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~~ <br />° ~- ~ o~ a- <br />Sod/ <br />Un 3 <br />~~- ~ ~ <br />.~~ i~~ <br />~" ° ~ ~ <br />~ I ~~, ~'~ ~ ~~ Imo, <br />y?~~~ <br />^ Complete items 1, 2, antl 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and adtlress 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 />Ms Georgia Rubeck <br />2010 Woltl Ave <br />Colorado Springs CO 80909 <br />A <br />B. Received <br />C. <br />D. Is delivery address different from item 77 ~ Yes <br />Ii YES, enter delivery address below: ^ No <br />3. Service Type <br />^ Certified Mall ^ Express Mail <br />^ Registeretl ^ Return Receipt for Memhantllse <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivey! (Exha Fee) ^ Yes <br />2. ArticleNUmber 7~p3 168!] D17~0 6431 6416 <br />(transfer Irom service labeq <br />PS Form 3811, Febmary 2004 DOmeslic fleturn Receipt 102595-02-M-1540 <br /> U.S . Post al Ser vice,M <br />' CE RTIF IED MAIL <br />R ECEIPT <br /> TM <br /> (Dom estic M ail Only ; No Insuran ce Coverage Provided) <br /> <br />~ ~~~ l~-'b Z~ L~OY <br />`° Pestepe a <br />~ Certllled Fee <br />O <br />~ (EMO aen eM Re equl~) 1 <br />m ReeCicled DeIMry Fee <br />~ (Endwbement fiequlre0) <br />'~ 7btel Poste9e a Fees @ ~ ' (~ 4 <br />m - <br />o sear ro <br />O <br />M1 . ................... .___._..-... <br />Street, Ape NO.; Ms Georgia Rubeck , <br />or PO BO.r NO. 2010 Woltl Ave <br />Gn: srere,zrPw Colorado Springs CO 80909 <br />:,, <br />