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Z 255 653 382 • <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />Do not use for Intemational Mail (See reverse) <br />m <br />m <br />`c <br />a <br />O <br />a <br />ear.' <br />li <br />V <br />a <br /> <br />st C. Raymond & Sally K. Sears <br />13644 Weld County Rd. 64 _ <br />P` Greeley, CO 80631 <br />Postage $ ~ j <br />Cerohed Fee ~ l~ <br />Spedal Delwary Fee <br />Restncletl Delivery Fee <br />Relum Receipt Showing to ~ ; <br />Whom 8 Date Delivered <br />Rehm Rseiq Stowing Io YROm, <br />Da@, 8 Addressee's Address <br />TOTAL Postage d Fees $ a G; <br />Postmark or Dale <br />CC <br />~C~-~O~ <br />/~,/ail <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 it Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Adicle Addressetl to <br />C. Raymond & Sally K. Sears .: ,, <br />13644 Weld County Rd. 64 ` ~' ~~ <br />Greeley, CO 80631 /t!~~ <br />3 <br />2. Micle Number (Copy /mm service /abel)i, <br />ASS <br />PS Form 3811, July 1999 Domestk Ratum Receipt <br />Z 255 653 391 <br />102595-99-M-1109 <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Pmvided. <br />Do not use for Intemational Mail I.Ran rr <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to <br />''' `- ~ ~ ~ <br />F; ^! - § <br />Weld County <br />915 l0'" Street <br />Greeley, CO 80631 <br />A R eived by (Please Pdnr CleadyJ Bn. Date of Delivery <br />~v i 1 I-~-~ ~7 1 <br />C. Signature (~-/ <br />X ^ Agent <br />I G'-~-~ ^ Addressee <br />D. Is delivery adtlress tlHlerent hom dem 17 ^ Yes <br />If YES, enter delivery atltlress below: ^ No <br />Et) <br />• ~q-~~a- <br />A. Received by (Please Print Clearly) ~ 8. Date of Delivery <br />C. <br />D. Is delivery atld tldferent fro ~ 1? <br />If VES, enter livery atltlress ~o <br />U Service Type I <br />~tCenified Mail ^ Express Mail <br />^ Registered ^ Return Receipt for Memhantlise i <br />^ Insured Mail ^ C.O.D. <br />4. Restdctetl Delivery? (Extra Fee) ^ yes <br />(5 3 ~3 d=~2 ~ - /~~ <br />Weld County <br />915 10'" Street <br />Greeley, CO 80631 <br />Postage I ,S <br />Certified Fee <br />Spedal Delivery Fee <br />Restdded Delivery Fee <br />Retum Recapt Showing to <br />3. S~a fiCe Type neum necep anongw nnom, <br />IdT'.edifed Mail ^Express Mail ~~,Bldtressae's Mdress <br />^ Registered ^ Return Receipt for Memhantlise TOTAL Passage 6 Fees $ <br />^ Insured Mail ^ C.O.D. Postmadc or Dete <br />4. Restricted Delivery9 (Fxt2 Feel ^ Yes l <br />2. Article Number (Copy lrom service label) L rl I I ~r <br />PS Form 3811, July 1999 Domestic Return Receipt 102595-99~M-1]09 <br />~/d ~ ~ - <br />1 <br />ii <br />1 <br />{ <br />