LRG Expenditure Form

LRG Expenditure Form

Use this form to record your expenditure for each LRG lease that you prospect on. The Tenement Holder (Little Ripper Gold Inc) hereby authorises the members named below, to camp on, and where their membership allows, to carry out metal detecting using hand tools only, to a depth of 1 metre. All members listed are subject to the terms and conditions of LRG's Indemnity Waiver and Code of Conduct, on the Tenement identified below, for the purposes of Section 118A of the Mining Act 1978.
If you require assistance to complete this Expenditure Form, please see the Example Form in the Files section of the LRG Facebook page.
Member #1's Name

First NameLast Name
Member's Number and Membership Class

Member's NumberMembership Class (Child, Junior, Associate, Ordinary)
Member #2's Name

First NameLast Name
Member's Number and Membership Class

Member's NumberMembership Class (Child, Junior, Associate, Ordinary)
Member #3's Name

First NameLast Name
Member's Number and Membership Class

Member's NumberMembership Class (Child, Junior, Associate, Ordinary)
Member #4's Name

First NameLast Name
Member's Number and Membership Class

Member's NumberMembership Class (Child, Junior, Associate, Ordinary)
Enter the Lease District Number here*
Enter the 2 digit district number, without the 'P'
Enter the Lease Number here:*
Enter the 4 digit lease number here
Date Arrived at Lease

DayMonthYear
Date Arrived
Date Departed Lease

DayMonthYear
Date Departed
Total amount of gold found (in grams): Amount in grams

Total number of nuggets found: No. of nuggets
Describe the general location on the lease where nuggets were found, ie. middle of the lease, north east corner, etc.
A note on recording your expenditure:

Please enter the number of days you have spent on the lease, in (1) and the number of prospectors that were on the lease, in (2). Do not include non-detecting members.

Your total expenditure will be calculated and shown in the Total Expenditure window.

You are no longer required to record your fuel, food and other costs associated with this expenditure form.
(1) Enter no. of days on lease here: Days on lease

(2) Enter no. of prospectors (Junior & Ordinary) on lease here: No. of prospectors
Total Expenditure (calculated from data input in 1 & 2)
Member #1's Signature*

Clear
Member #2's Signature (if applicable) If a Child, Junior or Associate member under 18 years old, a parent/guardian must sign here.

Clear
Member #3's Signature (if applicable) If a Child, Junior or Associate member under 18 years old, a parent/guardian must sign here.

Clear
Member #4's Signature (if applicable) If a Child, Junior or Associate member under 18 years old, a parent/guardian must sign here.

Clear
Are there any issues on the lease that the committee should be made aware of? If so, please enter the details below.
Should be Empty: