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416 99fkZ <br /> Receipme <br /> or <br /> Certified*ah`V\ Vo o <br /> No Insurance Coverage Provided CV <br /> Do not use for International Mail CD <br /> (See Reverse) co <br /> p�j Sent to O <br /> NN DRAWS N BIRMAND U <br /> $1ee1 CM CDNBTBUCTION (27NPANY <br /> P o s P O BOY 1240 a1 <br /> c <br /> Po:rag. RAND JIMLTION 0) 81502 <br /> Go <br /> co <br /> E cemLed Fee / <br /> 1L <br /> 00 Spemat Dehven,gee r <br /> o. lT <br /> FemKtea Dc.. fv <br /> C <br /> Return Receipt Sh '» <br /> io Whom B Date Darla ref �.13 f E_ <br /> Relu.n Receipt Showing to Whom. <br /> Date,and Addre$see's AdFess <br /> TOTAL Posnage �a <br /> 8 Fees $ Cl) <br /> T <br /> Pp5lmdrk or Dale CV) <br /> Sv <br /> L <br /> to SENDER: <br /> v •Complete items 1 and/or 2 for additional services. I also Wish to receive the <br /> o .Complete items a,4a,and 4b. following services(for an <br /> s Prim your name and address on the reverse of this form so that we can return tine extra fee): <br /> card to you. <br /> C •permit.this form to the horn of the mailpiece,or on the back if apace daee not 1, ❑ Addressee's Address <br /> a 0Wnte'Retum Receipt Requasted'on the mailpiam below the article number. 2. 0 Restricted Delivery rK <br /> •The Return Receipt will show to whom the article was dethroned and the date 6 <br /> delivered. Consult postmaster for fee. <br /> o <br /> a 3.Article Addressed to: 4e.Article Number <br /> o - Z o <br /> E N8 DBNNIS N 9I6PLAND 4b.Service Type <br /> CORN CONBT8GC710N COMPANY ❑ Registered Certified <br /> P 0 BOX 1240 ❑ Express Mail ❑ Insured o <br /> GRAND JUNCTION GO 81502 ❑ Return Receipt for Merchandise ❑ COD <br /> 7.Date of Delivery <br /> a <br /> 5.Received By:(Print Name) 8.Addressee's Address(Only if requested <br /> and fee is paid) c <br /> l— <br /> g 6.Sago ture (Addressee or Age t) <br /> 0 <br /> T <br /> A <br /> PS Form 811, December 1 V4 Domestic Return Receipt <br />