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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ` Agent <br /> ■ Print your name and address on the reverse X <br /> so that we can return the card to you. Addressee <br /> ■ Attach this card to the back of the mailpiece, B. eceived (Printed ame) C. Date of Delivery <br /> or on the front if space permits. <br /> 1. Article Addressed to: D. Is delivery s t item 1? ❑Yes <br /> la Z Ckalas Hevner If YES,enter delivery address below: [I No <br /> ThEastern Colorado Bank JAN 22 2010 <br /> P &oX 888 <br /> i <br /> Cheyene Wells, CO 80810 <br /> DIVISION OF RECLAMATION <br /> I ROPGANDSAFM <br /> Sd O 3. Service Type ❑Priority Mail Express® <br /> III III III I I I II II Irill <br /> I'l(I 1 I III I I II El ❑ R Adult Signature ❑Registered Mail <br /> ❑Adult Signature Restricted Delivery Registered Mail Restricted <br /> N-Certified Mal® Delivery <br /> 9590 9402 2543 6306 1188 54 ❑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 0 Signature ConfirmationW <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7016 2 710 0000 2904 5 9 3 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 />