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■ 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 />Mr. Nikolaus Arnusch <br />34527 W. CR 6 <br />Keenesburg, CO 80643 <br />2. Article Number <br />(transfer from service label) <br />RepIGCe <br />LCC <br />A. Signature <br />�� / ❑ Agent <br />`'�❑ Addressee <br />8. Received by (Printed Name) C. Date of Deli <br />� 1L, rat dRK(( l2 it 7 <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: J:r'No <br />3. Service Type <br />%Certified Mail O Express Mall <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />7012 3460 0000 6384 5238 <br />i PS Form 3611, February 2004 Domestic Return Receipt <br />M (Domestic <br />Ln <br />_r 1 $0.66 <br />CO Postage: $3.10 <br />.B Certified Fee: $2.55 <br />C3 Return Receipt Fee: <br />C3 $6.31 mark <br />C3 Total Postage &Fees: e <br />C3 c� <br />--2- Total Postage & Fees $ <br />M <br />Sent To <br />ru <br />'-q StEaif,Apt -/Q&- Nikolaus Arnusch <br />C3or PO Box No. <br />CrtyState,ZlP +4 34527 W. CR 6 _____ ________ <br />Keenesburg, CO 80643 <br />102595- <br />