_GENERAL DOCUMENTS - M1981044 ‎(4)‎

• Permit No: M1981044
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Name: Certified Mail Receipt
• Media Type: D
• Archive: No

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SENDER- COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired.
Is Print your name and address on the reverse X l Addressee
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: 11 If YES,enter delivery address below: ❑ No
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Ms. Amy Burns ,� _
Wells Fargo Insurance Servicts US_*, Inc.
400 Hwy 169 South 8th Floor - {
St. Louis Park, MN 55426 I
3. Service Type i
-- - - %Certified Mail® ❑Priority Mail Express'"
❑Registered ❑Return Receipt for Merchandise
❑ Insured Mail ❑Collect on Delivery i
4. Restricted Delivery?(Extra Fee) ❑Yes
1
2. Article Number
(Transfer from service label) 7 014 0150 0000 9138 8502
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S Form 3811,July 2013 Domestic Return Receipt
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