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COLORADO <br />Division of Reclamation, <br />A7 Mining and Safety <br />Department of Natural Resources <br />1313 Sherman St. Room 215 <br />Denver, CO 80203 <br />August 1, 2015 <br />Dale Herbertson <br />Sara Ray Silver Mining LLC <br />6542 W. Mexico Ave. <br />Lakewood, CO 80232 <br />Ajax Mine, Permit P-2011-004, Annual Fee Invoice and Report Request <br />PLEASE READ CAREFULLY — ACTION REQUIRED <br />Please attach your COMPLETED written Annual Report and Annual Report Map to this form <br />Under the terms of your NOI and Colorado Statutes, you must submit an Annual Fee and Annual Report <br />(including a map). You must pay the Annual Fee and submit an Annual Report each year until reclamation <br />responsibility release is granted. The Annual Fee is not a renewal fee. The Fee and Report are for LAST <br />YEAR'S exploration and reclamation season, and MUST be paid even if your operation was inactive. <br />The Annual Report and Fee requirement will be considered submitted when we have received the <br />following components: <br />1. ANNUAL FEE ($86) <br />2. COMPLETED ANNUAL REPORT <br />3. ASSOCIATED MAP as required by rule <br />If you have requested reclamation responsibility release from the Division of Reclamation, Mining and Safety <br />("Division") but your permit is not released by the anniversary date listed below, the Annual Fee MUST be <br />paid. If the permit is released before the anniversary date, then by Statute, it is not necessary to pay an Annual <br />Fee or submit an Annual Report for that year. Division records indicate the $86.00 fee is due for the following <br />NOI(s) on or before the Anniversary Date: <br />Permit: P-2011-004 <br />Operation Name: Ajax Mine <br />Anniversary Date: September 1, 2015 <br />Total Fee Due: $86.00 (Due on or before your Anniversary Date) <br />Return the enclosed Annual Report FORM, a MAP, and a CHECK or MONEY ORDER made payable to: <br />Division of Reclamation, Mining and Safety, 1313 Sherman St., Room 215, Denver, CO 80203. If your records <br />indicate these documents and fees have already been submitted, please notify the Division. <br />1313 Sherman St. Room 215 Denver, CO 80203 P (303) 866-3567 F <br />John W. Hickentooper, Governor I Mike King, Executive Director I Loretta E. Pineda, Director <br />