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FOREST SERVICE <br /> BILL FOR COLLECTION <br /> Doc. Date : 06/04/2013 PAGE: 1 <br /> ENCLOSE A COPY OF THIS BILL WITH YOUR CHECK OR MONEY I MAIL PAYMENT TO: <br /> ORDER. DO NOT SEND CASH. PLEASE INCLUDE BILL NO. AND US Forest Service C/O Citibank <br /> CUSTOMER NUMBER ON YOUR CHECK OR ON YOUR ONLINE BILL P.O. Box 301550 <br /> PAYMENT. Los Angeles CA 90030-1550 <br /> MAKE CHECK PAYABLE TO: Or pay online at www.fs,fed.us/billpay <br /> FOREST SERVICE <br /> TO: PAYER INDICATE <br /> THOMAS G MILLER i AMOUNT ENCLOSED: <br /> 5260 GARRISON ST.,#12 <br /> ARVADA CO 80002-0000 US I NET AMOUNT DUE : $ 2,896.00 <br /> i DUE DATE: 07/04/13 i <br /> FMMI BILL NUMBER : 1800790422 <br /> CUSTOMER NUMBER: 3365301 <br /> REFERENCE CONTRACT/PERMIT/AGREEMENT NUMBER : DESCRIPTION : RECLAMATION PERFORMANCE <br /> MROSERITCHIE@FS.FED.US BOND <br /> REMARKS : PRINCIPAL : $ 2,896.00 <br /> RE: OTC-BDA1-FMM1314010212 <br /> NOTE : INTEREST: $ 0.00 <br /> PLEASE SEND ALL CORRESPONDENCE, INQUIRIES,AND CHANGE OF ADMINISTRATIVE COST: $ 0.00 <br /> ADDRESS - <br /> TO <br /> PENALTY: $ 0.00 <br /> PSI NF'S 8k CC NG'S AMOUNT DUE : $ 2,896.00 <br /> 2840 KACHINA DRIVE AMOUNT CREDITED : $ 0.00 <br /> PUEBLO CO 81008 US <br /> NET AMOUNT DUE : $ 2,896.00 <br /> FAILURE TO MAKE PAYMENTS BY THE DUE DATE WILL RESULT IN THE ASSESSMENT OF LATE PAYMENT CHARGES <br /> (INTEREST,ADMINISTRATIVE COST,AND/OR PENALTY CHARGES) IN ACCORDANCE WITH YOUR CONTRACT, PERMIT, <br /> OR THE DEBT COLLECTION ACT OF 1982, AS AMENDED. POSTMARKS ARE NOT HONORED. LATE FEES DO NOT APPLY <br /> FOR BILLINGS IN ADVANCE OF RECEIPT OF GOODS OR SERVICES. <br /> RECLAMATION PERFORMANCE BOND FOR THE PURPLE HILL UNPATENTED MINING CLAIM PLAN OF OPERATIONS, <br /> OWNED AND OPERATED BY THOMAS MILLER. <br /> LINE LINE INFORMATION AMOUNT <br /> 000001 FS.00.0212.86.2001 $ 2,896.00 <br /> ARVA 10403 W.COLFAX AVE. 1059171 <br /> LAKEWOOD,CO(800)964-3444 80215 82-504/1070 <br /> REMITTER <br /> Thomas G Miller DATE June 25,2013 <br /> PAYABLE TO Forest Service <br /> AMOUNT <br /> $2,896.00 <br /> CASHIER'S CHECK RECEIPT <br /> Notice to Customer:If this check is lost,stolen,or destroyed within 90 days of the <br /> date it is issued,we will not pay or reissue a replacement check without an NOT NEGOTIABLE <br /> indemnity bond or other adeouste security.After 90 days,we will pay or reissue a <br />