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<br /> <br />^ Complete tterns 1, 2, and 3. PJSO complete" ` <br />Rem 4 tt RestrictedDelivery fs desired, <br />^ Print your name and address on the reverse <br />so that we can ietum the card to you. <br />~ Aftach this card to the back of the mailpiec4i;~~, <br />or on the front tt space permits. _ ~,.~;;~^ <br />1. Aitide Addressetl to: ,*„~,= <br />~~ `~ s 2 - <br />SL~c~ g4to3 <br />A S he' <br />- t7 naent , <br />J D Addressee <br />B, Received (Printed Name) C. Date d DeltrerY <br />D. Is delivery. tlress m ^ Yea <br />R YES, erser tlel'wery r t10 <br /> V <br />~ ~. <br /> fl3fl <br /> <br />3 Service Typo <br />~Dertifletl Melt ^ Express Mall <br />^ Registered ^ Retain Raceipt .fdr Metohendbe <br />^ Insured Mall O C:O.D, <br />4. Restricted Delivery? (Fxha Ppa) 17 y„ <br />2. AnicleNUmber <br />- <br />w~ ~jg~j <br />(freruletf'S'7'se~q"`e;fa~~?j4'r'~~ <br /> , <br />PS Forth 3811, February 20114 DanmtlcTieturn Recelpi ~, <br /> <br /> <br />'; D' ft+ 71 r <br />ire <br />ire <br />.. <br />#~ - <br />.., <br /> O~FICiA ~~ <br />~~ <br /> ~°~° • ~ <br />t1J <br />O CeNaetl Fee ?~ <br />~ <br />~ ReNm RedaM Fee ~ <br />G <br /> IErWOrcement Resulted) <br />D Restripetl Derrvery Fr <br />ra (fMaBemerrt neGaired) <br />7 <br />fU Total Postepe 6 Fees <br />N <br />O <br />° -~--~ JeiTery D. Herzick <br /> r"~I' 179 S Street # 2 <br />I <br />I c"~'• s. Salt Lake City, Utah 84103 <br /> <br />