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~- <br />- <br />~, <br />- ~~~°?~A ~ STATE OF~OLORADO <br />Roy Romer, Governor <br />DEPARTMENT OF NATURAL RESOURCES <br />MINED LAND RECLAMATION DIVISION <br />FRED R. BANTA, Dlreetor <br />ASSIGNMENT OF CERTIFICATE OF DEPOSIT <br />TO WHOM IT MAY CONCERN: <br />REFERENCE: Certificate of Deposit Number 30249 <br />8y submission of this letter, to be attached to the above referenced <br />Certificate of Deposit, I he reby relinquish all title and claim to said <br />certificate, except for accrued interest against the original monies, until <br />such time as the Mined Land Reclamation Division/Board releases the <br />certificate. This assignment of Certificate of Deposit supersedes any <br />signature cards that may already be on file at the bank~~~~v'J <br />~ I <br />Operator/ <br />Depositor of Original Monies <br />ACKNOWLEDGMENT OF BANK <br />SECURITY NOTIONAL BANK <br />HOLYOKE, COLORADO <br />CASHI <br />NOTARY (Qf Operator Signature) <br />Cotmnission Expires 11/19/ <br />cc: t"inert Lard Reclamation Division <br />Attn: Deborah Mulloy <br />13'13 Sherman Street, Rm 215 <br />Denver, Colorado 80203 <br />Note to Operator: <br />In the event that your bank is unwilling or unable to prepare a <br />certificate of deposit made payable to the Mined Land Reclamation Board, <br />this assignment will need to be executed in the presents of a notary with <br />a copy orovided to the bank to allow only (dined Land Reclamation access <br />to these funds. <br />Doc. No. 8088E <br />215 Centennial Building, 1313 Sherman Street Denver, Colorado 80203-2273 Tel. (303) 866.3567 <br />