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• • • • • DELIVERY <br /> • Complete items 1,2,and 3.Also complete A. Sig nat e <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your name and address on the reverse X ❑Address <br /> so that we can return the card to you. B. Receiv by( Tinted Name) C. Date of DelivE <br /> ■ Attach this card to the back of the mailpiece, - <br /> or on the front if space permits. ` <br /> D. Is delivery address different from item 17 Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> f <br /> Paul Geffner <br /> 9 L.Marin Ave. 3. Service Type <br /> Sausalito. CA 94965 ❑Certified Mails I]Priority Mail Express' <br /> ❑Registered ❑Return Receipt for Merchandi <br /> ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (Transfer from service label) 7 014 2120 0001 8040 2433 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> ci` <br /> UNITED STATES �iilk First-Class Mail <br /> Postage&Fees Paid <br /> 27.FE ,"16 USPS <br /> 111111 Permit No.G-10 }, <br /> • Sender: Please print your name, address, and ZIP+4®in this box• <br /> State of Colorado <br /> Department of Natural Resources <br /> Division of Reclamation, Mining&Safety <br /> 1313 Sherman Street, Room 215 <br /> Denver, CO 80203 Spec TG <br /> Ill,lllli,lllll'III"Ill,l„lI,I,Iillll'IIIIIIIIIIIIiIi,llil!'II' <br />