_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
DELINQUENT ACCOUNTS WORK SHEET
Dept. of Natural Resources
Mined Land Reclamation Division
12 Agency 71 18 Type 9 ho Account Number 21 22
TB
950 00 1 01 13 92
23 Balance Due 29 3o Date Last 35 36 Adjust
justmenta2l I Cr I
Statement To Balance
Mid-Continent Resources, Inc. I 1 Ms. Diane Delaney
23 Debtor's Name (Last, First) 511 152 Recipient of Service If Different 80
P.O. Box 1298 same
3
23 Address Line One 51 52 Address Line Two 80
4 1Glenwood Springs, CO 81602 ( 945-4958 ) 1 3003
23 City,State 471 148 Zip 521 153 Telephone 591 16o Area Code 62
If Applicable
32 Date 371 138 Set Next 431 1 44 45 46 47 48 49 63 r,91 Cr 1 1 70 171 73
Promised Action Date to 1st 2nd 3rd 4th 5th 6th Amt. Comm. Status Assignment or
Letter Action Adjustment Disp. Transfer Code
NOV C-91-022
23 Date of Birth /Employer 51 52 Reference 80
8
23 Reference 51 152 Reference 80
9*
23 Note for Next Monthly Collections Report eo
A* 23 PS 26 27 CBR 30 31 DMVR
34 135 AC 38
Form- AC-76-04 «
Line 6,9 and A is for Central Collection Use Only
f `i