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COMPLETESENO f ON DELIVERY <br /> ■ Complete items 1,2,and S.Also complete A. Signature • . <br /> Rem 4 if Restricted Delivery Is desired. ` ' ' O Agent <br /> ■ Print your name and address on the reverse X ❑Addressee <br /> so that we can retum the card to you. B. Received b�Jt�rr(od./Nar jij C. Date of Delivery <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 Rem 1? 0 Yes <br /> 1. Article Addressed to: If YES,enter delivery address below ❑No I <br /> CO Division o Relclamation <br /> Mining,and S fety <br /> 1313 Sherman St, Rm 215 { <br /> 3. Service Type <br /> Denver,CO 80203 G-difled Mail ❑Express Mail <br /> 0 Registered 0 Return Receipt for Merchandise <br /> 0 Insured Mail ❑C.O.D. { <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> abet 7013 1090 0002 0889 9256 <br /> (fransw from service label) <br /> PS Form 3811,February 2004 Dommtic Return Receipt 1o2595-02-M-1540 <br />