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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> • Complete items 1,2,and 3. A. •.ature <br /> • Print your name and address on the reverse X ), 0 Agent <br /> so that we can return the card to you. _ Addressee <br /> • Attach this card to the back of the mailpiece, Receiv by(Priv ed ame) C. Date of Delive <br /> J <br /> or on the front if space permits. /5 rd 'Orr l i -" 1--4"1 <br /> , ' j <br /> 1. A to°rtr'roccor'. D. Is delivery address different from item 1? 0 Yes <br /> If YES,enter delivery address below: Vo <br /> Dustin Hribar <br /> Huerfano County <br /> 1038 Russell Ave <br /> Walsenburg, CO 81089 <br /> k._ 3. Service Type 0 Priority Mail Express® <br /> lii IIIIII liii III I II I II lull 1111111111(III 11 III Signature0 Adult Ma® D <br /> Restricted Delivery 0 Registered <br /> d Mail ResVicta< <br /> ❑Certified <br /> 9590 9402 8259 3094 0424 59 0 Certified Mail Restricted Delivery 0 Signature Confirmation"+ <br /> 0 Collect on Delivery 0 Signature Confirmation <br /> 0 Collect on Delivery Restricted Delivery Restricted Delivery <br /> 7019 2280 0001 8254 8746 0InsuredMail <br /> ❑Insured Mail Restricted Delivery <br /> , (over$500) <br /> PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt <br />