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NOI NAME: <br />NOI NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE AND REQUEST FOR UPDATE OF INFORMATION <br />ike Joosten <br />1 2009 -023 <br />Joosten Prospecting - Portion of Jones Placer <br />August 20, 2011 <br />$$86.00 (Due on or before your anniversary date) <br />Clear Creek <br />On the anniversary date of the Notice of Intent (NOI), the operator must submit the annual fee. <br />MOM ii;o0011Aill'Ai, <br />AUG 102011 <br />Division of Reclamation, <br />Mining and Safety <br />Division records indicate the following NOI contact information. Please verify and make any necessary changes: <br />Explorer Contact: <br />Explorer Name: <br />Address: <br />Phone Number: (720) 201 -0258 <br />Fax Number: <br />If you have additional comments and /or information that should be provided to the Division, please provide it <br />below or attach it to this form. We thank you for your attention to this matter. <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />Mike Joosten <br />Mike Joosten <br />11355 Chase Way <br />Westminster, CO 80020 <br />M: \OSSV WD\ANNFEE \1ST LTRS., EC, 8 -11 \P- 2009 -023_F 1.DOC <br />