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o SENDER: <br /> o .Compete items 1 and/or 2 for additional services. f 9ISo wish to receive the <br /> m sCpm#ste ileme 3,4e,and 46. following services(for an <br /> a .Prim your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. <br /> o •Mach this term to the from of the mallpiscs,or on the beck d apace does not 1. ❑ Addressee's Address <br /> perm <br /> m eWdterRefum Receipt Requestedron the mailpieoa below the arlide number. 2. 0 Resldeted Delivery y <br /> @The Return Receipt will show to whom the anic a was delivered and the data n <br /> delivered. Consult postmaster for fee. <br /> 0 <br /> v 3.Article Addressed to: 4a.Article Number <br /> m Z 416 942 842 r e <br /> E JOHN HARDAWAY 4b.Service Type � 8 <br /> o CRIPPLE CREEK & VICTOR GOLD ❑ Registered GYCertified ¢° <br /> u <br /> 2755 STATE HIGHWAY n�PA04,Po <br /> ❑ Express Mall ❑ insured e <br /> o P 0 BOX 191 ❑ Rehm Receipt for Merchandes ❑ COD <br /> p VICTOR CO 8086 V 7.Date of Delivery <br /> 5.Received By: (Print Name) 8.Addressee's Address(Only if requested <br /> and fee is paid) 14 <br /> r- <br /> g 6.SXnatyfe:(Addressee or Agent) <br /> T __VV//'"''' <br /> O <br /> PS Form 3811, December 1994 Domestic Return Receipt <br /> Z 416 94&:�Pl <br /> ReceCertPW1A <br /> No Insurance Coverage Provided O <br /> Do not use for International Mail aD <br /> ISee gave- O <br /> h'a1011HINPA — U <br /> mA 7 <br /> go <br /> T <br /> E [enaletl Fee tN <br /> o` C <br /> NLL special Ceiweiy Fee <br /> 1 IY <br /> Rese¢ted Delnery Fee cm <br /> ((13 <br /> Reno Recepl Srmwmg C <br /> to Whom&Date Del,ered <br /> Date.and <br /> Ad i Showing% m faWhom. U)Dale.and Atldhessee's Adtl�ess <br /> TOTAL Passage M <br /> &Fees 1 <br /> cr) <br /> Postmark or Dale <br /> cV <br /> C <br />