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, <br />~ STAZ ~OF COLORADO <br />MINED LAND RECLAMATION DIVISION p e rm i t M- 83 -141 <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver. CO 80203 <br />303 866-3567 <br />FA Z: 303 632-8106 <br />ASSIGNMENT OF CERTIFICATE OF DEPOSIT <br />TO WHOM IT MAY CONCERN: <br />REFERENCE: Certificate of Deposit Number 532012 <br />pF COQ <br />rf'~' 'pr <br />~~.~ ~~ <br />N <br />•'.n~n'• <br />•'L~~yr . <br />~ r e'16 <br />Roy Romer <br />Gwnnpr <br />Micr aei 6. Long. <br />Division Ortactor <br />By submission of this setter, to be attached to the above referenced <br />Certificate of Deposit, I hereby relinquish ail 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. <br />BY: <br />Mi ~/ida Enterprises and <br />Operator/Colina CrD Ptclino, Inc. <br />Depositor of Original Monies <br />ACKNOWLEDGEMENT OF BANK <br />NOTARY (Of Operator Signature) <br />Commission Expires <br />BY: <br />TITLE: <br />BANK NAME: <br />cc: Mined Land Reclamation Division <br />ATTN: Deborah Mulloy <br />1313 Sherman Street, Room 215 <br />Denver, Colorado 80203 <br />Note to Operator: <br />In the event that your bank 15 unwilling or unable to prepare a <br />certificate of deposit made payable only to the Mined land Reclamation <br />Board, this assignment will need to be executed in the presence of a <br />notary with a copy provided to the bank to allow only Mined Land <br />Reclamation Division access to these funds. <br />8088E (Rev. 3/92> <br />