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3� L M- 2001 - CJ-1 2 <br />Cer�i�ie8 a.i � - Lc;c_ release <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 />Mr. Jeffrey L. Schumacher <br />18751 County Road 37.5 <br />Sterling, CO 80751 <br />3 <br />A. Signature _ <br />❑ Agent <br />'X--�- ❑Addressee <br />1 eceived by {(P inted Name) /. C. Date of D livery <br />D. Is delivery address different from item 1? ' ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />OrcerHfled 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 rfrom service la6e 7012 3460 0000 6384 7645 <br />(transfer from <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />N. <br />S <br />M <br />m Postage $ <br />Certified Fee _ / <br />Q stmark <br />Q Return Receipt Fee ere <br />(Endorsement Required) —70 <br />C] { . ` <br />C3 Restricted Delivery Fee <br />(Endorsement Required) <br />_a Lry <br />`a Total Postage & Fees $ n tit lJ <br />M <br />LTo _ IL r. Jeffrey L. Schu macher <br />751 County Road 37.5 <br />erling, CO 80751 <br />i�eplace� <br />CERTIFIED <br />MAILTM RECUP <br />1 <br />(Domestic <br />Mail Only; <br />No Insurance <br />Coverage Provided) <br />For delivery <br />information <br />visit our website <br />at www.usps.como <br />S <br />M <br />m Postage $ <br />Certified Fee _ / <br />Q stmark <br />Q Return Receipt Fee ere <br />(Endorsement Required) —70 <br />C] { . ` <br />C3 Restricted Delivery Fee <br />(Endorsement Required) <br />_a Lry <br />`a Total Postage & Fees $ n tit lJ <br />M <br />LTo _ IL r. Jeffrey L. Schu macher <br />751 County Road 37.5 <br />erling, CO 80751 <br />i�eplace� <br />