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_... I <br />,~ . :, • <br />;.aLt_IFls._T~_=F_~~~_~5.~ <br />I riereDy certify tnat I carved a cosy of the foreoin; <br />:v:;i;LE JF ~PJPDScD AAti-„j,'1T „F Ci'JIL PE"~aLTY On the operator <br />to?r?~n JeSCriaao ~y ______(,y):~ personal s:rviC2 upon the <br />ocerator cr it; r?,;rasentative at ________________________ <br />------------------- -----, Colora~o cn ---- <br />19 __. ur _~_(u)= Oy d?pOSiti.~5 a true copy thereof first <br />C1~55~ NOSta~d ~7r?aai•~ in the Unite:] StotaS rails ?t i.enver. <br />(,JiJr'a:.Ot ~auras~=c to -!-~? o?ar~tor at th? d~Jure55 3~OVC. On <br />CERTIFIED P1AIL ll P20 1401529 <br />S~ <br />Siynatura ~ <br />__~~CHAEI~ S__SAVAGE_________________ <br />-------- <br />:Vane Printed <br />-- Check applicable R~ethoC of servica. <br />3F451ESI_=1K _L~_F;3sV~.~ <br />The UGe'rdtOr aDOVe described heresy regUe5i5 an d55°SS- <br />nent Dr settlerrant conference as perinitte0 by C.R.S. 34-33-123(°). <br />Operator <br />~y---------- <br />(Siynature) <br />Date <br />LvR/L'.~IOOJS/1CE <br />. 19 <br /> <br />