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a <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X ❑Agent <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery <br /> or on the front if space permits. <br /> 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes <br /> If YES,enter delivery address below: ❑No <br /> Jason Lockard <br /> Washington County <br /> 501 E. 4th Ave. <br /> Otis, CO 80743 <br /> I I I II' (') II I I I I I II I I I III I II I I I 3. Service Type El Priority Mail Express <br /> El Adult Signature ❑Registered MaiIT'" <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> ❑Certified Mail® Delivery <br /> 9590 9402 2543 6306 1175 36 ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> El Collect on Delivery Merchandise <br /> 2. Article Number(transfer from service label) El Collect on Delivery Restricted Delivery 0 Signature Confirmation^^ <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7017 2400 0000 9119 2843 Insured Mail Restricted Delivery Restricted Delivery <br /> _ (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt i <br />