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• 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 />Kelly M. Eggenberg <br />Miners & Merchants Bank <br />P0 Box 310 <br />Lake City, CO 81235 <br />2. Article Number <br />(transfer from service label) <br />PS Form 3811, July 2013 <br />t:3 <br />Er- <br />C <br />F <br />cent, • -- Fee: <br />rr Return Receipt <br />y $6.69 <br />e & Fees: <br />Mai I — R�pl ck-r, e-- II-Oc- <br />A. Signature y <br />X �rv►�ll'� �LL ❑ Agent <br />❑ Addressee <br />B. Received b (Printed Name) C. Date of Del' ry <br />Milo by lc - -z ► -1 t <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />P,8 Certified Mail® ❑ Priority Mail Express- <br />13 Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />7212 3460 0000 6385 0690 <br />Domestic Return Receipt <br />C3 Total Posta9 Posttua[k <br />p __. —.1L nequred) b�' IC ©cG <br />O ✓°_ <br />Restricted Delivery Fee <br />C3 (Endorsement Required) T <br />Total Postage & Fees $ /( <br />M <br />Sent To <br />enbe'T <br />t„ Kelly M. Egg ��� <br />. - -- - Miners & Merchants <br />� Street, Apt. No.; _ . -^ <br />t, or Po eoX No. P 0 Box 310 <br />----- - - - - -- <br />City, State, ZIP+ <br />Lake City, CO 81235 Em <br />