Second National Reconcilation Study EITI Peru - unofficial…

Consultancy for the Second National Reconciliation Study of the Extractive Industries Transparency Initiative (EITI) in Peru
(2008 – 2010) (Continuation)
Annexe IV Validity Right
Company: ______________________________________________________________
No. of Claim Amount
(A)
Instructions to complete the form:
Consultancy for the EITI Peru Multi-Sector Permanent Working Committee
Year 2008 Year 2009 Year 2010
Payment date
(B)
Amount
(A)
Payment date
(B)
Amount
(A)
Payment date
(B)
(A) Refers to the amount paid to INGEMMET for validity rights based on the information entered in the List of Registered Mines and applying the rates required
by law. IMPORTANT: Include all claims registered in the name of the company, regardless of whether the company or a third party has paid for such
claims. Indicate cases where the validity right was paid by a third party.
(B) Pertains to the date on which payment of the validity right was made.
Statement of responsibility of the Management
We hereby acknowledge on behalf of ......................................................................................................................................................................................... our
responsibility for the information contained in this template.
Name:
Title:
Legal Representative
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