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■ Complete items 1,2,and 3.Also complete A. Signature <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, �i�kf2((1/F l��[</!/C� - <br /> or on the front if space permits. <br /> D. Is delivery addro a�f f)? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: -196N0 <br /> Mike L. Koellner <br /> Mike L. Koellner dba L&L Ready Mix 2WSION OF RPri <br /> 810 South Colorado 3. Service Ty - ,- <br /> P.O. Box 218 �ertified Mail® ❑Priority Mail Express" <br /> Haxtun, CO 80731 E Registered ❑ Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect on Delivery <br /> —1 170/-50/r— M POW ky �y 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number7 014 212 0 0001 8040 1429 <br /> (transfer from service label) <br /> PS Form 3811,July 2013 ',r„stir Returo P <br />