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~~[~z?-Z.vL <br />/- 5 - ~ ~ <br />' ~~~ ~2~,t.-Q <br />^ Complete items 1, 2, and 3. Also complete A. <br />item 4 if Restricted Delivery is desired. X <br />^ Print your name and address on the reverse <br />so that we can return the card to you. g. <br />^ Attach this cartl to the back of the mailpiece, <br />or on the front if space permits. <br />7. Artlcte Addressed to: <br />NerC ICPearz <br />va;w. mc. - <br />Rocxy Fora Divsmn <br />P.O. Bak 550- 222fi] HigOVray 50 <br />ROCky ForE, CO 8108] <br />°; ~i~l~S <br />~ - ~~~'~ <br />Agent <br />C..Date of <br />Is delivery adtlress different from item 1? ^ Yes <br />If YES, enter delivery address below: ^ No <br />s. serv;ce rypa <br />^ CertKed Mail ^ Express Mail <br />^ Registered ^ Retum Receipt for Merchandise <br />^ Insured Mail ^ G.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ yes <br />2. ArtialeNumber 71105 3Z7,~ 000 2297 8273 <br />(Transfer Irom servke IebeQ <br />PS Form 3811, February 2064 Domestic Return Receipt lozsss-oz-M-tsao <br /> ." <br />m <br />r` ~ <br />m '' <br />ti DKMS-t:f9~,Sh~rrrt~it,~~~1~ ~n~•C <br />O813 <br /> , ~ <br /> <br />o Postage $ ~ ~~ A O~~ <br />a6~ <br />` ., ` <br />O CertlriedFee 2 ZQ It ' <br />fiC <br />"`ti <br /> <br />~ <br />Retum Receipt Fee / M D <br />(EtMOraement Required) <br />_ ~ Postm <br />l <br />j <br />He ' <br />~ Restricted Del(very Fee <br />(Entlarsemerrt Re <br />ui <br />d ~ <br />" <br />~ q <br />re <br />) <br />m <br />Total Postage 6 Fees <br />$ _ <br />, <br />' <br />u'I <br />0 Sent o <br /> <br />M1 Sveef""'_~.-..-.. <br />Mr. No.: Rere x. P.arsan <br />_ ....................... <br />varA <br />ura <br /> or PO 6axN0. <br />' . <br />. <br />Wady Fore D;r,amn <br /> <br />~''~~'T/f1f/ P.O. Boa 550.22$e] M Ow 50 <br />e <br /> Rocky Faro. CO 9108] <br /> ilr 1, <br />