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• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />❑ Agent <br />• Print your name and address on the reverse <br />--� <br />❑ Addressee <br />so that we can return the card to you. <br />j— RRece�ived b ( tinted Name) <br />C. Date of Delivery <br />• Attach this card to the back of the mailpiece, <br />• (� ; <br />�"< <br /><= <br />or on the front if space permits. <br />.� <br />D. Is delivery address differs from em i? <br />❑ Yes <br />1. Article Addressed to: <br />If YES, enter delivery a ss bel w: <br />❑ No <br />Mr. Mike Bucklen <br />jo: -�Bucklen Equipment Company <br />804 N 25th Ave <br />Greeley, CO 80631 <br />2. Article Number <br />(Pansfer from service label) <br />PS Form 3811, February 2004 <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 />700° - <br />Domestic Return Receipt <br />NITED STATES POSTAL SERVICE First -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G -10 <br />—.Sender- Please print your name, address, and ZIP +4 in this box • <br />State of Colorado <br />Department of Natural Resources <br />division of Reclamation, Mining & Safety <br />1313 Sherman Street, Suite 215 <br />Denver, CO 80203 Spec <br />"-*,File H%?) 31 <br />Iliiillill; illllllii; Sllillli�iilllilliliilliitltli�311 fliiii <br />'� JGKGf r/ T-> ly Pfi Aj PeA7 66V h 4 <br />L't�' qll,7 <br />071,8 <br />102595 -02 -M -1540 <br />A�,6g: --' c4AD <br />