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N120KO S3 <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired, ent <br /> ■ Print your name and address on the reverse X ❑Addressee <br /> so that we can return the card to you. B. Received b rlte Name (.". Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, C _ r <br /> or on the front if space permits. <br /> D. Is liv address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,en* ress below: 11No <br /> Ms.Florence Jackson <br /> Canyon Rim Stone, LLC <br /> �v,, 3. Sep�r'cep�.. utr <br /> 27500 CR 183 e>� ,s Certified Mail® ❑Priority Mail Ekpress" <br /> Kim, CO 81048 ❑Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect on Depvery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (Transfer from service label) 7 014 0150 0000 9138 1091 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />