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MINED 0 RECLAMATION DIVISION D 21507 <br /> iii3 Sherman, Rm. 215 — <br /> Denver, Colorado 80203 DATE 3ep 19 <br /> `/.11-,\ (303) 866-35&'. - •�� <br /> �FRROOMJ,RECEIVED \Ifi_.11y�l'l $ <br /> ❑ CASH <br /> ZHECK <br /> FOR(%�'V1'I V .� /' (J. )" S� A25 y M.D. <br /> AMOUNT OF ACCOUNT...... ... $ <br /> AMOUNT PAID...................$ / <br /> BALANCE DUE. ...... ... ......$ BY !!llll <br />