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COMPLETE • <br /> ■ Complete items 1,2,and 3.Also complete"','"' A. Signature <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your name and address on the reverse _ ❑Addressee <br /> so that we can return the card to you. B. Rece' by fi nted Name) ate of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> D. Is ddress ifff t from ite 1 Yes <br /> 1. Article Addressed to: If a er delivery"address belo No <br /> Daniel J. Gaudreault �� <br /> P.O. Box 69 6 y� <br /> Elizabeth, CO 80107 �fa� <br /> 3. Service Type <br /> XCertifled Mail® ❑Priority Mail Express- <br /> _ 4 ❑Registered ❑Return Receipt for Merchandise <br /> 4�f ❑Insured Mail ❑Collect on Delivery <br /> . <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 014 2120 0001 7885 7139 <br /> (transfer from service labeq <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />