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ANCA <br />? -col I- 001-1 <br />• Complete items 1, 2, and 3. Also complete A. Signature <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse Agent so that we can return the card to you. ee v Attach this card to the back of the mailpiece, B. Received by (Printed Name) :77 <br />Date of Delivery <br />or on the front if space permits. <br />1. Article Addressed to: D. Is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: 0 No <br />Dale Herbertson <br />Sara Ray Silver Mining LLC <br />6542 W. Mexico Ave. <br />Lakewood. CO 80232 <br />DEC 23M' <br />3. Service Type <br />❑ Certified Mails, 0 Priority Mail Express'" <br />0 Registered 0 Return Receipt for Merchandise <br />0 Insured Mail 0 Collect on Delivery <br />4. Restricted Delivery? (Extra Feel 13 Yes <br />2. Article Number <br />( 7 014 0150 0000,9138 3 4 6 0 <br />transfer from service label) <br />PS Form 3811, July 2013 Domestic Return Receipt <br />C3 • <br />..D <br />M <br />WT I <br />Co <br />rn Postage: <br />I' Certified Fee: <br />M Return Receipt Fe <br />ED Re <br />(Endors4 Total Postage & F <br />rlx�, $0.69 <br />$3 .30 <br />j $2.70 <br />$6.69 <br />gnu <br />Restrict <br />(Endorse,.— . negmred) <br />r-9 <br />Total Postage 8 Fees <br />O <br />Sent To <br />Dale Herbertson <br />r� <br />C3 <br />Street, Apt. No.; <br />Sara Ray Silver Mining LLC ------°°----------- <br />6542 W Mexico Ave. <br />fti <br />or PO Box No. <br />--- ------ <br />-7; -§ <br />Lakewood CO 80232 <br />i------ <br />Cty, ate, ZIP +4 <br />PS Form :0r August 2006 <br />See Reverse for Instructions <br />