_ENFORCEMENT - C1981017 ‎(20)‎

• Permit No: C1981017
• IBM Index Class Name: Enforcement
• Doc Name: Bid Documents ‎(IMP)‎ Violation CV-91-008
• Violation No.: C-91-008
• Media Type: D
• Archive: No

91-008
Card No. DIVISION OF ACCOUNTS AND CONTROL
DELINQUENT ACCOUNTS WORK SHEET
Mined Land
1Reclamation Div.
2 Agency 71 Is Type 9 ho Account Number 211 2 2
TB
1 1250 . 001 11 221 91
23 Balance Due 291 l3o Date Last 35 36 Adjustment42 I Cr I
Statement To Balance
r Mid—Continent Resources, Inc. I I Ms. Diane Delaney J
23 Debtor's Name (Last, First) 51 152 Recipient of Service If Different eo
818 Colorado Avenue, P.O. Box 1298
3 23 Address Line One 511 52 Address Line Two 801
4 I Glenwood Springs, Colorado J 81601 ' _ I 945-4958
1-23 City,State 47 48 Zip 52 53 Telephone 59 6o Area Code 62
If Applicable
6*1 1 1 1
73
11
32 Date 37 38 Set Next 43 44 45 46 47 48 49 63 69 Cr 70 71
Promised Action Date to 1st 2nd 3rd 4th 5th 6th Amt. Comm. Status Assignment or
Letter Action Adjustment Disp. Transfer Code
I _ I
23 Date of Birth /Employer 51 52 Reference Sol
8
123 Reference 152 Reference S o
9*
23 Note for Next Monthly Collections Report Sol
A' 23 PS J27 CBR 30 131 D M V R___�34 13s AC 38
Form• AC-76-04 " Line 6,9 and A is for Central Collection Use Only