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iiiiiiiiiiuiiu iii <br />999 <br />e SENDER: <br />na •Complale items 1 and/or 21or etlditiorel wniw•. <br />18IS0 wish t0 reCBIVe the <br />~ •Camplela itarro 3, b, end 4D. fdlOWing serVICBS (}Of en <br /> • Pdm your name and address on tha rewne of this form w drat we can ralum Ihie eX(ra }9e): <br /> <br />j certl to you. <br />•Atlach this loan to the hoot of the mellplsu, or an the beds if <br />apace does not <br />t. ^ Addressee's Address <br /> <br />T <br /> perms. <br />• Wdte'Refum Remipt Requecfed' on Its meilpiece below the ertige number 2. ^ RBStdcted DBIIVery <br />$ •The Retum Recelpl will show to whom the ertitle was tleliveretl end Me tlate n <br />~ delivered. CAnSUIt pCSlRlabler }Or }ee. <br /> <br />O g <br /> <br />0 <br />3. Article Addressed to: <br />4a. ArDcle Number F <br />O <br />~ Z 434 941 585 <br /> A L <br />M <br />S <br />i <br />a ew <br />r <br />cott <br />s <br />4b.SeMCeType <br />o <br />~ Cripple Creek b Victor Gold ^ Registered ~ Certlfled <br /> PO Box 191 <br />^ 6cpress Mell ^ Insured a <br />5 <br /> Victor CO 80860 <br />^ Rtrium Receipt for Me dice ^ COD <br /> 7. Date of Derive 3 <br /> 0 <br />0 <br /> a <br /> 5. Re ed By: (Pdnf Name) B. Addressee's Addr ry if requested <br /> S~ and lee is paid) <br />g or <br />Ag <br />enfl <br />S. Signs re: (Address <br />ee <br />T ~ <br />/ <br />~ <br />l <br />X ~ ! / J r-.--C i <br />A <br />PS Form 3811, December 1994 <br />r025959] 8-0179 Domestic Retum Receipt <br />_ Spe~~- ~ M <br />T t 3 4` 9 4 ~j~~~ 5 c°~t <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. U <br />Do not use for Inlemahnnal u~a res.. .......__, <br />91 <br />0 <br />Postage $ `7 2d <br />Certified Fae ~/ <br />Spedal Delivery Fea ~~199/ <br />nestnged Delivery <br />n <br />~ Relum Recefpl Sh[ <br />wu.._ • ,.~_ .._~_ <br />Postage d Fees l a S r <br /> <br />0 <br />LL <br />N <br />a <br />