Saskatchewan Targeted Mineral Exploration Incentive – TMEI
Verification of Work Form
Application is hereby made under the provisions of The
Targeted Mineral Exploration Incentive Regulations.
Resource Development, Ministry of Energy and Resources
Regina, SK S4P 3Z8
Phone: 306-798-4212 | tmei@gov.sk.ca
Part 1 – Contact Information
Company /Applicant:
Contact Person:
First & Last Name
Mailing Address:
Contact Info:
Title
Civic address, rural route, etc., City, Province, Country, Postal Code
Email
Phone
Mobile
NOTE: As per your approved application form, if the person or company applying for the Saskatchewan TMEI
is not the sole holder of a disposition under The Mineral Tenure Registry Regulations, or, if the legal
disposition holder designates another party to apply for this incentive according to the TMEI Regulations,
permission must have been obtained via the signed schedule of dispositions (please refer to part 3 of your
approved Application Form).
Part 2 – Summary of Work
Project 1
Project Name
Work
Period
From (dd/mm/yr)
To (dd/mm/yr)
Commodities Targeted
Total Number of
Dispositions
Total Number of Drill
Holes Completed
Total Meters Drilled
Total Project Expenditures
TMEI Drilling Related
Expenditures
Project 2
Project 3
Project 4
Part 3 – Contractor Details
The sum of each of the contractor expenditures should equal the total Drilling related expenditures being claimed in Part
2 – Summary of Work.
Company:
Contact Person, Title:
Contact:
Number
Total Contractor Expenditures:
Email
Company:
Contact Person, Title:
Contact:
Number
Total Contractor Expenditures:
Email
Company:
Contact Person, Title:
Contact:
Number
Total Contractor Expenditures:
Email
Company:
Contact Person, Title:
Contact:
Number
Total Contractor Expenditures:
Email
Company:
Contact Person, Title:
Contact:
Number
Total Contractor Expenditures:
Email
Company:
Contact Person, Title:
Contact:
Number
Total Contractor Expenditures:
Email
Part 4 – Schedule of Completed Drilling
Drill Hole ID
Disposition ID
Drilled Collar Locations
(UTMs - NAD83, Zn13)
Easting
Northing
NTS Map
Sheet (e.g.
64L06)
Drill Hole Orientation
(dip/azimuth)
Final Drill Hole
Depth (m)
Part 5 – Declaration
I, _______________________________________________, hereby declare:
I am the person applying (on my own behalf or on behalf of an entity) for the Targeted Mineral
Exploration Incentive.
I am an authorized signing officer for the entity submitting the verification of work
(only select this option if application is made on behalf of an entity).
I have been authorized to apply on behalf of all disposition holders as set out in the schedule of
dispositions contemplated in the application (only select this option if a disposition
contemplated in the application is held by more than 1 eligible holder and such holders have
approved the application)
The contents of this verification is accurate and true.
I make this declaration conscientiously believing it to be true.
Dated at
Signature
Witness Name:
Witness Signature:
, this
, day of
, 20