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MS Forest <br />000000000 <br />FORESTWISE LLC <br />PH. 719 - 941 -4378 <br />PO BOX 521 <br />AGUILA,R, CO 81020 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2006010 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />1870 <br />5700 <br />Minerals Civil PenaltyNiolation Fines <br />M- 2006 -010, CMB <br />$100.00 <br />Receipt Total: $100.00 <br />PAY TO <br />THE ORDE <br />INTERNATIONAL <br />xxxxx 1^VAI <br />MEn - <br /> <br />M \ Jot' aft <br />95- 24/1022 <br />DATE <br />^ttv aOU d 1 e <br />1 <br />Receipt #: 12559 <br />Date: 03/22/2012 <br />Permit: M2006010 <br /> <br />DOLLARS ei` <br />IIP <br />SPECIAL, MINT <br />Page 1 of 1 <br />