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COMPLETE THIS SECTION ON DELIVERY <br /> r,ENDER: COMPLETE THIS SECTION <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X0 Agent <br /> so that we can return the card to you. WddresseE <br /> ■ Attach this card to the back of the mailpiece, -(eceive y(Printed Name) C. Da e of Delivery <br /> or on the front if space permits_. ��;�,�� � ������� <br /> I. AI D. Is delivery address different from item 1? ❑Yes <br /> If YES,enter delivery address below: '�rNo <br /> Mr. Kevin Larimore <br /> Rebel Mining LLC <br /> 670 Oak Street <br /> Del Norte, CO 81132 <br /> II II�III(III III I II I II�II I II III II I I III II'�I I 3. Service Type ❑Priority Mail Expresso <br /> 1 ❑Adult Signature ❑Registered MaiIT" <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricte <br /> 9590 9402 2053 6132 7838 46 0 Certified Mail® Delivery <br /> ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery 0 Signature Confirmation- <br /> 71716 2140 0000 Insured Mail ❑Signature Confirmation <br /> 2 3 4 5 5 6 9 7 (over$500 nsurd)it Restricted Delivery Restricted Delivery <br /> 'S Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br /> WS TRACKING# First-Class Mall <br /> Postage&Fees Paid <br /> USPS <br /> Permit No.G-10 <br /> 9590 9402 2053 6132 7838 46 <br /> United States <br /> •Sender:Please print your name,address,and Zll"' in this box* <br /> Postal Service State of Colorado <br /> Department of Natural Resources Safety <br /> Division of Reclamation, <br /> Suite 215 <br /> 1313 Sherman <br /> Spec Denver, CO 80203 <br /> File <br /> `i <br />