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STATE OF COLORADO J .,�r., a ;...�,..
<br /> DIVISION OF RECLAMATION,MINING&SAFETY '
<br /> Attn:Camille Moyar
<br /> 1313 SHERMAN STREET, ROOM 215
<br /> DENVER,CO 80203
<br /> 341300000
<br /> -- 7 016 2140 0 0 0 0 2345 9497 :, .;` s
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<br /> SENDER:COMPLETE THIS SECTION
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<br /> COMPLETE z„^7�9„�:':.-k 1��,'�vez.��-"Y,'
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<br /> ® Complete items 1,2,and 3. A. Signature
<br /> ■ Print your name and address on the reverse ❑Agent
<br /> in drdi *e can return the Card to you. X 0 Addressee •` I-_ 9"', "`_ .�
<br /> ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery
<br /> or on the front if space permits.
<br /> 1 Artirid Arirl--
<br /> D. Is delivery address different from item 1? ❑Yes r
<br /> If YES,enter delivery address below: ❑ No y'
<br /> Eustice Zacher
<br /> 80430th Ln. uy 't:
<br /> Pueblo, CO 81006 "`s s ,. t OT
<br /> I II I I f 1 I 3. Service Type
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<br /> Priori. Mad ress®
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<br /> e'isierea Ivtad�"^ 1`t�A1�N�`a.
<br /> G L,d y ❑Registered Maii Restricted ult Signatwe hestrictea Deliveo ;,"-' f'�" ayt¢'pY ti.
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<br /> 9590 9402 2053 6132 7803 57 Ce rtified Mad© Delivery
<br /> ❑Certified Mad Restricted Delivery ❑Retuin Receipt forEl
<br /> 2, Article Number!Transfer from service label) Collect on Delivery Restricted Delivery Merchandise
<br /> e Confirmation
<br /> ❑Collect on Delivery ry ❑Si TM
<br /> ad Mail �Signature Confirmation
<br /> 016 2140 0000 2345 9497 >''. ° `. = ^, .•.ysi.,:, ;
<br /> =d Mad Restricted Delivery Restricted Delivery �, _'�.�., '' -
<br /> $500) _. •�.. —44 PS Form Form 3811, July 2015 PSN 7530-02-000-9053 a r.
<br /> Domestic Return Receipt
<br /> U N1.L A i'tED
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