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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:r <br />M 2041;, 0 S3 <br />A. Signature <br />v� <.tX / �. ❑ Addressee <br />B. Received b P".nte Nama C. Date of Delivery <br />I - <br />D. Is ii�liv address different from item 1? ❑ Yes <br />If YES, ent@r AW below:lo <br />Ms. Florence Jackson <br />Canyon Rim Stone, LLCM ��, 3. Se celyPa- <br />27500 <br />e : <br />27500 CR 183 , F�*,0 rtified Mail® ❑ Priority Mail Express" <br />Kim, CO 81 048 ❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(Transfer from service label) 7 014 0150 0000 913 8 1091 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />