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<br />¦ Complete items 1, 2, and 3. Also complete A. Sign Lure <br />item 4 if Restricted Delivery is desired. X ? Agent <br />M4?Z <br />?? <br />¦ Print your name and address on the reverse _. <br />? <br />! ? Addressee <br />so that we can return the card to you. B. Receiv y (Printed Name) C. Date of Delivery <br />¦ Attach this card to the back of the mailpiece, <br />t <br />or on the front if space permits. <br /> D. Is delivery address different from item 1? ? Yes <br />1. Article Addressed to: If YES, enter delivery address below: ? No <br />Troy Swain Weld County Department of public <br />Health and Evironment <br />1555 North 17th Avenue <br />Greeley, Co 80631 3Type <br /> _ tified Mail ? Express Mail <br /> ? Registered ? Return Receipt for Merchandise <br /> ? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article Number 7008 1140 0003 4437 6347 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Retam Receipt 102595-0