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Gold Hill Mines, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1983141 <br />Receipt #: 14029 <br />Date: 11/01/2012 <br />Permit: M1983141 <br />Payment Method Revenue Code <br />Fee Description /Notes <br />Amount <br />2090 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M1983 -141 <br />$259.00 <br />Receipt Total: I $259.00 <br />Page 1 of 1 <br />