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Ce- )' mall. <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. 0 Agent <br /> ■ Print your name and address on the reverse X 0 Addressee <br /> so that we can return the card to you. g, e' ed by(Printed Name) C. Date of elivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> Mr. Bob Kalenek <br /> Delta County <br /> 501 Palmer Street 3. Service Type <br /> Delta, CO 81416 A Certified Mall ❑Express Mail <br /> ❑Registered 0 Return Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (Transfer from service label) 7012 3460 0000 6384 7362 <br /> PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> Postal <br /> (DomesticCERTIFIED MAIL. RECEIPT <br /> m <br /> For delivery Information visit our website at www.usps.coma <br /> M <br /> m Postage $ <br /> Certified Fee % J <br /> O / l/ <br /> Postmark <br /> � Return Receipt Fee Here <br /> O (Endorsement Required) <br /> C3 <br /> Restricted Delivery Fee <br /> Ej (Endorsement Required) <br /> .A <br /> Total Postage&Fees $ <br /> m <br /> ru Sent o Mr. Bob Kalenek <br /> a .. <br /> � Street,Apt --------�---------------- <br /> r 3 or PO Box No. Delta County <br /> City State,-zrP+: 501 Palmer Street ------------------------- <br /> ,,, , Delta, CO 81416 <br />