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<br /> <br /> <br />III I ~To~~ <br />IIIIIIIIIIIIIII o~ co~o~,~o <br />DIVISION OF~\tINER~LS ?.ND GEOLOGY <br />p <br />l R <br />~ ggg <br />Cpanmmt o <br />Natura <br />eSou¢es <br /> u i n t i D v o. <br />1113 Sherman St.. Roon .t i ~ .N I ~: E R •\ L S <br />OCnvCr. COIDfJdO 9D103 -a- <br />PhonC: 11031 96%x3:6: G E O L O G Y <br />F.\;(: (103i x1_3106 -i:i ~~ -' :'~r <br /> 3dl G.~ns <br /> C:,-•-rncr <br /> 45SIG`t'~tEYi OF CERTiFiCATE OF DEPOSIT er.;=.~talcne, <br /> Exru;rve D~rr_:o, <br />~~r~duel a. long <br />TO urTiO ff MAY CONCERy: °ieir <br />REFERS, ICE: Certificate of Deposi[ Number O 2 2 9 ~ ~ .S ~ ~ ~ <br />By submission of this letter, to be attached to the above refetenced Certificate of Deposit I hereby relinquish all title <br />and claim to said certificate to the State of ColoradoNlined Land Reclamation Board, except for accrued interest <br />against the original monies, until such tune as the Division of Minerals and Geology/Ivlincd Land Reclamation Board <br />releasts rite certificate. This assitmturnt of Certificate of Deposit supersedes any signature cards. that tray already be <br />on file at the bank. <br />BY': <br />6`0~ G <br />ACK*IOWLEDGbIENT OFBANK <br />SIGNATURE: ~(,!/Z4~- ~.CCf~IL~Q~.Z <br />Depositor of Original Monies ~~ ~6 <br />NOTARY (Of Operator Signature) <br />BY: ~'U77/,,S~~F~~ ~~~1~/{{e,,6~~0~~ S /J~ ~ ~ ComFnission Esptres 7~z ~j'1 UO ~ <br />TITLE: /~/ "Y_ec eti0 ~~ . +~. ;:. .: <br />DATE: fin/ J~/9~ `^~'`~ <br />..~, •~i' <br />t .... .' <br />Return Original Form to: Division of Minerals and Gcolog.' ~~, - '" `~~ ~••'r~' <br />131= Sherman St._ Rm 2l? ... """'~ - <br />Dcnver. CO 8023 ~,~ ~ ;,~n"~ <br />Nom ro Operator: <br />This avieumcnt loon twill need to be eseauted iu the presence ota ootan~. The onsinal ~ heid be tha Dicisiou kith a <br />aopv provided to the bawl: to allow ooh the Division of Muterals and Geolo~~ acxss to these hmri;. <br />