District 5 100 Gossett Drive, Suite A Aztec, NM 87410 Phone District 6 407 Galisteo Street Room 102, Bataan Memorial Building P.O. Box 25102 Santa Fealli102 Phone # EFTA00310952 Hie No NEW MEXICO OFFICE OF THE ST CHANGE OF OWNERSHIP OF 72-12-1 PERMI K Individual 1. OWNER OF RECORD (Seller) Name: