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` ~ Complete items 1, 2, and 3. Also complete <br />' item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />~~ or on the front if space permits. <br />1. Article liddressetl to: <br />Benton D. and Karen Jensen <br />P. 0. Box 676 <br />Meeker, CO 81641 <br />A R ¢ivetl by (Please Print Clearly; B. Date of Delivery <br />C. Signet <br />^ Agent ' <br />d Addressee <br />D. Is slivery address different ham item 77 ~ Yes <br />If YES, enter delivery address below: ^ No , <br /> <br />3. Service Type <br />CertiFled Mail ^ Express Mail , <br />^ Registered ~ Retum Receip[ for Merchandise ; <br />^ Insured Mail ^ C.O.D. <br />i <br />4. Restricted Delivery? (Extra Fee) ^ Yes 1 <br />2. Article Number (Copy hom service IabeQ <br />7099 3400 0017 2945 5423 <br />_. <br />PS Form 3811, July 1999 Domestic Return Receipt 102595-0a•M-0952 <br />m <br />N <br />~`^ Peter `~° <br />T Pcstage $ n ~ <br />rr n <br />rL Certifletl Fee q 4, °' (~ , <br />i .10 C. n ~\'POStmark <br />r~ Return Receipt Fee 1 'y V~ Here ~ I <br />~ (Endorsemen[Requiretl) ~~.ASQ ~ , <br />~ Res[rictetl Delivery Fee ~ ` <br />~ (Endorsement Required) ('~ <br />~ Total Postage 8 Fees $ ;_*^ ~' t_ti,~ ' <br />S Y'1 <br />fTl Recipient's Name(Please Print Cleary){IO ~Oecomp,~ e!}. r' <br />Benton--D`--& Karen,'Je,Rs~„_---- --- - --- <br />O- Sfraeq Apt. Np; or PO Box Nc. <br />o --.-P..-O.Box_676 ------ ------ - ----- -~ ----° <br />r• ClN, State, ZIPW <br />Meeker CO 1 <br />~ :.. .. - <br />