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;; SENDER: <br />$ • Complete Hems 1 anrllor 2 for adtlitional sernces. <br />m • Complete hems 3, 4a. antl 4b. <br />• Prmt your name antl address on the reverse of this form so Thal we can rewrn this <br />cartl to pou. <br />d • Attach Ihie Inrm in the Iron) of the mailpiece. or on the back it space does not <br />penne <br />d • Wnte 'Return Recerpf Requesletl'on Ine maeprece below the article number <br />y • Tne Retum Receipt will show to whom the article was tleliveretl antl the date <br />tl¢Irveretl. <br />C <br />I also wish to receive the <br />following services (tor an <br />extra fee): <br />1. ^ Addressee's Address <br />2. [] Restricted Delivery <br />Consult postmaster for fee. <br />'i o 3. Article Addressed to: 4a. Anicle Number <br />°m Mr John Nichols Z 268 233 368 <br />u <br />.~ <br />y~ <br />i a Nichols Gravel Pit 4b. ServlceType <br />PO Box 285 ^ Registered ~ Certified <br />rix Mesa CO 81643 ^ ExpressMail ^ Insured ~ <br />^ Return Receipt far Merchantlise ^ COD ~ <br />., <br />~ 6. Signat~u[rgJ, (Addressee..or{A~ger <br />r-^ PS Form 3811, December 1994 <br />7. Date of Delivery <br />3 ~ .C`~~ <br />0 <br />8. Addressee's Address (Only r/ requested x <br />and lee is paid) n <br />f <br />102595-9a~e-0229 <br />< Z 2,68 233~r68 m~~D/3 <br />US Postal Service ~~ ~`~ °fe^w~ <br />Receipt for Certified Mafl <br />No Insurance Coverage Provided. ~ <br />Do not use for IntemaUonal Mail See reverse <br />~4~°John Nichols r <br />ree u ar (il <br />PO Box 28 5 w <br />Posage O`r~ $ ~ !,r <br />Certified Fee J~ Q ~ ~) Y U ~ I <br />Spatial Delivery ~. nr ~ ~/ <br />ResMpetl pelivery Fe~ rY_ ~ ~~ <br />N \ / <br />~ N I <br /> <br />~ Retum Receipt Shoring tD <br />Whom d Date D¢liveretl / <br /> <br />~ ~ ~ 1 1 <br />(y. <br />~n R¢Nm Receipt Slxrxvp mkTxm, ~ <br />Q Dale, 6 Pdtressee's gtldress ~ <br />TOTgL Postage 8 Fees $ r K }_ ~ <br /> <br />Postmark orpafe 1 <br /> <br />LL O <br />a 00 <br />O ' <br /> N <br />