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• jj-j* COUPLE&THIS SECTION ON DELIVERY <br /> • Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> B Print your name and address on the reverse �p (�1,�,� ❑Address <br /> so that we can return the card to you. B. Received by(Pnnted Name)— C ivE <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 1? Yes <br /> 1, Article Addressed to: _ If YES,enter delivery address below: ❑ No <br /> Walter Taylor <br /> Animas Credit Union <br /> 2101 E. 20th <br /> 3. ,S�ervice Type <br /> Farmington, New Mexico 87401 9s/Certified Mail ❑ Priority Mad Express7' <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 7869 7 216 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED STATES POSTAL SERVICE <br /> 4 <br /> �a a <br /> • Sender: Please print your name, Mdit Is_bc <br /> State of Colorado N e <br /> Department of Natural Resources <br /> Division of Reclamation, Mining&Safety <br /> dIV <br /> 1313 Sherman Street, Room 215 <br /> Denver,CO 80203 l.(JL 01401 Spec <br /> File M!144107 <br /> SCANNED <br />