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SENDER: COMPLETE THIS SECTION COW!'LETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete nature <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your name and address on the reverse X ,ca4k Addressee <br /> so that we can return the card to you. B. Aeceived by(Pnnfe ame) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, I Pt (/ '3 <br /> or on the front if space permits. <br /> D. Is delivery address d fferent from item Yes <br /> 1. Article Addressed to: If YES,enter delive address below: QNo <br /> CT(JJ 2�,%4UIU <br /> DMSIOIy OF <br /> Rod Clayton M►NIN �a-Z.,CL4AfATION <br /> P.O. Box 2 3. Service Type <br /> ❑Certified Mail® ❑Priority Mail Express' <br /> Hooper, CO 81136 ❑Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect on Delivery <br /> I'9AI•D Z�' v golft 910 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 014 2120 0001 7869 9869 <br /> (Transfer from service label) <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />