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l <br />�cicn —CS I <br />cc_ �-� ���C r �CL <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 />Jason Burkey <br />Oldcastle SW Group, Inc. <br />dba United Companies of Mesa County <br />2273 River Road <br />Grand Junction, CO 81502 I <br />A. Signature <br />,.LA CC ` ❑ Agent <br />� ❑ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />l_. \"L x \ �n rw A 13 &I t <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />Service Type <br />0 Certified Mall ❑ 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 />(rransfer from service label) 7 012 3460 0 0 0 0 6384 6 7 61 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />►� (Domestic Mail Only; <br />.J7 <br />tti _ <br />Posts <br />� ge: <br />Certified Fee: <br />CO °a <br />� RReceipt Fee: <br />C3 Total P $2.70 <br />0 ostage & F <br />O(Endorsement Hequ--, Fees: <br />Restricted Delivery Fee <br />C3 (Endorsement Required) <br />—0 <br />= Total Postage & Fees $ <br />M <br />s Jason Burkey <br />a s Oldcastle SW Group, Inc. <br />C o dba United Companies of Mesa County <br />2273 River Road <br />_____Grand Junction, CO 81502 <br />