REP03128

• Permit No: M1981256
• IBM Index Class Name: Report
• Doc Date: 10/27/1980
• Doc Name: EKBERG PIT FN 80-215 ETAL
• From: DMG
• To: YUMA CNTY
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

^' SENDER:
° 1 also wish to receive the
! Complete items 1 endlor 4 tar additional services.
^ '• complete items s, end as s b. following services Ifor en extra
y • Print your name and address on the reverse of this form so chat we can fee):
m return this card [o You.
~ • Attach this form ro the Irani of the mailpiece, or on the beck if space 7. ^ Addressees Address
~ i foes not permit.
L • Write"Return Receipt Reouasted'an the meilpieca below the article number. 2 ^ Restricted DeIlVefy
• The Return Reeeipr wJl show to wham the article was tlelivered and Me date
e delivered. Consult ostmaster for fee.
~ 3. Article Addressed to: 4a. rticle Number // {l-^
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YUMA --------
COUNTY 4b. ervice Type
^ Registered
^ Insured
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"r ROAD DPT Certified ^ COD
1310 S BLAKE
^ Express Mail Return
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WRAY
CO 80758 March
p 7. Date of De y ~
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~ 5. Signature (Addresseet 8. Addressee's Address
f- and fee is paid)
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6. Signatur"e IAgentl
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PS Form 11, December 1991 d US.G.P.O.: 1994.307-570 D
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P 179 166 215 +~'
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Receipt or
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L sneROAD DPT
> 1310 S BLAKE
a~i POWRAY CO 80758
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