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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. r Agent <br /> ■ Print your name and address on the reverse ❑Addresse( <br /> so that we can return the card to you. B. Received by( ted Name) C. ate f Deliven <br /> ■ Attach this card to the back it the mailpiece, i Ilium f q� <br /> or on the front if space permits. D. Is delivery a dress different from item 1? Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: 0 No <br /> Ms. Shannon Gore <br /> Mountain Valley Bank <br /> P O Box 279 3. Service Type <br /> Hayden, CO 81639 ®Certified Mail® ❑Priority Mail Express" <br /> _ ❑ Registered ❑ Return Receipt for MerchandisF <br /> 0 Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) p Yes <br /> 2. Article Number 7 014 212 0 0001 7885 6651 <br /> (Transfer from service label) <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED STATES POSTAL SERVICE First-Class Mail <br /> Postage&Fees Paid <br /> USPS <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 YA-Cq <br /> File 0I Nd""I <br /> ! F mill , l` 7 ! 'I'!!! <br />