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Division of Reclamation, Mining, and Safety <br />Fee Receipt for Minerals <br />Receipt #: <br />Date: <br />5773 <br />William Collins <br />Permit: <br />000000000 <br />Visa 4400 Mineral Copies <br />M-1983-052 <br />06/04/2009 <br />Minerals <br />$20.00 <br />Receipt Total: 1 $20.00 <br />Page 1 of 1