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• <br />M~oO- <br />;; SENDER: <br />~ .Complete ilemslandior2 for atldilional services. <br />H .Complete items 3, 4a, and 46. <br />a • Pnnl your name antl address on the reverse of this Corm so that we can return this <br />cflrtl la you. <br />> • Adach ihib form Io the Ironl of the malpiece. or on Iha back if space does not <br />m pennil. <br />~ • Write 'Return Receipt Requesretl'on the mailpiece below the amide number. <br />C • The Relum Receipt will show to whom the adicle was dehv¢red and me dale <br />deliveretl. <br />0 3. Adicle Addressed to: 4a. Article <br />a <br />o Z 1 <br />l Ms. Elizabeth Pacheco County Adm" ~ t - 4b. Service <br />1 also wish to receive the <br />following services (for an <br />extra fee): <br /> <br />1. O Addressee's Address U <br />• <br /> <br />2. ~ Restricted Delivery ~ <br />N <br /> <br />Consult postmaster for fee. c <br />' Costilla County ~ mis razor ~ Registered <br />P.O. Box 100 ^ Express Mail <br />San Luis, CO 81152 ^ Return Receipt f <br />' 7. Date of Deliv <br />_ ` <br />0 <br />~ Certified <br />^ Insured ~ <br />^ COD ~ <br />0 <br />/~7~~, ~ ~I i o <br />5. Received By: (Pnnl Name) 8. Addressee's Address (Only i/requested Y <br />and lee rs paidJ m <br />t <br />6. Signature: (Addressee or ge t) r' <br />~ X <br />i. <br />Ps l=am 9 11, m r issa ,t,a~~aa~ Domestic Return Receipt <br />` - <br />~„~ Z 379 538 673 <br />N US Postal Service <br />~ Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />Q Do not use fa Intematlonal Mail See re <br />Ms. Elizabeth Pachuo, Coumy Administr <br />Costilla County ~~ <br />P,O. Box 100 `~ <br />San Luis, CO 81152 <br />V7 Postage <br />T <br />N <br />GNfie~Fa~: ~ O <br />rte, o <br />Ir SpedZ_ ryF ~~ tv <br />NRiorn 8 Da ~ ' <br />Regan Recat 91oe*q b When, <br />~. <br />~.2J <br />~ ~ <br />m m <br />ak ~ <br />1~ <br />u <br />0.+1 <br />Postage 6 Fees I; <br />