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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 Agent <br /> so that we can return the card to you. 13 Addressee <br /> ■ Attach this card to the back of the mailpiece, B.IReceived by(Printed Name) C. Date of Delivery <br /> or on the front if space permits. J Fr I C l�%Z 1 <br /> 1. Article Addressed to: - D. Is dell ? 0 Yes <br /> If YES,e t i res A No <br /> Fred M. Lundy NOV 0 Z 2021 <br /> Lincoln County <br /> PO BOX 39 DIVISION OF RECLAMATION <br /> Hugo, CO.80821 � - : <br /> ()I'I'I�I Ifll 'I I III I I I I I I I II I II I I II III 3, Service Type ❑Priority Mail Express® <br /> ❑Adult Signature ❑Registered MaiITM <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> Delive <br /> 9590 9402 5506 9249 0528 34 ❑Certified Mail Restricted Delivery EJRetu n Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. nrfi�l<ni,, k—rr—.f,F--—4-1,1-8 E Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM <br /> 3 Insured Mail ❑Signature Confirmation <br /> ?016 2140 0000 2346 17 0 4 ❑Insured Mail Restricted Delivery Restricted Delivery <br /> -- - - -- ---- T (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />