(1) On or before December 30th of each year following the end of any set time or annual period allowed for the performance of labor or making improvements upon any lode claim or placer claim, or for the payment of an annual claim rental fee as required by federal law in lieu of such work or improvements, the person on whose behalf such outlay was made, or such person's representative, may make and record in the office of the recorder of the county wherein such claim is situate an affidavit in substance as follows:

STATE OF COLORADO)

) ss.

County of .....................................)

Before me, the subscriber personally appeared ............, who, being duly sworn, saith that at least ....… dollars [worth of work or improvements were performed or made upon] [claim rental fee as required by federal law was paid upon] (here describe claim or part of claim), situate in ..........… mining district, county of .............., state of Colorado, between the ..........… day of .............., A.D..., and the … day of .............., A.D… Such expenditure was made by or at the expense of .............., owners of said claim, for the purpose of complying with the law, and holding said claim.

Jurat:

(Signature) ..................................…

(2) Such affidavit when recorded shall be prima facie evidence of the performance of such labor or the making of such improvements or the payment of such annual claim rental fee. The original thereof, or a certified copy of the record of the same, shall be received as evidence accordingly by the courts of this state, and this class of evidence shall be receivable, where relevant or material, in all causes.

(3) The fee for recording the affidavit described in subsection (1) of this section is set forth in section 30-1-103 (2)(m), C.R.S.