Laserfiche WebLink
i. <br /> <br />N <br />W <br />m <br />n <br />6 <br />G <br />M <br />lLL <br />N <br />a <br />Z 239 763 780 <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />nn nnf um inr Infwmalinnwl Mail /.Caw rwvarswl <br />$eni <br />~nren S~ne <br />StreN a Number <br />z oo ch <br />P <br />Part ce State, a LP Code <br />rS <br />3Z3 <br />Postage a 55 <br />Certified Fee <br />5 <br />3 <br />Spedal Delivery Fee <br />Resumed Delivery Fee <br />Rehm Rece'pt S71awin9 tp <br />Wham a Date Delivered <br />Patiun RecegSMigm WMm, <br />Dam, a Addressees AEdea ~, ~O <br />TOTAL Postage a Fees S 3 <br />Pastinark or Date <br />~oZ/~C7 ~l~ ~~i <br /> <br />..! <br /> _ •.- s • .. _• - - - - --. <br />m SEN • _•. _ _ ... _ . _ • .. <br />v •Cam ale Gems , an or ~ sor acanorw wmna. I x150 WISh 10 f0001V0 St10 <br />~ •COmplele items 3, da, end 4b. }OIIOWing SBMCBS (}Or en <br />a • Pdm your name arM eddraaa on the ravens of INS brtn to Nat we can ntum tNe 0%tfa 1ee): <br /> card toyou. 8 <br />c c' ihia form to the ham ar the mailpiece, or on d,e Wrx d spare does not <br />•Aa <br />a }, [] Addf0ss00's Addr05S Z <br />° r <br />m <br />•Wrile'Retum Reaaipf Aequeeted'on the mailpieca below Ne adide number. $, ^ RBStdded DBIIVery Q <br />Jj <br /> <br />$ •The R°um Receipt will show Io whom Ne erode was delivered end Na data <br /> delivered. Consult postmaster for fee. <br />o <br /> 3. Argcle Addressed to: 4a. Article Number <br />a Z ~3 D E <br /> Daren Stone 4b. SeMCe Type <br />u ^ Registered ~ CertlBed <br /> 24600 Count Road P <br />Y O1 <br />c <br /> ^ Express Mail ^ Insured <br /> Dolores CO 81323 <br />r ~or <br />Rehm Receipt for Melcttar,dise ^ COD <br />° °' <br />~ I <br /> 1 <br />` ~ <br /> 7. Date o} Delivery <br />~ 5 <br />- ; <br />~ <br /> . <br />' ,~ <br /> 5. Received By: (Print Name) 8. Addressee <br />s Address (Only Il requested ~ <br /> and lee is paid) <br />~ <br />~~ , 6. Signat <br />urg: (Addressee or AgenfJ I <br />r ' <br />X Y~~ ~ ~.o ~ <br />e <br />`sss9,~e-0,>s Domestic Retum Receipt <br />Ps Form 3811, Deee er tssa M -47 -089 s+ <br />; <br />;.: <br /> , <br /> .~ <br /> - ~> <br /> ~ ~ * ~.~ <br />- <br /> : <br />• , ~; ~ s~:. <br />.,- <br />~" <br />~V~ <br />~ ~ <br />rt. ~.5 <br />, <br />i <br />- - - - <br />- - <br />