2003-04-01_REPORT - M1983067

• Permit No: M1983067
• IBM Index Class Name: Report
• Doc Date: 4/1/2003
• Doc Name: Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

MAR-27-03 15:30
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P.O. Box 5112
Southfield, MI
48086-5112
FROM-Colorado Division of Minerals & GaDlDay [phone]
Return Serviee RequeStCd
DIVISION ^F MINER4LS & GEOLOGY
1313 SHERMAN ST RM 215
DENVER CO 80203
00099a
T-763 P.002/003 F-610
R~~~Id%Ep -_
APR 0 1 2003
Division of Minerals and Geology
CHEC9C DATE 03/20/2003
VENDOR NUAtBFR 710185
1NVOILE DESCRIPTION OATS P.O. NO GROSS AMOUNT DISCOUNT NET AMOUNT
FSLE929D3 '(^ ~
l~z~ 03/10/03 688.OD 68a. o0

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FOR PAYMENT INQUIRIES CALL: 8668535506 688.00 O.OD 688.00
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SHADED AREA MUST GRADVALLV CHANGE FROM B WE AT TOP TO GREEN AT BOTTOM _~ ~- -
TD THE
ORDER
OF
WaChovia Bank. N.A.
Wl nston-Salem, NC 27150
t'~r
Au{horized Signs{ut~e
RECEIVED
MAR 2 7 Y~03
Division at Minerals and GeDlogy
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