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SECTIONSENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverseX �I Agent <br /> so that we can return the card to you. 0 Addressee <br /> ■ Attach this card to the back of the mailpiece, B. eceived 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,1MfflT1 V EjVM: l4 No <br /> Fred M. Lundy G <br /> Lincoln County NOV 0 2 2021 <br /> PO Box 39 <br /> Hugo, CO 80821 <br /> 3. Service 7yFMINING AND SA.= 'rionty Mail Expresse <br /> II I II I I "I III I I'�I I' hI'I 111 O Adult Signature ❑Registered MailTM <br /> II ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> 11 Certified Mail® Delivery <br /> 9590 9402 5506 9249 0549 68 ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> — , ,� ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTm <br /> 2. _ I Insured Mail ❑Signature Confirmation <br /> 7 016 2140 0000 2346 1728 1 Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />