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M017,105W <br /> SENDER: COMPLETE THIS SECTION COMPLFTE THIS <br /> DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signaturew <br /> Item 4 if Restricted Delivery is desired. X f}')��G ent <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 /> D. Is delivery address different from item 1? Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> Cathleen Van Egmond <br /> Russ Van Egmond <br /> 546 Doe Valley Rd. 3. Service Type <br /> Certified Mail® ❑Priority Mail Express- <br /> Guffey, CO 80820 ❑Registered ❑Return Receipt for Merchandise <br /> - ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (transfer from service label) 7 014 2120 0001 7871 1608 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />