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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2012013 <br />Smithburg Family Partnership, LLLP <br />111111111 <br />Receipt #: <br />Date: <br />Permit: <br />19917 <br />07/20/2015 <br />M2012013 <br />PaynIVIVAg&d <br />Revenue Code <br />Fee Description/Notes <br />Amount <br />11 1 <br />Minerals Annual Fees• <br />M2012-013 <br />11 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />