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IaS <br />lt)LJS <br />SDm <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 Addressed to: <br />Colorado State Land Board <br />Northwest District Office <br />555 Breeze St. <br />P.O. Box 1094 " <br />Craig, CO 81626 <br />A. Signature <br /> <br />X ? Agent <br />c lJ ? Addressee <br />B. Received by (Printed Name) C. Date f Delivery <br /> <br />D. Is delivery address different from Item 1? ? Y <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? (Extra Fee) ? Yes <br />2. Article Number 7667 3020 0001 6340 0010 <br />(transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595.02-M-1540