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COMPLETE • <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. Recei d ted Name) C. Date of Delivery <br /> or on the front if space permits. p <br /> 1. Article Addressed to: D. Is d v ddr D P <br /> If YES,enter de i <br /> LeRoy A. Bellmore <br /> North Weld Gravel, RLLP DEC 10 2019 <br /> 13480 Weld County Rd 100 D'VIS'1ON <br /> Nunn CO 80648-9700 �FRECCA <br /> 3. Service Type iority Mail Expresso <br /> I I III III 'I I I I'I I I II I I I I ' II I I III ❑Adult Signature El Registered Mail <br /> ❑ R <br /> ❑Adult Signature Restricted Delivery Registered Mail Restricted <br /> 10 Certified Mail(D Delivery <br /> 9590 9402 3488 7275 7569 87 ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> o A+I,-lo Ni,-har(Transfer from service label) ❑Collect on Delivery Restricted Delivery 11 Signature ConfirmationT" <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7 018 2290 0001 8923 21384 ❑Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />