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• A.Signature: (O Address""" gent) 1 <br /> Ert•ur•IOems 1,2,mid 3 are completed. /n, <br /> Attach this and to the back of the mallpkoe,or on <br /> the front 9 spas permits. B.Received By:(Printed Nww) C.Date of Delivery <br /> Article D.Isdetivery t`!!1? ❑Yes i <br /> "C'�i` fiance Lynn Wilson MYES abler 7,o No <br /> 36 Road 2380 <br /> Aztec NM 87410-9305 <br /> jUIN <br /> 11= IIIIIIIIII,ill�lllllllllllllllillllllllll Servic <br /> 9490 9118 9956 2806 9465 26 <br /> Article Number(Transfer from service labs✓) <br /> S Form 3811 Facsimile,July 2015(SDC 3930) Domestic Return Receipt <br /> iENsT�0% COMPLETE THIS SECTIONON DELIVERY <br /> �• A.Signature: (13 Addressee or[3 Agent) <br /> I <br /> Ensure items 1,2,and 3 are completed n 1 <br /> Attach this card to the back of the mailpiece.or on I <br /> ' <br /> the front If space permits' B.Received By:( nted Name) C.Date of Delivery <br /> 6-a1- a <br /> .Article A�r�spQto� D.Is delivery address different from Item 11 ❑Yea <br /> p i I Q!, f--)u n 1� if YES,emer delivery address below: C No . <br /> PO Box 194 <br /> Austin CO 81410-0194 <br /> IIiIII�IIIiIIIHiIII II IIIIIII��Ililh II I II ill 3.SerAcsType fertr,eC lead <br /> 9490 .118 9J56 2901 0599 34 <br /> ZjIS 99561304 0599 62 <br /> 2.Article Number(Transfer from service label) <br /> IS Form 3811 Facsimile,July 2015(SDC 3930) Domestic Retum Receipt i <br />