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UNITED STATES POSTAL SERVICE I I Firet-Class Mail <br />It `I Postage & Fees Paid <br />I I I USPS <br />I permit No. G-10 <br />• Sender: Please print your name, address, and ZIP+4 in this box <br />STATE OF COLORADO <br />DEPARTMENT OF ~ TfON, MINING AND SAFETY, `: <br />DMSION OF RN ST~MET SUITE 215 - I '~ <br />1313 SNERMA ~ ' <br />DENVER, COLORADO 80203 ` '? _ <br />341300000 ~tr1- a°f <br />,. F . <br />~> 11;,L11,,,,,I,IIL„.,IL„i.l„LId„L,N„li'„rl;~"rrlJd <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Atltlressed to: <br />rLls,~s9~ }~,,~i <br />C5 ! l iM 1~0~ 5'7~ ~U c ~ csL., <br />~~~~ ' ~ ~ ~'1~.2~ <br />A <br />~vVl . 'J7P~J . G.~>.~ <br />~c/~ ,~a,'l ~~,'p,~. <br />~o ~~/o(a <br /> <br />~pwL ~~<. <br />~` % ~~- <br />B. Recelvetl by (Pooled NAne) ~ C. Date of Delivery <br />D, Is delivery address different fmm item 1? ^ Yes <br />If YES, enter delivery address below: ^ No <br />3. Service Type <br />^ Certified Mail ^ Express Mail <br />^ Registered ^ Return Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (EMre Fee) ^ Yes <br />2. Article Number <br />(riansfer /rom service /abed 7 0 0 3 16 8 0 2 0 2 0 6 4 2 7 9 4 3 8 <br />PS Form 3811, February 2004 Domestlc Retum Receipt - t0zsss-02-M-1540 <br />