REV100094

• Permit No: M1991074
• IBM Index Class Name: Revision
• Doc Date: 3/15/2006
• Doc Name: Amendment
• From: Kiowa County
• To: DMG
• Media Type: D
• Archive: No

U.S. Pos
CERTI tal Se
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MAIL RECEIPT
(Domes tic Mai l Only; No Insurance Coverage Provided) ~.
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Return Receipt Fee ~
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p Total Posta9e 8 Fees ~ ~S P 5
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fU Nama (P/ease Prlr Commissioners
Kiowa Co
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p- Street, Apt. No.; o p0 BOX 100
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r°, ciry, Sirs, zid: a EadS, CO 81036
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v .Complete Nama 1 ardor 2 for additional serNCes. !also Wlsh to receive the
es .Complete Nems 3, 4a, and 4b. fnilOWing SBrVICBS {for en
w .Print your name arM address on the reveBe of this tone so that we can return this eXtfa fee):

j card to you.
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Attach this form to the front of the meilpiece, or on the back d space does not 1. ~ Addressee's Address
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m • Wrile'Retum Receipt Requested' on the mailpiece below the ediGe number. 2. ~ Restricted Delivery ~j
§ .The Return Aecerpt will show to whom Nte article was delivered erM the date
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a 3. Article Addressed to: 4a. Article Number m,
Kiowa County Commissioners 7099 3220 0007 4095 4027 E
c PO Box 100 4b. Service Type ~'
Eads, CO 81036 ^ Registered ~ Certified ~.
^ F~cpressMail ^ Insured ~;
c ^ RetumReceipttorMetchendse ^ COD °,
~ 7. Date of Delivery
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5. eceived By: (Print Name) 8. Addressee's Address (Only fl requested Y -
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Ck! ~' ~n l r and lee is paid)
g 6. Signs 're (Addressee orAg
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Ps Po 3811, Decembe 102595-9)-8-0119 Domestic Return Receipt