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AAMartin <br /> c Marietta ":,Y3 031,d0Nl�",,, <br /> NOUV,AIYI0n:10 NC. <br /> OZOZ 5 Z AC' NoveIMCEIVED <br /> State of Colorado VV CC <br /> 1313 SHERMAN ST ROOM 215 <br /> DIV OF RECLAMATION, MINERALS & SAFETY <br /> Denver, CO 80203 DIVISION OF RIOU&fIM <br /> IMPORTANT NOTICE MININO AND AVITy <br /> Our records indicate that a check sent to you has not been presented for payment. When a <br /> check remains unclaimed for six months, it is presumed abandoned by the owner and must be <br /> submitted to the state of the last known address of the owner. We are required to make a final <br /> attempt to send any unclaimed funds to the rightful owner and are asking your assistance in <br /> resolving this matter. <br /> In order to claim your funds, please complete and return this form to the address below by <br /> December 3, 2020. If you are not entitled to such funds, please indicate the reason on the form. <br /> If you should have any questions, please feel free to contact us at(919) 783-4666. <br /> Check Date Check Number Check Amount Invoice Number/Reference <br /> 09/27/2019 1919004 $216.00 63604916310071919 <br /> Check received and cashed. <br /> Check not received. Please re-issue. <br /> Check not received. Do not re-issue. <br /> Other- (please explain) <br /> Signature: <br /> Date: <br /> Address: ( ) Same as address listed above. <br /> ( ) New address listed below. <br /> The return of this form is necessary for payment to be made on the above amount. <br /> Please return this form to: <br /> Accountspayable(&martinmarietta.com <br /> In the subject line put"ESCHEAT"and your company name. <br /> Martin Marietta <br /> P.O. Box 30013 <br /> Raleigh, NC 27622-0013 <br /> (919) 783-4666 <br />