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-�G U <br />M zol I 007 <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 />Ms. Bev Jackson <br />Colorado West Insurance <br />2782 Crossroads Blvd <br />Grand Junction, CO 81506 <br />A. Signature <br />X vtt'a Agent <br />❑ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />iS ICQ i V>a1 <br />D. Is delivery address di erent from item 1? 0 Yes <br />If YES, enter delivery address below: O'No <br />T e Type <br />tified Maih ❑ Priority Mail Express`" <br />istered ❑ Return Receipt for Merchandise <br />ured Mail ❑ Collect on Delivery <br />4. Restricted neli --? iF f— c, <br />u ICJ <br />2. Article Number <br />(Transfer from service label) 7 014 0150 0000 913 8 9745 <br />PS Form 3811, July 2013 Domestic Return ReceiptM <br />(Domestic Mail Only; No Insurance Coven <br />For delivery information visit our websiie a <br />co I €` $0.69 �— <br />� <br />L Postage: $3.30 <br />°^ Certified Fee: $2.70 <br />M Return Receipt Fee.- <br />o $6.69 <br />E3 (En( e Fees: <br />RTota, Postage <br />E3 (Ends._- .,-riequired) <br />u-i <br />ra Total Postage & Fees <br />C] <br />Sent To Ms. Bev Jackson <br />O Streef,Apt Colorado West Insurance <br />or PO Sox l 2782 Crossroads Blvd - - - -- -- <br />Ciry Stare, <br />Grand Junction, CO 81506 <br />