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m^, acta 0 fit <br />SENDER: COMPLETE THIS SECTION <br />COMPLETE THIS SECTION ON DELIVERY <br />4. Restricted Delivery? (Extra Fee) <br />C. Date of Delivery <br />0 Yes <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 />1. Article Addressed to <br />C .. ic:�� <br />4 1300 "u -s C'rerk �i'11ra Sev e1, <br />SG 2_4"e - i $3c- <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />O <br />C3 <br />ru <br />7011 2000 0001 2412 5275 <br />Domestic Return Receipt <br />U . Postal ServceTM <br />'CERTIFIED MAIL. RECEIPT <br />gkinfmic Mal/ Only No Theorems Coverage Provided) <br />takonatiOnvleit our wet>sb, * movalepteem <br />DENVER CO o/� <br />`JV2'�h <br />3 0.00 <br />A. Signature <br />X <br />D. <br />1°. 4 <br />- _ 0154 <br />✓rn Foe <br />0 <br />32. s5 <br />- e �i t equ reLi Po <br />n <br />/ Ng- <br />d <br />Dewar!: Fe <br />c rr, <br />01 /04./. <br />Is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: 0 No <br />JAN 1 l 2012 <br />CDPHE ;,I„ �t RO M <br />3. Service Type <br />0 Certified Mail <br />0 Registered <br />0 Insured Mail <br />0 Agent <br />0 Addressee <br />0 Express Mail <br />0 Return Receipt for Merchandise <br />0 C.O.D. <br />102595-02 -M -1540 <br />