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<br /> ~ r <br />Z 217 446 293 <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />Do not use lorintemational Mail See reverse <br />Sem ro' r.. ~ <br />I" - I c; ( <br />S !~l ~: L, <br />y 7r i /1 „ i <br />v <br />. SENDER: <br />•Complele nemst antlror 2lor aodnional serves l also wish to receive the <br />. <br />SIrEe18 Numbe N •Complele hems 3, 4a, antl at. f011n'Ning ServICeS (for an <br />j <br />' N . Pnnl your name antl atltlress on the reverse of this funn so Ihal wa can return Ihis extra fee): <br />(~ ^,i; :'.-- !{ l ~ <br />j card to ou. <br />• Anach this loan to the Iron/ of Ine manpiece <br />or on Ine back <br />R space tloes not 1 <br />^ Addressee's Address d <br />-° <br />Post Ollic Stale, 8 P Code ~ <br />1. ' r ~~ <br />~. - ~ ~ ~ ~/ I <br />! (. ` . <br />, <br />permd. 2. ^ Restricletl Delive <br />• Wnte Warorn Rece~pf Requesred'on the mailpiece below the article number ry d <br /> <br /> <br />Postage $ <br />~ -~ <br />- <br />i L <br />« <br />• The Relwn Receipt will show to whom the amcle was tlelrv <br />deliveretl <br />eretl antl the tlate <br />Consult postmaster for fee. W <br /> <br />g <br /> <br />CeNfied Fee ~ <br />G ~ <br />0 <br />I 3. Article Addressed to. 4a. Article Number <br />7 <br />~ w <br />/ / ~, <br />. o Thaddeous M. & Susan Kocol c ~ <br />=_ r [ [ <br />-, <br />! ! ~ C <br /> <br />specal Delivery Fee <br />n <br />11101 Brighton Road <br />ab. Service Type ~ <br /> Henderson. CO 80640-8931 ^ Registered ~Certlfled <br />Restricletl Delivery Fee <br />in <br />^ Express Mail ^ Insured ~ <br /> <br />m Retum Receipt Showing to / <br />wh <br />d D <br />t <br />D <br />li <br />d <br />~ "- <br />~ <br /> <br />^ Return Receipt for Merchandise ^ COD ~ <br />'N <br />~ <br />vere <br />om <br />a <br />e <br />e <br />n Rehm Rxdpl Showig to YAlom, <br />7. Date of Delivery <br />Dale,6Atltlresees Address ~- o <br />D TOTAL Postage 8 Foes $ ~~ <br />~ ` ' % ~ ~ <br />` ~ I 5. Received ey: (Print Name) 8. Addressee's Address /Only it requested x <br /> <br />~ Postmark or Date and lee is paid) ~ <br /> <br />€ <br />r <br />A <br />g <br />6. Signatur~Addr see/IO <br />en <br />t)(lq/ <br />it F <br /> , <br />~ <br />~ <br />~ <br />~ <br />a <br />- 25 U "~ <br />` <br />[ <br />~ ~ PS Form 3811, December t994 1p2595~9e B~o229 DomestC Return Receipt <br />Z 217 446 290 <br />m <br />m <br />rn <br />a <br />Q <br />O <br />m <br />f7 <br />E <br />0 <br />ll <br />a <br /> <br />US Postal Service ~ <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. ' <br />Dn nnhrtse for Inlemational Mail /See reverse) <br />Sant to <br />i i~` CL•~ 'h l~~~% <br />Street 6 Num <br />Po hce, Sole, 8 I Code <br /> <br /> <br />Posage $ ~ i <br />Cenilied Fee ~ C ~ ~ <br />Spedal Delivery Fee <br />Rrstdclatl Delivery Fee <br />Retum Receipt Showing to .t ,~ <br />Whom d Data Delivered <br />Rehm Receipl5hawirg to K71om, <br />Dale, 6 Atldresee's Addrtss <br /> <br />TOTAL Postage 8 Fees <br />$ .~ <br />^ t <br />Postmark or Dale <br /> <br /> <br />it <br />