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e-ostai ziervi <br /> CERTIFIED oRECEIPT <br /> ErDomestic Mail Only <br /> -a I0 For delivery information,visit our website at www.usps.como. <br /> Ln <br /> Certified Mail Fee rj <br /> m $ <br /> Extra Services&Fees(check box,add fee as appropriate) <br /> ❑Return Receipt(hardcopy) $ <br /> Q ❑Return Receipt(electronic) $ C t POstmar� <br /> d El Certified Mad Restricted Delivery $ t!N Here <br /> ❑Adult Signature Required $ ;%P <br /> []Adult Signature Restricted Delivery$ Q <br /> p Postage <br /> = $ <br /> NTotal Postage and Fees <br /> „p Sent To Ms. Marcy Brossman <br /> o sieei�;ie Cheyenne County ------------------ <br /> City,State, 51 S. 1 st Street ------------ <br /> Cheyenne Wells, CO 80810 <br /> Certified Mail service provides the following benefits: <br /> ■A receipt(this portion of the Ce ified r,lad.�) for an electronic return receipt,see a retail <br /> •A unique Identifier for your mai4ec 1 associate for assistance To receive a duplicate <br /> ■Electronic verification of delivegLegattem �d ret n cwpt for no additional fee,present this <br /> delivery. the rl _Dim tmarked Certified Mail receipt tothe <br /> ■A record of delivery(including the recipient's retail associate. <br /> signature)that is retained by the Postal Service- Restncted delivery service,which provides <br /> for a specified period. delivery to the addressee specified by name,or <br /> Important Reminders:, /Vim"-t to the addressee's authorized agent <br /> Adult signature service,which requires the <br /> ■You may purchase Certified Mail service with signee to be at least 21 years of age(not <br /> First-Class Mad°',First-Class Package Service®, available at retail). <br /> or Priority Mad'^service. Adult signature restricted delivery service,which <br /> ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age <br /> international mail and provides delivery to the addressee specified <br /> ■Insurance coverage is not available for purchase by name,or to the addressee's authorized agent <br /> with Certified Mail service However,the purchase (not available at retail) <br /> of Certified Mail service does not change the ■To ensure that your Certified Mad receipt is <br /> insurance coverage automatically included with accepted as legal proof of mailing,it should bear a <br /> certain Priority Mail items. OSPS postmark If you would like a postmark on <br /> ■For an JD#i ,f d with a proper this Certified Mail receipt,please present your <br /> endorsemen WyRryvi•ouest Certified Mail item at a Post Office-for <br /> the following serve ����RR�t��m a ¢�grkingdon't need a postmark on this <br /> Return receipt ord I I drM i 1 � rtion <br /> of delivery(including the rea n ,lab to thE�maleIQ � <br /> You can request a hardcopy r V,�n o i n"I"c1 t5p mailpiec. <br /> electronic version For a hardcopy r�bipt <br /> complete PS Form 3811,Domestic Return 2� <br /> Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records, <br /> PS Form 3800,April 2015(Reverse)PSN 7530-02-000-9047 <br />