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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: <br />Jordan Willeke <br />Northr Bank <br />615 W.8th Ave <br />Yuma, CO 80759 <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, July 2013 <br />COMPLETE THIS SECTION ON DELIVERY <br />A. Si. nature <br />X <br />❑ Agent <br />❑ Addressee <br />5 ate of D Y�D. <br />r/ <br />delivery address different fro <br />If YES, enter delivery addre <br />3. Service Type <br />❑ Certified Mail® 0 Prior . it Express" <br />❑ Registered 0 Retur <br />❑ Insured Mail 0 Collect on Delivery <br />ch <br />4. Restricted Delivery? (Extra Fee) <br />7014 0150 0000 9138 8663 <br />0 <br />Domestic Return Receipt <br />