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ANNUAL FEE AND REQUEST FOR UPDATE OF INFORMATION <br />NOI NAME: <br />NOI NO.: <br />OPERATOR NAME <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />W IIf <br />Rio Grande Silver, Inc. <br />P- 2009 -026 <br />Midwest Exploration Project <br />August 21, 2013 <br />$86.00 (Due on or before your anniversary date) <br />Mineral <br />On the anniversary date of the Notice of Intent (NOI), the operator must submit the annual fee. <br />Division records indicate the following NOI contact information. Please verify and make any necessary <br />changes: <br />Explorer Contact: <br />Explorer Name <br />Address: <br />Phone Number: <br />Randy McCLURE <br />Rio Grande Silver, Inc. <br />P.O. Box 610/112 E. 12th Street PO Box 610/625 USFS Road 504.IA <br />Creede, CO 81130 <br />(719) 658 -1080 <br />Fax Number: (719) 658 -1082 <br />If you have additional comments and/or information that should be provided to the Division, please <br />provide it below or attach it to this form. We thank you for your attention to this matter. <br />/fav'4 MC(tv'4-t, <br />Signature of Corpo ate Officer, Owner, or Designee <br />7�lolz,01,3 <br />Date <br />