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^.^^ <br />^^^.. <br />NORWE51' BANKS <br />iivi <br />NORWEST BANK GRAND JUNCTION, N.A. 04/03/95 15:18:47 <br /> <br />------------- INVESTMENT <br />---------------------- CERTIFICATE <br />------------------------ <br />------------- <br />----------------------------------- <br />NICHOLS GRAVEL PIT ------------------------ <br />account no ------------- <br />606569006 <br />STATE OF COLORADO face amount 9,300.00 <br />MINED LAND RECLAMATION DIVISION maturity - <br />BUSINESS BANKING DEPT. date 04/02/11996 <br />AT BANK <br />HOLD CO 81501-0000 term 365 DAYS <br />_ interest - <br />homP 303-269-5514 ~T~ . annual percentage <br />business 30324.318-9~-5~~~ ~;:,. ;i.,r yield 5.00 <br />soc sec no rate 4.88 <br /> frequency AT MATURITY <br />issue date 04!03/1995 day base year 365{366 <br />auto renewal AUTO-RENEW method COMPOUND <br />withholding NO disposition DEMAND <br />market code 999 disposition no 6061001750 <br />pod - <br />opened by EFFIE RUCKER Released add-made payable only to: <br /> John, Terry and Ward ichol s <br /> ;y <br /> <br /> ichael B. Long, Director ~a~-iggL <br /> Division of Minerals and Ge ology <br /> Office of Mined Land Reclamation <br /> State of Colorado <br />The Internal Revenue Service (IRS) requires for interest paying accounts the following: the owner whose <br />social security,nr.taxpayeridentification number appears above certifies, under penalty of perjury, that (1) the <br />owner's sociaFsecurity or taxpayer identification number is correct, or the issuance, of a social security <br />number or.a taxpayer Identification number has been applied for, (2) the owner has;received a copy of the <br />instructions contained in'iRS'Fo~m W-9 (incorporated herein by reference), and (check one); <br />~] that suchowner is not subject tb'beckup income tax withholding either because such owner is exempt or because no notice has <br />been given that backup withholding is required due to Iailure to report all interest or dividends, or because the Internal Revenue <br />Service has given ~notipe,that.badkUp withholding is no longer required; or <br />^ that such owner is subject to backup withholding. <br />Authorized Signatures: .`•tate o` Colorado <br />@:ir.hol^_:;reve Pi; ~ ~ ~ Mined La.n~ ~'r~zation Division <br />.i~, j C ~ ' <br />Signature of Depositor ' 9gnature of Depositor ~ ~ <br />i :' \ <br />. ~- _ Received By: \ <br />Signature of Depositor ~; Aut /ized Agent <br />The Terms on the Reverse Side are Part of this Agreement <br />Thank you for investing y at Norwest Banks <br /> <br />Investment Deposit Agreement <br />(Book Entry) „~; <br />]J~1 (Rev roNJI <br />