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4AY-11-03 14:08 , FROM-Colorado Division of Minerals $ Geology +13038663567 T-308 P.007/007 F-653 <br />DIVISION OF MINERALS AND GEOLOGY STATE OF COLORADO <br />Department of Natural Resourm <br />1313 Sherman St., Room 215 K E C H VE D <br />Denver. Colorado 80203 <br />Phone: (303) 866.3567 JUL 2 9 20Q3 <br />FAX. (303) 831.8106 <br />Division of Minerals and Geology <br />ASSIGNMENT OF GERrEVCA1"E OF DEPOSI')(' <br />,1v MQM rr -MAY QQ=M: <br />REFERENCE: Certificate of Deposit Number <br /> <br />0 1 V 1 5 1 0 N 0 <br />M[N&RAL. <br />Gb0LOG`. <br />RECLAMAT16P, <br />MININGrSAFETt <br />Bill Owens <br />Governor <br />Creg E. WaIeher <br />Executive Director <br />Michael 0. Long <br />Division Director <br />By submission of this letter, to be attached to the above re£ereoced <br />Certificate claim to said certificate to the State of Colorado/Mined Land Reclamation Bov Deposit, I hereby relinquish all title and <br />original monies, until such time as the Division. of Minerals and Geology/Mmed Land Refor accrued ainst the <br />clamation Bourg releases the <br />catifieate. This assignmeut of Certificate of Deposit supersedes any stgnatt>re cards that may already be on file at the bank <br />BY <br />Signature <br />Operator <br />Depositor of OrigMal Monies <br />ACKNOWLEDGMENT OF BANK; <br />_4 ' <br />BY QYIe- 2 4- /1 1Q ?/ <br />TITLE: _ i Vj' <br />Le- ? Pr-" A- <br />DATE:? '? -'0 3 <br />Return Original Forst to: <br />Note to Operator. <br />?J <br />N <br />4 RY (Of Operator Signature) <br />C031201ilssion Expires f1 <br />IQWA NO My COMMISSION EXPIRES:44? <br />*Q'iAL W LENE G. WOLLFR <br />i•r,,? ? A <br />Division of Minerals stud Geology <br />1313 Sherman St. Rm 215 <br />Denver, CO 80203 <br />This asS*MCW form WM need to be exoctned in the prMoe of a notary. The original is held by the Divigon with a copy <br />Pzrnrided to the bank to allow only the Division of Minerals and Geology access to these fitg& <br />}'I-q4Wa oRj SZA3SZCB4UWPD