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Nl `��6 Qo7 <br /> DEL IVERY <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. 13 Agent <br /> ■ Print your name and address on the reverse 4X ❑Addressee <br /> so that we can return the card to you. B. Received 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 addres i er nt from itx m 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter deli t No <br /> Ms. De eDoyel Nov 1`9201 <br /> Home State Bank <br /> 935 North Cleveland AveW MCI <br /> Loveland, CO 80537 3. Service Type C <br /> 06 Certified Mail® ❑ Priority M ill Express- <br /> ❑Registered ❑Return R elpt for Merchandise <br /> ❑ Insured Mail ❑Collect or Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 014 2120 0001 7869 5892 <br /> (transfer from service labeq <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />