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V5 <br />G <br />VP\ <br />m2c)1� --01 -1 <br />c� Mai <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 />A. ture <br />OX <br />B. Received by (Printed N C. <br />D. Is delivery address differe Q 1? ❑ <br />If YES, enter delivery addr s ow: 13 <br />Mr. Mar„ Krivanek <br />101 F Suet <br />Salida, C0012&1 ` <br />3. Service Type <br />❑ Certified 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 Number <br />(Transfer from service labeo 7012 3 4 6 0 0000 6 3 8 5 4902 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />(Domestic Mail Only; No Insurance Coverage Provide <br />For delivery information visit our website at www.usps.come, <br />$ <br />2, ` <br />MPostage <br />M <br />Certified Fee <br />/ /����� <br />C3 <br />C3 <br />Return Receipt Fee <br />, ^ <br />2��f✓ <br />p <br />4,91' <br />(Endorsement Required) <br />C3 <br />Restricted Delivery Fee <br />(Endorsement Required) <br />' <br />O <br />$ <br />Q� <br />Total Postage & Fees <br />_ ( <br />M <br />Sent To <br />ru <br />� <br />- -p----.- Mr. <br />Street, A t No.; <br />Mark Krlvanek ------------------------ <br />0 <br />r� <br />or PO Box No. <br />101 <br />F Street ----- - - - - -- -- - - - - -- <br />C�ty, State, ZIP +• <br />RON 10 —z- CO 81201 <br />