University of Nevada, Las Vegas

Forward Mining Development Company Prospectus application

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30c INSTALLMENT APPLICATION BLANK. 30cTHE FORWARD MINING DEVELOPMENT CO.,19 Toltec Bldg., Denver, Colo.: -------------------------------------------------------190-----I hereby subscribe for_______________shares of the treasury stock in THE FORWARD MINING DEVELOPMENTCOMPANY, at Thirty (30) Cents per share, and enclose herewith $______________as my first monthly payment, the balanceto be paid in_____________equal monthly installments of $_______________each, the full amount of stock to be at onceassigned to me, but retained in the treasury of the Company until final payment is made.It is expressly understood that I may discontinue the payments at any time, and that lapse of payment for 90 days will be deemed an abandonment, but that the Company in any event shall issue to me full paid stock for the amount I have paid. The Company to reserve the right to reject any and all subscriptions and cancel any unpaid assignment.Date________________________________________ Name________________________________Street_______________P. O.____________________ State_____________________________________

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