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Cassiar Gold Mines, Limited

Nor-personal Liability

APPLICATION FOR SHARES

To the Directors,
Cassiar Gold Mines, Limited,
(Non-personal Liability.)

I hereby apply for allotment tO me: Ob: 22 shares
in the capital of Cassiar Gold Munes, Limited, (Non-personal

Eoloiliddnys tae os joer Share ama: en@lose= . =
OI bee ee ee (ee payment for same, and

agree to accept the said shares upon allotment.

Make all remittances payable to Cassiar Gold Mines, Ltd.
CNRS)

Send all applications for shares and remittances to Northern
Securities Company, Fiscal Agents, 720 Hastings Street, West,
Vancouver, B. C.

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