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Phillips County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1989095 <br />Receipt #: 14233 <br />Date: 12/11/2012 <br />Permit: M1989095 <br />Payment Method Revenue Code <br />Fee Description /Notes' Amount <br />26999 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1989 -095, CMB <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />