ÿ.IR'r!,'E¥',ÿ

D, ANN'UAÿ TENIFJ'ÿt'k-ET li:F.N'r AND RAÿi;

F. 14.ÿlEilt) LÿND ACÿEEÿNAIl"ÿECOS]IS;

II,

[_ÿ

1 l' l

= O" 11Ptÿ.OSi'ECWING A['-,[DiOR SMALL SIC'ALE MI,.N1]ÿIG AL-'1ÿrlTIES

This section is not required to be

completed for 'Mineral Exploration

and/or Mining Activity'

i.ÿ, tÿi,,d

Alut:t, nuÿ I

IInsert tenement type& number

IMake sure you clearlyidentify the beginning &end of the period coveredby the report

Make sure these totalare the same as the

corresponding totalson Attachment I

Make sure this total is thesame as that shown in

"TOTAL EXPENDITURE" onthe frontpage of the Form 5Report

I

How to complete an Expenditure

Report for Mineral Exploration

and/or Mining Activity (Page 3)

, rJ l ÿ ÿ.d

i Insert the full name & address of

: the tenement holder(s)

ii[nrÿn=

rnillMlll

This only needs to be completed if the operator(s)of the tenement is different from the holder(s)

!-m iÿ'n

r, I.==.t mtm.aJplim¢ÿo

mÿ,rt.

Mtma'al=ÿzlpl.ÿ r=pÿrt qtÿr =rmSj= t*ÿnÿM}

Cuÿ mlÿzling nuÿ for lÿ,ÿmÿnl Br, z...ÿ. (= t

Comlÿ,M peperlin!ÿ date for ÿ!;ZUUlÿ. I / f

This only needs to becompleted if you are requiredto attach detailed Mineralexploration Reports asrequired by Section 115A ofthe Mining Act 1978)ORif the tenement is part of acombined reporting project

I ÿ=--.ÿry ma ÿ= =rÿ,.mÿi,,p ,ÿ I"Iÿ ! :rp] i ÿ In Aiÿhrr=mz I *',ÿrm-urrÿ ÿr Mmerÿi,Eqplÿzziÿ L"ÿr

te [eNmÿB peÿlÿi ipÿir.tÿt

• ÿijmh;.re ,",f hp)d,ÿr

LTÿ:t

bin. =ÿ dÿrr*,.Ix=ÿku=

! ,,-_..__.

J iÿn nre .$ ....... ! = j Minrralÿdÿ $

I ÿidÿlJ'Cÿaalz $ , ! ritlirr i:ÿrÿllry) i-- , mpÿ"ÿ' ÿ! ................................

Zinÿ.Riher

Please ensure that you sign& date the report beforelodgementandIndicate what mineral youare exploring for/mining &the amount you have spent

exploring for/mining eachmineral

nk

b

JlIF

iiP11!

t

Processing an Expenditure Reports

(Form 5) and Applications forExemption

Tenement holder

ascertains if he will

lodge the Form 5 withinthe required period

I Form 5 will be lodged I I

within the requiredperiod

I

I Extension request 1approved

1

II

Tenement holder 1 Iapplies for extension of

time to lodge Form 5-wJtfÿimt-ime-

Form 5 will not be

lodged within therequired period

ITenement holder does

not apply for extension

of time to lodge Form 5

I

I Extension request ÿ_refused

J

I Tenement holder 1

completes & lodges

Form 5 Report withinthe require time or has

been given extensionI Tenement holder doesn't

lodge Form 5 or it is

lodged late, incorrectly or

incomplete

Details of Form 5 |

Jentered in tenement

records

I

I Expenditure 1requirement

expended in full

I Form 5 has been 1completed correctly

& complies

I

I Expenditure 1requirement only

partially expended

1I Application for 1

exemption applied for

II

Application for 1 Iexemption granted

I Tenement holder has 1complied fully with

expenditure conditions

I

i F° has een 1completed incorrectly

or is incomplete

I No Application for

exemption applied for

IApplication for 1

exemption refused

I Forfeiture action 1commenced