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<br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 COLORADO <br />Denver, Colorado 80203 DIVISION OF <br />RA L S <br />M I N <br />Phone: (303) 866-3567 E <br />,' I< «. • <br />J <br />FAX: (303) 832-8106 ' <br />G E O L O G Y <br />' RECLAMATION. MINING <br /> SAFETY-SCIENCE <br />Bill Owens <br />ASSIGNMENT OF CERTIFICATE OF DEPOSIT Governor <br />Russell George <br />Executive Director <br />Ronald W. Cattany <br />TO WHOM IT MAY CONCERN: Division Director <br />Natural Resource Trustee <br />REFERENCE: Certificate of Deposit Number <br />By submission of this letter, to be attached to the above referenced Certificate of Deposit, I hereby relinquish all title <br />and claim to said certificate to the State of Colorado/Mined Land Reclamation Board, except for accrued interest <br />against the original monies, until such time as the Division of Minerals and Geology/Mined Land Reclamation Board <br />releases the certificate. This assignment of Certificate of Deposit supersedes any signature cards that may already be <br />on file at the bank. <br />BY. <br />Warrantor: <br />Depos r of Original Monies <br />ACKNOWLEDGMENT OF BANK <br />Gl <br />GNATUR 4 <br />BY-i_ laad / iz J 1? ran !? <br />TITLE: 5r? l? <br />DATE: i © sz- <br />N TARY (Of Warrantor Signature) <br />Commission Expires 8 - 6 - 0 6 <br />pR........ <br />RUTH E. <br />WONENBERG <br />OF It <br />Note to Warrantor: <br />This assignment will need to be executed in the presence of a notary. The original is held by the Division <br />with a copy provided to the bank, to allow only the Division of Minerals and Geology access to these funds <br />Office of Office of Colorado