REV93801

• Permit No: C1981020
• IBM Index Class Name: Revision
• Doc Date: 1/27/1993
• Doc Name: COAL RECLAMATION BOARD MUNGER MINE PN C-81-020 US TREASURY NOTES
• From: DMG
• To: GRAND VALLEY COAL CO
• Type & Sequence: SO1
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY
Department of Natural Resources
131 } Sherman St-, Room 215
Denver,C080203 ASSIGNMENT OF TREASURY NOTE(S)
Phone: [phone] fi 7
FAX: [phone]
TO WHOM IT MAY CONCERN:
OF'~~/O
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~~~~
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Roy Romer
Governor
Michael B. Long
Division Director
Reference: Treasury Notes:
Receipt No. 880142, CUSIP 912827622, Issued 7/31/92, Mat. Value $100,000
Receipt No. 774231, CUSIP 912827655, Issued 8/15/92, Mat. Value $123,000
Receipt No. 880141, CUSIP 912827655, Issued 8/15/92, Mat. Value $100,000
Receipt No. 903169, CUSIP 912827655, Issued 8/15/92, Mat. Value $8,000
By submission of this letter, to be attached to the above referenced U.S.
Treasury Notes, I hereby relinquish all right, title and claim to said
principle investment of U.S. Treasury Notes, except for accrued interest
against the original monies, until such time as the State of Colorado,
Division of Minerals and Geology, Office of Mined Land Reclamation and U.S.
Government, Office of Surface Mining Reclamation and Enforcement releases the
U.S. Treasury Notes. This assignment of U.S. Treasury Note(s) supersedes any
signature cards that may already be on file at the bank.
The bank understands that these U.S. Treasury Notes are piedged to the State
of Colorado, Division of Minerals and Geology, Office of Mined Land
Reclamation and the U.S. Government, Office of Surface Mining Reclamation and
Enforcement and that a proper record of this assignment has been made on the
books of the bank.
(Permittee Name)
(Authorized Signature and Title)
(Print or Type Name)
Notary (of Permittee Signature)
Commission Expires:
ACKNOWLEDGMENT OF BANK
(Name of Financial Institution)
(Authorized Signature)
(Name Typed or Printed)
(Date
Doc. No. 6013E