Laserfiche WebLink
I <br /> COMPLETE • COMPLETE■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse <br /> so that we can return the card to you. Addre <br /> ■ Attach this card to the back of the mailpiece, B. R ived by(Pdnted Na4bO <br /> of Deliv <br /> or on the front if space permits.1. Article Addressed to: D. Is delivery address differeYes <br /> If YES,enter delivery adNo <br /> 805Z1 <br /> MR GEORGE E OTTEN <br /> 11438 CR 19 <br /> FORT LUPTON, CO 80621 <br /> ll I'lII'I I'll lil I II Il lI III I l I I l��l(l lII I l l i III 3. Service Type ❑Priority Mail Express® <br /> ❑Adult Signature ❑Registered MatITM <br /> ❑ dult Signature Restricted Delivery ❑Registered Mail Restricted <br /> q Certified Mail® Delivery <br /> 9590 9402 2543 6306 1371 45 CI Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number ffransfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTm <br /> 7 016 2140 0000 2346 1230 ElInsured Mail ❑Signature Confirmation <br /> ❑Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br /> Postal <br /> CERTIFIED o RECEIPT <br /> o Domestic Mail Only <br /> m <br /> ruFor delivery informatibin,visit 0 <br /> •sit <br /> eat wwtv.7 r li ,;a m <br /> $0.670 <br /> m Postage: <br /> ru <br /> C3 Certified Fee: z}V $3.350 <br /> c3 Return Receipt Fee: 3�Jl $2.750 anark <br /> o are <br /> C3 <br /> C3 Total Postage &tkjjj $6.770 <br /> NTotal Postage and Fees <br /> a <br /> .A Sent To <br /> r-1 <br /> c3 b'o-ee!WAjit7ifo:;iWlWff& MR GEORGE E OTTEN <br /> N <br /> Criy 3feie; iP+d+------------ 11438 CR 19 <br /> FORT LUPTON, CO 80621 <br />