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-- <br /> �� l <br /> SENDER: DELIVERYSECTION ON <br /> ■ Complete items 1,2,and 3.Also complete LSignature <br /> item 4 if Restricted Delivery is desired. • ❑Agent <br /> ■ Print your name and address on the reverse ❑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, <br /> or on the front if space permits. <br /> I. Article Addressed to: D. Is delivery address different from item 17 ❑Yes <br /> If YES,enter delivery address below: ❑No <br /> Steve Williams <br /> Washington County <br /> 11920 Co. Rd CC 3. Service Type <br /> P.O. BOX 32 !23 Certified Mail ❑Express Mail <br /> Anton, CO 80801 ❑Registered ❑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 labeq 7 012 3460 0000 6384 7 218 <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> Postal <br /> CERTIFIED MAIL,rl RECEIPT <br /> a (Domestic Mail Only,No Insurance Coverage Provided) <br /> rru- <br /> co .� <br /> M Postage $ <br /> Certified Fee t(� <br /> ED <br /> 3 <br /> Return Receipt Fee C LD Post <br /> C3 (Endorsement Required) H <br /> C3 <br /> Restricted Delivery Fee �o <br /> C3 (Endorsement Required) <br /> Total Postage&Fees $ <br /> m <br /> rUL Steve Williams Washington County -__________------------------ <br /> � 11920 Co. Rd. CC <br /> P.O. Box 32 <br /> Anton, CO 80801 <br />