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P ost a l <br />CE MAIL, RECEIPT <br />C (Domestic Mail Only; N o ins urance C overage P rov i d e d ) <br />1.1 <br />[] � 1 � I � � • tea <br />f ' n <br />ru Postage: _;. t $2,80 <br />r`' Certified Fee: %% $2,30 <br />ru Return Receipt Fee: �. (mark <br />are <br />C3 Total postage & Fees: <br />C3 nequirea) <br />M $ <br />�.., <br />ru Total Postage &Fees <br />M <br />on' o <br />CO <br />___ Les Ewegen ------- - - - - -- <br />� S`treet,ApCNo., Les Ewegen LLC <br />or PO Box N. WCR 39 <br />Clay State, Z %P +4 <br />Eaton, CO 80615 <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />A. <br />Agent <br />1. Article Addressed to' <br />ecelved b ( Printed NameI C. Date of Delivery <br />��7 (C a4--ql 6 <br />D. Is delivery address different from item 1? 13 Yes <br />If YES, enter delivery address below.. ❑ No <br />Les Ewegen <br />Les Ewegen LLC <br />WCR 39 3 . T <br />Eaton, CO 80615 QMail 0 �1 for Merchandise <br />- - _ ❑ Registered ❑ Retum Receipt <br />- - - ❑ Insured Mail 0 C.O.D. <br />4. Restricted Delivery? (Extra Feel ❑Yes <br />2. Article Number 7008 3230 0022 - - 7253 2932 <br />(Transfer from service label - - - - - - - - -- to25g5 -o2 M-f540 <br />PS Form 3811, February 2004 D Return Receipt <br />S b -()I <br />