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COMPLETE • COMPLETE <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. l ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Received Printed Name) C. Dat5 of Delivery <br /> or on the front if space permits. �, - (..1 <br /> -_:--- — Is deliv i' 1? Yes <br /> If YES, n Ivery a"dress ❑ No <br /> Mr. Wilbur Benham <br /> 200 9th street MAR 31 2021 <br /> Ft. Lupton, CO 80621 <br /> M-1984-039 Lucas West DIVISION OF RECLAM,'T O,N <br /> MINING AND S 1F_-..,y <br /> III I I I I I I I I I I I III I III a. Service Type ❑Priority Mail Express® <br /> ❑Adult Signature ❑Registered MaiIT"' <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> ❑Certified Mails Delivery <br /> 9590 9402 2543 6306 1 146 72 ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(rransfer from service label) E. <br /> Collect on Delivery Restricted Delivery C Signature ConfirmationTM <br /> --fired Mail ❑Signature Confirmation <br /> Q 17 2400 0000 9119 1495 .r$5Ma I Restricted Delivery Restricted Delivery <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />