Registration Form - MRA Mining Cadastre Portal - Mineral Resources

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INDEPENDENT STATE OF PAPUA NEW GUINEA MINERAL RESOURCES AUTHORITY (MRA)

FORM TMP-1 REGISTRATION FOR THE MRA ONLINE MINING CADASTRE PORTAL SECTION A: PURPOSE OF REGISTRATION I wish to make use of the Mining Cadastre Portal on my own behalf Complete section A, B, D Please provide:  Proof of identity (passport or ID card)

I wish to make use of the Mining Cadastre Portal on behalf of a company, either as an employee or agent of that Company Complete sections A, B, C, D Please provide:  Proof of identity (passport or ID card)  Proof of company registration (certified copy of certificate of incorporation)  Signed letter of authority to use the Mining Cadastre Portal on behalf of the Company

I am already a Registered User on the Mining Cadastre Portal and would like to act as an employee or agent of another Company Complete sections A, B, C, D Please provide:  Proof of identity (passport or ID card)  Proof of company registration (certified copy of certificate of incorporation)  Signed letter of authority to use the Mining Cadastre Portal on behalf of the Company This registration form and associated documents must be submitted in person to Mining Haus, Poreporena Freeway, Port Moresby, Papua New Guinea Any queries may be submitted by email to [email protected].

ADDENDA FORMS If you are / have been, or the company you represent is / has been, the legal owner of mineral tenements in Papua New Guinea, then additionally complete Addendum TMP-1A. If there are additional users that you wish to add for the same company at the same time, then additionally complete Addendum TMP-1B for each user. Number of additional users:

Papua New Guinea Mineral Resources Authority Form TMP1: Registration for access to the MRA Online Mining Cadastre Portal

SECTION B: DETAILS FOR THE AUTHORISED USER Surname First Names Email Address (used for login and email notifications)

Mobile Number (used for SMS notifications)

e.g. +44822354111 not +44(0)822354111

Mr

Title Identity Number

Mrs

Ms

Dr

and / or

Passport Number Nationality Date of Birth Gender

d

d Male

/ m m / y y y y Female

Physical Address Line 1 Line 2 Line 3 Province Post Code / Zip Country Postal Address

Same as Physical

Line 1 Line 2 Line 3 Province Post Code / Zip Papua New Guinea Mineral Resources Authority Form TMP1: Registration for access to the MRA Online Mining Cadastre Portal

Prof

Hon

Other

Country Telephone 1

e.g. +44822354111 not +44(0)822354111

Telephone 2

e.g. +44822354111 not +44(0)822354111

Fax Number

e.g. +44822354111 not +44(0)822354111

SECTION C: COMPANY DETAILS Company Name Abbreviation Registration Number Registered Country d

Registration Date

d

/ m m / y y y y

Private

Company Type

Listed

Official Email Address Email Address

The main authorised user’s email address will be used for all official communications for this company. (Should you need email to be sent to multiple recipients, you can set up an internal distribution list.)

Physical Address Line 1 Line 2 Line 3 Province Post Code / Zip Country Postal Address

Same as Physical

Line 1 Line 2 Papua New Guinea Mineral Resources Authority Form TMP1: Registration for access to the MRA Online Mining Cadastre Portal

Line 3 Province Post Code / Zip Country Telephone 1

e.g. +44822354111 not +44(0)822354111

Telephone 2

e.g. +44822354111 not +44(0)822354111

Fax Number

e.g. +44822354111 not +44(0)822354111

Website

SECTION D: TERMS OF USE I confirm that all information provided is correct I agree to the Terms of Use and Privacy Statement of the Mining Cadastre Portal Number of pages submitted for this application (including addenda) D D / MM / YYYY Signed by

Date

Location

FOR OFFICIAL USE ONLY Yes

No

All documents received and in good order

Yes

No

All existing mineral tenements in good standing (where such tenements existed)

Yes

No

User added to Mining Cadastre Portal

Yes

No

User given access to requested Company Comments D D / MM / YYYY

Signed by Cadastre Officer

Date

Papua New Guinea Mineral Resources Authority Form TMP1: Registration for access to the MRA Online Mining Cadastre Portal

Location

INDEPENDENT STATE OF PAPUA NEW GUINEA MINERAL RESOURCES AUTHORITY (MRA)

ADDENDUM FORM TMP-1A: DECLARATION OF MINERAL TENEMENT INTERESTS SECTION A: PURPOSE OF REGISTRATION This addendum must be completed by persons of companies that are, or have been, the legal owner of mineral tenements in Papua New Guinea. Complete sections B, C Please provide:  Proof of ownership for all mineral tenements  Proof that all existing mineral tenements are in good standing as registration will not proceed if any of their mineral tenements are in default (e.g. letters, receipts of payment, etc.) This addendum and associated documents must be submitted along with form TMP-1 in person to Mining Haus, Poreporena Freeway, Port Moresby, Papua New Guinea Any queries may be submitted by email to [email protected].

SECTION B: LIST OF MINERAL TENEMENT INTERESTS The following mineral tenements are held / have been held by myself or the company I will represent: Tenement Code

Tenement Type

Application Date

Grant Date

Papua New Guinea Mineral Resources Authority Form TMP1: Registration for access to the MRA Online Mining Cadastre Portal

Expiry Date

Tenement Status

*continue on separate sheet if required

SECTION C: VERIFICATION I confirm that all information provided is correct I confirm that I have verified all existing information in the Mining Cadastre during this registration process and confirm that this is correct. D D / MM / YYYY Signed by

Date

Papua New Guinea Mineral Resources Authority Form TMP1: Registration for access to the MRA Online Mining Cadastre Portal

Location

INDEPENDENT STATE OF PAPUA NEW GUINEA MINERAL RESOURCES AUTHORITY (MRA)

ADDENDUM FORM TMP-1B: ADDITIONAL COMPANY USER REGISTRATION SECTION A: PURPOSE OF REGISTRATION Application as an additional user of the Mining Cadastre Portal on behalf of a company, either as an employee or agent of that Company Complete sections B, C Please provide:  Proof of identity (passport or ID card)  Proof of company registration (certified copy of certificate of incorporation)  Signed letter of authority to use the Mining Cadastre Portal on behalf of the Company This addendum and associated documents must be submitted along with form TMP-1 in person to Mining Haus, Poreporena Freeway, Port Moresby, Papua New Guinea Any queries may be submitted by email to [email protected].

SECTION B: DETAILS FOR THE AUTHORISED USER Surname First Names Email Address (used for login and email notifications)

Mobile Number (used for SMS notifications)

e.g. +44822354111 not +44(0)822354111

Mr

Title Identity Number

Mrs

Ms

Dr

and / or

Passport Number Nationality Date of Birth Gender

d

d Male

/ m m / y y y y Female

Papua New Guinea Mineral Resources Authority Form TMP1: Registration for access to the MRA Online Mining Cadastre Portal

Prof

Hon

Other

Physical Address Line 1 Line 2 Line 3 Province Post Code / Zip Country Postal Address

Same as Physical

Line 1 Line 2 Line 3 Province Post Code / Zip Country Telephone 1

e.g. +44822354111 not +44(0)822354111

Telephone 2

e.g. +44822354111 not +44(0)822354111

Fax Number

e.g. +44822354111 not +44(0)822354111

SECTION C: TERMS OF USE I confirm that all information provided is correct I agree to the Terms of Use and Privacy Statement of the Mining Cadastre Portal D D / MM / YYYY Signed by

Date

Papua New Guinea Mineral Resources Authority Form TMP1: Registration for access to the MRA Online Mining Cadastre Portal

Location