Miners Lien Forms Regulations

The prescribed forms for a claim of lien referred to in subsection 3(1) of the Miners Lien Act are set out in Forms 1 and 2 of the Schedule.

The prescribed form of a claim of lien where there is more than one claimant, referred to in subsection 3(1) of the Miners Lien Act, is set out in Form 3 of the Schedule.

The prescribed form of an affidavit referred to in subsections 3(2) and 4(2) of the Miners Lien Act is set out in Form 4 of the Schedule.

The prescribed form of a summons referred to in subsection 11(1) of the Miners Lien Act is set out in Form 5 of the Schedule.

SCHEDULE

FORM 1 (Section 1)

CLAIM OF LIEN

..................................................................... of .........................................................................., (if so, as assignee (name of claimant) (residence of claimant) of ..............................................................................................) claims a lien under the Miners Lien Act on the estate (name and residence of original lien holder) or interest of ........................................................................................................................... in the mine or mining claim (name and residence of the entrant or lessee of the mine or mining claim on which the lien is claimed) described below in respect of the following work done (or materials furnished) (here give a short description of the work done or materials furnished and for which the lien is claimed) which work was (or is to be) done (or materials furnished) for ..................................................................................... on or before .................................... (name and residence of the person on whose (date) credit the work is done or materials furnished) The amount claimed as due (or to become due) is the sum of $ .....................................

The following is the description of the mine or mining claim to be charged: (here set out a concise description of the mine or mining claim to be charged sufficient for the purpose of registration).

(When credit has been given, insert: The work was done (or materials were furnished) and the period of credit agreed to expired (or will expire) on ...............................................)

Dated at ........................................ on .............................................

............................................................ (signature of claimant)

FORM 2 (Section 2)

CLAIM OF LIEN FOR WAGES

................................................ of ................................................ (if so, as assignee of ........................................... (name of claimant) (residence of claimant) (name and residence of original lien holder) claims under a lien under the Miners Lien Act on the estate of .................................................................................. (name and residence of the owner of the mine or mining claim on which the lien is claimed) in the mine or mining claim described below in respect of work for ................................ days performed on the land described below while in the employment of ..................................................................... on or before .................... (name and residence of the person (date) on whose credit the work is done) The amount claimed as due is the sum of $ .......................................... The following is the description of the mine or mining claim to be charged: (here set out a concise description of the mine or mining claim to be charged sufficient for the purpose of registration).

Dated at ................................................... on .........................................

..................................................... (signature of claimant)

FORM 3 (Section 3)

CLAIM OF LIEN FOR WAGES WHEN SEVERAL CLAIMANTS

The following persons claim a lien under the Miners Lien Act on the mine or mining claim of ............................ .........................................................................(.n..a..m...e. .a..n..d.. .r..e..s.i.d..e..n..c..e. .o..f. .t.h..e.. .e..n..t.r..a..n.t.. .o..r. .l.e..s.s..e..e. .o..f.. .t.h..e. .m...i.n..e.. .o..r. .m...i.n..i.n..g.. .c..l.a. i m) in respect of wages for labour performed on the land described below while in employment of ..................................... ........................................................................................................................................................................................ (name and residence or names and residences of employers of the several persons claiming the lien):

NAME RESIDENCE AMOUNT OWED NUMBER OF DAYS

WAGES OWED

$

The following is the description of the mine or mining claim to be charged: (here set out a concise description of the mine or mining claim to be charged sufficient for the purpose of registration).

Dated at ............................................ on .........................................

......................................................................

...................................................................... (signatures of the several claimaints)

NOTE: If any of the claimants named above are assignees of the original lien holder, that fact must be stated and the name and residence of the original lien holder stated.

FORM 4 (Section 4)

AFFIDAVIT

I, ..................................., named in the above (or annexed) claim make oath that the claim is true (or the claim so far as it relates to me is true).

or

We, ..................................... and ..............................................., named in the above (or annexed) claim, make oath and each for himself swears that the claim, so far as it relates to him is true.

(Where this affidavit is made by an agent or assignee, a clause must be added to the following effect: I have full knowledge of the facts set out in the above (or annexed) claim.)

Sworn before me at.................... } in the Northwest Territories, } on ............................... } ............................................... (signature of deponent) or

......... and ...................... } were severally sworn before me at ..... } ..................in the Northwest} Territories on ..................... } ..............................................

.............................................. (signatures of deponents)

FORM 5 (Section 5)

IN THE SUPREME COURT OF THE NORTHWEST TERRITORIES

(here insert style of cause or matter)

ORIGINATING SUMMONS

Let all parties concerned attend in the Supreme Court at ........................................... (a.m. or p.m.) on the ............................... day of ......................................., 19..... on the hearing of an application on the part of ....................................................... that (set out the object of the application).

If you do not attend either in person or by your advocate at the time and place mentioned above, such order will be made in your absence as to the Court seems just and expedient.

.......................................... Judge

This summons was taken out by ........................................................... for the applicant.