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<br /> <br />^ Print • Complete ttems 1, 2, end 3. Also complete A. Signature <br />~. so tt <br />~ <br />- kem 4 tt Restricted Delivery is desired. <br />X ^ bent <br />, <br />~gttac ^ Print your name and address on the reverse ^ Addre: <br />or or so that WB can retu~m the Card to yOD, g,. Received by (Pdnted ) C. Date of li <br /> ^ 'Attach this card to the back of the mailpieCe; _ D <br /> <br />1. Article <br />or on the front H space permits. -~ ~ <br /> <br /> - <br />~ D. Is delivery address diNerent from Rem 11 ^ Yes <br /> t.. Article Addras5ed to: If YES, enter delivery address bebw: ^ No <br />PAT <br />277C PATRICA TUBERGEN <br />BOC 2770 61st LANE <br />BOONE, CO 81025 <br />2. Articl <br />~~' 2. Amide Number <br />PS Fort (transfer from service Iabe0 <br />~a:.~~ PS Form 3811, February 2004 <br />706 17810.0003 6212 5238 <br />Domestlc ~Retum Receipt <br />702595-02-M-1540 <br />rorvr <br />r. N r.,., <br />~ d <br />r z to <br />,~. tC+7 <br />~~ <br />_'-~ tom. <br />t " tzy <br />z <br />~d~ <br />o~z <br />o n <br />V <br />.-r . plc:- awy*n, Tara-a .S :FI:J <br />3 Odro <br />m ~ ' _?sags. a ~ <br />170 N 'b ~ , • • 01 mas o 0 <br />tr tr <br />p~9 <br />Z ~ ~ ~ A ~ 5~~ ~ ~ p~~8 I mel o 0 <br />l~1 rn 9 ~ ~O: , s,opv3) ~ ~ <br />Postage S ~ .. = ulsetl O t7 <br />,.~ rTt ~t ~+ sropu3) <br />~ ~ ~-.i W Certified Fee ~.~,'ti Vi es~mak '~OQl1 etl O O <br />,--. O r~ O C7 <br />O z' ~ Relum Receipt Fee rJ ~ ~ Here / l7 l7 <br />N ~ tT'f ~ (Endorsement Requiretl) +t. ~~~ V W W <br />~~~ <br />U ~ ~ Restricted Delivery Fee a ~. D-. Q. <br />ra (Endorsement Required) ~~4.i%'J <br />tt7 ` ~ N .N ~~ <br />z O G c,1 eJ ~, ..gin. OJ 4CJ ~ !~ L~ <br />TaW PostageB Fe=^ •~ 1~%~ fll fil <br />.~ <br />i, ~ Sent TO r N N ~~ <br />o ~__ PATRICA TUBERGEN ~ _ <br />~` srear,~aPtNa.; 2770 61st LANE w ~ <br />' y or Po Box No. <br />~v_ city, state, iiv+'d BOONE, CO 81025 <br />3. Servke Type <br />^ Cert~ed Mail ^ Express MaII , <br />.0 Registered ^ Retum Receipt for MercharHise. <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery! (Fx6a Fee) ~ O Yes <br />