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M�.od� ono <br /> COMPLETESENDER: COMPLETE THIS SECTION 1 • ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X ❑Agent <br /> v,tiidi we Glyn return ft Gard to yoU. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B.`/ eive (Pri 1 C. Date of Delivery <br /> or on the front if space permits. _J <br /> 1. Article Addressed to: D. Is delivery address different fro 11 ❑Yes <br /> If YES enter delivery address Gelow. ❑ No <br /> MR WALLACE F BURTIS <br /> 66 DARTMOUTH AVE. <br /> PUEBLO, CO 81005 <br /> II I'III�I IIII I'I I II I IIIII I II III II I II I II I)I I I i 3 Se"1 6 Ty pe _Rb9isi Mo aill e aE <br /> u 4Uun Siyiatwe G R�yiswieU Mad'"" <br /> ❑Adult Signature Restricted Dell" ❑Registered Mail Restncted <br /> 9590 9402 2053 6132 7813 16 O Certified Maiba Delivery <br /> ❑Certified Mail Restrcted Delivery ❑Return Receipt for <br /> __ _ _ _se_ ___ C I Collect on Delivery Merchandise <br /> 2 Article Number Crransfei from rvice fabe0 IJ Collect on Delivery Restricted Delivery Signature Confirmation"" <br /> 7 016 2140 0000 2346 1377 0 Insured Mad ❑Signature Confirmation <br /> Insured Mad Restricted Delivery Restricted Delivery <br /> — _ (over$500) <br /> PS Form 3811 JUIV 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br /> Postal <br /> CERTIFIED MAILP RECEIPT <br /> M1 Domestic <br /> m <br /> r-q <br /> FFLl , <br /> `� d 1 L <br /> Cier'tififYt Mall Fm <br /> ni $. Postage: �'ra"F $0.670 <br /> o Certified Fee: '+� $3.350 <br /> o I: Return Receipt Fee: $2.75001 <br /> { <br /> C3Lj Pc <br /> C c <br /> Total Postage &Fees: �.%r, <br /> if�'770 <br /> rU $ <br /> 7btal Postage and Fe" <br /> a <br /> Sent To <br /> ftNO °f � MR WALLACE F BURTIS' <br /> txh'sia ;21pxd+ ' 66 DARTMOUTH AVE. ---------- <br /> PUEBLO, CO 81005 <br />