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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X ❑Agent <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B.7Re' ed b (Printed Name) C. Date of Delivery <br /> or on the front if space permits. z <br /> 1. Article Addressed to: D. I9 ftem 11 ❑Yes <br /> 1 � ess Mr. Matt Welte below: ❑No <br /> Summit Brick &Tile Co DEC 2 0 L016 <br /> P O Box 533 <br /> Pueblo, CO 81002-0533 DIVISION OF RECLAMATION <br /> I I Mail <br /> 111111 Jill I I I I I I I I II 11 I I I I III III ❑Adult S gnaturee ❑Rreg s ered Mail—Expre ss® <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> 9590 9402 3 8 7 Z Certified Mail® Delivery <br /> ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service abe) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationT <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7016 271 2 9 6 5 12 1 •❑Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500 <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />