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<br /> <br />m SENDER: <br />9 <br />q Complete items 1 and/ar 2 for adtlitional services. <br />m • Complete items 3, and 4a & b. <br />• Print Your name and address on the reverse of thia form so that we can <br />return this care to You. <br />O • Attach this farm to [he Iran[ of [he mailpiece, or on [he bark it space <br />does not permit. <br />L • Write"Return Fecpipt FeQUested"on iha mailpiece below the article number <br />"" • the Return Receipt will show to whom the ankle wee tlelivere0 and the date <br />C del~veretl. <br />I also wish to receive [he <br />following services (for an extra <br />fee): <br />1. ^ Addressee's Address <br />2. ~ Restricted Delivery <br />v 3. Article Addressed to: 4a. Article Number <br />o Letha Nickell P 037 472 813 <br /> <br />E c/o Russell Nickell 4b. Service Type <br /> <br />° <br />6834 Road 2 ^ Registered <br />, <br />, <br />H Genoa, CO 80818 ~] Certified <br />w ^ Express Mail <br /> <br />G 7. Date of Deliver) <br />a ' .S ~. <br /> 5. Signature (Addressee) 8. Addressee's Ad <br /> and fee is paitll <br />H <br />~ 6. Sig/nature (Agent) <br />0 <br />~ PS Form 3871, December 1991 ous. GPO: trrov-aszau D, <br />^ Insured <br />^ COD <br />® Return <br />for <br />RECEIPT <br />