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Permit# m-~47R- ~3( MV- a~~~-DS~ <br />Date: 9 ~ ©~o Recipients: ~rn~~-T~ <br />TO: bCe-~-~- O+G ~- <br />Ct G . f~cn`n <br />Certified Mail Receipt - <br />FROM: DRMS <br />^ Complete items 1, 2, and 3. Also complete A. 4naLxe <br />~ <br />item 4 if Restricted Delivery is desired. y ~,Agent <br />^ Print your name and address on the reverse '(' ^ Addressee <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece g. Received by (Panted Name) C. Dat~~ livery <br />, ~~ ~~ <br />or on the front if space permits. oo <br /> ^ Y <br /> D. Is delivery address tli(ferent from Rem t? es <br />1. Article Addressetl to: If YES, enter delivery address below: ^ No <br />Bank of Ordway <br />PO Box 278 <br />Ordway, CO 81063 <br />3. Service Type <br />^ Certified Mail ^ Express Mail <br />^ Registered ^ Aeturn Aecelpt }or Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Res[dcted Delivery? (Extra Fee) ^ Yes <br />2. AnicleNumber 7003 1680 0000 6427 9186 <br />(riansfer from service label <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1590 <br />