SCHEDULEDESCRIPTION OF RETAINED INTEREST(c)

(d)

NOTES:

a

Insert name, and in the first case the address, of the person or body giving the notice.

b

Insert whichever alternative is applicable.

c

The nature of the retained interest and the coal or mine of coal in which it subsists should be accurately described. If it is found necessary to refer to a map or other document it should be attached to the notice and signed by the person signing the notice so as to identify it.

d

Date and signature of the person or body giving the notice or a person duly authorised by that person or body.