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i <br /> �Yjb/ P 436 789 69 M <br /> award <br /> US Postal Service Q <br /> Receipt for Certified M�I <br /> No Insurance Coverage Provided. 0 <br /> Do not use for International Mail See re eMe V <br /> Sent to i <br /> Street&Number <br /> Post Office,State,&ZIP Code <br /> LC) <br /> Postage 02 04 <br /> Certified Fe V `9 �U t <br /> > Special D Fee\ <br /> Restricted Fee <br /> in <br /> rn Return Receip ing to <br /> Whom&Date Deli <br /> Q Return Receipt Showing to Whom, CV) <br /> Q Date,&Addressee's Address .— <br /> 0 TOTAL Post ge&Fees $ e3 ` t"' .cr>-- <br /> Postmark or Date , <br /> E <br /> 0 <br /> u_ <br /> a <br /> r I also wish to receive the <br /> Complete SENDER ems 1 and/or 2 for additional servic . following services(for an 1 <br /> a ■Complete items 3,4a,and 4b. <br /> m ■Print your name and address on the reverse of this form so that we can return ffiIs extra fee): S <br /> y 1.❑ Addressee's Address <br /> ■Attach this form to the front of the maifpiece,or on the back If space does not <br /> ppe�rmit. 2.❑ Restricted Delivery <br /> 0 ■Write'Return Receipt Requested"on the mallplece below the article number. <br /> ■The Return Receipt will show to whom the article was delivered and the date Consult postmaster for fee. TL <br /> « delivered. <br /> 3.Article Addressed to: 4a.Article Number <br /> DIRT N IRON INC 2 <br /> 4b.Service Type <br /> a 1685 17 RD ❑ Registered ® Certified <br /> LOMA CO 81524 ❑ Express Mail ❑ Insured c, <br /> ❑ Return Receipt for Merchandise ❑ COD a <br /> 7.Date oDelivery <br /> 5.Received By:(Print Name) <br /> 8.Addressee's Address(Only if requested m <br /> and fee is paid) 0 <br /> 6.Signature:(Add ess a or A9ent) <br /> °a <br /> PS Form 3811,December 1994 Io2ss��a oz2s Domestic Return Receipt <br /> I <br /> j <br />