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ti. UNITED STAT,ES.O?AL,fitCeE , r.? .. *F & fitlgil <br />19 <br />7-i c c f kc RL,r' e.?r». ?.. c Gw•.,ex.KVi' er 6.`?,.s* . <br />CGC???;? Sender: Please print your name, address, and ZIP+4 in this box • " <br />STATE OF COLORADO FIVF <br />nn DEPARTMENT OF NATURAL RESOURCES <br />-t'Q t ?Ks DIVISION OF RECLAMATION, MINING & SAFETY <br />1313 SHERMAN STREET, SUITE 215 JAN ??.?'LUuy <br />DENVER, COLORADO 80203 OwiSlQi1 of Re68M ton, <br />? ow sa <br />341300000 <br />Spec. <br />File #_M <br />J <br />¦ Complete items 1, 2, and 3. Also complete <br /> <br />icted Delivery is desired. <br />t <br />if R A. Signat <br />O Agent <br />e <br />dd <br />O <br />r <br />es <br />item 4 <br />¦ Print your name and address on the reverse <br />so that we can return the card to you. <br />B. Received by (Pri t Na ) <br />Received resse <br />A <br />C. Date of Delivery <br />¦ Attach this card to the back of the mailpiece, a O--U <br />or on the front if space permits. D. Is delivery address di erent m item l? ? Yes <br />1. Article Addressed to: If YES, enter delivery address below: ? No <br />Mr. Sam M. Keeling Jr <br />Charles Bud Keeling 3. Service Type <br />P.O. Box 361 ? Certified Mail O Express Mafl <br />0 Registered 133 Retum Receipt for Merchandise <br />LaVeta, CO 81055 <br />? Insured Mail 0 C.O.D. <br /> 4. Restricted Delivery? (Extra Fee) 0 Yes <br />2. Article Number 7008 1140 0003 4437 0581 <br />(Transfer from service labeq <br /> <br />102595-02-M.1540 <br />PS Form 3811, February 2004 Domestic Return Receipt <br />