Laserfiche WebLink
a .... ....:Lal ~ „-~.: .. _~~..... .. f..+ .,.,..,.~ ... :'vf bl.~ l'l'Ji ~ .IUJ'... f":-. <br />COLOKADO BURFD OF LAND COMM].SSICNCKS <br />52G Centennial Building, 131: Sherman Strc:c-.k <br />Uenuer, CG 80X3, (303) 666-32A7 <br />;aINERRI aOYRLTY REPORT <br />LoaSe Type L? GM GL GP QR L'R C1' PL GE GS Dw' OS Ohi (CIRCLc ONcj <br />Stare Lease No. GP3395 Original X Adjustment <br />Countu._Goneic,s Production vienlh & Year/ ~'J~. <br />Lessee PraducCd and/or Operated (ly • <br />Subsc:c~.zvn_' SBOTR Section(s)_~_iownshi.p_____,~~Z~__~,Rangi,_~~ <br />Pr'oduc,':_ Pit Run <br />Unit or Mcasur:> 1'D TP! L8 02 B~ OT (CTRCI,E OtJE) <br />0eginnng inventory Units Produced <br />Ending Inventory knits Sold <br />Selling Price Per Unt ~ Gress Sales <br />Royal t Rate .30 ROYALTY DUE <br />For r',d,''usted .P~ports. Previous Amount Paid. <br />Rdvance.i':inir~,urct Roya~sty CreJit (if applicable) <br />ROYALTY RAID <br />IF this 'is an an adj~strr;ent, please explain <br />Contact ;carne <br />Telephone n1o. 719-~9-Fi9fi2 - _ <br />I cert:Fy that :his is a true and correct statzment of production sold, uaiue <br />receive:;, and royalty due the State. of Cclo.rado for the period indicated. <br /> <br />i:eportic_~ Company Naim_ Alamosa County Road & Bridge Number 7~_7,_ <br />:address 8663 S. County Road 109 <br />Alamosa, CO 81101-9423 <br />Subscribed anc sworn :~ before the by <br />Or.~ This day or' _19 <br />I'~y Contnission Expires____ 19, <br />Nccary.-Public_ _ _ _ -_ <br />Date' StamF <br />F~~.`~ED <br />~ .'Ii'~~-ice , <br />Land Eoard Use Gn:y <br />Verified <br />Posted <br />Notes <br />eceipt No. <br />a <br />Ruthorized Signature G Title <br />