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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> • Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your name and address on the reverse X ❑Addressee <br /> so that we can return the card to you, B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, j I`�� <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: °YES,enter delivery address below: ❑No <br /> Sharon Colon <br /> Travelers Casualty and Surety Company of America <br /> 6060 Willow Dr. <br /> Greenwood Village, CO 80111 s, Service Type <br /> {{ ®Certified Mail® ❑Priority Mail Express- <br /> 0 Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7014 2120 0001 7885 6521 <br /> (Transfer from service labeq <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED 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 CS ,Q;i Spec sam 404 <br /> File rm tg83)7s <br />