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Certified Mail Receipts <br /> COMPLETE THIS DELIVERY <br /> SENDER: COMPLETE THIS SECTION <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. [I Agent <br /> ■ Print your name and address on the reverse X .°� a 'Addressee <br /> so that we can return the card to you. IlAeceiyed by(P'nted N�e) C. Da of D live <br /> ■ Attach this card to the back of the mailpiece, , I_ �' <br /> or on the front if space permits. <br /> D. Is delivery address different from hem 1? LI Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: �-p No <br /> Jordan C.Burdick <br /> Jordan C.and Jone L.Burdick <br /> 2707 Glad Rd. <br /> Loveland,CO 80539-9227 <br /> 3. Se ice Type <br /> ertified Mail® ❑Priority Mail Express' <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 014 2120 0001 7885 3391 <br /> (transfer from service lab( <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> Postal <br /> CERTIFIED MAILO RECEIPT <br /> r9 Domestic <br /> Er <br /> m <br /> m For delivery information, <br /> _ <br /> cc <br /> `O Postage: $ -A60 <br /> N <br /> Certified Fee: $3 3T50 <br /> C3 Retum Return Receipt Fee: ?$-2.750 <br /> t3 (Endormne <br /> C3 a <br /> Restricted <br /> c3 (Endorseme Total Postage and Fees: $6.56 <br /> r1J <br /> r 1 Total Postage 8 Fees <br /> ru <br /> -2 Jordan C.Burdick <br /> Jordan C.and Jone L.Burdick _______ <br /> t� 3Yreet8ifpL 1�10, 2707 Glad Rd. <br /> 11 or PO Box No.----- <br /> Loveland,CO 80539-9227 <br /> ---------------- <br /> CJry;State,ZIRf4 ----------------- <br /> PS Forni <br /> a•• <br />