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'Date <br /> <br /> <br /> <br />CERTIFICATE OF DEPOSIT SIGNATURE CARD <br />Amount of <br />Deposit: One Hundred Seventy-six Thousand Dollar And No Cents $176000.00 <br />This Time Deposit is Issued to: Issuer: <br />I ~MOUNT ROYALE VENTURES/LLC PPA9 # 01000yo0,s/01 46siq ED STATE OF COLORADO <br />MINED LAND RECLAMATION BOARD <br />1313 SHERMAN ST RM 215 y?? NL(i <br />DENVER CO 80203 lv' I y 6 <br />Not Negotiable - Not Transferable - Additional terms are below. <br />AMERICAN NATIONAL BANK Ar%omfty <br />1360 WALNUT STREET <br />BOULDER, CO 80302 <br />By - 6&?-ta 1) %,e4 <br />Additional Terms and Disclosures <br />This form contains the terms for your time deposit. It is also the Minimum Balance Requirement: You must make a minimum deposit to <br />Truth-in-Savings disclosure for those depositors entitled to one. There <br />are additional terms and disclosures on page two of this form, some of open this account of $ 1 000.00 <br />which explain or expand on those below. You should keep one copy of <br />. <br />this form. X You must maintain this minimum balance on a daily basis to earn the <br />Maturity Date: This account matures 11/13/2011 annual percentage yield disclosed. <br />_ (See below for renewal information.) Withdrawals of Interest: Interest ? accrued ® credited during a <br />Rate Information: The interest rate for this account is 4.8500% term can be withdrawn: <br />with an annual percentage yield of 4.94 %. This rate will be <br />paid until the maturity date specified above. Interest begins to accrue on Early Withdrawal Penalty: If we consent to a request for a withdrawal <br />the business day you deposit any noncash item (for example, a check). that is otherwise not permitted you may have to pay a penalty. The <br />Interest will be compounded quarterly . penalty will be an amount equal to: 90 Days <br />Interest will be credited quarterly 4o <br />interest on the amount withdrawn. <br />® The annual percentage yield assumes that interest remains on deposit Renewal Policy: <br />until maturity. A withdrawal of interest will reduce earnings. ? Single Maturity: If checked, this account will not automatic <br /> ou close your account before interest is credited, you will not renew. Interest ? will ? will not accrue after maturity. <br />receive the accrued interest. X Automatic Renewal: If checked, this account will automatically <br />The NUMBER OF ENDORSEMENTS needed for withdrawal or any renew on the maturity date. (see page two for terms) <br />other purpose is: Interest ? will ? will not accrue after final maturity. <br />ACCOUNT OWNERSHIP: You have requested <br />and intend the type of account marked below. <br />? Individual <br />? Joint Account - With Survivorship tnr.?o,°n?m`o`"°"`s <br />? Joint Account - No Survivorship (. ?-u In common) <br />? Trust: Separate Agreement Dated <br />? Revocable Trust Designation as defined in this <br />agreement (Beneficiaries' names and addresses) <br />BACKUP WITHHOLDING CERTIFICATIONS <br /> <br />® Taxpayer I.D. Number - The Taxpayer ? Exempt Recipients - I am an exempt <br />Identification Number shown above (TIN) is recipient under the Internal Revenue Service <br />my correct taxpayer identification number. Regulations. <br />® Backup Withholding - t SIGNATURE - I certify under penalties of <br />to backup withholding either because I have perjury the statements checked in this <br />not been notified that I am subject to backup section and that I am a U.S. person <br />withholding as a result of a failure to report (including a U S. resident alien). <br />all interest or dividends, or the Internal <br />Revenue Service has notified me that I am no <br />longer subject to backup withholding. X <br />DATE / _ 1 - <br />ul---+`b ©1993 Bankers Systems, Inc., St. Goud, MN Form CD-AA-NPO (2) 1/3/2001 <br />SIGNATURES: 1 REE T T TERMS STATED ON PAGE ONE AND PAGE TWO. <br />X <br />X <br />X <br />READ PAGE TWO FOR ADDITIONAL TERMS (page 1 of 2)