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rl-rgQo - o~t7 <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Mr. Kenneth Klco <br />Azurite, Inc. <br />Fremont County <br />PO Box 338 <br />Cotopaxi, CO 81223 <br />A. Received by (Please Print CleaAy) ~ B. Date of Delivery <br /> C. Signature <br /> ,(~ ^ Agen: <br /> ~~ Addressee <br /> D. I tl livery atldress " erem frem item 17 ^ Yes <br /> I S, enter tlelivery address below: ^ No - <br /> <br />t <br /> 3. Service Type <br /> ^ Cenilietl Mail ^ Express Mail <br /> ^ Registeretl ^Ralurn Receipt for Merchandise <br /> ^ Insured Mail ^ C.O.D. <br /> 4. Restricted Delivery? (Extra Feel ^ yes <br />2. Article Number (Copy /rom service label) <br />7000 lV10 ODW DIaB9 (nllg <br />PS Form 3811,-.`uly lsss Domestic Ralurn Receipt 1x2595-09-M-095Y <br /> <br />rl <br />a •1313 Sherrt <br /> <br />~ Postage 3 <br /> <br />0 Certilietl Fee <br />~ Return Receipt Fee <br /> (Entlorsamem Requiktl) Q <br />O <br />p Resincte0 Delmery F <br />p (Enoorsemen~ Reomreo <br />~ Tpfal PocUga 6 Fees S <br />`` AAr <br />K <br /> . <br />E <br />215, Denver, CO Y0203 <br />~ Here <br />y~~~~ PoslmaM <br />L <br />IG <br />a Azurlt~ ~. <br />o Fremorit Couhty <br />° PO Box 338 <br />~ Cotopaxi, CO 81223 <br />J <br />