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NI lgS,`n - Uci 3 <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 />maf <br />A. <br />CS ►- <br />.� Il cSer- <br />❑ Agent <br />.Ca � ( a A . � _❑ Addressee <br />B. Received by (PAted Name) C. Date of Delivery <br />D. Is delivery ad <br />If YES, enter <br />Florietta Acosta —" <br />Travelers Casualty and Surety Company of America <br />Willis of Colorado, Inc. , 'I <br />2000 South Colorado Blvd ,Tower Il, Suite 900 <br />different from item 1? ❑ Yes <br />,rl elow: El No <br />_tR e <br />Z <br />Denver, CO 80222 3. Service Typ "p ? �o <br />id Certified M ' s Express' <br />❑ Registered eceipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(Transfer from service label) 7012 3460 0000 6385 4568 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />-• (Domestic Mail C <br />For delivery inform, <br />ro <br />$0.48 _J <br />M <br />`° <br />postage* <br />$3.30 <br />$2.70 <br />C3 <br />C3 <br />fee, <br />Re <br />FteCeipt <br />C3 <br />C3 <br />(EndorsReturn <br />Restrict <br />$ g,48 <br />Q <br />(e% <br />(Endorse Total Postage u'- <br />Total Po. _ a rees � <br />M <br />._ <br />Florietta Acosta <br />ru <br />a <br />Travelers Casualty and Surety Company of America - <br />r° <br />Willis of Colorado, Inc. <br />2000 South Colorado Blvd ,Tower II, Suite 900 <br />Denver, CO 80222 moomp- -See Reverse <br />for Instructions <br />