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STATE OF COLORADO <br /> • DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 COLORADO • <br /> Deriver,Colorado 80203 DIVISION OF <br /> Phone:(303)866-3567 RECLAMATION <br /> FAX:(303)832-8106 MINING <br /> —&— <br /> SAF ETY <br /> ASSIGNMENT OF CERTIFICATE OF DEPOSIT <br /> TO WHOM IT MAY CONCERN: <br /> REFERENCE: Certificate of Deposit Number 350007899 <br /> By submission of this letter,to be attached to the above referenced Certificate of Deposit,I hereby relinquish all title and <br /> claim to said certificate to the State of Colorado/Mined Land Reclamation Board,except for accrued interest against the <br /> original monies,until such time as the Division of Reclamation,Mining and Safety/Mined Land Reclamation Board releases <br /> the certificate. This assignment of Certificate of Deposit supersedes any signature cards that may already be on file at the <br /> bank. <br /> LINDA A HAGEDORN BY: <br /> NOTARY PUBLIC Ga CBO Ce <br /> STATE OF COLORADO Operator: y <br /> NOTARY ID 20134047784 Depositor of Original Monies <br /> MY COMMISSION EXPIRES OCTOBER 30,2017 <br /> ACKNOWLEDGMENT OF BANK <br /> p(F2$T 50UT14 Wf.S"T 13A-0le- <br /> NOTARY(Of Operator Signature) <br /> Commission Expires - <br /> SIGNATURE: <br /> TITLE: <br /> DATE: <br /> Note to Operator: <br /> This assignment will need to be executed in the presence of a notary. The original is held by the Division with a <br /> copy provided to the bank,to allow only Division of Reclamation,Mining and Safety access to these funds <br /> Office of Office of <br /> • <br /> Mined Land Reclamation Denver • Grand lunction • Duramto Active and Inactive Mines <br />