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CO ON COMPLETEON 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, Received by( tinted Name) C. Date of Delivery <br /> or on the front if space permits. �c--(e S S I /,--k '/3-/(-- <br /> 1. Ar D. Is tern 1? ❑Yes <br /> If <br /> John M. Everitt 24274 C R 17 0 DEC1 7 19 <br /> 0 3 <br /> Haxtun, CO 80731 7 <br /> f % <br /> 3. Service Type ❑Priority Mail Express(D <br /> II I III' III II I II I I I I I I I I I II I I ❑Adult Signature ❑Registered Mail <br /> ❑ R Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> ■Certified Mail@ Delivery <br /> 9590 9402 3488 7275 7570 69 Certified Mail Restricted Delivery ❑Return Receipt for <br /> El Cc on Delivery Merchandise <br /> 2. Article Number(Transfer from service label)) ElCollect on Delivery Restricted Delivery Signature Confirmation"' <br /> 2 615 Insured Mail El Signature Confirmation <br /> 2290 0 1 8923 ❑Insured Mail Restricted Delivery Restricted Delivery <br /> 7 018 (over$500) <br /> July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />