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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 />Glen R. Ausmus <br />Baca County <br />741 Main St_,Suite 1 <br />ngfield, CO 81073 <br />A. <br />X <br />B. <br />[-1 <br />y <br />D. Is delive ddress die nt,from item 1? 13 Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />• Certified Mail® ❑ Priority Mail Express'" <br />• Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7 014 0150 0000 913 8 L,, , 5 3 <br />(Transfer from service label) <br />PS Form 3811, July 2013 Domestic Return Receipt <br />j11 r , r • <br />,n <br />CO TPostage, <br />� Certified Fee: 7 <br />tr Return Receipt Fee: Qf <br />i3 (End r Total Postage Fees: <br />soz�� 69 <br />p Restrk <br />(Endorsement Required) <br />tI) <br />r-q Total Postage &Fees <br />ED <br />Sent To <br />Glen R. Ausmus <br />S Baca County -------------------- <br />rl 741 Main St-,Suite 1 <br />Street, Apt No.; <br />C7 Springfield, CO 81073 ...... - - - - - -' <br />(` or PO Box No. <br />City, State, ZIP +4 <br />