REP34977

• Permit No: C1981022
• IBM Index Class Name: Revision
• Doc Date: 7/12/1993
• Doc Name: SOMERSET MINING CO TR 13 RECLAMATION BOND CALCULATIONS PN C-81-022
• From: J E STOVER & ASSOCIATES
• To: DMG
• Type & Sequence: TR13
• Media Type: D
• Archive: No

~ ~~ UCC-1 OCR UN.~,~AM COMMERCIAL CODE
FEE 510.00 INSTRUCTIONS ON REVERSE SIDE FINANCING STA7EMENT
1ST DEBTOR S.S. No /FED Tax I.D. ~ _ _ __ __
(PERSONAL)
Lest Nama First 8 Middle Name
002
1ST DEBTOR (BUSINESS) Name SCflIPSSet _- _
M, n, MJ-.y...-_ .
street Q.P.O. B02t 535 Dnv ~p=.~t Stale ~ ap--- zip x__81434__...__
- .V_.... _......_...__ .... .. ... ......_ _. .. _._ _...._.......... .. -.- _.. . __.. -.._.. _.-.._. _. __....._._._ ....._._.. ,
THIS DOCUMENT MUST ~
BE TYPED IN BLACK
I r
SECRETARY OF STATE • 1560 Broadway, Ste. 200, Denver, CO 80202 ~ t
[phone] EXT 7
r
2ND DEBTOR r-i Adtldional debtor(s)on adachment S.S. No.ffED Tax LD. ~_ ____
(PERSONAL)
Last Name
2ND DEBTOR(BUSINESS)Name
First d Midtlle Name
Street ~dY Slate ~ Zip
_-~+. r._._~.._.r.__._. .-. .. ._._ .. .____ ... ._. .. ... _...___._._-._.___._-._..-.-__-.._._. _.__._.~_-___._._.._
1ST SECURED '`~ AtlOitional secured parry on anachment
PARTY
Name _Division..of_MiTIQra>s..ard_Geol
street 1313 S1wrm.~Yn St., Rolm 215 city ppn~ state ,W zip 80203
ASSIGNED
PARTY
Name ,
Street ~
CHECK IF APPLICABLE
Cny
UU This statement is to be filed for record in the real estate records
Slate ~ Zip ..
Ll The debtor is a transmitting utility
PLEASE CHECK APPROPRIATE BOX.
THIS STATEMENT IS SIGNED BY THE SECURED PARTY INSTEAD OF THE DEBTOR TO PERFECT A SECURITY INTEREST IN COLLATERAL
Already subject to a security interest in another jurisdiction when it was brought info this II,, As to which the filing has lapsed; or
^ Stale, or when the debtor's location was changed to IhiS slate; u
I'-'1 Which is proceeds of the original collateral described below in which a
~J security interest was perteged 1~7 Acquired after a change of name, identity or
~J corporate structure of the debtor
COLLATERAL USED use additional sheets 8th x t 1 it more space is needed.
f'"1 Accounts, Accounts ~X~ Fixtures ' ! Proceeds ~-
L~ Receivable -~~ _~ Equipment, Machinery ~ ~ Livestock, Farm Animals, Elc.
^ Contract Rights i _ ~ Inventory ~, ~ Products Truck, Car, Vehicle I Other
See bdLibit A - 4 pages - fixtTSe listing and locati~l
SnMFRSRT MTNTN(: C(1MPANV OTVTRT(1N (1F MTNF.R AT.R ANTY (7F.(1LT1pV
DEBTOR(S)SIGNATURES SECURED PARTY SIGNATURE:
REPRODUCTION OF THIS FORM BY AUTHORIZED VENDERS ONLY
No. 6(12. Rer. 11-91. FINANCING SfATEMBM' NCC-1) Bradford Publishing, 1]47 Waxee SL, Denver, C0 80202 - [phone] - b-92 ^