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FROMM1111 <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866 -3567 <br />FAX: (303) 832 -8106 <br />December 10, 2013 <br />HATE of COLORADO <br />MI°ga 'OQ5 <br />Mr. Laurens W. Leffingwell, Jr. <br />Gold Basin Mine, LLC <br />c/o Simpson Estates, Inc. <br />30 N. La Salle St., Ste 1232 <br />Chicago, 1160602 <br />Re: Gold Basin Mine, Permit M -1992 -045: Incomplete Application for Transfer of Mineral Permit <br />and Succession of Operators, Revision SO -03 <br />Dear Mr. Leffingwell: <br />COLORADO <br />D IV IS I ON OF <br />RECLAMATION <br />MINING <br />SAFETY <br />John W. Hickenlooper <br />Governor <br />Mike King <br />Executive Director <br />Loretta E Pineda <br />Director <br />On December 10, 2013, the Division of Reclamation, Mining and Safety received Application Form for Transfer of Mineral Permit and <br />Succession of Operators for the Gold Basin Mine, Permit M- 1992 -045. The following items are incomplete: <br />1. The Application form notary acknowledgement is incorrect, page 9. Should list James Van Ella. <br />2. The Application form notary acknowledgement is incomplete page 10 and notary states her commission expires 06 -27 -2013. <br />3. Demonstration of Legal Right to Enter not provided. See instructions. <br />4. Structure Agreements not provided. See instructions. <br />5. Performance Warranty notary acknowledgement is incomplete. <br />6. Financial Warranty Check for Deposit in State Treasury Third Party is required for funds received from Laurens W. <br />Leffmgwell, Jr. for Operator Gold Basin Mine, LLC. Template form available on website. <br />7. W -9 required from Laurens W. Leffingwell, Jr. for Financial Warranty Check Deposit Third Party. <br />8. Affidavit of Authority for Laurens W. Leffingwell notary acknowledgement incomplete for Laurens W Leffingwell. <br />9. Annual Report and Fee for 2013 is due in the amount of $259.00. <br />In order to complete the acceptance of this application, please return the original signature documents to the State at the above <br />address by February 10, 2014. Forms required may be accessed at http://minina.state.co.us . <br />If you have any questions, contact me at (303) 866 -3567 ext 8148. <br />Sincerely, <br />Barbara Coria <br />Financial Assurance Specialist <br />Enclosures <br />Certified Mail No. 7012 3460 0000 6384 5368, return receipt requested <br />cc: Dustin Czapla, Division of Reclamation, Mining & Safety <br />James Van Ella Certified Mail No. 7012 3460 0000 6384 5375, return receipt requested <br />180 Ln 200 Bass Lake <br />Angola, IN 46703 <br />jon@simpsonestates.com <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />