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COMPLETE .N COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X �1 �I 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(f5Print d Name) C. Date of Delivery <br /> or on the front if space permits. vp; Qr l6/ r/Z( <br /> 1. Article Addressed to: D. Is deli v alt 1? 13 Yes <br /> If YES, ��,,yy No <br /> Fred M. Lundy NOV O 2 2021 <br /> Lincoln County <br /> PO Box 39 DIVISION OF RECLAMATION <br /> hA041111jrIAWR RAI <br /> Hugo, CO 80821 3. Service Type <br /> II I IIID rr r 1 0 Priority Mail Express@ <br /> I I�I�I�� ��I�I I���1��� ������I'I I III 0 Adult Signature 0 Registered Mail R <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> 0 Certified Mail@ Delivery <br /> 9590 9402 5506 9249 0549 51 0 Certified Mail Restricted Delivery 0 Return Receipt for <br /> 0 Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service label) 0 Collect on Delivery Restricted Delivery 0 Signature Confirmation TM <br /> 7 Insured Mail 0 Signature Confirmation <br /> 7 016 2140 0000 2346 1711 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 />