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M <br /> 00 01� <br /> SECTIONSENDER: COMPLETE THIS SECTION COMPLETE THI S . . <br /> ■ Complete Items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X ❑Agent <br /> so that we can return the card to you. _�_ ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, 9, Received by(P;RZ�5 <br /> ell I C. Date of Delivery <br /> _or on the front if space permits. /1�1N��( r7 - 3 <br /> 1 Article Addressed to: D. Is delivery address different from Item 1? ❑Yes <br /> Ms. Marcy Brossman If YES enter delivery address below. ❑ No <br /> Cheyenne County <br /> 51 S. 1st. <br /> P.O. Box 567 <br /> Cheyenne Wells, CO 80810 <br /> 3- S3eroct Type L Priority Mar Express@ <br /> II I'IIIII IIII III I II I II�'I I II III II II I'I I I I II I( Q Adult e❑Adult Signature Restricted Delivery ❑Registered MailMail Restricted <br /> ❑Certified Maile Delivery <br /> 9590 9402 2053 6132 7812 24 O Certified Mail Restricted Delivery ❑Return Receipt for <br /> _ ❑Collect on Delivery Merchandise <br /> 2 Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM <br /> / - CJ Insured Mail ❑Signature Confirmation <br /> -7 C)`(o t-(t�D © oZ <br /> OQO 3If(, f 33q ❑Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811, July 2015 PSN 7530-02 000-9053 Domestic Return Receipt <br /> Postal <br /> CERTIFIED ■ ■ <br /> Er <br /> m <br /> Domestic Mail Only <br /> M For delivery information,visit our website at tvww.usps.com'. <br /> m <br /> Postage: r2-, <br /> � <br /> ti Certified Fee: 6 <br /> o Return Receipt Fee: <br /> o <br /> 0 <br /> Total Postage& Fees: yY . 0 <br /> o Postage <br /> rig T P°'u9e and <br /> Ms.Marcy�'rossman <br /> $ <br /> -U Sent To Cheyenne County <br /> `3 51 S. 1st. <br /> � Stree'tendApENo:;oi�gozNc <br /> r` P.O. BOX 567 <br /> Cheyenne Wells, CO 80810 <br />