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COWLETE THIS SECTION ON DELIVERY <br /> SENDER:COMPLETE THIS SECTION <br /> ■ Complete items 1,2,and 3.Also complete A. Si atum <br /> item 4 if Restricted Delivery is desired. Agent <br /> ■ Print your name and address on the reverse Addresse <br /> by(Printed N me) C. Date o <br /> so that we can return the card to you. B. Received f D liver <br /> ■ Attach this card to the back of the mailpiece, ���a <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1__ rlinle ArldrPssarl tnc ----- If YES,enter delivery address below: ❑No <br /> Mr. Gerald Nalezny <br /> Verus Bank of Commerce <br /> 3700 S. College Avenue Unit 102 <br /> Fort Collins CO 80525 3. Service Type <br /> Certified WHO ❑Priority Mail Express' <br /> ---— -- —- -- ❑ Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7Qy4 212(J �(]�1 8�4� 0781 <br /> (Transfer from service label) <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED STATES PQS-JrERVICE <br /> First-ENo.G-10 <br /> 3 `_i~s_, LISPPostage <br /> Paid <br /> �'Iyi 8r L Permi <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 1� <br /> 1313 Sherman Street, Suite 215 <br /> Denver,CO 80203 -Tn,W-,f IWo Spec <br /> File mAoardeo <br /> �Irulr�Irlr�rrhll�llli'lllrf II,II���IIIIIIr�rlf'l'lltlrrllrrfl' <br />