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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. ignature <br /> • Print your name and address on the reverse X k 0 Agent <br /> so that we can return the card to you. 0 Addressee <br /> • Attach this card to the back of the mailpiece, B. Received y Tinted Name) Date of Delivery <br /> or on the front if space per 'J� Y-�u <br /> 1. Article Addressed to: �q���1V D. Is delivery a D 0 Yes <br /> If YES,ent: . "il, el r ❑ No <br /> Rudolph Fontanari rusk <br /> .---- <br /> � h <br /> 3316E3/4RdRt1q (�`1��0 <br /> Clifton, CO 81520 DIVISION OF RECLAMATION <br /> MINING AND SAFETY <br /> II")I III II I II I I I I I I I I I I I( Registered <br /> 3. Service Type ❑Priority Mail Express® <br /> 0 Adult Signature 0 RegisMaiITM <br /> ❑Adult Signature Restricted Delivery 0 Registered Mail Restricted <br /> 9590 9402 2543 6306 1178 71 ❑Certified Mail® Delivery <br /> 0 Certified Mail Restricted Delivery 0 Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service label) 0 Collect on Delivery Restricted Delivery 0 Signature Confirmation", <br /> Mail 0 Signature Confirmation <br /> 7017 2400 0000 9119 1242 fail Restricted Delivery Restricted Delivery <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />