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SENDER:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse ~ ; ❑Agent <br /> so that we can return the card to you. M Addresse <br /> ■ Attach this card to the back of the mailpiece, $ Redeived by(Priiried Name) C.,Date of Deliver <br /> or on the front if space permits. <br /> 1. Article Addressed to, 1 delivery address different from item 1? ❑Yes <br /> *NILS,enter Oellvery addr4ss below: © No <br /> LueAnn Doebber , <br /> High Country Bank <br /> 150 North Raynolds Ave, �F <br /> P O Box 1570 <br /> Canon City, CO 81212 <br /> 3. Service Type ❑Priority Mail ExpressS <br /> 1 ❑Adult Signature ❑Registered Mail— <br /> (�� ❑Adult Signature Restricted Delivery ❑Registered Mail Restrio <br /> XCerttfied MailQ5 Delivery <br /> 9590 9102 3438 7275 759 68 ❑Certified Mad Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number RransfP,frr,—---rnti ri ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation <br /> 7016 2710 [1 0 0 0 2965 4349 D Insured Mail ❑Signature Confirmation <br /> �7 nsured Mad Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receir <br /> USPST11t; G# <br /> First-Class Mail <br /> Postage&Fees Paid <br /> USPS <br /> �. Permit No.G-10 <br /> 9590 9402 3488 7275 7595 68 <br /> United States •Sender:Please print your name,address,and ZIP+4®in this box• <br /> Postal Service State of Colorado <br /> Department of Natural Resources <br /> Division of Reclamation,Mining&Safety <br /> 1313 Sherman Street, Room 215 <br /> Denver,CO 80203 Spec iyt <br /> File,Mi4ello <br /> -2 2 4:21E:G i I I f I I I <br />