To be attached to and form a part of Surety Company Bond No. written by , AS SURETY, on behalf of , AS PRINCIPAL, in the sum of Dollars ($), in favor of the State of Wyoming and the United States Secretary of the Interior and executed on .

Whereas, the Department of Environmental Quality, Land Quality Division, issued:

Drilling Notification or
Permit to Mine or
Ten Acre Permit

Number and dated , and amendment(s) numbered and dated pursuant to the application of the Principal,

Whereas, said bond and rider shall cover any and all lands affected or to be affected by the operation under the above mentioned notification or permit and amendment(s) since the date of issuance,

Now, therefore, the amount of the bond is increased/decreased by Dollars Dollars ($), to a total sum of Dollars Dollars ($), to cover the additional/reduced cost of reclaiming all affected lands.

It is further understood and agreed that all other terms and conditions of this bond shall remain unchanged.