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NOI NAME: <br />NOI NO.: <br />OPERATOR N <br />• ►0 •� <br />ANNUAL FEE DUE: $86.00 (Due on or before your anniversary date) <br />COUNTY: Mineral <br />On the anniversary date of the Notice of Inten <br />Division records indicate the following NOI c <br />changes: <br />Explorer Contact: Randy McCLURE <br />Explorer Name: Rio Grande Silver, In <br />Address: P.O. Box 610/625 U� <br />Creede, CO 81130 <br />Phone Number: (719) 658 -1080 <br />Fax Number: (719) 658 -1082 <br />If you have additional comments and/or info: <br />provide it below or attach it to this form. We <br />(NOI), the operator must submit the annual fee. <br />ntact information. Please verify and make any necessary <br />Road 504.1A <br />Signature of Corp4ate Officer, Owner, or De ignei <br />? Z 2-D/4 <br />Date <br />a that should be provided to the Division, please <br />you for your attention to this matter. <br />