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/, <br />LC-C GWXall�lbrL <br />• Complete items 1, 2, and 3. Also complete A. Sitem 4 if Restricted Delivery is desired. Agent <br />X ■ Print your name and address on the reverse <br />so that we can return the card to you. g, c rated b (Print d Name C. Da of eli <br />• Attach this card to the back of the mailpiece, v& i <br />or on the front if space permits. l t I S / <br />1. Article Addressed to: <br />Miss Deb Rudibaugh <br />5291 CR 76 <br />Parlin, CO 81239 <br />D. Is delivery address differen from item 1? ❑ e;: <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />IliCertiffed Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mall ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7012 3460 0000 6384 7065 <br />(Transfer from service labeo — -- — _ <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -7540 <br />(Domestic <br />C3 <br />1=%stacr.' <br />�- <br />� <br />M <br />Certified Fee- <br />Return Recei <br />$0.48 <br />C3 <br />Pt Fee; <br />$3.30 <br />C3 <br />C3 <br />ReturTotal p <br />(Endorserr ostage & Fees: <br />$2.70 <br />0 <br />Restricted Delivery tee <br />(Endorsement Required) <br />$6.48 <br />' <br />Total Postage & Fees <br />$ <br />M <br />Sent To <br />aA <br />--- - - - - -- p -t. - -- lVo - - - - -- Miss Deb Rudibaugh <br />Sfreet, <br />--------- - - - - -- <br />� <br />- <br />, <br />°'POeoX " °. 5291 CR 76 <br />--------- x No. - - - - -- <br />ity, State, ZIP+4 Parlin, CO 81239 <br />--------------- <br />