Laserfiche WebLink
Cr�'� �ieG{ Mai I- LCD 1 -�-Tit1 <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print y ur name and address on the reverse <br />so th a can return the card to you. <br />• Attac card to the back of the mailpiece, <br />or on ront if space permits. <br />1. Article�lressed to: <br />Vt'lleke <br />Community Bank <br />h Ave <br />80 759 <br />A. <br />X <br />❑ Agent <br />❑ Addre <br />D. Is delivery address differen Yes -'-- <br />If YES, enter delivery a re s 110101F69 <br />OCT 18 2014 <br />3. Service Type <br />� Certified Mail® ❑ ity �re ❑ Registered 99 Retur <br />❑ Insured Mail ❑ Collect on Delivery <br />14. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />I (Transfer from service label) 7 012 3460 0 0 0 0 6385 0 713 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />Postal <br />CERTIFIED RECEIPT <br />(Do <br />N <br />Postage: <br />Certified Fee: <br />$0.48 <br />M Return Receipt Fee: <br />_ <br />$w-'T <br />$' <br />To ta l Postage $ Fees: <br />11ostmark <br />$s. &I H®r-r <br />O <br />Restricted Delivery Fee <br />O (Endorsement Required) <br />M Total Postage $ Fees <br />M <br />$ <br />nu <br />Sant To Jordan Willeke <br />r=I C3 <br />Street, Bo; A" Colorado Community Bank ---------------- <br />or PO <br />�. <br />�;n siatE 615 W. 8th Ave <br />-------- - - - - -- <br />Yuma, CO 80759 <br />