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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Sig ture <br /> ■ Print your name and address on the reverse /�� ❑Agent <br /> so that we can return the card to you. /.� Addressee <br /> ■ Attach this card to the back of the mailpiece, Received by(Printed Name) C. Date of Delivery <br /> or on the front if space permits. jz 0 r <br /> 1. Article Addressed to: D. Is delivery address different from item 1?e70 Yes <br /> If YES,enter delivery address belovM No <br /> Mr. Michael B. Dorman " <br /> Golden Grains, LLC <br /> 70 Webster Ave <br /> Burlington, CO 80807 Sm <br /> I'lllll III III I II 11 I I I I II I I (II III I I I II I I 3. Service Type ❑ r: ail MaiITM <br /> ® ; <br /> ❑Adult Signature ❑ e i ed Mailr"" <br /> ❑Adult Signature Restricted Delivery OR e�ir.ed Mail Restrict <br /> *Certified Maile Delivery <br /> 9590 9402 3488 7275 7559 11 ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationT" <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7 016 2 71 0000 2965 11 2 ❑Insured Mail Restricted Delivery Restricted Delivery <br /> over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />