_ENFORCEMENT - C1981017 ‎(9)‎

• Permit No: C1981017
• IBM Index Class Name: Enforcement
• Doc Name: Bid Documents ‎(IMP)‎ CV-91-023
• Violation No.: C-91-023
• Media Type: D
• Archive: No

Card No. DIVISION OF ACCOUNTS AND CONTROL
Dept. of Natural Resources DELINQUENT ACCOUNTS WORK SHEET
Mined Land Reclamation Division
12 Agency 7 a Type 91 t o Account Number 21 2 2
TB
700 00 01 13 92 �
1 •
23 Balance Due 29 3o Date Last 3s 136 Adjustmentasl Cr
Statement To Balance
Mid-Continent Resources, Inc . Ms . Diane Delaney 1
23 Debtor's Name (Last, First) 51 52 Recipient of Service If Different So
P.O. Box 1298
3 same
23 Address Line One 511 52 Address Line Two So
4 ( Glenwood Springs, CO 81602 945-4958 I 303
23 City,State 471 148 Zip 521 153 Telephone 591 6o Alen Code 62�
If Applicable
6*1 1 1 1 1 1 1
I t I I I I I I I �� �
32 Date 37 138 Set Next 43 44 45 46 47 48 49 63 69 Cr 70 71 73
Promised Action Date to tst 2nd 3rd 4th 5th 6th Amt. Comm. Status Assignment or
Letter Action Adjustment Disp. Transfer Code
I NOV C-91-023 1
23 Date of Birth/Employer 511 152 Reference Sol
8
123 Reference 51 1 52 Reference e 0
9*
23 Note for Next Monthly Collections Report eo
A 23 PS 26 27 CBR 30 131 D M V R__
�34 13s AC 38
Forms AC-76-04 " Line 6,9 and A is for Central Collection Use Only