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SENDER: COMPLETE THIS SECTION COMPLETE TAIS SECTION DELIVERT <br /> J <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X ❑Agent p <br /> so that we can return the card to you. ❑Addressee ¢ x <br /> ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery O <br /> or on the front if space permits. N <br /> 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes 0 <br /> If YES,enter delivery address below: ❑ No o <br /> BLOSS LONNY B o z <br /> 424 32 RD UNIT 370 (D N <br /> o <br /> CLIFTON, CO 81520 <br /> o � r � <br /> IIIIII I'll III I I IN 1111111111111111111111111 3. Service Type ❑Priority Mail Express® ~ <br /> ❑Adult Signature ❑Registered MaIIT'" p WN <br /> ❑fldult Signature Restricted Delivery ❑Registered Mail Restricted <br /> Certified Mail® Delivery <br /> 9590 9402 4715 8344 2088 55 ❑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 0 Signature ConfirmationTm <br /> n�...............I ❑Signature Confirmation <br /> 7019 1640 0001 9352 9636 <br /> I Restricted DeliveryRestricted Delivery <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br /> x <br /> a <br /> n .P� <br /> _r fV r <br /> ;' O <br /> —f w N <br /> O N N <br /> z x r <br /> O <br /> C) <br /> 0 C: C3 <br /> 00 z < <br /> Ln <br /> N V rim <br /> O p 0-• <br /> Cn ED <br /> C3 <br /> C3 <br /> !gq <br /> 1 :t7t1 i•`" A9 o e m W <br /> r t^' Ln <br /> N <br /> Ct r 4 <br /> Q' <br /> :? W <br /> t T!iat 1AEr <br /> G>e)m m �� <br /> > N <br /> 'Fi <br /> ro �mcn�in <br /> ` t Cy'Zr� <br /> Z W4 ZW DOO <br /> 4f3 cn■ �i �. � <br /> Z<D <br /> i O <br /> !♦:1- ,. Q -i M <br /> _ O <br /> O <br /> „. s, 0 <br />