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M- VV -t ()5 7 <br />SENDER: COMPLETE THIS SECTION <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 />Mark Wadsworth <br />First Mountain Bank <br />409 Harrison Avenue <br />Leadville, CO 80461 <br />COMPLETE THIS SECTION ON DELIVERY <br />A.Signat <br />X <br />re <br />Q( p Agent <br />Addressee <br />C. Date of Delivery <br />—3-,5-' <br />D. Is delivery address different from item 1? <br />If YES, enter delivery address below: <br />Yes <br />3. Service Type <br />Certified Mail® <br />❑ Registered <br />❑ Insured Mail <br />❑ Priority Mail Express'" <br />❑ Return Receipt for Merchandise <br />❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) <br />❑ Yes <br />2. Article Number <br />(Transfer from service label) <br />7014 0150 0000 9138 4924 <br />PS Form 3811, July 2013 <br />Domestic Return Receipt <br />