Government of Canada / Gouvernement du Canada
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Prospector’s Assistance Terms and Conditions Order (SOR/81-145)

Regulations are current to 2024-05-14

SCHEDULE II / ANNEXE IIStatement of Expenditures / État De Dépenses

Indian and Northern Affairs Canada

Affaires indiennes et du Nord Canada

I, blank line am the prospector who signed the application for Prospectors Assistance dated the blank line day of blank line 19 blank line.

Je, blank line suis le signataire de la demande d’aide aux prospecteurs dublank line jour de blank line 19 blank line .

Food Costs — Coût De La Nourriture

Total months / Total des mois blank line

Cost 1 month / Coût 1 mois $ blank line

Total food costs / Coût total de la nourriture $ blank line

Equipment Costs — Frais D’Équipement

I purchased the following equipment at the following prices:

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Frais d’équipement (préciser le matériel acheté):

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Travelling Expenses — Frais De Déplacement

I spent the following sums as travelling expenses on the following trips:

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Frais de déplacement (donner des précisions sur les déplacements):

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Other Expenses — Autres Dépenses

In addition I have incurred the following expenses (such as rental of equipment, fuel, explosives, and other expendable items):

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Autres dépenses (telles que location de matériel combustible explosifs et autres articles):

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In support of this statement I attach receipts, invoices and other pertinent documents.

Joindre reçus, factures et autres pièces justificatives.

Signature blank line


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