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r <br /> P6sta <br />i service <br />`CERTIFIED MAIL-RECEIPT <br /> . <br />(Domestic .• ProVid <br /> rq r9 <br />' ? C V L <br /> ? Ln <br /> <br /> CO CO Postage $ <br /> <br /> r9 <br />ul r ZI <br />u-t Certified Fee <br /> <br />r"l <br />rI <br />Return Receipt Fee <br />(Endorsement equired) Postmark <br />Here <br /> .....r.r.?? C C3 <br /> C3 C3 Restricted Delivery Fee <br />• ..........???.. C3 E3 (Endorsement Required) <br /> .' <br />C3 <br />Total Postage & Fees <br /> Er Er <br />rU9 Sent To <br /> <br /> <br />0 - <br /> <br /> <br />C3 ----------------- --------- - - <br />Street, Apt No.; <br />or PO Box. No. ?t <br /> r3 c3 <br />?- city, State,Z1P+4-b Cre <br />ov e- fS ?3a <br /> :rr rr <br />¦ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />¦ Print your name and address on the reverse <br />so that we can return the card to you. <br />¦ Attach this card to'the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />A. Received by (Please Print Clearly) B. Date of Delivery <br />C. Signature <br />X ? Agent <br />? Addressee <br />D. Is delivery address different from item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />Jerry & Julie Martin I <br />10045 Hwy 491 <br />Dove Creek, CO 81324 3. Service Type <br />? Certified Mail ? Express Mail <br />? Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article Number (Copy from sera; r7k <br />601 19411 00111 5168 9561 <br />PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1789 <br />T <br />