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<br />STATE OF COMVDO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department or Natural Resources <br />i 313 Sherman St., Room 2 13 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />TO WHO IT MAY CONCERN: <br />RECEIVED <br />NOV 17 7C21 <br />Cidision of Minarals aid GealogY <br />ASSIGNMENT OF CERTIFICATE OF DEPOSIT <br />REFERENCE: Certificate of Deposit Number <br />,Qf?• ?® ?iviSiON OP <br />'°?°?d?sd9 ®+? M I N E R .A L S <br />V GEOLOGY <br />AM ON <br />VV ?O NINi NG-SAFETY <br />Bill Owens <br />Governor <br />Greg E. Walther <br />Executive Director <br />Michael B. Long <br />Director <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 />Q-- <br />BY: <br />Pip2nature <br />Operator: Monarch Stone Company <br />Depositor of Original Monies <br />ACKNOWLEDGMENT OF BANK <br />SIGNATURE: ?U N)&?' Alm"nm <br />BY:?illC t . `A ?,, 1y C?tYI <br />TITLE: kvn () ?Otl(l ? r <br />DATE: <br />Return Original Form to: <br />Note to Operator: <br />Division of Minerals and Geology <br />1313 Sherman St., Rm 215 <br />Denver. CO 80203 <br />Y, jj,?,Uj <br />NOTARY (Of Operator Signature) <br />My Commission Expires <br />Commission Expires 8/23/M <br />UC <br />NOTAI?Z <br />pv® L `o <br />•, .••®Q` <br />c <br />This assignment form will need to be executed in the presence of a notary. The original is held by the Division with a <br />copy provided to the bank to allow only the Division of Minerals and Geology access to these fiends. .