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02 zo/ <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVERY AZ <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. Received <br /> �by�rinted Nam' .. C. D t 7fDeliv ryt <br /> or on the front if space permits__. J " o_�_ �J <br /> 1. ss different ff��qq__ item <br /> iv ry addrD�low: 4 <br /> Daniel Clark �ly��, v// �$ <br /> Bucklen Services Company, Inc "``y,��yy 2p 9 <br /> 804 North 25th Avenue <br /> Greeley, CO 80631 sgcI <br /> 3. Service Type ❑Priority Mail Express® <br /> I'I I III II I I I I I I I I �'II I ❑Adult Signature ❑Registered MailT" <br /> ❑Adult Signature Restricted Delivery El Registered Mail Restricted <br /> 10 Certified Mail(D Delivery <br /> 9590 9402 3488 7275 7562 84 LJ 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 Confirmation— <br /> d Mail ❑Signature Confirmation <br /> 7 017 2400 0000 9119 4991 d Mail Restricted Delivery Restricted Delivery <br /> 5500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />