2018-19NovaScotiaMineralResourcesDevelopment Fund (MRDF)

ApplicationforProspecting and ExplorationGrant

Please study the Terms and Conditions for a Prospecting and ExplorationGrant carefully before you submit this application. Omission of critical information may lead to an application being rejected.

Enter data into the fields below(tables and text boxes are expandable if more space is required):

1.PersonalInformation

Name:

Project Name:

Address:

Town/City: Province: PostalCode: Phone(home):Phone (work): Phone (cell):

E-mail:

Occupation: Prospector’sIdentificationCardNo:

HaveyoutakentheNovaScotiaProspectingCourse? If“yes”,whatyear? Anyotherprospectingcourse?

If“yes”,indicatewherethecoursewasgivenandyear:

Provideasummaryofyourprospectingexperience,includingtotalyears:

Is the applicant eligible for federal government re-imbursement of the Harmonized Sales Tax (HST)?

2.ProjectInformation

Pleaseprovideanaccuratelistingoftheclaimreferencemapsheets,tractsandclaims,issuedateand expirydate(asemployedintheN.S.RegistryofMineralandPetroleumTitlesonNovaROC)ofthe explorationlicence(s)youareproposingtoworkon.Amapshowingtheexplorationlicence(s)is required.Detailsofanyagreementswithoutsidepartiesthathaveavestedinterestinthepropertyareto besubmittedwiththeapplication (see application checklist).

Exploration
LicenceNo. / ClaimRef.
Map / Tracts / Claims / IssueDate yyyy-mm-dd / ExpiryDate yyyy-mm-dd

3.DescriptionofProject

Estimatedstartingdateofproject Estimatedcompletiondate of project

A)Locationoftheworkprogram(s) and confirmation of landowner access and/ or documentation showing submission of Crown land access application (attachmap(s))

B) Comprehensivesummaryofpreviousworkcompletedonthepropertybytheapplicantorothers

C) Previous Grants

List of all previous grants received from the Nova Scotia Mineral Incentive Program and the Nova Scotia Mineral Resource Development Fund for this property (how many grants and what years). For each grant listed, provide a summary of results of how the property advanced as a result of each grant.

D) ExplorationPlan

The exploration plan must be well researched, achievable and based on an ideaor an approach that is worth testing. Proposals must explain how the approachwill build on any previous work. Extra credit will be given to projects thathave higher potential tosuccessfully discover new mineral exploration targets orto use innovative techniques toenhance theeconomic potential of existing mineral occurrences.

E) Descriptionoftheplannedwork

Provide a detailed description of the proposed exploration activities.Maps must be included, showing proposed exploration grids (sampling, geophysics, etc.), trench locations, drill collar locations including dip, azimuth and proposed depthand showing all historic drillhole collar locations. Justification for the proposed locations must be provided on this or accompanying maps. No proposed work may be conditional on the results of work described on this application. Follow-up activities can be considered under future applications. Extra credit will be given for proposals that includenew and/or innovative exploration ideas or approaches.

F) Proposedperformanceschedule/dates

Activity / Commencement
Date(dd/mm/yr) / CompletionDate
(dd/mm/yr)

4.ListofEstimatedExpendituresRelatedtotheProposedProject

All costs over $5,000 require three quotes/estimates, unless this requirement is waived by the MRDF manager. Exceptions will be permitted where there is a lack of available contractors for that specific task in Nova Scotia, or in the local area where you are working. The request for an exemption for providing three quotes/estimates on a cost over $5,000 must be accompanied with the application form. Ifrequestingsole-sourcecontracting,pleaseincludethe reasonforchoosingthecontractor.Wheneverpossible,NovaScotia-basedcontractors shouldbeutilized.Pleasenotethatsomeexpendituresareineligible(pleaseseethe Prospecting/Exploration GrantTerms and Conditions).

ProposedExpenditures / Total
TotalMRDF Prospecting/ExplorationGrantRequested($20,000max.)

Forenquiriespleasecontactthe MRDF manager:902-424-3053,e-mail .

This application along with accompanying documents (see checklist) must be received no later than 4:00 pm on Monday, May 7, 2018, by the MRDF manager at .

All applicants are required to complete and sign the application checklist on the next page and include all the required documentation with this application.

NOVA SCOTIA MINERAL RESOURCES DEVELOPMENT FUND (MRDF)

PROSPECTING/EXPLORATION GRANT APPLICATION CHECKLIST

(Ensure that ALL required information is included and attached BEFORE submitting application)

Completed application form / yes
☐ / n/a
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NovaROC claims map (showing exploration licences) / yes
☐ / n/a
☐
Regional location map / yes
☐ / n/a
☐
Location map at adequate scale showing proposed and historic work with licence boundaries (e.g. exploration grids, collar locations, trench locations, sample locations). The map must be assessment report quality as defined in the Mineral Resources Regulations. / yes
☐ / n/a
☐
Copy of Provincial/Extra-Provincial Company Registration Certificate / yes
☐ / n/a
☐
Three quotes/cost estimates for expenditures over $5000 attached / yes
☐ / n/a
☐
Written request for sole source (see Eligible Work in Terms and Conditions) / yes
☐ / n/a
☐
List of proposed subject matter expert(s) to be used / yes
☐ / n/a
☐
Have read and understand the Prospecting/Exploration Grant Terms and Conditions document. / yes
☐ / n/a
☐
Included a list of all relevant supporting scientific/assessment reports / yes
☐ / n/a
☐
Included references of relevant case studies for any unconventional work being proposed / yes
☐ / n/a
☐
Included all relevant licensee/holder/agent/company/joint venture agreements (these should be registered with the Registry) / yes
☐ / n/a
☐

Applicant’s signature: ______

Date: ______