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Orr- <br /> �V�urna <br /> xiBA to ret»ive the <br /> m • tdMMus per en eirtra to <br /> 0 • Prind address on the reverse of this form so that we can fee): •� <br /> e return thT_lard to you. <br /> • Attach this form to the front of the mellpiembr an the back if space 1. ❑ Addressee's Address y <br /> m does not permit. die <br /> y • Write"Return ROWIFIr Requested"on the m0piecabelow the article number. 2, ❑ Restricted Delivery •m <br /> • The Return Recelpt will show to whom the article was delivered and the dote <br /> ior delivered. Consult postmaster for fee. <br /> 3. Article Addressed to: 4a. Article Number cc <br /> m ?. <br /> 3 Mr• Paul Banks 4b, Service Type 0 <br /> AGRA Earth 8. Environmental , Inc ❑ Registered ❑ Insured e, <br /> y Q Certified ❑ COD 5 <br /> 17301 W. Colfax Avenue, Return Recei t for oz <br /> W ❑ Express Mail ❑ P <br /> cc Suite 170 Merchandise <br /> Golden, CO 80401 7. Date Del' cry <br /> 5to <br /> a o . <br /> 5. Si nature (Add see) 8. Addressee's Address(Only if requested w <br /> and fee is paid) <br /> H r ' <br /> 6: Shpialure (Agent)0 ~ <br /> ►s Form WTI,Wearibeir am ftmam -3:+m' DOMESTIC RETURN RECEIPT <br /> a <br /> DLM P, 296 r609 T68 Portland <br /> Receipt for C - 't <br /> �, to all <br /> C3 No IRRstir��ce C e Provided <br /> 0 Do.rttllau�'e for International Mail <br /> C0 •� ISe Re er I <br /> Q s„ <br /> U <br /> •, Sheer a,,o No <br /> b <br /> � P 0 Siaoe a�G ZIP Codes <br /> C <br /> (� Postage $ <br /> Ce,Rhed Fee ,l <br /> N <br /> Soeea:Oarhrery Fee <br /> CC Revo,ord De,ve„sw r^ <br /> Return Recem 5 ow.. <br /> to venom d Dare enve �d <br /> Q& Rewm Recehor Sho p mbbm <br /> Z..and Aderes,ee s ,KS <br /> TOTAL Postage 1 <br /> h Fees a <br /> Postmark or Dare <br /> L� <br />