In the Water Court of the State of Montana

Clark Fork River Division
Union Creek - Basin 76FA

---

IN THE MATTER OF THE ADJUDICATION OF THE EXISTING RIGHTS TO THE USE OF ALL THE WATER, BOTH SURFACE AND UNDERGROUND, WITHIN THE UNION CREEK BASIN (76FA)

Request for Extension - Basin 76FA

1. Name, address and phone number of party requesting extension:

_____________________________________________________________________
 Last Name              First Name             Middle Initial

___________________________________________________________
Street Address or Post Office Box

___________________________________________________________
City                  State      Zip Code              Phone

2. Name, address and phone number of party's attorney, if any:

___________________________________________________________
Last Name              First Name             Middle Initial

____________________________________________________________
Street Address or Post Office Box

___________________________________________________________
City                  State      Zip Code              Phone

3. On the space provided on back or on an attached 8 X 11 1/2 sheet of paper, include the following:

    A. A statement of the party's rights or interest that could adversely be affected;

    B. A precise statement of the reasons why the objection could not be completed within the 180 days prescribed.

Send completed Request for Extension forms to:
Montana Water Court
PO Box 1389
Bozeman, MT 59771-1389
Phone: 586-4364  Fax: 522-4131