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SENDER COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Sign El_ <br /> item 4 if Restricted Delivery is desired. A ent <br /> ■ Print your name and address on the reverse X ddressee <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. L ir✓t <br /> CAC <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> Mr. Levi Schlosser <br /> Schlosser Incorporated 3. Service Type <br /> 755 Hwy 385 a Certified Mail® ❑Priority Mail Express`" <br /> Burlington CO 80807 ❑ Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 014 2120 0001 7885 6507 <br /> (Transfer from service label) <br /> PS Form 3811,July 2013 Domestic Return Receipt yy� <br /> UNITED STATES POSTAL SERVICF� t 4t `° " N,r:.t,,;..•,�sys <br /> w .a <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 Spec Ck <br /> File m,'holuM <br /> =': "i•;`i <br />