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UNITED STATES€ First-Class Mail <br /> LISPS e&Fees Paid <br /> +y <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 Spec L,-"M <br /> r3f� UC File t'11 OOd YS <br /> SENDER: COMPLETE THIS SECTION OMPLETE THIS SECTION ON DELIVERY <br /> ■.Complete items 1,2,and 3.Also complete A. Signa re <br /> item 4 if Restricted Delivery is desired. X, <br /> ■ Print your name and address on the reverse Agent <br /> so that we can return the card to you. Addressee <br /> ■ Attach this card to the back of the mailpiece, eceived by rint ame)/ C. Date of Del've <br /> Ir (tP ry <br /> or on the front if space permits. , / <br /> 1. Article Addressed to: D. Is delivery address different from item 1? 11 Yes <br /> If YES,enter delivery address below: ❑No <br /> Mr. Douglas Aiken <br /> The Dolores State Bank <br /> O BOX 848 74. Restricted <br /> rvice Type <br /> Certified Mail® ❑Priority Mail Express'" <br /> Dolores, CO 81323 Registered ❑Return Receipt for Merchandise <br /> nsured Mail ❑Collect on Delivery <br /> Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (7ransfer from service label) 7 014 2120 0001 7 8 6 9 7 5 51 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />