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Page 5 of 5 <br /> Division records indicate the following permittee contact information. If this information is not current,please type or print <br /> current contact information: <br /> Permittee Contact: Mike London <br /> Permittee Company: IGWT Mining, Inc. <br /> Address: P.O.Box 622001 <br /> Littleton, CO 80162 <br /> Phone Number: (303)946-9195 <br /> Fax Number: (303)979-0468 <br /> Email Address: Igwtmining@msn.com <br /> 1,the undersigned,hereby state that the information provided in this report is true and accurate,and that site operations are <br /> being conducted in accordance with the Division approved mining and reclamation plans. <br /> `ice 1"-4eA 18 a-14 <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Dat <br /> M-AF-02 <br />