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<br /> <br />o SENDER: <br />a •COmplate items 1 enNOr 21or etltlilionel aenACe•. 18150 Wish t0 feCBIVe the <br />N •Complale items 3, aa, and 4b. }ollOWing SBrVICBS (for 8r1 <br />N • Print your name and address on the reverse of this loan so that we can ratum this extra fee <br />~ <br /> <br />~ <br />w f,8ltl to you. <br />' •Atlach this farm to tha hoot of the meilpieca, or on Iha back <br />i <br />tl space does nrn <br />~ . ^ Addressee's Address ai <br />°- <br /> <br />n perm <br />t. <br />•W1ile'RelumReceiptRequesled'onlhamailpiecebelowN <br />eadidenumber. <br />p.^RestddedDBllVery ~ <br />y <br /> •Thf~RMUm Receipt will show to whom Iha artide was Oeliverstl and tha tlate <br />c deavered. COneult postmaster for fee. <br />d 3. Artlcle Addressed to: 4a. Article Number d <br />u Z ~ ~ G~ <br />a <br />E <br />4b. Service Type <br /> <br />d <br />• Ms. Nancy Dodd ^ Registered ~ Certified ~ <br />w 41931 Hwy. 50 W. ^ Express Mail ^ Insured <br />c Canon Ctty, CO 81212-9740 ^ Retum Receipt for andise ^ COD ~ <br />a 7. Date of De ~ ry NO <br /> <br />z \ <br />'~ <br />° <br /> a, <br />F 5. Received By: (Pont Name) 6. Atldre ~f~ (J~n quested '° <br />w and !ee 's~ i~ ~--. `_ _ .~ L <br /> <br />6. Sign~Nre: (Add <br />ress~e or Agent <br />n <br />O r <br />o /q/ <br />X Gz.Gr.oiw .~~~/C ZlZ~~ <br />as Form 3811, December }sea Dom~*tfLrReturn Receipt <br />• <br />