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COMPLETE •N 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 4_/fl ❑Addressee <br /> so that we can return the card to you. <br /> ■ Attach this card to the back of the maiipiece, B. eceived by(Printed Name) 1 Date of Delivery <br /> or on the front if space permits. ')'-UA A K " -/-1 <br /> 1. Articles D. Is delivery aI e I m 1? 1:1 Yes <br /> If YES,enter ; a i _VIED <br /> No <br /> Fred M. Lundy <br /> Lincoln County NOV 0 2 2021 <br /> PO Box 39 <br /> 'Hugo, CO 80821 DIVISION OF RECLAMATIOm <br /> 3. Service Type '. Mail II Express®I'IIIII/III I'I I III II I I II'IIII((III I IIII III L3Adult Signature ❑Registered MailTM <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> El Certified Mail® Delivery <br /> 9590 9402 5506 9249 0530 08 ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2 ArfinlP hh rmhPr(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation"^' <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7 016 2140 0000 2346 1797 ❑Insured Mail Restricted Delivery Restricted Delivery <br /> ------- - — --•-- <br /> (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />