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•SENDER,Complete items I and 2 when additional services ire desired,and complete items 3 and 4. <br /> Pqs qw address in the"RETURN TO"space on the reverse side.Failure to do this will prevent this <br /> Q�p��a returned to you.The eturarecei t fee will rovide ou the name of the anon <br /> siilStd the date of deliver or additional fees t e following services are available.Consult. <br /> 1�BIRW r fees and check box esi for additional services)requested. <br /> I, p 5 Ow to who <br /> delivered,date,and addressee's a ress. 2. ❑ Restricted Delivery. <br /> fIT a Atldressed to: 4.Article Number <br /> Baca County Commissioners P-573 686 150 <br /> P.O. BOX 116 Type of Service: <br /> Springfield CO 81073 Registered Insured <br /> r Certified COD <br /> 9 <br /> ❑ Express Mail <br /> Always obtain signature of addressee or <br /> agent and DATE DELIVERED. <br /> S.Signature—Addressee 8.Addressee's Address(ONLY if <br /> X requested and fee paid) <br /> 6. 'ant e— gent <br /> )C <br /> 7, a of DeliveLy <br /> ,J <br /> h Previn 011111,Feb.1986 DOMESTIC RETURN RECIN" <br /> P-573 686 150 <br /> RECEIPT FOR CERTIFIED MAIL <br /> NO INSURANCE COVERAGE PROVIDED <br /> NOT FOR INTERNATIONAL MAIL <br /> I�ad 176Vcrnief <br /> m Sent to <br /> r) Baca ount Commission rs <br /> Street and No <br /> o P.O. BOX 116 <br /> v g$1?V'eT? P4 , CO 81073 <br /> jPostage S <br /> Certified Fee <br /> Special Delivery Fee `OO <br /> Restricted Delivery Fee <br /> Return Receipt showing <br /> in to whom and Date Delivered 0/V <br /> w Return Receipt he., 10 whom. V <br /> Data,and Add,Ess o vE <br /> m <br /> TOTAL Postage Q <br /> V Postmark or , <br /> tE — V <br /> s 6,J 199�� w <br /> use <br />