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• 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 />1. Article Addressed to: <br />Mr. Bob Kalenak <br />Delta County <br />501 Palmer St Ste 227 <br />Delta, CO 81416 <br />A. Signature <br />X �ent <br />❑ Addressee <br />B. Received (Printed Name) C. /Date of Pelivery <br />D. Is dWIvery address different from item 11 ❑ Yes <br />If YES, enter delivery address below: r0'No <br />3. Service Type <br />21 Certified 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 <br />(Transfer from service label)' ?010 1060 000 <br />1 0936 2 2 4 D <br />PS Form 3811, February 2004 Domestic Return Receipt <br />S. Postal Service,,. <br />ERTIFIED MAIL,., RECEIPT <br />ornestic Mail Only; No Insurance Coverage Provided) <br />...; r ;, S <br />Postage $ <br />Certified Fee <br />i�. Postmark <br />Return Receipt Feed Here <br />(Endorsement Required) ✓ ' ` , <br />Restricted Delivery Fee <br />(Endorsement Required) <br />Total Postage & Fees L . 1 J <br />4entT, Mr. Bob Kalenak <br />aDelta County _ _ 501 Palmer St Ste 227 Delta, CO 81416 <br />m ;_; <br />102595 -02 -M -1540 <br />