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<br />;, SENDER: <br />,v_ •Complae items t end/a z for atlaitional services. 1 also wish to receive the <br />n .Compete nwne s, ae, and ab. following services (for an <br />„ • Pdnt your name and atldreas on the reveres of this lam eo that wa can ratan This extra fee): <br /> <br />i W rtl to you. <br />•Adach this loan to the hom of the meilpiers, or on the back if apace does not <br />1. ^ Addressee's Address m <br />-° <br />~ pemxt. Z <br /> <br />Y • Wate'Rerum gecei f q Ueared' on the meilpiece below Ne article number. <br />~ <br />s <br />2. ~ RBSidaed Delivery d <br />w <br />t <br />„ •The Relum Receip <br />nll <br />how lowMmthe ertiae was tlelivered endlhe data <br />G tlelrvered. Consult pOStmaeler for f99. .~ <br />~ 3. Article Addressetl to: 4a. Aricle Number ii <br />~ P 213 351 911 c <br />E CHARLES KEELING ab. Service Type <br />Y <br />~ P 0 BOX 361 ^ Registered - „7 ~ Certified ~ <br /> LA VETA CO 81055 ^ ExpressMail -~',~ <br />^ Insured .m <br />c ~ <br />^ RetumReceiptfo[Meichan ~5e. COD <br /> 7. Date of Deliveryr ~ 1 ~ <br /> <br />Z <br />x ,,,,~ r <br /> 5. Received By: (Print Name) 8. Addressee's Address (Only N requested ~ <br />iu and /ee is paid) ~ m <br />IL != <br />g 6. Signature: ress or ^ <br />o <br />T X <br />~A <br />Ps Form 3811, December rasa / Domestic Return Receipt <br />P 3 351 °11 <br />u s ~ <br />'M + Certified Mail ~ <br />N n r y~Coverage Provided. <br />~6 M S <br />~~ <br />m <br />rn <br />S <br />t7 <br />0 <br />LL <br />N <br />a <br />Do n e r Intemalional ail ee reverse _. <br /> <br /> RLES KEELING W <br /> <br />~a ~B(TXer 361 ~ <br /> <br />i te, 8 C e C^ <br /> 3 <br />Posuge ~ ~ <br />CeNfied Fee -~ <br />~~ ~ <br />Spedal Daliva ea '^. IV <br /> <br />Restricted D rvery F ~ <br />Rehm Rec Stowing ~ ~ ~ <br />Whom 8 Dal Deli red <br />fleWm fleceipt When, ~ <br />Ddb„S Aatlress AOdr ~ <br />T07AL Prutaged ~.;p S f, C7 <br />PosMark or Dale C+ <br /> <br /> O <br /> N <br /> O <br /> (~ <br />w <br /> <br /> <br />