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_GENERAL DOCUMENTS - M2018010
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_GENERAL DOCUMENTS - M2018010
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Last modified
9/3/2020 3:43:46 PM
Creation date
6/29/2018 11:46:34 AM
Metadata
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Template:
DRMS Permit Index
Permit No
M2018010
IBM Index Class Name
GENERAL DOCUMENTS
Doc Name
Certified Mail Receipt
From
DRMS
To
Mr. Tony Adamic
Media Type
D
Archive
No
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SENDER: COMPLETE THIS SECTION COMPA ETE THIS SECTION ON DELIVERY <br /> ■-Complete items 1,2,and 3. A. gn lure r r <br /> ■ Print your name and address on the reverse f i ? ❑Agent <br /> so that we can return the card to you. �� -6 El Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Recely by(P nted Name) i' I C.D t of eli <br /> or on the front if space permits. �J <br /> 1. Article Addressed to: D. Is delivery address different from Item 17 L1 Yes <br /> If YES,enter delivery address below: ❑No <br /> Mr. Tony Adamic <br /> Fremont County <br /> 1170 Red Canyon Road <br /> Canon City, CO 81212 <br /> II I�IIIli I'I)III I II II'I II I II III I II'II III II I III ❑AduR Signature Restricted Delivery ❑Rregistered Mail Restricted <br /> 9590 9402 3488 7275 7596 50 VeDe <br /> ❑ 'wed Mail® Delivery <br /> Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7 016 2 710 0000 2965 4165 ❑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 /> -D DO(nestic Mail Only <br /> -0 Certified Mail Fee <br /> Er <br /> ru $Extra - -...s&Fees(c c •z,add ree s <br /> f� etum Receipt(hardcopy) $ <br /> Q ❑Return Receipt(electronic) $ <br /> C3 ❑Certi ied Mail Restricted Delivery $ P H k: . <br /> C3 ❑Adult Signature Required $ <br /> ❑Adult Signature Restricted Delive,y$ - -- <br /> C3 Postage <br /> ru Total Postage and Fees - <br /> $ �r J <br /> Sent To Mr. Tony Adamic <br /> o Fremont County <br /> C3 Street and Apt.%Vo.,or PG7 Boz P%. <br /> City State,ZiP+a3---------------- 1170 Red Canyon Road - <br /> Canon City, CO 81212 <br />
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