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^ 13 <br /> SENDER: <br /> 4 th i h t i also wish o receive e <br /> y Complete items 1 and/or 2 for additional services. I a ' <br /> • Complete items 3,and 4a&b. following services (for an extra v <br /> ` • Print your name and address on the reverse of this form so that we can fee): <br /> 41 return this card to you. L <br /> d • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address N . <br /> does not permit. <br /> (D • Write"Return Receipt Requested"on the mailpiece below the article number. G <br /> 2. ❑ Restricted Delivery <br /> • The Return Receipt will show to whom the article was delivered and the date V <br /> c delivered. Consult postmaster for fee. a) <br /> -a 3. Article Addressed to: 4a. Article Number . <br /> _m Kessler Reclamation Z 202 769 898 5 <br /> °' P.O. Box 41 4b. Service Type <br /> 0 Rockvale CO 81244 ❑ Registered ❑ Insured <br /> 171 <br /> N Certified ❑ COD 5 <br /> w ❑ Express Mail ❑ Return Receipt for 03 <br /> oC Merchandise C <br /> 7. Date of Delivery <br /> Q o <br /> 5. Si,B ature (Addressee) Ad ressee's Address(Only if requested Y <br /> � n/ and fee is paid) � <br /> ca <br /> 2 6. Signature (Agent) F" <br /> L <br /> NPS Form 3811, December 1991 *U.S.GPO:1993-352-714 DOMESTIC RETURN RECEIPT <br />