REPUBLIC OF THE PHILIPPINES )

PROVINCE OF __________________)
CITY OF __________________)

AFFIDAVIT OF NON-OPERATION

I, _________________________A, Filipino, of legal age, ____________ with residence and

postal address at _______________________________________________________________
_____________________after being sworn in accordance to the law do hereby depose and say:

1. That I am applying for permit with the office of Governor of __________________ to

extract _____________________materials at ________________________________
_____________________________________________.

2. That I, as an individual applicant have NOT been granted any mining permit in any
province of the country and that my permit is under process by the Office of Governor
in the province of ______________________;

3. That I have no previous environmental management and community relations

experience in resource venture, locally or internationally;

4. That I am executing this affidavit in connection with my application for EXEMTIPON

from securing a certificate of Environmental Management and Community Relations
Records required under Section 19 of DENR Administrative Order No. 96-40, as
amended, and

That I further sayeth none.

IN WITNESS WHEREOF, I have hereunto set my hands this _____________day of

_____________, 2007 at ________________, Philippines.

__ ____________________________
Affiant

SUBSCRIBED AND SWORN to before me this ____________________ in the

_________________, Philippines, personally appeared ______________________ and
exhibited to me his/her CTC No. __________________ issued at __________________ on
___________________.

___________________
NOTARY PUBLIC
Doc. No. _____________
Book No. _____________
Page No. _____________
Series No. ____________