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-� S-A <br /> - maCn <br /> y <br /> SENDER: COMPLETE■ Complete items 1,2,and 3.Also complete A. Si atur <br /> item 4 if Restricted Delivery is desired. X I� 4gent <br /> ■ Print your name and address on the reverse ❑Addressee <br /> so that we Can return the Card to you. B. eceived by(Printed Name) C. Da a of Delivery <br /> ■ Attach this card to the back of the mailpiece, r, <br /> or on the front if space permits. `'✓l h L1`���'►'L �'j`f�(b <br /> 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes <br /> If YES,enter delivery address below: ❑No <br /> Mr. Randy Quillen <br /> Grand Mountain Bank <br /> P 0 Box 964 3. Service Type <br /> Granby, CO 80446 2(Certified Mail® ❑Priority Mail Expresse' <br /> ❑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) 70142120 00017885 4909 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />