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Second National Reconcilation Study EITI Peru - unofficial…

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Consultancy for the <strong>Second</strong> <strong>National</strong> Reconciliation <strong>Study</strong> of the Extractive Industries Transparency Initiative (<strong>EITI</strong>) in <strong>Peru</strong><br />

(2008 – 2010) (Continuation)<br />

Annexe III (continuation)<br />

Company: _____________________________________________________<br />

Ref.<br />

(A)<br />

Item / Period<br />

Amount of royalty<br />

paid (USD)<br />

(B) Payment date<br />

Lot<br />

1st half<br />

Jan<br />

Ref. Item / Period Lot 1st half<br />

Jul<br />

(A)<br />

Amount of royalty<br />

paid (USD)<br />

(B) Payment date<br />

Instructions to complete the form<br />

2nd half<br />

Jan<br />

2nd half<br />

Jul<br />

1st half<br />

Feb<br />

1st half<br />

Aug<br />

Consultancy for the <strong>EITI</strong> <strong>Peru</strong> Multi-Sector Permanent Working Committee<br />

2nd half<br />

Feb<br />

2nd half<br />

Aug<br />

1st half<br />

Mar<br />

1st half<br />

Sep<br />

(A) Refers to the bi-monthly paid by the company for royalties originating in such period..<br />

(B) Pertains to the date on which payment of the royalty for the indicated period was made.<br />

Statement of responsibility of the Management<br />

Year 2010<br />

2nd half<br />

Mar<br />

Year 2010<br />

2nd half<br />

Sep<br />

1st half<br />

April<br />

1st half<br />

Oct<br />

2nd half<br />

April<br />

2nd half<br />

Oct<br />

1st half<br />

May<br />

1st half<br />

Nov<br />

2nd half<br />

May<br />

2nd half<br />

Nov<br />

We hereby acknowledge on behalf of ......................................................................................................................................................................................... our<br />

responsibility for the information contained in this template.<br />

Name:<br />

Title:<br />

Legal Representative<br />

1st half<br />

Jun<br />

1st half<br />

Dec<br />

2nd half<br />

Jun<br />

2nd half<br />

Dec<br />

182

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