State of Arizona, county of ____________________ ss: _________________________________, being duly sworn, deposes and says that: I am a citizen of the United States and at least eighteen years of age. I reside at ____________________, in _________________ county, Arizona. I am personally acquainted with the mining claim known as ___________________ mining claim, situated in _________________ mining district, ______________ county, Arizona, the location notice of which is recorded in the office of the county recorder of that county at [county recorder information]. Between the _____________ day of _______________, _________________, and the _______________ day of ___________________, ___________________, at least _________________________ dollars worth of work and improvements were done and performed on the claim, not including the location work of the claim. Such work and improvements were made by and at the expense of ___________________________, owners of the claim, for the purpose of complying with the laws of the United States pertaining to assessment or annual work, and _______________________________________ (here name the miners or persons who worked on the claim) were the persons who are employed by the owner and who labored on the claim, doing the work and improvements as follows: (Here describe the work done and add signature and verification.)
State of Arizona, county of ____________________ ss: _________________________________, being duly sworn, deposes and says that: I am a citizen of the United States and at least eighteen years of age. I reside at ____________________, in ___________________ county, Arizona. I am personally acquainted with the mining claim known as ______________________ mining claim, situated in __________________ mining district, ______________ county, Arizona, the location notice of which is recorded in the office of the county recorder of that county at [county recorder information]. A claim maintenance fee of _________________________ dollars was paid by or at the expense of ___________________________, owners of the claim, instead of recording an affidavit of annual work for the purpose of complying with the laws of the United States and holding the claim. (Here add signature and verification.)
A.R.S. § 27-208