Personal information collected on this form is obtained under the authority of section 41 of the Mining Act. This information will be used for invoicing annual rental and to maintain public record of the status of Mining Licences of Occupation. Questions about this collection should be directed to the Senior Manager, Mining Lands, Ministry of Northern Development and Mines, 3rd Floor, 933 Ramsey Lake Road, Sudbury, Ontario, P3E 6B5. Telephone number 1-888-415-9845. Fax (705) 670-5863.
I, (print or type) of being the holder of an undivided % interest in Mining
Licence of Occupation numbered in the register of Mining Licence of Occupation in the Ministry of Northern Development and Mines, which Mining Licence of Occupation did give full right and liberty, leave and licence to dig for, excavate and remove all ores and minerals from or under:
in consideration of the sum of dollars, or other valuable consideration, the receipt of which is hereby acknowledged, do hereby assign and transfer to: (print or type)
whose postal address is: (include postal code)
an undivided % interest in and to the said Mining Licence of Occupation and to the rights and privileges thereto and thereunder.
Note: If the transferor is a corporation a) the corporate seal may be affixed over the signature of an officer of the corporation on the transfer document or (b) the transfer must contain a signed statement that he/she has authority to bind the corporation.
Print or Type Name of Transferor (and title in company)
Transferor’s signature Date (yyyy/mm/dd)
(Office Use Only) For the Minister of Mines, I hereby sanction and approve the above transfer.
Signature Date (yyyy/mm/dd)
"Mining Lands Website: http://www.mndm.gov.on.ca/mndm/mines/lands/default_e.asp"
0199E (2022/12)
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© King's Printer for Ontario, 2022