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MINED L,._,.D RECLAMA710N DIVISION N~ 0 0 6 6 8 8 <br />• 1313 Sherman, Room 423 <br />Denver, Colorado 80203 ~ ,, ~ r~ <br />(303)-~8-{6.6-3567 OATS Q( j[ qg ~~_ <br />RECEIVED FROM _~,t'~ Ua~ LLyYI. 7-P/1 ~( <br />THE SUM OF~ °I' dye (T~2 OLLARS $ ~O . <br />FOR ILYQ „ / ~ ~ .lO S~YJ /ti-~~K <br />AMOUNT OF ACCOUNT...... $ <br />AMOUNT PAID ................ $ ~ ~„~ ~ou I <br />BALANCE DUE ............... $ By SjJ~'-' <br />. SENDER: Com~'tems t end 2 when eddltlonal iarVlCes an desired, ~Q~O~tl~itelDe9 eM <br />Put your address in the "RETURN TO" space on the reverse side. Failure to .his will prevent this <br />card f rpm being returned to yau. The return receipt fee will provide you the nS'ine of the person <br />dallvand to end the data of dellve .For additional h <br />postmaster for lees and check box esl for additional s <br />1. ^ Show to whom delivered, date, end addressee's <br />3. Atticle Addressed to: <br />((~P~ ~ n <br />K~"T p7 <br />m~yt.c~s ~ ~'r 3a~ <br />5. Signature - <br />6. Sign ure - <br />X <br /> J_ (' <br /> Q p <br />o ~ <br />° ~ ~ <br />tr 0 s ~ r <br /> w a~ U <br /> <br />N F' Q O N <br />CD ~~ NH W <br /> W c <br />' ~ <br />v <br /> V oz <br />Uw <br />a F- at <br />~I 0; Gj2 d <br />O W ~¢ <br />~ o h <br /> F, <br />a a ~~ <br /> w ?° <br />~ <br /> U o 1. <br /> W z <br /> lL C <br />(equested. <br /> <br />Insumd <br />',COD <br />Always obtain signature of addressee or <br />agent and DATE DELIVERED. <br />artd <br />-s09ea9Bes'O'd'D'S'rl <br />zees 'aed 'OOffE ut~od Sd <br />