_GENERAL DOCUMENTS - M2003016 ‎(2)‎

• Permit No: M2003016
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Name: Certified Mail Receipt
• Media Type: D
• Archive: No

SECTIONSENDER- COMPLETE THIS SECTION COMPLETE THIS .
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired, t
■ Print your name and address on the reverse X ,-ddressee
so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: if YES,enter delivery address below: ❑ No
Ms. Amy Burns ,� -
Wells Fargo Insurance Services U8A, Inc.
400 Hwy 169 South 8th Floor �.
St. Louis Park, MN 55426
3. Service Type �
-- ZSCertified Mail® ❑Priority Mail Express"
❑Registered ❑Return Receipt for Merchandise i
❑Insured Mail ❑Collect on Delivery
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(Transfer from service label) 7 014 0150 0000 9138 8502
S Form 3811,July 2013 Domestic Return Receipt