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UNITED STATES,FgT4�.y ERVICE <br />t. <br />I <br />I <br />First -Class Mail j <br />Postage & Fees Paid <br />USPS <br />Permit No. G -10 <br />i <br />• Send . Prase print your name, address, and ZIP +4 in thi box • <br />State of Colorado <br />Department of Natural Resources 204 <br />i <br />Division of Reclamation, Mining & Safe41 egOV1, <br />1313 Sherman Street, S' ..E RQ sa {eky <br />Denver, CO 80203 jL <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addfled to: <br />C /D/H 1 <br />C-1981-01() <br />SL-16 insP Notification Le <br />tier <br />I <br />.I <br />A. Signature <br />X ❑ Agent <br />❑ Addressee <br />B. Received by (Printed Name) I C. Date of Delivery <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: 13 No <br />�,... x <br />r� -it <br />Colorado State Board of Land Commissioners <br />1313 Sherman St Room 620 3. Service 13 Certlfied Mail 13 Express Mail <br />Denver, CO 80203 <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />- 14. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(Transfer from service label) ?010 1060 D 1 0936 0659 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02 -M -1540 <br />