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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Sig ture <br /> ❑Agent <br /> ■ Print your name and address on the reverseAddressee <br /> so that we can return the card to you. <br /> ■ Attach this card to the back of the mailpiece, Received by(Printed Name) C. Date of D livery <br /> or on the front if space permits. J �z r <br /> 1. Article Addressed to: D. Is delivery address different from item 1?„ Yes <br /> If YES,enter delivery address belmi#, '.XNo 0 <br /> Mr. Michael B. Dorman <br /> Golden Grains, LLC <br /> 70 Webster Ave kZj <br /> Burlington, CO 80807 ;m <br /> 3.I IIII' I'll lIl I I II I I I I I I II I I�III I I I II I I ❑•AduI�Signature Restricted Delivery ❑Reyi_ ed Maa::TR ice Type ;Zr$Wail ®t <br /> la Certified Mail® Deliv" <br /> 9590 9402 3488 7275 7559 11 ❑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 Confirmation- <br /> 1 ❑Insured Mail ❑Signature Confirmation <br /> 7016 2 71 0 2965 110 2 ❑Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />