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'o - zGt -� ° -C-)q) <br />U.S. Postal Service,. <br />M CERTIFIED MAIL,,.i RECEIPT <br />, (Domestic Mail Only; No Insurance � Q yl <br />iAL USE <br />M <br />Cr Postage: $0.46 <br />° Certified Fee: <br />$3.10 <br />r-9 Return Receipt Fee: $2.55 <br />o <br />EM (En( € <br />a Re(En( Total Postage &Fees: t <br />0 rotal Postage & Fees <br />r L$---Li i <br />Sent o <br />rq BRIAN BUSSE ............... ........ <br />orPOearNo. 1437 G ST <br />City" Siaie;ziP +a--- "' - - - - -- SALIDA, CO 81201 -------------------•--- <br />PS Form 3800. ALIgUst 2006 See Revel c;e fur ltistTuctiorir: <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. Sign. re <br />13 Agent <br />X <br />❑ Addressee <br />B. Re eived by nted N e) <br />tk <br />4 ^ Mal,- <br />C. Date of Delivery <br />% — <br />1. Article Addressed to: <br />D. Is delivery address different from Rem 1? <br />If YES, enter delivery address below: <br />❑ Yes <br />❑ No <br />BRIAN BUSSE <br />1437 G ST. <br />SALIDA, CO 81201 <br />3. Service Type <br />❑ 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) 7010 1, 0 6 0 0001 0 9 3 6 9553 <br />PS Form 3811, February 2004 Domestic Retum Receipt 102595 -02 -M -1540 <br />