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-144-047 <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources RECEIVED ~~ <br />1313 Sherman SL, Room 2 i 5 b I V I S 1 0 N o <br />Denver, Cobrado 80203 <br />Phone: (303) 866-3567 MAR ~'~ ~. ~ M 1 N E RA L <br />PAX: (303) 832-8106 & <br />.._ _.._ _:~.~ef G E O L O G' <br />°- ""'°' ~°"° REC LAM ATI OI <br />MINING•SAFET' <br />ASSIGNMENT OF CERTIFICATE OF DEPOSIT <br />sal ovens <br />Governtir <br />TO WHOM IT MAY CONCERN: Greg E. wanner <br />Executive Director <br />'~ Sa~ Michael B. long <br />_- _ _-REFERENCE: Certificate Of osrt NUn7bef _ _ _ _ - _ _ _ _ _ _ _ -_ -- _ _ __ _ - _ - _ Division Direcror _ _ _ <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 Colotado/Mined Iand Reclamation Boars, except for accrued interest against the <br />original monies, until such time as the Division of Minerals and Geology/Min Reclamation releases the <br />certificate. This assignment ~' Certificate of Deposit supersedes any signature may already file at the bank <br />BY: <br />Operator. ~~-' <br />ACKNOWLEDGMENT OF BANK <br />SIGNATURE L <br />BY: ELI i~1 ~naC~. ~ 1~1~1IoYel~c~ d1 <br />TITLE: UIC~ 1'Y'esi~l2w~ <br />DATE: ~-' la -~3 <br />Return Original Form to: <br />Division of Minerals and Geology <br />1313 Sherman Sk, Rm 215 <br />Deaver, CO 80203 <br />Depositor of Original Monies <br />Operator Signature) ,, <br />Commission Expires ~~~~,~,~~W <br />TIFFANY <br />WANCURA <br />Note 1n Operator. <br />This as~gDlme~ form will need to be executed in the presence of a notary. The original is held bq the Division with a copy <br />provided to the bank to allow oniy the Division of Minerals and Geology access W these funds. <br />u~1,>~aroamr~lm~o,a, em.a« <br />REV75&D (rL1YBr <br />