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P4 / 57C/- OSZ� <br /> 0 7 - 0 3 >� <br /> S119 K <br /> SENDER: COMPLETE THIS SECTION F COMPLETE THIS ON ON DELIVERY <br /> ■ Compleete items 1,2,and 3.Also complete A. p4Gei by(PI Print Clean) B. Date a <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. C. Signatu <br /> ■ Attach this card to the back of the mailpiece, ❑Agent <br /> or on the front if space permits. 11 Addressee <br /> s address different from item 1? ❑yes <br /> 1. Article Addressed to: y ,enter delivery address below: ❑ No <br /> QW!& VflYl'0. <br /> \(0.rr& CAm ►�eSZnG <br /> 0120 ( /Iagc �+ <br /> 11,y /10 ii5o�'I _p 3. Service Type <br /> ((��.... C ./ 9Certifed Mail ❑ Express Mail <br /> ❑ Registered ❑ Return Receipt for Merchandise <br /> ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑yes <br /> 2. Article Number(Copy from service' 7 0 01 2 510 0004 2146 0876 <br /> PS Form 3811,July 1999 Domestic Return Receipt 102595-00-M-0952 <br /> Postal <br /> (DomesticCERTIFIED MAIL RECEIPT <br /> t <br /> JR�wmd� <br /> 13 Sherman,Rm.215,Denver, GO 80203 <br /> o <br /> Postage $ -3 <br /> /SaS� <br /> Srtified Fee ('t� \ <br /> fillZ , 011l arm \` <br /> eceipt Fee / r i Here <br /> Required) / ( 1 S ! r <br /> O livery fee I= (7 <br /> O Required) `' 20Oge&Fees $ � �� <br /> NSent iol.1 -- 1.1_�...------- <br /> Street Apt.No.;�/yy�] I'� �/r p <br /> .-a or Po Box No. L! ZV_AKA. L --_--_.......-..--_---_.... <br /> C3 Ciry,State,L <br /> O <br />