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SENDER: COMPLETE THIS SECTION COMPLETE 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 /> X <br /> ■ Print your name and address on the reverse Addressee <br /> so that we can return the card to you. 13. Re eive y(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, S r-� 1 Q 2b <br /> or on the front if space permits. ��R4 <br /> D. Is delivery address different from item 19 ❑Ye <br /> 1. Article Addressed to: If YES,enter delivery address below: 11 No <br /> Vr. David Grzenia, Sr. VP." <br /> Bridgeview Bank Group <br /> 4'I�3 N. Broadway 3. Service Type <br /> Id Certified Mail- ❑Priority Mail Express- <br /> Chicago, IL 60640 <br /> ❑Registered ❑Return Receipt for Merchandise <br /> 0 Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(E)rtra Fee) ❑Yes <br /> 2. Article Number 7 014 2120 0001 7869 6493 <br /> (rransfer from service!abet) <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED STATES IBC) IAL SERVICE First-Class Mail <br /> 4 Postage&Fees Paid <br /> USPS <br /> a <br /> 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, Suite 215 <br /> Denver,CO 80203 FcC✓i5eA Ue- Spec <br /> File H iR e 5 iiL <br /> _s_`4-iti`= li' <br />