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SENDER: <br />• Complete items 1 and/or 2 for additional services. <br />• Complete items 3, 4a, and 4b. <br />■ Print your name and address on the reverse of this form so that we can retum this <br />card to you. <br />• Attach this form to the front of the mailpiece, or on the back if space does not <br />permit. <br />■ Write'Retum Receipt Requested' on the mailpiece below the article number. <br />• The Retum Receipt will show to whom the article was delivered and the date <br />delivered. <br />3. <br />5. ceived By: (Print Name) <br />( 74 g./ A 1).4 )ar -f1. <br />6. Signatu Addressee or Agent) <br />x e.--- /I <br />PS Form 3811, December 1994 <br />Gary A. and Mary C. Valora <br />32195 County Rd. 37 <br />Hayden CO 81639 <br />7007 3X6340 0133 c <br />4b. y Service Type - ` "O\ d <br />cc <br />c <br />T• <br />1 also wish to receive the <br />following services (for an <br />extra fee): <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery <br />Consult postmaster for fee. <br />. Date of Delivery <br />-�� - <br />8. ddres e's Address if ,quested <br />aid) <br />egist red <br />Express Mail <br />Retum Merchandise ❑ ° -COD <br />® Certified <br />❑ Insured <br />Domestic Return Receipt <br />0 <br />d <br />rn <br />6) <br />