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ND <br /> aCcr pMAe Rams t aridlw 2 fa addIb"NrAm, 1 awo wistr 60 feCMve tl» <br /> • aComptete Rem&3,4e,end 4b. ,� n, pipet"SWV"f(for An <br /> opdm your name and addraes an the nvacte 0 ws foam so atat we can return thN Cxlra No): <br /> card to you. <br /> aARach It"to m to the frond of the MOW,".a M the becic it apace dcom to 1. 0 Addressee's Address <br /> WMe A <br /> UA- <br /> sw aum R"pt Regwetad•on it*maiipi"Wow the Midde mffnba. 2. 0 Restricted Delivery J}I, <br /> sTM Rsturn Recetq will Now to whom s•anide was clelivend and the date <br /> d4livered. Consult postmaster for fee. <br /> 3.Article Addressed to: 4a.Article Number <br /> Asa <br /> c Mr Wes Hertzog 4b.Service Type o <br /> Wes Hertzog Trucking l3 Registered ` 3&fled a <br /> 3591 Douglas B23 ❑ Express Mail (❑ Irdsured <br /> Craig CO 81625 O Retum Reo tot for Merchandse 0 COD <br /> 7.Date of Delivery <br /> 0 <br /> J o a <br /> 5.Received By:(Print Name) B.Addressee's Address(Only I1 requested <br /> and fee is paid) • <br /> 6.Signature:(Addressee or Agent) <br /> o x <br /> r <br /> • <br /> Ps Form 3811,DecwrAw 1994 taasdco4"179 Do"wsW Retum Receipt <br /> P 436 789 352 Ar-4-L� <br /> US Postal Service ' <br /> Receipt for Ceir�j�ilAd 811 - <br /> No Insurance Coverage Provided'�'"3`— <br /> Dnnt n .uselDrintemationalMail See reverse <br /> s MT Wes Hertzog ' <br /> Wes Hertzog Trucking <br /> 3591 Douglas B23 <br /> P Craig CO 81625 <br /> Postage p248- S 7 <br /> CerUfiea F Q r y d <br /> Special D I Fee r7 <br /> Restricted D JC2 <br /> mo Whom Receipt / <br /> Whom A Data Delivered <br /> o, %-Rzerq Sgwp b ytem. <br /> Q Date.A Addressee's Address <br /> O <br /> ON TOTAL Postage 6 Fees $ <br /> Postmark or Date <br /> LL O <br /> N M <br /> a b <br /> N <br />