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Colorado Division of Minerals & Geology <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203 <br />SOLD TO <br />David Goss <br />Sales Receipt <br /> <br />DATE SALE NO. <br />12/31/2003 11236 <br /> CHECK#/CASH <br /> 1624 <br />DESCRIPTION NOTE AMOUNT <br />Min: Annual Fee M-1985-140 281.00 <br /> Total $z81.oo <br />