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i ~, <br />i~ <br />~~ <br />~~ <br /> <br /> <br /> <br />Z 583 623 655 <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided <br />Do not use for International Mail /See re <br /> <br />Certified Fee <br />Spetial0elivery Fee <br />Reslnned Delivery Fee <br />N <br />~ Rerum Receipt Slrowmt <br />Whom 8 Dale Deliverer <br />nnum nxerytSruxing toWhn.~ I ` O - 1 <br />Dale,BAdtlressee's pCtlress l <br />(TOTAL Ppstaqe 8 fees $ 1 <br />E __._ <br />0 <br />LL <br />~, ~ 7 3 <br />a <br />d SENDER: I also wish to receive the <br /> <br />~ • Comph+~e nems t andror 2 for atlamonai services <br />• Complete items 3, 4a, antl 4b. following services (For an <br />v • Prim your name and atltlress on the reverse of ibis loan so Thal we can return this extra lee): <br /> <br />w cam In you <br />. anacn mss form tp the Iron p~ me madpiece, or on me ba <br />ck .I space does not <br />1. ^ Andressee'S Address ~ <br />~~ <br />L permit <br />• Wnte 'Return Receip! Requested' on Ine madpiece below the ad¢ie number <br />2. ^ Restricted Delivery <br />rn <br />N <br />w • The Return Receipt will snow to whom the aline was tlel rveretl antl the tlale <br />Consult postmaster for lee. <br />n <br /> dei,veretl <br />0 3. Article Addressed to: 4a. Article N umber <br />d Z 583 623 655 <br /> Fort Collins SCD <br />n 4b. Service Type ~ <br /> 1415 N. College Ave. , H3 ^ Registered ~ Certified <br /> ^ Express Mail ^ Insured <br /> Ft. Collins, C~ $524 <br />^ Return Receipt for Merchandise ^ COD N <br />~ <br /> 7. Date of Delivery <br /> <br />¢ ~/ <br />1' ~ ~ ~' rs'O-~ <br />c <br />¢ 5. Receivetl By: (Peel Name) 6. Addressee's Address (Only it requested r <br />F and tee is paid) ` <br /> ` <br /> 6 Sign e: (Addresse or nq 9g-2'73 <br />t <br />9 <br />~~ <br />T <br />" PS Form 3811, D. emb r ss 1p2595~9e~e-0.2^ Domestic Return Receipt <br />