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i <br /> 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 X ❑Agent <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Received by nit am C. Date of Delivery <br /> or on the front if space permits. ro <br /> 1. Article Addressed to: D. Is delivery dress erenf from item 1? ❑Yes <br /> State of Colorado If YES,enter delivery address below: ❑ No <br /> Div of Recl Mining & Safety <br /> 1313 Sherman St Room 215 Receive,) <br /> Denver, CO 802033. El Priority Mail Express@:, <br /> JU <br /> N14 <br /> III II IN I'I IIIIII I(I I I I I)I I ❑Adult ❑Registered MMajlTM ail Restri ed <br /> ElCertfed Mail a�� Delivery <br /> 9590 9402 4715 8344 2338 64 El Certified Mail Restrict w V��s ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation <br /> Mail ❑Signature Confirmation' <br /> 7 012 1640 0000 7879 6754 MO)il Restricted Delivery Restricted Delivery <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />