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Black Range Minerals <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for P2009025 <br />Payment Method Revenue Code <br />Fee Description/Notes Amount <br />5815 <br />4300 -15 <br />Prospecting Modification Fee <br />P- 2009 -025, MODIFICATION, CMB <br />$86.00 <br />Receipt Total: I $86.00 <br />Receipt #: 12659 <br />Date: 04/09/2012 <br />Permit: P2009025 <br />Page 1 of 1 <br />